NR 603 Week 1 Discussion Compare and Contrast
University:
Chamberlain University
NR 603 Week 1 Discussion Compare and Contrast
Paper Instructions
Preparing the Assignment
Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.
General instructions
Identify the assigned topics listed by the first letter of your first name. For example, if your first name begins with the letter G then your?assigned topic is dementia and delirium.
| First Letter of Your First Name | Topic |
| A – E | Benign positional vertigo and Meniere’s disease |
| F – J | Dementia and delirium |
| K – O | Trigeminal neuralgia and giant cell arteritis |
| P – S | Post-concussive syndrome and traumatic brain injury |
| T – Z | Migraine headache and tension headache |
Include the following sections;
Application of Course Knowledge
Compare and contrast the assigned topics in your initial discussion post. The goal of this assignment goes beyond simply listing information for each disease; it requires a careful examination of both disorders with a thoughtful discussion of both the similarities and the differences of each.?Consider the clinical presentation of each client to the office.?Describe their clinical presentation and how their history would impact their diagnosis.
Address each of the following components using your own words;
Presentation
- Demographics, onset of symptoms, history of present illness, associated risk factors?
Pathophysiology
- Similarities and differences in pathophysiology
Assessment
- Physical assessment techniques, appropriate diagnostic testing
Diagnosis
- Additional differential diagnoses to consider, positive findings for each diagnosis
Management
- Similarities and differences in pharmacologic and nonpharmacologic treatments, client education, referral, and follow-up care
Integration of Evidence
Integrate relevant scholarly sources as defined by program expectations. Links to an external site.
- Cite a scholarly source in the initial post.
- Cite a scholarly source in one faculty response post.
- Cite a scholarly source in one peer post.
Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.
Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations.
Engagement in Meaningful Dialogue
Engage peers and faculty by asking questions, and offering new insights, applications, perspectives, information, or implications for practice.
Peer Response
- Respond to at least one peer.
Faculty Response
- Respond to at least one faculty post.
Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.
Professionalism in Communication
Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.
Reference Citation
Use current APA format to format citations and references and is free of errors.
Wednesday Participation Requirement
Provide a substantive response to the graded?discussion topic (not a response to a peer or faculty), by Wednesday, 11 59 p.m. MT of each week.
Total Participation Requirement
Provide at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.
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Sample Answer
Giant cell arteritis (GCA) and trigeminal neuralgia (TN) are conditions often associated with facial pain, among other symptoms. However, the etiology of facial pain is different as the conditions affect different structures located within the face. The purpose of this paper is to compare and contrast the presentation, pathophysiology, assessment, diagnosis, and management of both conditions.
Presentation
GCA is a multi-systemic condition that commonly affects Caucasians, with females and persons above 50 years being at a higher risk. The condition is associated with systemic and ocular symptoms, including myalgia, jaw claudication, scalp tenderness, fever, anorexia, and vision loss.On the other hand, TN has no racial predilection but commonly affects persons aged above 40 years, with females and multiple sclerosis patients being at a higher risk.
Patients with TN often present with recurrent paroxysms of unilateral facial pain that affects areas innervated by the trigeminal nerve (Lambru et al., 2021). The pain is usually severe, stabbing, and lasts for a fraction of a second to two minutes.
Pathophysiology
GCA is a type of vasculitis that affects medium and large-sized arteries, including ophthalmic and temporal vessels. The vasculitis results from the accumulation of inflammatory cells, such as dendritic cells, along the walls of affected vessels, causing narrowing of the lumen and predisposing them to partial or complete occlusion (Paroli et al., 2024). The inflammatory process is responsible for most systemic symptoms, while ophthalmic artery involvement is associated with ischemic optic nerve neuropathy.
TN occurs due to nerve compression at the ganglia, causing microvascular ischemia and demyelination (Gambeta et al., 2020). As a result, there is a decrease in the excitability threshold of affected A-β fibers, which inappropriately activate nociceptive A-δ fibers, causing fast and stabbing facial pain.
Assessment and Diagnosis
While performing a physical examination for a suspected GCA patient, one must inspect and palpate the temporal area of the scalp for any visible and tender artery. Additionally, one needs to auscultateaffected arteries, such as carotid, for any bruits, perform visiontests, and use an ophthalmoscope to check for any ischemic changes in the optic nerve and retina (Piccus et al., 2022). Erythrocyte-sedimentation rate (ESR) and C-reactive protein (CRP) are the common laboratory tests performed, with the histologic evidence of nodular thickening of the temporal artery being the confirmatory test for GCA (Awisat et al., 2023).
The differential diagnoses for GCA includes migraine, TN, sinusitis, and primary headache syndromes. On the other hand, examination of TN patients involves touching trigger areas to elicit pain, while brain MRI or CT are the imaging tests used to diagnose TN (Allan et al., 2023). Differential diagnoses for TN include maxillary sinusitis, post-herpetic neuralgia, post-traumatic trigeminal neuropathy, and odontalgia.
Management
The pharmacologic treatment of GCA involves high-dose corticosteroids, usually prednisolone, with regular follow-ups with ESR and CRP until they stabilize. With symptomatic relief and reduced levels of CRP and ESR, steroid tapering should start(Awisat et al., 2023). It is thus crucial to educate the patient on their condition and treatment, including the side effects of corticosteroid use and the need for frequent follow-up.
Carbamazepine, oxcarbazepine, and lamotrigine are the common medications used in the treatment of TN, with surgical treatment considered for patients whose conditions are non-refractory(Gambeta et al., 2020). Patient education is required, with regular follow-up sessions to check on the prognosis and any adverse effects of the medication.
Conclusion
GCA and TN are associated with facial pain, with GCA being a major cause of ischemic optic neuropathy. A detailed physical examination and relevant diagnostic tests have to be performed to establish a conclusive diagnosis. The use of recommended treatment guidelines has been associated with symptomatic improvement.
References
- Allam, A. K., Sharma, H., Larkin, M. B., &Viswanathan, A. (2023). Trigeminal Neuralgia Diagnosis and Treatment. Neurologic Clinics, 41(1), 107-121. https //doi.org/10.1016/j.ncl.2022.09.001
- Awisat, A., Keret, S., Silawy, A., Kaly, L., Rosner, I., Rozenbaum, M., Boulman, N., Shouval, A., Rimar, D., &Slobodin, G. (2023). Giant Cell Arteritis State of the Art in Diagnosis, Monitoring, and Treatment. Rambam Maimonides Medical Journal, 14(2). https //doi.org/10.5041/RMMJ.10496
- Gambeta, E., Chichorro, J. G., &Zamponi, G. W. (2020). Trigeminal neuralgia An overview from pathophysiology to pharmacological treatments. Molecular Pain, 16. https //doi.org/10.1177/1744806920901890
- Lambru, G., Zakrzewska, J., &Matharu, M. (2021). Trigeminal neuralgia A practical guide. Practical Neurology, 21(5), 392-402. https //doi.org/10.1136/practneurol-2020-002782
- Paroli, M., Caccavale, R., &Accapezzato, D. (2024). Giant Cell Arteritis Advances in Understanding Pathogenesis and Implications for Clinical Practice. Cells, 13(3). https //doi.org/10.3390/cells13030267
- Piccus, R., Hansen, M. S., Hamann, S., &Mollan, S. P. (2022). An update on the clinical approach to giant cell arteritis. Clinical Medicine, 22(2), 107-111. https //doi.org/10.7861/clinmed.2022-0041
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