Engage peers by asking questions and offering new insights, applications, perspectives, information, or implications for practice:  

 

Reflect on your learning experience in this course. Which concepts stood out to you and made an impact? How do you envision using these concepts in your future nursing practice as a master’s prepared nurse? 

Throughout this course, I have gained a deeper understanding of disease processes and their implications for patient care. One of the most impactful concepts was the pathophysiology of chronic conditions such as GERD, peptic ulcer disease, and cardiovascular disorders. Learning how these diseases develop and progress over time has improved my ability to assess patients and care for them on a greater level. I now recognize how factors such as genetics, environment, and lifestyle choices influence disease onset and severity, which is crucial in providing comprehensive care.

As I advance in my nursing practice, I will apply this knowledge to enhance patient education, implement preventative strategies, and collaborate with healthcare teams. Understanding disease processes allows me to anticipate complications and take proactive measures to improve patient outcomes. For example, when caring for individuals with GERD, I will emphasize lifestyle modifications, dietary adjustments, and medication adherence to prevent progression to more severe conditions like Barrett’s esophagus.

Describe how course learning activities and assignments will help you achieve Program Outcome 1: Provide high quality, safe, patient-centered care grounded in holistic health principles.

The assignments and learning activities in this course have strengthened my ability to provide safe, high-quality, and patient-centered care. Through case studies and discussions, I was able to apply theoretical knowledge to real-world scenarios, refining my skills in critical thinking and clinical decision-making.

By analyzing patient cases, I learned to connect pathophysiological changes with clinical presentations, ensuring assessments consider not only symptoms but also psychosocial, environmental, and lifestyle influences. This aligns with a holistic approach to healthcare, where patient well-being extends beyond physical symptoms to include emotional and social factors. Also, reviewing evidence-based treatment options has prepared me to incorporate the latest research into my practice, promoting the highest standard of care.

Describe how course assignments or activities will help you achieve ONE of the sub-competencies from the advanced-level nursing education competencies from AACN Essentials Competency 1.3 Demonstrate clinical judgment founded on a broad knowledge base.

• 1.3d: Integrate foundational and advanced specialty knowledge into clinical reasoning.
• 1.3e: Synthesize current and emerging evidence to influence practice.

A vital skill for an advanced practice nurse is clinical judgment founded on evidence-based knowledge, particularly 1.3e: Synthesize current and emerging evidence to influence practice. This course has supported the development of this competency through research-based assignments and literature reviews, which required me to critically evaluate clinical guidelines and treatment protocols.

For example, while exploring GERD treatment, I analyzed the effectiveness of PPIs, H2 blockers, and lifestyle modifications, allowing me to understand their mechanisms, benefits, and potential risks. This ability to synthesize research findings is essential for ensuring safe, effective, and up-to-date patient care. As a nurse, staying informed about the latest advancements will enable me to make well-informed clinical decisions and contribute to the improvement of healthcare practices.

This course has significantly enhanced my ability to apply pathophysiological knowledge to patient care, reinforcing the importance of a holistic, evidence-based approach. By integrating research findings and advanced clinical reasoning, I will be better equipped to improve patient safety, treatment efficacy, and overall health outcomes. These skills will allow me to contribute to advancing nursing practice, ensuring that my care remains proactive, patient-focused, and aligned with the latest healthcare innovations.

• You should respond by extending, refuting/correcting, or adding additional nuance to their posts. 
  • Your response should be at least 150 words.
• All replies must be constructive and use literature where possible. apa format with references

Discussion 1

Describe the diagnostic criteria of osteoarthritis versus rheumatoid arthritis

Osteoarthritis (OA) functions as a different condition from rheumatoid arthritis (RA) because they display separate diagnostic standards.  The primary degenerative joint disease known as OA causes cartilage breakdown which creates painful stiffness in patients (Arcangelo et al., 2021).  Weight-bearing joints including knees and hips and spine become most frequently affected by the disease.  Joint space narrowing and osteophyte formation combined with clinical symptoms serve as the basis for diagnosing this condition (Mayo Clinic, 2023).

Rheumatoid arthritis differs from osteoarthritis since it is an autoimmune disease that makes the immune system target joint synovial tissue to produce inflammation (HealthLink BC, 2022).  The diagnosis of RA becomes apparent through clinical assessments combined with serological tests for rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies and imaging studies which reveal joint erosion (Arcangelo et al., 2021).  Symmetrical joint involvement especially in hands and feet accompanies this condition (Arcangelo et al., 2021).

