Virtual Case Patient Case Study of Reg Bowen †MyAssignmenthelp.com

Question: Discuss about the Virtual Case Patient Reg Bowen Answer: Introduction The virtual case patient based assignment has focused upon the case study of Mr. Reg Bowen, who is a 76 years old former train driver, who is living alone at her home. His wife, Marjorie has been living in a high care accommodation, Golden OaksNursing home, since past 2 years. He is significantly concerned about his wifes well being. He has previous history of GORD and hypertrophic prostate. The patient is representing several recent symptoms, through the past 24 hours, including massive abdominal pain, diarrhoea, vomiting and reduced urination. Digestive system of the patient has been affected. His faecal samples were sent to the laboratory. The patient has been admitted in the emergency department, from where the patient would be treated for his current condition. Here, in this essay, the anatomy and physiology of Mr. Bowens current condition, pathophysiology, microbiological aspects of his condition. Anatomy and physiology The case history of Mr. Brown represented that he has been experiencing severe abdominal pain, lethargy, headache, inability to urinate, diarrhoea and vomiting, which led to his admission in the emergency department of hospital (Jones et al. 2014). He was on two medications, i.e. Omeprazole 20mg mane and Cenovis Prostate Health Saw Palmetto 3200mg 1 tablet BD for controlling his past medical history of Benign hypertrophic prostate (BHP), Gastro oesophageal reflux disease (GORD). From the laboratory tests of his two separate faecal samples, the norovirus infection has been confirmed for Mr. Bowen. Mr. Bowen has been affected with norovirus gastroentirities. The disease mainly affects the Gastro Intestinal tract of the patient, which lead to the problem in digestion processes. The norovirus infection causes the gastro entities disease. The Gastro Intestinal tract is approximately nine meters long that is extended from mouth to the end part of the large intestine. It continues besides the major digestive system organs including stomach, pancreas, liver, kidney and ends at rectum, the end part of the large intestine. The gastric juices in the digestive organs, i.e. pancreas, stomach produces digestive juices and hormones, which promotes the digestion procedure. However, in case of norovirus infection, the digestion procedure is hampered by the alteration of host immune protection by the virus (Bruggink et al., 2016). Pathophysiology The norovirus can be transmitted via both the faecal-oral route and via airborne or direct person to person contact. The virus has been isolated from the faecal sample of Mr. Bowen. When he has been infected by the virus, it affected and replicated in small intestine. The symptoms appear approximately one or two days later (Brown et al. 2017). The symptoms of noroviral gastroenteritis include general lethargy, headache, abdominal pain, diarrhoea and vomiting, which have been represented by the patient, Mr. Bowen. The replicated progenies of norovirus damage the microvilli in small intestine by producing and extracting toxins. These viral toxins interfere with the function of ion transporters situated in the cell membrane of brush border cells. It leads to the issues with cell permeability (Woodward et al. 2015). This damage to the microvilli leads to malfunctioning of the digestion enzymes in the brush border cells, which are responsible for absorption and digestion of fat and D-Xylo se. However, the epithelium and mucosa is not affected (Troeger et al. 2009). The disrupted cell permeability leads to the fluid and electrolyte imbalance, as the anions are leaked in the extracellular space, thereby disrupting the ion gradient through the cell membrane. The leakage of ions and water molecules triggers diarrhoea, which is also promoted by the delayed empty of stomach and virus mediated alteration in the gastric motility (Whyte and Jenkins 2012). The symptoms presented by Mr. Bowen are similar to the gaastroenterits by the norovirus. Microbiological aspects The Norovirus is classified under the calcivirus family, group IV positive strand RNA virus. The virus consists of a single stranded positive RNA genome, as its genetic material. The single stranded RNA genome is protected by a capsid. The capsid core body also consist of several functional proteins along with the genome, useful for viral replication. The most common type of norovirus, affecting the human population is Norwalkk virus (Zhang et al. 2017). In case of Mr. Bowen, the laboratory tests of his two separate faecal samples revealed the presence of norovirus in faeces of the patient. After 3 weeks of infection, the viral particles bind to the polymorphic HBGAs, which are assumed to key infection receptors. Binding of the viral particles to different HBAGs indicates the risk of reinfection (Green 2014). Nursingprecautions The patient needs to avoid the contaminated foods and drinks to avoid the diarrhoea. The patient needs to wash the hands before and after taking the meals as well as after the sanitization. The patient needs to increase the fluid intake to balance the fluid balance of the body. Conclusion The case study presented the Norovirus infection of the patient, causing viral gastroenteritis. Although the condition is curable via through management, re-infection can occur, as a result of lacking long-term immunity or cross-strain reaction. References Brown, S.J., White, S. and Power, N., 2017. Introductory anatomy and physiology in an undergraduatenursing curriculum.Advances in Physiology Education,41(1), pp.56-61. Bruggink, L.D., Dunbar, N.L. and Marshall, J.A., 2016. Emergence of GII. Pg norovirus in gastroenteritis outbreaks in Victoria, Australia.Journal of medical virology,88(9), pp.1521-1528. Green, K.Y., 2014. Norovirus infection in immunocompromised hosts.Clinical Microbiology and Infection,20(8), pp.717-723. Jones, M.K., Watanabe, M., Zhu, S., Graves, C.L., Keyes, L.R., Grau, K.R., Gonzalez-Hernandez, M.B., Iovine, N.M., Wobus, C.E., Vinj, J. and Tibbetts, S.A., 2014. Enteric bacteria promote human and mouse norovirus infection of B cells.Science,346(6210), pp.755-759. Troeger, H., Loddenkemper, C., Schneider, T., Schreier, E., Epple, H.J., Zeitz, M., Fromm, M. and Schulzke, J.D., 2009. Structural and functional changes of the duodenum in human norovirus infection.Gut,58(8), pp.1070-1077. Whyte, L.A. and Jenkins, H.R., 2012. Pathophysiology of diarrhoea.Paediatrics and child health,22(10), pp.443-447. Woodward, J.M., Gkrania-Klotsas, E., Cordero-Ng, A.Y., Aravinthan, A., Bandoh, B.N., Liu, H., Davies, S., Zhang, H., Stevenson, P., Curran, M.D. and Kumararatne, D., 2015. The role of chronic norovirus infection in the enteropathy associated with common variable immunodeficiency.The American Journal of Gastroenterology,110(2), p.320. Zhang, Z., Lai, S., Yu, J., Geng, Q., Yang, W., Chen, Y., Wu, J., Jing, H., Yang, W. and Li, Z., 2017. Etiology of acute diarrhea in the elderly in China: A six-year observational study.PloS one,12(3), p.e0173881.