In this assessment task you will be provided with a scenario and relevant patient information (Assessment task 4: the person).

Task description

In this assessment task you will be provided with a scenario and relevant patient information (Assessment task 4: the person).

You will apply clinical reasoning to your knowledge of anatomy, physiology, pathophysiology, therapeutic interventions, and pharmacotherapy to answer a variety of questions.

You'll be required to complete three short answer questions (SAQs) that you will obtain througha quiz.The answers to these questions will be submitted in a WORD document via a Turnitin-enabled assignment box. Ensure thatall of the answer is in your own words.

Ensure that you review your Turnitin scorebefore submitting your work. Any part of your answer that is completely or partially text-matched to another source by Turnitin may not be considered as part of your answer, as these are not your words. Substantial scores will be reported for investigation as possible breach of Academic Integrity, as well as submissions that appear written by artificial intelligent sources.

The questions will require you to:

consider the patient situationandidentify cues(signs and symptoms, as well as other cues) from the case description and clinical information provided.

process this informationby analysing the cues, and explaining the relevant physiology and pathophysiology underpinning the patient presentation and progression.

apply knowledge of physiology toexplain the rationaleof suggested therapeutic approaches for that patient.

analyse for accuracy, a response generated by artificial intelligence to a question asked of it

It is expected that you willengage with sources of scholarly information and literature to substantiate your clinical reasoning.

How to research for this task

Review the presentationsBioscience and the clinical reasoning cycleRead BEFORE you write. Read to understand, and learn. Do not write your assignment based on what you believe you already know, and then go looking for references to support what you have said. Read the references first and then use them to construct your answer, citing them.

Go to MyLO first.Engage with the content on MyLO. Modules 4 & 5.Important information is also provided in Module 1. You do NOT need to reference MyLO content

Use the followingtextbooks,which you can access as eBooks and/or as hard copies in the UTas library. Textbooks should be no more than 10 years old.

Amerman, E. 2019.Human Anatomy & Physiology. 2nd Global ed. Pearson: UK.

Bullock, S. & Hales, M. 2019.Principles of Pathophysiology.2nd Ed. Pearson: MelbBullock, S. & Manias, E. 2022.Fundamentals of Pharmacology. 9th Ed. Pearson: MelbRelevant chapters in G. Bauldoff et al.Lemone & Burke's Medical-Surgical Nursing. Pearson: Melb.

Norris, T. 2020.Porth's Essentials of Pathophysiology. 5th Ed. Wolters Kluwer: Phil

Websites- ensure that you are ONLY using informationfor health professionals. Do NOT use consumer information. Wherever possible, identify an author, and that the work has been peer reviewed. Acceptable sources will have a date of authorship. Is the website a recognised source of information e.g. the Australian Medicines Handbook ? If in doubt, you can alwaysask the Unit Coordinators.

Guidelines- ensure that you use current Australian guideline documents. Learn more about what guidelines are,here.

Journal articles- use these judiciously. Ensure that the article is relevant and that the author is actually supporting what you have written. Have you actually read, and understood the article? Is the article discussing HUMAN physiology? Is it about people of the same age? Journal articles should be no more that 5 years old. You should NOT use journal articles to support statements about anatomy, physiology or pathophysiology. These statements should be supported by your textbooks.

Assessment criteria and marking rubric

PLEASE NOTE THAT THE RUBRIC IS IS STILL UNDER DEVELOPMENT AND WILL BE MADE AVAILABLE AS SOON AS POSSIBLE.

Your submission will be assessed against the criteria below. You are strongly encouraged to review the marking rubric for this assessment task as it provides more detailed information about the assessment criteria.

This information will be provided when the rubric is finalised.

You should preferably write in complete sentences and structured paragraphs. Do not use bullet-point lists or tables to present your response. Flow charts are acceptable (e.g. activation of PSNS ->decrease in HR) as long as the relationship between one item and the next is unequivocally clear to the reader.

