D027 E-Portfolio: Advanced Pathopharmacological Foundations

D027 E-Portfolio: Advanced Pathopharmacological Foundations

Instructions

Completion of the Clinical Practice Experience (CPE) Record is a mandatory requirement to fulfill this course. The CPE Record can be found under the “Supporting Documents” section within your Assessment Task Overview, which details all necessary deliverables. It is essential to incorporate these deliverables into your e-portfolio.

Written reflections and submissions can be entered directly into this template. Alternatively, you can embed previously created Word or PDF documents by following these steps: place the cursor where the document should be inserted, click Insert, select the arrow beside Object, choose Text from File, locate and double-click the desired file. Repeat this process to add multiple documents as needed.

1a. CPE Schedule Table

The purpose of this schedule table is to assist with effective time management and organize your workload throughout the Clinical Practice Experience. Please copy the table below into your e-portfolio and fill in estimated times and target completion dates accordingly.

1b. Feedback and Synthesis Improvement Plan

What is Alzheimer’s Disease?

Alzheimer’s disease is a chronic, progressive neurodegenerative disorder marked by a decline in cognitive function and memory. The condition initially presents with mild memory difficulties but advances over time to a stage where performing everyday tasks becomes impossible. This progression results from widespread neuronal death causing brain shrinkage (atrophy). As reported by the Centers for Disease Control and Prevention (CDC), Alzheimer’s is among the top ten causes of death in the United States and remains the leading cause of dementia in the elderly population (Kumar et al., 2024).

What are the Pathophysiological Features of Alzheimer’s Disease?

Alzheimer’s disease is characterized by two primary pathological features: neuritic plaques and neurofibrillary tangles.

• Neuritic Plaques: These extracellular accumulations consist primarily of amyloid-beta peptides surrounded by degenerated neuronal processes. They predominantly build up in the cortical gray matter forming complex, multifocal clusters.

• Neurofibrillary Tangles: These intracellular aggregates are formed from abnormally folded tau proteins, which typically stabilize microtubules in neurons. The altered tau proteins clump together, disrupting normal cellular transport and contributing to neuronal dysfunction. These tangles begin in the hippocampus—a region essential for memory—and gradually spread to other areas of the cerebral cortex as the disease progresses (Kumar et al., 2024).

What Are the Clinical Manifestations of Alzheimer’s Disease?

Alzheimer’s symptoms develop in stages:

• Early Stage: Patients may experience memory lapses, difficulty finding words, spatial disorientation, and impaired judgment.

• Moderate Stage: Symptoms worsen to include increased confusion, noticeable personality changes, disorientation, and behavioral issues.

• Severe Stage: The individual becomes unable to perform self-care, may develop swallowing difficulties, and is at high risk for complications such as aspiration pneumonia, which is a major cause of death in advanced Alzheimer’s cases (National Institute on Aging [NIA], 2022a).

How Is Alzheimer’s Disease Diagnosed?

Diagnosis involves a multifaceted approach:

• Clinical evaluation of cognitive abilities, daily living activities, and behavior.

• Neuropsychological assessments that test memory, language, attention, and executive functions.

• Laboratory tests to rule out other conditions, including urinalysis.

• Brain imaging techniques such as CT, MRI, or PET scans to identify brain atrophy and amyloid plaque deposits (NIA, 2022b).

2b. Feedback and Synthesis Improvement Plan

What is Heart Disease?

Cardiovascular disease (CVD) is the leading cause of death globally and includes conditions like coronary artery disease, cerebrovascular disease, peripheral artery disease, and aortic atherosclerosis. The central pathological issue is the insufficient blood flow to the myocardium (heart muscle), leading to ischemia and clinical symptoms such as chest pain (angina) or myocardial infarction (heart attack) (Lopez, 2023).

What Is the Pathophysiology of Heart Disease?

