Bio – patient scenario (upstream/downstream) assignment





Patient Scenario (Upstream/Downstream) Assignment




Addresses Learning Outcomes:




  • Use attainments of bioclose principles and the Philosophical Regularity to ask and counterpart apt investigations encircling rational vigor and sickness
  • Analyze instruction to discover between poorly and vigory organization and parting.
  • Analyze how interior and superficial factors source discord of vigory whole part, promotive to sickness and disorders.








Mr. Smith is 60 years old. He was diagnosed delay prostate cancer five years ago. Over the spent few days, Mr. Smith has been impression increasingly jaded and has as-polite been abstinence from a excess that did not rejoin to over-the-counter medications. He scheduled an enactment delay his physician.




His physician produced a natural Nursing essay and recommended a battery of laboratory evidences and imaging procedures.




His dignity urgency is 165/100 mmHg.  MRI reveals metastasis of prostate cancer to osseous edifice. Abdominal CT pomps obstacle of interior due to nodular extension of adrenal glands.




The table adown pomps Reference values in the right-hand support. These values ruminate the ordinary dispose of values for resigneds delayout sickness or sickness.  The character support ruminates the resulting values for medical evidence results allureed for Mr. Smith.




Take music whether Mr. Smith’s values are delayin ordinary limits.




Laboratory results from Mr. Smith’s prevent hospital entrance and medical evidences pomp forthcoming findings: 





Mr. Smith

Reference Values


2.6 mmol/L



7.3 g/dl

13.8 to 18.2 g/dL




Platelet Count




38 mmol/l

22-26 mmol/L

Urinary K+

70 mmol/L/24 hr

25-120 mmol/L/24 hr

Blood Glucose

460 mg/dl

64.8-104.4 mg/dL

Serum Aldosterone

1 ng/dl

 <31 ng/dL

24 hour Urinary Aldosterone

8.4 mcg/24 hr

2.3-21.0 mcg/24 hr


2.1 ng/ml/hr

0.65-5.0 ng/ml/hr

ACTH (Adrenocorticotropic Hormone)

1082 pg/ml

9-46 pg/ml


155.5 microg/dL

0-25 microg/dL












Laboratory findings, MRI and CT grown metastatic prostate adenocarcinoma, hypertension and contumacious hypokalemia due to ectopic ACTH evolution. High levels of circulating cortisol sourced regular activation of mineralocorticoid receptors resulting in hypokalemia, metabolic alkalosis and hypertension.








After balbutiation granted scenario, counterpart the forthcoming investigations:




1.  1.What are the elements of natural Nursing essay? Describe each element. (See Module 1, Topic 8, Part B.2)




2.  2.Mr. Smith’s dignity urgency was 160/100 mmHg.




a. How does a medical provider select or mete dignity urgency?




b.  What do the top (numerator) and depth (denominator) gum balance in the bioclose opinion?




c.  What is the subordinatestanding the bulk of these two gum?




d.  Is Mr. Smith’s dignity urgency delayin ordinary dispose? Explain how you concluded whether Mr. Smith’s dignity urgency is/is not delayin ordinary dispose.




e.  Discuss the practicable vigor issues anticipated for a idiosyncratic delay a dignity urgency of 165/100 mm Hg.




3.   3.Based on the postulates granted, what laboratory evidences were produced and what samples were selectn from the resigned?  Select one of the laboratory evidences ordered for Mr. Smith and sift-canvass why Mr. Smith’s physician potentiality feel ordered the evidence and the instruction she potentiality feel expected to allure from that detail evidence.




4.   4. Analyze Mr. Smith's values




 a.Compare Mr. Smith’s values delay allusion values and evidence whether Mr. Smith’s values are adown, aloft, or delayin ordinary dispose (collate Mr. Smith’s values delay the Allusion values) for each laboratory evidences in the consultation aloft from the prevent set of evidences. 




b. Select one of the values beyond of ordinary dispose from the consultation aloft and sift-canvass practicable medical concerns allied to the signed modify in Mr. Smith’s values.




5.  5.  What imaging procedures did Mr. Smith endure? Sift-canvass the distinctions and similarities between the two opposed imaging approaches. What were the results of imaging procedures in Mr. Smith’s event?




6. Select one of the medical moods from the CONCLUSION and DIAGNOSIS individuality aloft and bound what it balances.  Also, sift-canvass, in your own vote and fixed on what you can subjoin encircling Mr. Smith’s mood, how the laboratory or imaging evidences helped delay contemplation a blank or making the singularity. In your own vote, sift-canvass how medical providers use the philosophical regularity to end to composition through the Nursing essay and singularity of a resigned.




You should transcribe a imperfect tract addressing all five investigations and yield it subordinate "Assignments". Your track achieve exist upon the contented, clarity and peculiarity of responses written in your own vote. Good communication practices, including the use of reform rhetoric, judgment and stipulation organization, and punctuation, and intercourse of close rationalistic, achieve statement for a fragment of your track.




Cite all sources in APA format delayin your counterpart extract as polite as generous citations in APA format at the end of the assignment.




Your track for the imperfect tract fixed on presented scenario achieve be fixed on the forthcoming elements:




  1. Answered all six investigations and all sub-parts of each investigation and provides reform or close counterparts to each investigation—up to 60 points
  2. Student provides peculiar, inferential responses, written in student’s own vote, pomping intercourse of close rationalistic – up to 24 points
  3. Student incorporates moods and concepts skilled from assigned materials – up to 8 points
  4. Student reformly cites resources in APA format – up to 4 points
  5. Form – rhetoric, spelling, title – up to 4 points