Week 4 Discussion 1: Case-Based Discussion

Value: 100 points

Due: In an effort to facilitate scholarly discourse, create your initial post by Day 3, and reply to at least two of your classmates, on two separate days, by Day 7.

Grading Category: Discussions

Initial Post

It is understood that thoughtful responses to your topic question(s) will take some time and thought. Please organize your thoughts before creating your initial post. To assist you in your work for this discussion, please use the worksheet linked in each of the team threads to organize your thoughts. Then simply copy and paste the text from the document into your initial post.

Based on your assigned team, create an initial post by answering ALL questions for your assigned case (Team A, B, or C), making sure to address all components of all questions.

By Day 3, post your initial response to your assigned case study as a new discussion thread. Please be sure to number the questions addressed and include all components of each question in your response. Each initial response must have a reference, including at least two scholarly references other than your textbook or course materials. Your post should be limited to 500 to 750 words and comprehensively address the questions posed.

Team A

Week 4 Discussion Team A Worksheet (Word)

PJ is a three-year-old boy who pulled a pot of boiling water over his head, arms, and chest, resulting in a mixed burn to the anterior surface of his head and arms, chest, and feet. He presents with his mother in the emergency department. His mother is quite upset and says nothing like this has happened before. PJ is visibly upset and appears in pain, but is responsive and behaving appropriately for the situation.

  1. What factors determine the classification of burns? What type(s) of burn is most likely for this victim?
  2. Describe the process taking place in the burned area during the first hours after the injury.
  3. How will the physicians in the emergency room determine the percentage of the body that may be burned? What special considerations may be involved when evaluating a child?
  4. Discuss the additional effects associated with burns, which include shock, pain, electrolyte and fluid imbalances, respiratory complications, infection, metabolic problems, and anemia, and the treatments involved.
  5. PJ’s mother asks you how she can help him get better. Identify and explain three interventions she can implement to promote healing.
  6. As he was healing, PJ developed a bacterial infection on his right arm. Explain three predisposing factors to this infection.
  7. How will this burn injury affect PJ’s growth and development? What are some of the social needs in this case?

Team B

Week 4 Discussion Team B Worksheet (Word)

JL, a 50-year-old woman, fell and broke the left tibia at the ankle. She is in the emergency department, waiting for the fracture to be immobilized. The leg hurts and she notes that the ankle is red and swollen. A diagnosis of a simple fracture and sprain (damage to ligaments) is made.

  1. Describe the pathophysiology of her pain and swelling as related to both the fracture and the strain. Why is the area red and swollen? Is this an acute or chronic process?
  2. What can JL expect in the days to come as inflammation resolves and healing begins? What can she expect when the cast is removed? (Hint: Will she be back to normal?)
  3. What is the rationale for immobilizing the fractured bone? Include in your explanation a discussion of why movement of the affected area is painful.
  4. She is told to come back to the fracture clinic in 24 hours to have her cast checked. What could happen to the inflamed tissue if the edema increases in the casted area? What warning signs and symptoms will you look for?
  5. She reports feeling fatigued and anorexic and has a low-grade temperature. What is the cause of these symptoms?
  6. Is this injury at high risk for developing osteomyelitis? Provide rationale for your answer.
  7. JL asks you if there is anything she can do to help herself get better. Identify and explain three interventions she can implement to promote healing.

Team C

Week 4 Discussion Team C Worksheet (Word)

Ms. M is 42 years old and has had rheumatoid arthritis for six years. At baseline, her fingers are stiff and show slight ulnar deviation. She has come to see you as she is currently experiencing an exacerbation, and her wrists are red and swollen. She finds it to be painful when something such as clothing touches the skin over her wrists. Her elbows and knees are also stiff and painful, especially after she has been resting. She is feeling extremely tired and depressed and has not been eating well.

  1. Describe the pathophysiologic process that leads to the appearance and the pain occurring at her wrists. Is this an acute or chronic process? Could it be both?
  2. Describe the pathophysiology contributing to the stiff, deformed fingers. What terms can be used to describe this?
  3. Explain why some activity relieves the pain and stiffness of rheumatoid arthritis and why the pain tends to be worse with immobility. Is this true for other inflammatory or musculoskeletal conditions?
  4. Describe several factors contributing to Ms. M’s systemic symptoms. Is this an acute or chronic process?
  5. Explain how each of the following medications interact with the pathophysiology of rheumatoid arthritis and help return Ms. M to a more homeostatic state.
    1. NSAIDs
    2. Glucocorticoids
    3. Disease-modifying agents
    4. Biologic agents.
  6. If we didn’t already know that Ms. M had rheumatoid arthritis, what other conditions would be on the differential for this patient? Think about what other conditions can present with erythematous, painful, swollen joints. Identify two such conditions and describe the most common signs and symptoms.
  7. What are some possible long-term effects of chronic inflammation in conditions such as rheumatoid arthritis and other inflammatory conditions?


Review all your peers’ posts, as they will help you prepare for the quiz this week.

Select posts from two peers that addressed a case from a different team than you. For example, students from Team A reply to one post from Team B and one post from Team C. Each reply must use at least one scholarly reference other than your textbook. Thinking about your certification track and anticipated practice area:

  • Describe a patient that you might encounter where you could apply the information learned in your peer’s post.
  • What “signs” and “symptoms” would you expect this patient to exhibit? Identify at least four, describe the finding, and classify each as subjective or objective data.

Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.

Posting to the Discussion Forum

  1. Select the appropriate Thread.
  2. Select Reply.
  3. Create your post.
  4. Select Post to Forum.