1. Discuss types of headaches and their treatment

There are unique medical treatments that are used to help manage the different types of headaches.  Tension type headaches are the most frequent headache diagnosis because this pain has bilateral pressing symptoms and doctors prescribe NSAIDs and acetaminophen for the treatment (Arcangelo et al., 2021).

Migraine headaches are characterized by headache that starts from one side and develop into throbbing pain, and may be associated with nausea and sensitivity to light or sound.  These headaches are treated with NSAID or triptans, and primary or secondary prophylaxis consists of beta-blockers and topiramate, an antiepileptic drug (Mayo Clinic, 2023).

Cluster headaches cause one-sided severe headache attacks at certain intervals.  Triptans and oxygen therapy are provided to patients and preventive care includes verapamil, a calcium channel blocker (Arcangelo et al., 2021).

1. Discuss types of seizures and treatment

Medical experts divide seizures into focal along with generalized categories.  Seizures beginning in a particular brain region result in focal seizures that produce motor responses and sensory reactions and autonomic dysfunction (Arcangelo et al., 2021).  The brain cells that control both sides participate in generalized seizures which include absence seizures and tonic-clonic seizures and myoclonic seizures (Mayo Clinic, 2023).

The most common epilepsy treatments include levetiracetam, lamotrigine and valproate medications which doctors select by considering seizure type along with individual patient factors and medication side effects (HealthLink BC, 2022).  When epilepsy treatment fails physicians may select between ketogenic diet and vagus nerve stimulation and surgical procedures as alternative options (Arcangelo et al., 2021).

1. Discuss Parkinson’s disease, its causes, symptoms, and treatment

This is a progressive condition known as Parkinson’s disease that affects body movement and destroys the nerve cells in all parts of the body.  It includes both motor symptoms like bradykinesia and resting tremor and rigidity and non-motor manifestations which affect cognition and lead to sleep and mood disorder (Arcangelo et al., 2021).

To the best of our knowledge, the cause of PD is still partially unknown, but the condition develops when the substantia nigra – the structure of the brain that produces dopaminergic cells – deteriorates and the level of dopamine decreases (Mayo Clinic, 2023).  According to HealthLink BC (2022), pesticides or heavy metals can lead to the development of the disease and the disease develops from genetic and environmental factors.

Parkinson’s disease is a chronic neurological disease with the aim of symptom management and enhancement of the life quality of the patient.  Levodopa is the most efficient treatment because it replaces brain’s dopamine which in turn improve movement and decrease movement in patients.  The symptoms of Parkinson’s disease can be controlled with dopamine agonists like pramipexole or ropinirole.  The duration of dopamine in the brain is enhanced by inhibiting the enzyme monoamine oxidase-B (MAO-B) in patients.

The benefits of physical therapy and exercise are combined to help patients since these interventions enhance the physical functions of mobility and control of balance to enable patients to remain mobile for longer periods.  DXS is considered as a complementary medicine to help those patients who do not get relief from conventional drug therapy.  A surgical procedure entails putting electrodes in the right areas of the brain to manage disorders that cause abnormal neural activities and offers better symptom control to patients with advanced Parkinson’s disease who have not responded well to medical management (Arcangelo et al., 2021)

References

Arcangelo, P. V., Peterson, M. A., Wilbur, V., & Reinhold, A. J. (2021). Pharmacotherapeutics for advanced practice: A practical approach (5th ed.). Wolters Kluwer.

HealthLink BC. (2022). Comparing rheumatoid arthritis and osteoarthritis. https://www.healthlinkbc.ca/health-topics/hw122408

Mayo Clinic. (2023). Arthritis: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

Discussion 2

Osteoarthritis (OA) and rheumatoid arthritis (RA) are common types of arthritis with different pathophysiological mechanisms and diagnostic criteria. Osteoarthritis includes cartilage and subchondral bone changes, which leads to important joint pain and stiffness, especially after activity or at the end of the day. The American College of Rheumatology (ACR) indicates that diagnostic criteria for OA include knee pain, radiographic evidence of osteophytes, and one or more of these factors: age beyond fifty years, morning stiffness lasting under thirty minutes, and crepitus on motion (Westergaard et al., 2023). RA, conversely, is an autoimmune disorder known to feature intensely inflamed synovia along with severely damaged joints. RA’s diagnostic criteria include having at least one swollen joint and positive rheumatoid factor (RF) or anti-citrullinated protein antibodies (ACPA). Symptoms must also last more than six weeks. Each condition has a different underlying cause; therefore, these criteria all differ: RA involves an autoimmune response, but OA is more related to mechanical wear and tear.

