NP500 Week 7: Incivility and Healthful Environments Essay

NP500 Week 7: Incivility and Healthful Environments Essay

NP500 Week 7: Incivility and Healthful Environments Essay

Alzheimer’s Disease

Alzheimer’s Disease

Comparing and Contrasting the Pathophysiology of Alzheimer’s Disease and Frontotemporal Dementia.

Dementia is not a diagnosis of a single disease but rather a group of symptoms that indicate a physical issue in the brain. However, Alzheimer’s disease is widely regarded as the most critical contributor to the development of dementia. Sixty percent to eighty percent of all medical diagnoses account for Alzheimer’s disease. The brain is a common site for impairment in Alzheimer’s patients. However, the frontal and temporal lobes tend to be the first affected areas in frontotemporal dementia (McCance & Huether, 2019). Historically, these brain areas have been linked to an individual’s ability to influence behavior and character. Alzheimer’s disease’s major cause is still a mystery.

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The concentration of the toxic fragment is thought to lead to the emergence of neuritic plagues, which impair the typical functioning of nerve impulses, and consequently lead to the progression and primary cause of the condition (Tiwari et al., 2019). An accumulation of the aberrant protein forming inside the brain cells is thought to trigger frontotemporal dementia. All cases of Alzheimer’s disease are classified as dementia, but not all dementia cases are classified as Alzheimer’s. The mutation of genes encoding the tau protein is associated with frontotemporal dementia and Alzheimer’s disease. Memory loss and behavioral shifts are common symptoms of Alzheimer’s and frontotemporal disease, caused by effects on different brain parts.

Case Clinical Findings that Support Alzheimer’s Diagnosis.

Memory loss severe enough to get in the way of daily life is a prevalent indicator of Alzheimer’s disease. The case study claims that the patient could not make sound decisions and even forgot where he lived. The patient’s wife worries about his declining health, partly because of his memory loss. The patient’s father also had Alzheimer’s disease and passed away; the disease runs in the family. The individual has moderate dementia, as indicated by a Mini-Mental State Examination (MMSE) score of 12 out of 30.

The Hypothesis that Explains the Development of Alzheimer’s Disease

According to the amyloid hypothesis, Alzheimer’s disease is caused by the buildup of fibrillar amyloid peptide or oligomeric that causes Alzheimer’s disease. The decoration of the brain with amyloid β peptide leads to plaque that disrupts nerve cell communication. With time, it causes the death of nerve cells and leads to the loss of cognitive function, which is apparent in Alzheimer’s disease. Despite this hypothesis being the commonest, it has not been proven definitely.

Patient’s likely Stage of Alzheimer’s Disease

Patients who are affected by Alzheimer’s disease go through three distinct stages: the early, the middle, and the late stages. The case study reveals that the patient is currently in the middle stage of development. According to Lei et al. (2021), one of the indicators that support the middle stage that the individual is experiencing is the patient forgetting a significant event in their life, such as the anniversary and names of his close ones. The patient is having trouble effectively making decisions, balancing his checkbook and clothing, and allowing an unknown person into their home who was convincing him to buy a home security system they already have. Even though he gets lost some of the time and is found wandering, he gets angry and defensive, saying he was trying to buy some bread from the store.

References

Lei, P., Ayton, S., & Bush, I. (2021). The essential elements of Alzheimer’s disease. The Journal of Biological Chemistry, 296, 100105. https://doi.org/10.1074/jbc.REV120.008207

McCance, L. & Huether, E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier Health Sciences

Tiwari, S., Atluri, V., Kaushik, A., Yndart, A., & Nair, M. (2019). Alzheimer’s disease: Pathogenesis, diagnostics, and therapeutics. International Journal of Nanomedicine, 14, 5541–5554. https://doi.org/10.2147/IJN.S200490

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The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Compares and contrasts the pathophysiology between Alzheimer’s disease and frontotemporal dementia. (CO1)
2. Identifies the clinical findings from the case that supports a diagnosis of Alzheimer’s disease. (CO3)
3. Explain one hypothesis that explains the development of Alzheimer’s disease (CO3)
4. Discuss the patient’s likely stage of Alzheimer’s disease (CO4)

Due Date

Initial post is due on Wednesday by 11:59 p.m. MT. All posts are due by Sunday, 11:59 p.m. MT

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.

Total Points Possible: 100

Preparing the Assignment

Requirements

1. Read the case study below.
2. In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference by Wed., 11:59 pm MT.
3. Provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question using appropriate resources, before Sun., 11:59 pm MT.

Case Scenario

A 76-year -old man is brought to the primary care office by his wife with concerns about his worsening memory. He is a retired lawyer who has recently been getting lost in the neighborhood where he has lived for 35 years. He was recently found wandering and has often been brought home by neighbors. When asked about this, he becomes angry and defensive and states that he was just trying to go to the store and get some bread.

His wife expressed concerns about his ability to make decisions as she came home two days ago to find that he allowed an unknown individual into the home to convince him to buy a home security system which they already have. He has also had trouble dressing himself and balancing his checkbook. At this point, she is considering hiring a day-time caregiver help him with dressing, meals and general supervision why she is at work.

Past Medical History: Gastroesophageal reflux (treated with diet); is negative for hypertension, hyperlipidemia, stroke or head injury or depression

Allergies: No known allergies

Medications: None

Family History

• Father deceased at age 78 of decline related to Alzheimer’s disease
• Mother deceased at age 80 of natural causes 
• No siblings

Social History

• Denies smoking
• Denies alcohol or recreational drug use 
• Retired lawyer
• Hobby: Golf at least twice a week

Review of Systems

• Constitutional: Denies fatigue or insomnia
• HEENT: Denies nasal congestion, rhinorrhea or sore throat.  
• Chest: Denies dyspnea or coughing
• Heart: Denies chest pain, chest pressure or palpitations.
• Lymph: Denies lymph node swelling.
• Musculoskeletal: denies falls or loss of balance; denies joint point or swelling

General Physical Exam  

• Constitutional: Alert, angry but cooperative
• Vital Signs: BP-128/72, T-98.6 F, P-76, RR-20
• Wt. 178 lbs., Ht. 6’0″, BMI 24.1

HEENT

• Head normocephalic; Pupils equal and reactive to light bilaterally; EOM’s intact

Neck/Lymph Nodes

• No abnormalities noted  

Lungs 

• Bilateral breath sounds clear throughout lung fields.

Heart 

• S1 and S2 regular rate and rhythm, no rubs or murmurs. 

Integumentary System 

• Warm, dry and intact. Nail beds pink without clubbing.  

Neurological

• Deep tendon reflexes (DTRs): 2/2; muscle tone and strength 5/5; no gait abnormalities; sensation intact bilaterally; no aphasia

Diagnostics

• Mini-Mental State Examination (MMSE): Baseline score 12 out of 30 (moderate dementia)
• MRI: hippocampal atrophy
• Based on the clinical presentation and diagnostic findings, the patient is diagnosed with Alzheimer’s type dementia.

Discussion Questions

1. Compare and contrast the pathophysiology between Alzheimer’s disease and frontotemporal dementia.
2. Identify the clinical findings from the case that supports a diagnosis of Alzheimer’s disease.  
3. Explain one hypothesis that explains the development of Alzheimer’s disease
4. Discuss the patient’s likely stage of Alzheimer’s disease.

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