You are a first-year RN student and you volunteered to work for San Antonio Hospital in the ER Department. Patient John Doe was brought by the ambulance after he collapsed at work. The triage nurse is assessing him for further evaluation by the ER Physician on duty. Based on your study of Anatomy and using your critical thinking skills, you were given the following criteria about Mr. Doe: 1. Personal History: 65 years old, married with two children. 2. Medical History: Diabetes Mellitus, Hypertension, Renal Stones, Anemia, Acne, Prostatic Hyperplasia, Muscular Dystrophy, Hemiplegia, Coronary Artery Disease, G.E.R.D. and ED. The Triage Nurse asked the patient to wait for his turn, until Dr. Johnson examines him.
Diabetes Mellitus: a disorder in which the pancreas no longer produces enough insulin, or cells in the body stop responding to the insulin being produced. This causes high levels of glucose in the blood and cannot be absorbed into the cells in the body. Hypertension: is abnormally high blood pressure, blood pressure is a type of measurement to be able to tell what the force is against the walls of the arteries as the heart pumps blood through the body.
Renal Stones: a Kidney stone is a solid mass which is made up from crystals that separates from the urine and builds up on the inner surfaces of the kidney. Anemia: is a condition where the body has a deficiency of healthy hemoglobin (red blood cells) to carry adequate oxygen to the tissues in the body. Acne: is an inflammatory skin disease that occurs when the hair follicles becomes inflamed or infected due to clogging of sebaceous glands. Prostatic Hyperplasia: benign enlargement of the prostate gland. Muscular Dystrophy: is a group of inherited disorders that involve muscle weakness and muscle loss gradually decline over a period of time. Hemiplegia: is paralysis of one side of the body.
Coronary Artery Disease: condition due to a blockage or narrowing of small blood vessels that supply the blood and oxygen to the heart. Gastroesophagel Reflux Disease (G.E.R.D.): condition due to when the muscle at the end of the esophagus doesn’t close causing the stomach contents (food or gastric acid) that leaks backwards from the stomach into the esophagus. Erectile Dysfunction (E.D.): a sexual dysfunction which is the inability to achieve, or maintain an erection of the penis long enough to engage in satisfactory sexual intercourse.
Blood Calcium level: Normal values range from 8.5 to 10.2 mg/dL. Note: gm/dL = grams per deciliter
Male: 13.8 to 17.2 gm/dL
Female: 12.1 to 15.1gm/dL
C. Based on your knowledge of the normal values and Mr. Doe’s condition, explain the homeostatic disturbance of each problem that Mr. Doe suffers from. Diabetes Mellitus: Hemostasis in correlation with diabetes is the hemostatic system which is responsible for checking, maintain, and balancing the proper rise and fall of glucose levels in the blood. In Mr. Doe’s body since he had diabetes, his pancreas produces too not enough or no insulin. People with type II diabetes is normally developed later in life and becomes resistant to the effects of insulin overall, but can be reversed and controlled. Hypertension: Homeostatic disturbances that could be responsible for Mr. Doe’s HTN could be a result from some of the medication he is taking.
Another factor is his weight, diet, and lack of physical exercise. In a normal system the force of blood against the artery walls doesn’t have a negative effect. Therefore, would not cause physical him to have any serious health conditions. However, when a person like Mr. Doe suffers from HTN, the force of the blood against the artery wall thus resulting in heart disease. Renal Stones: In a normal system the calcium levels in the blood are at a safe level, and helps with contracting muscles, releasing hormones making sure that nerves and the brain are functioning properly. In like Mr. Doe who has too high calcium levels in his blood can cause renal stones can begin to develop.
Renal stones block the ability of homeostasis to occur. When these calcium deposits get lodged and block urine from being able to exit in order empty out the bladder, thus the body isn’t able to function properly. Anemia: Healthy hemoglobin (red blood cells) are extremely important in a person’s system, because they are rich carriers of oxygen to the tissues in the body. When a person like Mr. Doe loses this ability many negative symptoms can occur in the body. The cause of Mr. Doe’s anemia may be a result from any Non-Steroidal Anti-inflammatory Drug (NSAID) he may be on for any number of the other complications he is suffering from.
He may also have a vitamin deficiency which would be a factor in low iron levels. Without proper homeostasis it would be easy to understand why a patient like Mr. Doe is experiencing this condition. Acne: In a normal system the hair follicles on different surfaces of the body function properly and do not become clogged. When a person has hair follicles becomes plugged with oil from the sebaceous glands mixed with dead skin cells will result in acne. Homeostasis correlates to the removal of toxins from the body, and causes a disturbance which results inflammation and infections in the skin. Prostatic Hyperplasia: As men age they are more prone to experience enlargement of their prostate glands.
Mr. Doe is experiencing this condition which is more common for men his age, due to the homeostatic disturbance in his hormones and cellular growth. Muscular Dystrophy: Muscle fibers in a normally functioning system are extremely touch and resistant to damage and injury. In a person who is suffering from muscular dystrophy these fibers become weaker gradually over time and become more susceptible to damage. This is caused to defective genes that are involved in making proteins that protect the muscle fibers. Disturbance in homeostasis could factor that is responsible for some of these genetic mutations.
Hemiplegia: Most people have normal functions with movement on both sides of their body. When someone like Mr. Doe suffers from one side of their body having the same paralysis and limitations of movement. This is most often the leading culprit that is heard about hemiplegia. The homeostatic disturbance in Mr. Doe’s system related to HTN which could also be what is causing his movement disorder. Having a stroke could also be responsible for this condition and may have gone un-detected and untreated because Mr. Doe may not have realized he was having a stroke.
Coronary Artery Disease (CAD): The coronary arteries (which are the major blood vessels that supply the heart with oxygen, blood and nutrients) can become damaged if a high amount of cholesterol is continuously deposited over time. Homeostatic disturbances such as HTN and diabetes are indicators of why Mr. Doe is experiencing this disease. This is turn can cause him to suffer from a heart attack. G.E.R.D.: In a normal functioning system after a person eats a meal the food goes to the stomach to begin the digestion process.
The homeostatic disturbance that causes a patient like Mr. Doe to experience a reflux of stomach acid relaxation of muscles in the lower esophageal sphincter and its failure to close and prevent the back flow of food or liquid from returning upwards. E.D.: As most men age and are in Mr. Doe’s age begin to start experiencing issues, or complications with their prostate and the ability to perform sexually. A patient that is younger is able to maintain an erection for a longer period of time and perform a satisfactory sexual intercourse. Not have to worry or be concerned with experiencing this complication. Due to the fact Mr. Doe has an enlarged prostate gland and diabetes could be a leading indicator resulting in some of the homeostatic disturbances that is resulting in him having erectile dysfunction.
D. Upon histological examination of mammal pancreas under the microscope, describe the different features of this Specimen. Figure 1 Anatomy of the pancreas
Upon histological examination of a normal human pancreas the Aplha cells which produce glucagon, and Beta cells which produce insulin can easily be identified under the microscope. The bulk of the pancreas is an exocrine gland secreting pancreatic fluid into the duodenum after a meal. However, scattered through the pancreas are several hundred thousand clusters of cells called islets of Langerhans. Upon histological exam of a human pancreas with diabetes it is easy to identify the difference in the cells from a healthy pancreas. The reason is due to the fact the Beta cells are either attacked, or rejected the insulin which is causing the insulin production to be affected. The alpha cells are responsible for elevating the glucose levels in the blood which are also being affected due to the diabetes. The following describes the process of insulin in the pancreas: The islets are endocrine tissue containing four types of cells. In order of abundance, they are the: • beta cells, which secrete insulin and amylin