Do not include pictures.

Ensure that you effectively paraphrase by writing inYOUR OWN WORDS.

Direct quotes arenotaccepted for this assignment of short answers.

Consider the Patient Situation

Mr. Laszlo Szabo, a 68-year-old male of Hungarian origin, has been living in a rural area of Australia for the last 48 years. He is a retired farmer, living with his wife and their dog, Panni.

Laszlos medical journey began 12 years ago when he experienced an episode of Acute Kidney Injury (AKI) due to severe dehydration and heatstroke during a particularly harsh summer. Despite recovery from the AKI episode, his kidneys never fully regained their function, leading to chronic kidney disease (CKD).

When his glomerular filtration rate (GFR) declined to 10 mL/min/1.73m2 (CKD Management in Primary Care, 4th ed, 2020) it was suggested that Laszlo commence dialysis. There was no haemodialysis service within easy access of where he lived, and so peritoneal dialysis was proposed.

Recently, Laszlo has been experiencing difficulties with his peritoneal dialysis. Late one afternoon he presented to the emergency department at the rural hospital, over an hours drive from his home. When Laszlo was greeted by the nurse, he mumbled something that did not make sense. Assessment commenced.

Collect cues

Vital signs:

Respiration rate: 26 breaths per minute

SpO2: 96% (on room air)

Blood pressure: 100/60 mmHg (MAP 73 mmHg)

HR: 120 bpm

Temp: 38.5oC

GCS: Eyes: 4; Verbal: 3; Motor: 6 (Total 13/15)

Pain: not able to report due to confusion

Urine output: patients wife reports that Laszlo has not voided during the past 24 hours (usual urine output <400 ml/day)

Visual inspection:

Peritoneal catheter site is red and swollen

Patient is flushed and warm to the touch

Bloods:

Arterial blood gases:

pH 7.3 (ref range 7.35 - 7.45)

PaO270 mmHg (ref range 75 105 mmHg)

PaCO235 mmHg (ref range 35 45 mmHg)

HCO3- 20 mmol/L (ref range 22 28 mmol/L)

Lactate: 2.2 mmol/L (ref range < 2 mmol/L)

Hb: 100 g/L ( HYPERLINK "https://www.seslhd.health.nsw.gov.au/sites/default/files/2019-04/NSWHP%20Reference%20Ranges%20Adult%202019.pdf" t "_blank" ref range 130 170 g/L)

White Cell Count (WCC) 13.7 x 109/L (ref range 3.5 - 11.0 x 109/L)

Bilirubin (total) 19.2 mol/L (ref range 0 20 mol/L)

Platelets 170 x 109/L (ref range 150 450 x 109/L)

Creatinine 900 mol/L (ref range 60 110 mol/L)

Blood Urea Nitrogen: 16.06 mmol/L (4.5 - 10.0 mmol/L)

Dialysate (effluent from peritoneal dialysis) WCC: 300 / L (ref range < 100 / L)

Blood and dialysate fluid sent for microculture and sensitivities.

Other information gathered:

Laszlos wife reports that he has been feeling bloated and uncomfortable after his dialysis exchanges at home, and that there has been a noticeable decrease in the amount of waste fluid drained. He has complained of some abdominal pain. The fluid has been cloudy.

She also reports that Laszlo felt cold and shivery this morning.

Does not smoke tobacco.

Alcohol consumption: < 1 standard drink/week

Weight: last weight at home 1 week ago - 76 kg; todays weight 82kg

Height: 180 cm

BMI: 23.5

Usual medications:

perindopril 10 mg + amlodipine 5mg, daily

rosuvastatin 5mg, daily

furosemide 80 mg, twice daily (BD)

epoetin alfa 6000 IU (0.6mL syringe) subcutaneously, weekly (based on weight of 76kg)

calcitriol 0.25 mcg, daily

Dietary modifications

Low potassium & low sodium (< 6g/d) diet

Protein intake 0.75 gm/kg/day

Take action

Empirical antibiotic therapy was commenced as treatment for peritonitis as perguidelines.

