Assignment Details MN551: Develop cooperative relationships with clients when teaching concepts concerning pathological states to individuals and families Select one of the case studies below, and include discussion of your strategy for winning the patients cooperation while teaching concepts concerning pathological states to them and their families. Requirements  Make sure all of the topics in the case study have been addressed. Cite at least three sources; journal articles, textbooks or evidenced-based websites to support the content.  All sources must be within five years. Do not use .com, Wikipedia, or up-to-date, etc., for your sources. Case Study 1 Concepts of Altered Health in Older Adults  Joseph P. is an 82-year-old male living at home. He is in overall good health and enjoys taking long walks as often as possible. During his walks, he likes to stop for a cold glass of fruit juice at the local cafeteria. On cold or rainy days, he rides a stationary bicycle at home for 30 minutes to “stay in good shape.”  What physiological factors would typically increase Joseph’s risk of falling while walking outdoors?  What are the common changes in blood pressure regulation that occurs with aging?  Joseph enjoys fruit juice when he walks. Considering the renal system in the older adult, why would dehydration be a particular concern?  Case Study 2 Structure and Function of the Kidney  Rivka is an active 21-year-old who decided to take a day off from her university classes. The weather was hot and the sun bright, so she decided to go down to the beach. When she arrived, she found a few people playing beach volleyball, and they asked if she wanted to join in. She put down her school bag and began to play. The others were well prepared for their day out and stopped throughout the game to have their power drinks and soda pop. Several hours after they began to play, however, Rivka was not feeling so good. She stopped sweating and was feeling dizzy. One player noted she had not taken a washroom break at all during the day. They found a shaded area for her, and one of the players shared his power drink with her. Rivka was thirstier than she realized and quickly finished the drink.  In pronounced dehydration, hypotension can occur. How would this affect the glomerular filtration rate of the kidney? What actions by the juxtaglomerular apparatus would occur to restore GFR?  What is the effect aldosterone has on the distal convoluted tubule? Why would the actions of aldosterone be useful to Rivka in her situation?  What does a specific gravity test measure? If someone tested the specific gravity of Rivka’s urine, what might it indicate?  Case Study 3 Disorders of Fluid and Electrolyte Balance  Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced she was overweigh.

1. Assignment Details
MN551:
Develop cooperative relationships with clients when teaching
concepts concerning pathological states to individuals and
families
Select one of the case studies below, and include discussion of
your strategy for winning the patients cooperation while
teaching concepts concerning pathological states to them and
their families.
Requirements
Make sure all of the topics in the case study have been
addressed.
Cite at least three sources; journal articles, textbooks or
evidenced-based websites to support the content.
All sources must be within five years.
Do not use .com, Wikipedia, or up-to-date, etc., for your
sources.
Case Study 1
Concepts of Altered Health in Older Adults
Joseph P. is an 82-year-old male living at home. He is in overall
good health and enjoys taking long walks as often as possible.
During his walks, he likes to stop for a cold glass of fruit juice
at the local cafeteria. On cold or rainy days, he rides a

2. stationary bicycle at home for 30 minutes to “stay in good
shape.”
What physiological factors would typically increase Joseph’s
risk of falling while walking outdoors?
What are the common changes in blood pressure regulation that
occurs with aging?
Joseph enjoys fruit juice when he walks. Considering the renal
system in the older adult, why would dehydration be a particular
concern?
Case Study 2
Structure and Function of the Kidney
Rivka is an active 21-year-old who decided to take a day off
from her university classes. The weather was hot and the sun
bright, so she decided to go down to the beach. When she
arrived, she found a few people playing beach volleyball, and
they asked if she wanted to join in. She put down her school bag
and began to play. The others were well prepared for their day
out and stopped throughout the game to have their power drinks
and soda pop. Several hours after they began to play, however,
Rivka was not feeling so good. She stopped sweating and was
feeling dizzy. One player noted she had not taken a washroom
break at all during the day. They found a shaded area for her,
and one of the players shared his power drink with her. Rivka
was thirstier than she realized and quickly finished the drink.
In pronounced dehydration, hypotension can occur. How would

