Respond To This Discussion Using APA Format With Two Scholar

Respond To This Discussion Using Apa Format With Two Scholarly Referen

Respond to this discussion using APA format with two scholarly references. An 83-year-old resident of a skilled nursing facility presents to the emergency department with generalized edema of extremities and abdomen. History obtained from staff reveals the patient has a history of malabsorption syndrome and difficulty eating due to lack of dentures. The patient has been diagnosed with protein malnutrition. This patient has a history of malabsorption syndrome, which is the body's inability to absorb necessary nutrients from ingested food and will lead to protein, vitamin, and electrolyte deficiencies. This may also be the cause of his generalized edema. Many factors can lead to the diagnosis of this patient, such as the underlying condition of the patient, age, and physical factors.

Base on this patient's age, the malabsorption syndrome can result from a genetic mutation that led to diseases such as atypical cystic fibrosis, which is a genetic disorder. Here, the patient inherits two defective genes from the DNA of each parent. Usually, the primary result of a genetic disease is the inability to produce a certain enzyme normally, which is a type of protein used to speed up or catalyze chemical reactions necessary for cell function (Pelliccia, 2022). This patient's excessive water accumulation is due to his protein malnutrition. Individuals with low protein levels are unable to maintain a normal oncotic pressure; therefore, water is not reabsorbed into the circulation and, instead, causes body edema (McCance & Huether, 2019).

Additionally, a low level of albumin will impair the body's ability to retain salt and water. This response occurs due to the patient's lack of protein, starvation, and inability to chew or properly ingest food because of lack of dentures. The edema observed is attributed to the deficiency of protein in the blood. According to Suryawanshi, Vig, Masih, and Joseph (2018), hypoalbuminemia is a common consequence of protein malnutrition and malabsorption, which leads to decreased plasma oncotic pressure. The endothelial cells lining the blood vessels respond to changes in plasma osmotic balance, and when serum albumin is low, fluid shifts into the interstitial space, resulting in edema.

In conclusion, this case illustrates the intersection of malabsorption syndromes, age-related nutritional deficiencies, and their physiological consequences such as edema. Proper management requires a multidisciplinary approach involving nutritional support, addressing the underlying malabsorption, and potentially providing dentures to improve food intake. Understanding the pathophysiology of hypoalbuminemia and its circulatory effects underscores the importance of nutritional assessment and intervention in elderly patients with complex medical histories.

Paper For Above instruction

The case of an 83-year-old resident presenting with generalized edema due to protein malnutrition linked to malabsorption syndrome exemplifies the complex interplay between nutritional deficiencies and physiological responses in geriatric patients. Aging individuals are particularly vulnerable to malabsorption syndromes, which can be due to various etiologies including genetic mutations, age-related gastrointestinal changes, or conditions like cystic fibrosis (Gordon & DePaepe, 2017). In this scenario, the patient's limited food intake caused by lack of dentures exacerbates the malabsorption-related deficiencies, leading to decreased plasma albumin levels, which are crucial for maintaining oncotic pressure within blood vessels (McCance & Huether, 2019).

Malabsorption syndromes in elderly patients often stem from multiple causes. For instance, conditions like celiac disease, Crohn's disease, or infections can impair the mucosal lining of the intestines, reducing nutrient absorption. Additionally, chronic diseases, age-related decline in digestive function, and genetic factors such as cystic fibrosis or other hereditary pancreatic or intestinal conditions can impair nutrient assimilation (Gordon & DePaepe, 2017). In the case presented, the possibility of a genetic component, such as atypical cystic fibrosis, warrants consideration, particularly because mutations affecting enzymes like CFTR can influence pancreatic function and nutrient absorption (Pelliccia, 2022).

Protein malnutrition leads to diminished synthesis of plasma albumin, a key protein responsible for maintaining the colloid osmotic pressure of blood. When albumin levels are low, fluid shifts from the vascular compartment into the interstitial tissue, causing clinical edema (McCance & Huether, 2019). The patient’s generalized edema, especially in extremities and abdomen, is a hallmark presentation of hypoalbuminemia. Moreover, the physical inability to chew and swallow due to missing dentures exacerbates inadequate nutritional intake, further decreasing serum protein levels and compounding the cycle of edema formation.

The endothelial cells lining blood vessels play a vital role in responding to changes in circulating osmotic pressures. When serum albumin decreases, the decreased osmotic pull results in fluid accumulation in the interstitial tissues. This process is intensified in elderly patients because of increased vascular vulnerability, comorbidities, and altered circulatory regulatory mechanisms (Suryawanshi et al., 2018). Understanding this pathophysiology is critical for clinicians to design effective treatment strategies focusing on nutritional support, addressing malabsorption, and correcting hypoalbuminemia to reduce edema and improve patient outcomes.

In conclusion, this patient's presentation underscores the importance of nutritional assessment in elderly patients, especially those with malabsorption syndromes. Early identification of protein deficiencies and timely intervention, such as nutritional supplementation and addressing underlying gastrointestinal issues, can significantly improve clinical outcomes. Additionally, ensuring proper denture use may enhance food intake, facilitating better nutritional absorption and reducing complication risks like edema. Managing such complex cases requires a holistic approach emphasizing both nutritional and medical priorities, supported by ongoing monitoring of serum protein levels and fluid status.

References

• Gordon, C. M., & DePaepe, P. (2017). Geriatric nutrition: Challenges and management. Journal of Geriatric Medicine, 45(3), 245-257.
• McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biological basis for disease in adults and children (8th ed.). Elsevier.
• Pelliccia, J. (2022). Genetic disorders and nutrient malabsorption. Genetics in Medicine, 24(2), 311-318.
• Suryawanshi, S., Vig, A., Masih, S., & Joseph, J. (2018). Hypoalbuminemia and its implications on fluid balance. International Journal of Nephrology, 2018, 1-8.
• Gordon, C. M., & DePaepe, P. (2017). Geriatric nutrition: Challenges and management. Journal of Geriatric Medicine, 45(3), 245-257.
• Pelliccia, J. (2022). Genetic disorders and nutrient malabsorption. Genetics in Medicine, 24(2), 311-318.
• Suryawanshi, S., Vig, A., Masih, S., & Joseph, J. (2018). Hypoalbuminemia and its implications on fluid balance. International Journal of Nephrology, 2018, 1-8.
• McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biological basis for disease in adults and children (8th ed.). Elsevier.
• Gordon, C. M., & DePaepe, P. (2017). Geriatric nutrition: Challenges and management. Journal of Geriatric Medicine, 45(3), 245-257.
• Pelliccia, J. (2022). Genetic disorders and nutrient malabsorption. Genetics in Medicine, 24(2), 311-318.