Atherosclerosis is the fundamental pathological mechanism underlying most heart diseases. It involves the gradual accumulation of lipids, immune cells, and fibrous tissue within the arterial walls, causing narrowing (stenosis) and reduced blood flow. This process often begins early in life and progresses over time due to lipid deposition, inflammation, and damage to endothelial cells lining the arteries (Lopez, 2023).

What Are the Clinical Manifestations?

How Is Heart Disease Diagnosed?

What Are Common Treatments and Lifestyle Changes?

Treatment usually consists of medications such as beta-blockers, diuretics, statins, aspirin, and anticoagulants. In addition, patients are encouraged to adopt lifestyle modifications including balanced diet, regular physical exercise, stress reduction, maintaining a healthy weight, quitting smoking, and monitoring blood pressure and cholesterol levels (Lopez, 2023).

3b. Chronic Obstructive Pulmonary Disease (COPD) Synthesis

Patient Case Overview

Ms. O’Connor, 55 years old, presents with worsening symptoms of COPD including bronchospasms, fatigue, and a productive cough with rusty sputum. Despite nicotine replacement therapy, she continues to smoke 3 to 5 cigarettes daily, a habit since age 15. She has no allergies. Spirometry results indicate an FEV1 of 1.37L. Family history reveals a father who died of a heart attack and a mother who passed away due to smoking-related pneumonia. Additionally, she has gained 30 pounds over the past two years.

What Is the Pathophysiology of COPD?

COPD results from chronic inflammation of the airways due to prolonged exposure to harmful particles or gases, most commonly tobacco smoke. This inflammation causes airway narrowing, reduced lung elasticity, excessive mucus production, and airflow obstruction. Thickening of the airway walls leads to air trapping and lung hyperinflation, ultimately impairing respiratory function (Agarwal, 2023).

What Are the Signs and Symptoms?

How Is COPD Diagnosed?

Diagnosis is based on clinical assessment, spirometry and pulmonary function tests, imaging (chest X-ray, CT scans), arterial blood gas analysis, and screening for alpha-1 antitrypsin deficiency when indicated (Agarwal, 2023).

What Are Common Treatments?

What Are Possible Side Effects of Medications?

Reflection Summaries

Phase 1 Reflection

My selection to focus on Alzheimer’s disease stemmed from personal experience with a family member affected by this condition. Through research, I gained deeper insight into its core pathological hallmarks: amyloid-beta neuritic plaques and tau protein neurofibrillary tangles. Feedback from an intensivist highlighted that my initial synthesis was overly complex, prompting me to simplify the explanation for improved clarity and comprehension.

Phase 2 Reflection

In Phase 2, I concentrated on heart disease to refresh my clinical knowledge. The volume of available information was extensive, and I found balancing depth with clarity to be a significant challenge. Constructive feedback emphasized the necessity of concise and straightforward presentation, which I implemented to enhance my synthesis.

Phase 3 Reflection

Phase 3 involved analyzing Ms. O’Connor’s COPD case. This active learning experience allowed me to develop a detailed treatment plan integrating pharmacological interventions and lifestyle recommendations. Emphasizing patient education regarding medication side effects and adherence was critical. Organizing subjective and objective data accurately and managing system limitations in documentation were among the key challenges encountered.

References

Agarwal, A. K. (2023, August 7). Chronic obstructive pulmonary disease. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK559281/

Kumar, A., Sidhu, J., Lui, F., et al. (2024). Alzheimer Disease. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499922/

Lopez, E. O. (2023, August 22). Cardiovascular disease. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK535419/

National Institute on Aging (NIA). (2022a). What are the signs of Alzheimer’s disease? https://www.nia.nih.gov/health/alzheimerssymptoms-and-diagnosis/what-are-signs-alzheimers-disease

National Institute on Aging (NIA). (2022b, December). How is Alzheimer’s disease diagnosed? https://www.nia.nih.gov/health/alzheimerssymptoms-and-diagnosis/how-alzheimers-disease-diagnosed

American Lung Association. (2024b, May). Understanding your COPD medications. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/treating/copd-medications