Headaches are comprehensively classified into primary and secondary types: primary headaches prominently include migraine, tension-type headaches, and cluster headaches, while secondary headaches typically arise from fundamental underlying conditions such as infections or structural abnormalities (Luccarelli et al., 2020). Migraine features universally include recurring moderate to severe headaches, frequently accompanied by either light or sound sensitivity and sometimes nausea. Treatment usually includes acute medications, like several triptans, and preventive therapies, such as many beta-blockers or anticonvulsants. Often, tension-type headaches are treated with over-the-counter analgesics in addition to changes to lifestyle. However, cluster headaches might need oxygen therapy or triptans, which can be injected for quick relief. Recent studies further point out the role of behavioral interventions in managing headache disorders, suggesting that psychological support can greatly improve treatment outcomes (Dabilgou et al., 2020).

Seizures are classified as focal if they start in only one half of the brain and as generalized if they affect each half. Focal seizures fall into two special categories: simple or complex. The universal preservation of consciousness is absolutely dependent (Grinberg et al., 2023). Treatment for seizures usually entails the administration of all antiepileptic drugs (AEDs); quite frequently, certain choices like levetiracetam and lamotrigine are prescribed. Vagus nerve stimulators, among multiple surgical treatments or devices, could be options for any refractory seizure cases. Due to improvements in personalized medicine, treatment plans can be tailored to fit individual seizure profiles and medication responses (Martínez‐Pías et al., 2021).

Parkinson’s disease (PD) is a neurodegenerative disorder, along with a continuous depletion of dopaminergic neurons throughout the entire substantia nigra, which causes many motor symptoms, such as tremors, rigidity, as well as bradykinesia. Multiple genetic predispositions and diverse ecological factors are believed to be involved, even though the precise etiology of PD is still vague. PD symptoms can additionally include some important non-motor features such as cognitive decline, depression, and also sleep disturbances (Wheless et al., 2021). PD treatment options focus mainly on managing symptoms and might include dopaminergic drugs like levodopa, which increases dopamine levels in the brain. Non-pharmacological interventions, such as physical and occupational therapy, also greatly improve patients’ quality of life. Deep brain stimulation is one of several surgical options. Such options might be needed to ease several motor symptoms for many advanced cases (Bsteh et al., 2023).

In summary, the diagnostic criteria for OA, in addition to RA, differ quite greatly, accurately reflecting each of their special pathophysiological mechanisms. Headaches are either primary or secondary, and there are many ways to treat each kind. AEDs are the main treatment for seizures. Seizures are classified as either focal or generalized. Because Parkinson’s disease is typified by multiple motor and non-motor symptoms, treatment strategies have the ultimate goal of carefully managing all symptoms and substantially improving each patient’s quality of life.

References

Bsteh, G., Macher, S., Krajnc, N., Pruckner, P., Marik, W., Mitsch, C., … & Wöber, C. (2023). Idiopathic intracranial hypertension presenting with migraine phenotype is associated with unfavorable headache outcomes. Headache: The Journal of Head and Face Pain, 63(5), 601-610. https://doi.org/10.1111/head.14478Links to an external site.

Dabilgou, A. A., Dravé, A., Kyelem, J. M. A., Sawadogo, Y., Napon, C., Millogo, A., … & Kaboré, J. (2020). Frequency of headache disorders in neurology outpatients at yalgado ouedraogo university teaching hospital. a 3-month prospective cross-sectional study. SN Comprehensive Clinical Medicine, 2(3), 301-307. https://doi.org/10.1007/s42399-020-00238-8

Esparham, A., Boorigie, M., Ablatt, S., Connelly, M., & Bickel, J. (2020). Improving acute treatment of pediatric primary headache disorders with a novel headache treatment center: retrospective review of preliminary outcomes. Journal of Child Neurology, 36(1), 54-59. https://doi.org/10.1177/0883073820952997