Identify a person you know who has an immune system disorder or cancer. Review content in your text for potential types of disorders.
Interview the affected person and write a 3-5 page paper identifying your findings including:
- Identify the pathophysiology of the immune system disorder
- Discuss the treatment for the immune system disorder
- Summarize the findings of the interview.
- Use at least one scholarly source to support your findings or identify therapies that may be new or different from what the affected person may be using. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. You can find useful reference materials for this assignment in the School of Nursing guide: https://guides.rasmussen.edu/nursing/referenceebooks
- Cite your sources in-text and on a References page using APA format. Have questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apa
Questions you may want to use to guide your interview:
- Which immune system disorder do you have?
- How long have you had this disorder?
- How has this disorder changed your life (home and work)?
- Are you able to carry out daily activities independently?
- What therapies are you using to manage this disorder?
- What, if any, side effects does the treatment have?
- What therapies are you using to manage this disorder?
- What, if any, side effects doe the treatment have?
- Has this disorder changed your body?
- Does this disorder have any emotional effects on you?
- Have alternative therapies, such as Eastern medicine (acupuncture, herbal treatment, yoga) been tried or recommended?
- Rheumatoid ArthritisThelma H. WalkerRasmussen collage
NUR2063: Christi Desautels
October 18, 2020
Rheumatoid arthritis is a systemic autoimmune disorder with marked clinical signs and symptoms, including inflammatory arthritis and extra-articular disorders. The symptoms classify rheumatoid arthritis as early or established, depending on the onset. Duration of symptoms of less than six months is classified as early Rheumatoid arthritis. Rheumatoid arthritis is mostly unknown, although it results from the interaction of the patients and the environment. The risk of developing rheumatoid has been linked to HLA genes. However, other risk factors to developing RA include cigarette smoking, which increases the interaction of genes. Changes in intestinal flora’s composition and function have also been associated with RA (Guo et al., 2018, p. 15). Patients with RA have a decreased diversity of gut microbes. Epidemiologically, RA is more pronounced in North America and northern Europe.
RA is a chronic and systemic disease that affects multiple joints. The condition has unknown etiology and progresses to cause several systemic complications and death and, in some instances. Affected individuals incur high health care costs, which affect their socioeconomic levels. The disease is characterized by synovium hyperplasia, immune cytokines production, and anti-citrullinated protein antibodies (ACPA). Other mechanisms of the disease include the production of chemokines, rheumatoid factor, and angiogenesis. The resulting action of the immune mediators causes multiple cardiovascular, pulmonary, and skeletal complications. Cytokines play a crucial role in the development of RA. Interleukins and tumor necrosis factors enhance intracellular signaling and activation of mesenchymal cells. The results are in the activation and recruitment of immune cells of both the innate and the adaptive immune response. The immune cells activate synoviocytes, the cells of the synovium found in the bones. The, in turn, activate the other immune mediators, including TNF-alpha and IL-1 and IL-6, causing inflammation of the synovium (Cooles & Isaacs, 2011, p. 239). Thie also induces decreased lymphangiogenesis as well as increased angiogenesis.
In other case scenarios, the synovium of patients with RA is infiltrated with immune cells due to autoimmunity. The immune cells include T helper 1, B cells, and plasma cells. These cells attract other immune mediators, such as chemokines, to the synovial compartment. The fibroblasts in the synovium change to an invasive phenotype, which leads to bone erosion and osteoclast generation (Alam et al., 2017, p. 630). This is the hallmark feature of rheumatoid arthritis.
The RA treatment goals are to reduce inflammation on the joints, reduce pain, and maximize the function of the joint. The treatment regimens consist of various pharmaceuticals depending on the stage of the disease at the time of diagnosis and the age of the patient. Weight-bearing exercises have also been incorporated, and patient education to achieve positive clinical outcomes (Wilsdon & Hill, 2017, p. 55). Treatment of RA is personalized and depends on the patient’s overall health status, the joints involved, age and occupation, treatment compliance, and disease progression.
Therefore; Immediately after the diagnosis of the disease, the patient is put under first-line management, whose goal is to relieve pain and decrease inflammatory response around the synovium. Fast-acting non-steroidal anti-inflammatory drugs are administered, which include acetylsalicylate, ibuprofen, and etodolac. Acetylsalicylate, being commonly used, acts by inhibiting prostaglandins and more effective when used in high doses. The drug’s side effects include possible hearing loss and gastric intolerance (Wilsdon & Hill, 2017, p. 55). Corticosteroids may also be included during the medication as they are more potent than NSAIDs. However, corticosteroids have more excellent side effects and hence indicated for a shorter time in lower doses. Their side effects include weight gain, immunosuppression, and diabetes. Patients on corticosteroids are advised to take more calcium and vitamin D to prevent bone-thinning.
The second-line management includes disease-modifying anti-rheumatic drugs such as methotrexate. The goal of the second-line medications is to reduce disease progression. Methotrexate, the second-line drug, works by inhibiting the synthesis of amino acids and polyamine. It is an immunosuppressive medication and may cause liver problems and bone marrow deterioration. The drug has dosage flexibility and a lower incidence of side effects than other medicines in the same class. Hydroxychloroquine and sulfasalazine are among the disease-modifying anti-rheumatic class of drugs. While sulfasalazine acts by reducing the secretion of monocyte and IL-8 involved in bone inflammation, hydroxychloroquine works by decreasing the secretion of pro-inflammatory cytokines (Köhler et al., 2019, p. 938).