3. this affect the glomerular filtration rate of the kidney? What
actions by the juxtaglomerular apparatus would occur to restore
GFR?
What is the effect aldosterone has on the distal convoluted
tubule? Why would the actions of aldosterone be useful to
Rivka in her situation?
What does a specific gravity test measure? If someone tested
the specific gravity of Rivka’s urine, what might it indicate?
Case Study 3
Disorders of Fluid and Electrolyte Balance
Amanda is an 18-year-old with anorexia nervosa. She was
recently admitted to an eating disorders clinic with a BMI of
13.9, and although she was a voluntary patient, she was
reluctant about the treatment. She was convinced she was
overweight because her clothes felt tight on her. She
complained that even her hands and feet “were fat.” One of her
nurses explained that a protein in her blood was low. The nurse
further explained that, as difficult as it may be to believe,
eating a normal healthy diet would make the “fat hands and
feet” go away.
What protein do you suspect the nurse was referring to? How
would a deficiency in this protein contribute to edema?
What is the difference between the physiology of pitting and
nonpitting edema?
Because of her weakened condition, Amanda was moved around

4. the ward in a wheelchair when she was not on bed rest. How
does this affect her edematous tissues?
Case Study 4
Disorders of Acid–Base Balance
Shauna is a healthy, fit 28-year-old who decided to go on a 2-
week tour of Mexico for young singles. One hot afternoon in a
small market community, she grabbed some fruit juice from a
street vendor. Several hours later, she developed abdominal
cramping and diarrhea. The diarrhea became so severe that she
missed 3 days of the tour and stayed in her hotel room. By the
end of her illness, she felt weak and tired. Her head ached, but
the mild fever had disappeared, and she was able to join her
new friends for the rest of the tour.
What is the acid–base imbalance Shauna might have
experienced and its etiology?
What are the functions and importance of the bicarbonate buffer
system in the body?
Case Study 5
Disorders of Renal Function
Fred, a fit and healthy 44-year-old, was working outside one
warm summer afternoon. When he returned home by the end of
the day, his lower back felt sore and he felt nauseated. His wife
made him dinner, but he was not hungry and chose to go to bed

5. instead. Fred’s symptoms progressed, and soon he was rolling
on the bed with excruciating pain. He said his back hurt as well
as his stomach and groin area. The pain would ease off only to
return a short while later, and when it did, Fred would begin to
sweat and run to the bathroom to vomit. His wife became
concerned and started the car. When his symptoms abated, she
helped him into the car and rushed him to the hospital.
At the hospital, an abdominal radiograph showed the presence
of renal calculi in Fred’s right ureter (urolithiasis). What is the
mechanism of stone formation in the kidney? What is the role of
citrate in the kidneys?
Why would the administration of calcium supplements be useful
for a patient with calcium oxalate stones?
Hydronephrosis can be a complication of renal calculi. What is
hydronephrosis? How does back pressure occur in a kidney, and
what physiological mechanism is responsible for nephron
damage when back pressure is present?
Case Study 6
Acute Renal Injury and Chronic Kidney Disease
Will is a 68-year-old male with a history of hypertension. Eight
months ago, he started regular dialysis therapy for ESRD.
Before that, his physician was closely monitoring his condition
because he had polyuria and nocturia. Soon it became difficult
to manage his hypertension. He also lost his appetite, became
weak, easily fatigued, and had edema around his ankles. Will
debated with his physician about starting dialysis, but she
insisted, before the signs and symptoms of uremia increased, the

6. treatment was absolutely necessary.
What is the difference between azotemia and uremia?
Two years ago, Will’s physician told him to decrease his protein
intake. In spite of what the physician ordered, Will could not
stop having chicken, beef, pork, or eggs at least once a day.
Why did his physician warn him about his diet?
Will’s feelings of weakness and fatigue are symptoms of
anemia. Why is he anemic?
Knowing what you do about Will’s history, why is left
ventricular dysfunction a concern for his physician?
Case Study 7
Disorders of the Bladder and Lower Urinary Tract
Alvita is a frail 89-year-old woman residing in a nursing home.
She is able to move slowly around the residence with the use of
a walker, but appreciates when her daughter is there to hold her
arm and walk alongside her. When one of the health care staff
changes Alvita, her daughter helps. Alvita’s incontinence has
progressed, particularly over the last six years since she has
resided in the nursing home. Alvita can smile at her lack of
bladder control, however, and says that her incontinence really
began when she was a young woman, just after the birth of her
second daughter.
Alvita’s mobility is limited. How does this affect continence in
the elderly?

7. Shortly after the birth of her second daughter, Alvita
experienced mild incontinence, particularly after laughing or
coughing. What was she experiencing? What is the
pathophysiology behind this type of incontinence?
Assignment Requirements:
Before finalizing your work, you should:
be sure to read the Assignment description carefully (as
displayed above);
consult the Grading Rubric (under the Course Resources) to
make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:
follow the conventions of Standard American English (correct
grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and
insightful;
display superior content, organization, style, and mechanics;
and
use APA 6th Edition format.
To see your assignment instructions and grading rubric, go to
Course Resources / Grading Rubrics.