Analgaesia was provided as required.

Question 1

Take action

Laszlo has been advised to limit his potassium and sodium intake, with protein restricted to 0.75 gm/kg/day.

Provide a rationale for this therapeutic intervention by;

linking these dietary adjustments to his underlying chronic medical condition

explaining the consequences of electrolyte (sodium and potassium) disturbances, and the consequences of excessive protein intake, for Laszlo.

identifying the current recommended Australian guidelines for this treatment.

In your answer, identify in brackets ( ) the data or observations from the case scenario that support your explanations. For example:"... which causes vasoconstriction (pale skin) leading to..."

Suggested word limit: 300 words excluding in-text references.

Use the UTAS Harvard referencing guide. A link to this can be found in the "Assessment help and resources" section on MyLO.

Question 2

Laszlo has a MAP of 73 mmHg and his HR is 120 bpm. Referring to all other recent relevant data gathered after arrival at the hospital (specifically his white cell count), describe the pathophysiological mechanisms that have led to this presentation of blood pressure and HR. Considering Laszlo's cardiovascular data, identify the acute condition that he is experiencing.

In your answer, identify in brackets ( ) the data or observations from the case scenario that support your explanations. For example:"... which causes vasoconstriction (pale skin) leading to..."

Suggested word limit: 300 words excluding in-text references.

Use the UTAS Harvard referencing guide. A link to this can be found in the "Assessment help and resources" section on MyLO.

Question 3

IdentifyTWO (2)mistakes or inaccuracies in the ChatGPT-generated response below and describe why it is incorrect and what should be the correct information.

Use language appropriate for communication between health professionals.

Word limit: 150 words total.

___________________________________________________________________

Question asked of ChatGPT:

Describe the development of a malignant tumour from a single healthy cell.

ChatGPT answer:

The development of a malignant tumour from a single healthy cell involves a series of complex events that lead to uncontrolled cell growth and the ability of cells to invade surrounding tissues. This process is known as carcinogenesis, and it typically occurs in several stages:

1. Initiation:

- The process begins with a genetic mutation in a single normal cell. This mutation can be caused by various factors, including exposure to carcinogens (such as tobacco smoke, UV radiation, or certain chemicals) or spontaneous errors in DNA replication.

- The mutation affects genes that regulate cell growth, division, and apoptosis (programmed cell death).

2. Promotion:

- After the initiation, the mutated cell undergoes promotion, a stage where the altered cell starts to divide more rapidly than normal cells. This phase often involves the influence of promoting agents, which may include hormones, growth factors, or inflammation.

- The rapidly dividing cells form a group of cells known as a benign tumour. Benign tumours are not cancerous and do not invade nearby tissues.

3. Progression:

- In the progression stage, additional genetic mutations accumulate in the cells, leading to the transformation of the benign tumour into a malignant (cancerous) tumour. These mutations confer the ability to invade surrounding tissues and spread to other parts of the body.

- Malignant cells may develop the ability to evade the body's immune system and resist signals that would normally regulate cell growth.

4. Angiogenesis:

- Malignant tumours stimulate the formation of new blood vessels, a process called angiogenesis. This provides the growing tumour with a blood supply, ensuring a constant influx of nutrients and oxygen to support its rapid growth.

5. Metastasis:

- The most dangerous aspect of cancer is its ability to metastasize. Malignant cells can invade blood vessels or lymphatic channels, allowing them to spread to distant organs and form secondary tumours. Metastasis is a key factor in the severity of cancer and the difficulty of treatment.

Throughout these stages, the transformed cells may acquire additional mutations that enhance their survival and growth advantages. The overall process is highly complex and involves the interplay of genetic, environmental, and physiological factors. Understanding the molecular and cellular mechanisms of cancer development is crucial for developing effective prevention, diagnosis, and treatment strategies.

-End of ChatGPT answer-