Mrs. Scott is a 54-year-old mother of two who was diagnosed with rheumatoid arthritis three years ago. She complains that the disorder has affected her mobility as she has been reduced to walking with sticks. She adds that her life has since taken a different path as she seems to require support in carrying out her day to day work. Since her diagnosis, she had to stop running her business. She owns a bakery and complains that she has had to leave the job in her daughter’s hands, which is only 21. She has been using a combination of aspirin and methotrexate, and the results have been positive so far. However, she adds that adhering to the medications has been a nightmare. Apart from gastric problems, she does not experience other side effects of the medicines. She declines whether the treatments have changed her body but reports that she does not feel emotionally okay most of the time. She records that she has tried yoga for a few months, and it has been helpful.
Newer medications such as leflunomide have also been administered to yield significant results. Leflunomide is an oral prodrug converted in the body to malononitrile that inhibits the ribonucleotide uridine monophosphate pyrimidine. The drugs relieve RA’s symptoms by decreasing the rate of progression of RA (Bullock et al., 2018, p. 503).
Alam, J., Jantan, I., & Bukhari, S. N. A. (2017). Rheumatoid arthritis: Recent advances in its etiology, the role of cytokines, and pharmacotherapy. Biomedicine & Pharmacotherapy, 92, 615–633. https://doi.org/10.1016/j.biopha.2017.05.055
Bullock, J., Rizvi, S. A. A., Saleh, A. M., Ahmed, S. S., Do, D. P., Ansari, R. A., & Ahmed, J. (2018). Rheumatoid Arthritis: A Brief Overview of the Treatment. Medical Principles and Practice, 27(6), 501–507. https://doi.org/10.1159/000493390
Cooles, F. A. H., & Isaacs, J. D. (2011). Pathophysiology of rheumatoid arthritis. Current Opinion in Rheumatology, 23(3), 233–240. https://doi.org/10.1097/bor.0b013e32834518a3
Guo, Q., Wang, Y., Xu, D., Nossent, J., Pavlos, N. J., & Xu, J. (2018). Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies. Bone Research, 6(1), 15. https://doi.org/10.1038/s41413-018-0016-9
Köhler, Günther, Kaudewitz, & Lorenz. (, 2019). Current Therapeutic Options in the Treatment of Rheumatoid Arthritis. Journal of Clinical Medicine, 8(7), 938. https://doi.org/10.3390/jcm8070938
Wilsdon, T. D., & Hill, C. L. (2017). Managing the drug treatment of rheumatoid arthritis.
- Module 2 Assignment: Immune System DisordersYour Name
NUR2063: Essentials of Pathophysiology
Month Day, 2020
Module 2 Assignment: Immune System Disorders
Write your introduction to the paper here. Introductions typically include a brief summary of what the purpose of your paper is. In scholarly writing, refer to yourself as “this author” instead of “I” or “me”. For example, this author is aware that there are many different types of immune system disorders including Type II diabetes, Rheumatoid Arthritis, Systemic lupus erythematosus, Peanut Allergy (or any type of allergy), Hemolytic Disease of the Newborn, Myasthenia gravis, Graves’ disease, lymphocytic thyroiditis, Immune complex glomerulonephritis, Wiskott-Aldrich syndrome, DiGeorge syndrome, HIV/AIDS, Asthma, Eczema, Allergic rhinitis, cancers, and many others.
Pathophysiology of XXXX
Here include the pathophysiology of the immune system disorder or cancer that you chose for this paper. Remember that pathophysiology includes pathogenesis, etiology/risk factors, and clinical manifestations. This section is worth up to 10 points. Try to use your own words instead of cutting and pasting, this helps you learn, and demonstrates your understanding of the information. If you do need to “borrow” someone else’s words, because you really can’t figure out how to restate it, make sure to use “” around the short phrase and use in-text citations (Last name, year, page #). See the APA guide for more.
This section should also include more than one example of how the disorder impacts a person who has it.
Treatment of XXXX
In this section include detailed treatment options (more than 1) with expected outcomes for the immune system disorder you chose. Detailed is not just making a list, but providing information about the treatment, how it works, what the expected outcome it, how long it lasts, side effects, etc… This section is worth up to 20 points.
Here you can include your interview with your chosen person. The interview section is worth up to 15 points. Here are some ideas of questions you can use to guide your interview. Which immune system disorder do you have? How long have you had this disorder? How has this disorder changed your life (home and work)? Are you able to carry out daily activities independently? What therapies are you using to manage this disorder? What, if any, side effects does the treatment have? Wondering how to cite your interview in APA? Go here: http://rasmussen.libanswers.com/faq/32300 You will find that you do not create a reference in the reference section. Instead you would include the source (the person you are interviewing) in text. Make sure in this section you are able to show the relationship between the person you are interviewing with the immune system disorder and the pathophysiology
Here is where you wrap everything up that you discussed in this paper in a couple of sentences. Remember to go back and review for spelling, grammar, and APA. The mechanics of the paper are worth up to 5 points. You must use 2-3 evidence-based articles from peer-reviewed journals or scholarly sources to support your findings or identify therapies that are new or different from what the person you are interviewing uses. Do not forget about the resources you have available to you! Here is information on how to use the writing lab: http://rasmussen.libanswers.com/faq/32588 and here is information on how to use Grammarly: http://rasmussen.libanswers.com/faculty/faq/270050
Author’s Last Name, First initial. Middle initial. (Year). Title of article. Journal Title, Volume Number(Issue number), Page numbers. http://URL for journal home page OR database permalink