NURS 6501 Case Study Assignment: A 42-year-old man comes to the clinic with a chief complaint of pain, redness, and swelling of his right calf.

NURS 6501 Case Study Assignment: A 42-year-old man comes to the clinic with a chief complaint of pain, redness, and swelling of his right calf.

NURS 6501 Case Study Assignment: A 42-year-old man comes to the clinic with a chief complaint of pain, redness, and swelling of his right calf.

Advanced Physiology

Wound infection may be associated with a myriad of symptoms and complications that may contribute to wound breakdown or Wound Dehiscence. The case of the 42-year old man presents insights into some of the causes and symptoms of wound infection and the importance of providing timely and patient-centered care and support to ensure wound healing. In this short paper, an analysis of why the patient presented the described the symptoms, identification of the genes associated with wound dehiscence and explanation of the immunosuppression process and its effect on the body system.

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Patient’s presenting symptoms

As indicated in the case, the 42-year old patient presents key symptoms such as increased pain, swelling of his right calf, redness and fever. The symptoms experienced by the patient may be due to the injury he suffered to the foot and inflammation of calf as a result of tissue damage or soft tissue infection. Al-Ebrahim (2020) indicated that wound infection may result into the invasion of the affected place by pathogenic organisms that are responsible for colonizing the wound and leading to systemic complications (such as septicemia, osteomyelitis or cellutis) that may significantly result in a non-healing wound.  In the provided case study, the inability of the patient to seek urgent medical attention might have allowed abnormal concentration of microorganisms, increased skin tension, poor venous drainage, desiccation, presence of foreign body agents, and infection (INSERM, 2020; McCancE & Huether, 2019). Therefore, the occurrence of osteomyelitis may have contributed to the presence of the symptoms experienced by the identified patient.

Genes associated with the development of the disease

Epidemiological studies have established a range of genetic determinants for bacterial osteomyelitis. Xie et al. (2021) noted that both genetic and environmental factors play a major role in the pathogenesis of osteomyelitis. Chen et al. (2018) added that a myriad of single-nucleotide polymorphisms (SNPs) are responsible for the increased probability of developing this chronic osteomyelitis and they include: Fokl (rs2228570) and Taql (rs731236) of the vitamin D receptor gene polymorphism. Other findings by Xie et al. (2021) indicated that the AG and GG genotypes of rs16944, the CG and CC genotypes of rs1800796 and the CT and TT genes of rs1143627 were associated with increased risk of chronic osteomyelitis.  As such, the osteomyelitis-related genes tend to be enriched in inflammatory reaction pathways, implying that inflammation assume a major role in the pathogenesis of the disease.

Immunosuppression and its Effect on Body System

Immunosuppression is the incapacitation of the body’s immune system due to infection, use of specific drugs, surgery and exposure to certain health conditions or diseases such as cancer, AIDs, diabetes and others. Naik et al. (2020) noted that the suppression of the immune system of the body may significantly reduce the natural ability of the body system to fight diseases and infections, and thus heightening the risk of developing complications and adverse events. In the event of wound healing in immunocompromised patients, the health practitioner may select the appropriate combination of advanced technologies and approaches including advanced dressings and the use of scaffolds to enable foster wound closure, cellular stimulation, offer nutrients and reduce risks of infection (Harris, 2017).

Conclusion

The findings presented in this paper covered key reasons why the patient presents the described symptoms. It also examined the role of genetic determinants in the development of chronic osteomyelitis. A discussion of the immunosuppression process and its effect on the body system is also provided to determine what can be done in the event a wounded patient is immunocompromised.

References

Al-Ebrahim, K. E. (2020). Management of deep sternal wound infection: Complete sternal osteomyelitis. The Heart Surgery Forum, 23(3), E281-E284. https://doi.org/10.1532/hsf.2805

Chen, P., Yao, Z., Hou, Y., Hu, Y., & Yu, B. (2018).Differentially Expressed Genes in Osteomyelitis Induced by Staphylococcus aureus Infection. Frontiers in Microbiology, 9: 1093.doi: 10.3389/fmicb.2018.01093

Harris, A. (2017). Surgical wound healing in patients with epidermolysis bullosa. https://doi.org/10.26226/morressier.595a9c52d462b80296c9f5ca

INSERM, (2020).Chronic nonbacterial osteomyelitis/Chronic recurrent multifocal osteomyelitis. Definitions. https://doi.org/10.32388/gp1ibn

McCance, K. L., Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children. St. Louis: Elsevier.

Naik, S., Rakszawski, K., Cioccio, J., Zheng, H., & Shike, H. (2020). Immunosuppression and viral infections. Immunosuppression. https://doi.org/10.5772/intechopen.91954

Xie, X., Li, J., Gu, F., Zhang, K., & Sui, Z. (2021).Genetic Determinants for Bacterial Osteomyelitis: A Focused Systematic Review of Published Literature. Frontiers in Genetics, 12: 654792.doi:  www.10.3389/fgene.2021.654792   

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A 42-year-old man comes to the clinic with a chief complaint of pain, redness, and swelling of his right calf. He states that he had been working in his yard using a string trimmer when the trimmer slipped and cut his leg. He cleaned the wound with water from the garden hose and covered the wound with a large Band-Aid. Several days later, he developed a fever of 100.6° Fand chills and noticed that his leg was swollen and red. He comes to the emergency department for definitive care. Develop a 1- to 2-page case study analysis in which you:

Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
*Remember when you think of genes do not just think of congenital anomalies. Think environment, disease that would or could specifically modify the gene and cause mutation.
Explain the process of immunosuppression and the effect it has on body systems.
*When you have an injury to a gene why or how does this cause immunosuppression? If one is immunocompromised what as a provider should you do? Consider?