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Apoptosis is the Key to Life

Apoptosis is the process of programmed cell death. It is used during early development to eliminate unwanted cells. For example, those between the fingers of a developing hand (genonome.gov/genetics, “Apoptosis” 2025). Apoptosis removes unwanted cells so that new cells may develop.

Imagine if apoptosis didn’t exist and healthy cells would not regenerate, our chances for survival would become detrimental. Cells that are too damaged or too old if not removed can duplicate one another. Apoptosis plays a huge role in prevention of cancer cells from forming. It not only destroys unwanted cells but it also prevents from tumors to grow. Apoptosis helps keep the body healthy by replacing old cells, strengthens the immune system, gets rid of damaged cells, stops damaged cells from replicating and supports homeostasis (mycleavelandclinic.org/health articles 2024).

Apoptosis is very complex it has to be balanced. If too much of it occurs, it can produce neurodegenerative diseases to occur such as Parkinson’s Disease, Huntington Disease, and Alzheimer’s Disease. Apoptosis and necrosis both lead to cellular death. One main difference is that apoptosis plays a role in your developmental prior to birth (mycleavelandclinic.org/health articles 2024). Apoptosis can be viewed as a natural occurring process while necrosis is considered pathological (akadeum.com/blog/necrosis 2024).

Necrosis occurs when there has been damage caused to the cell due to infection, and other factors such as denaturation of proteins. For example in patients that have developed a diabetic wound that is showing signs and symptoms of necrosis not only contribute to diabetes but also to a decrease and loss of tissue perfusion. Most patients that develop such ulcers in the acute phase will be recommended to do hyperbaric oxygen treatment. The treatment consist of 100% oxygen to the entire body especially areas of less tissue prefusion with hopes of new cell regeneration. It is a type of therapy that is used in hopes of salvaging an extremity.

References:

National Human Genome Research Institute (January 2025). “Apoptosis”

https://www.genome.gov/human-genome-project

Cleveland Clinic (September 2024). “Apoptosis”

https://my.clevelandclinic.org/health/articles/apoptosis

Akadeum Life Sciences.(December,2024). “Necrosis vs. Apoptosis: Process, Necrotic Cell Death, & Apoptosis Steps”

https://www.akadeum.com/blog/necrosis-vs-apoptosis-processes-necrotic-cell-death-apoptosis-steps/?srsltid=AfmBOor81gCXCcCOS8cd81fgxpmwqajElZvyzA6bKSul04DyTDekR5-Y&cn-reloaded=1

The Importance of Cell Death Programs in Physiology and Disease Prevention

Cell death programs, such as apoptosis, are essential for maintaining cellular homeostasis, promoting tissue development, and preventing disease. Apoptosis, or programmed cell death, is a tightly regulated process that ensures the orderly removal of damaged, aged, or unnecessary cells without triggering inflammation (Elmore, 2021). This process plays a vital role in embryogenesis, immune system regulation, and tissue remodeling. For example, apoptosis eliminates autoreactive immune cells to prevent autoimmune diseases and removes mutated cells to reduce the risk of cancer development.

In contrast, necrosis, a form of accidental cell death, is characterized by the loss of membrane integrity and the uncontrolled release of intracellular contents, leading to inflammation and potential tissue damage (Kroemer et al., 2020). Unlike apoptosis, necrosis typically results from acute injury, such as trauma or ischemia, and lacks the orderly sequence of cellular disassembly seen in programmed cell death.

Apoptosis involves distinct pathways, including intrinsic (mitochondrial-mediated) and extrinsic (death receptor-mediated) mechanisms. The intrinsic pathway is triggered by internal cellular stress, such as DNA damage, and involves the release of cytochrome c from mitochondria, activating caspases to execute cell death. The extrinsic pathway, on the other hand, is initiated by ligand binding to death receptors, such as Fas, resulting in caspase activation (Elmore, 2021).

The distinction between apoptotic and necrotic pathways is critical for understanding disease mechanisms. Impaired apoptosis can contribute to cancer progression by allowing abnormal cells to survive, while excessive apoptosis may lead to degenerative diseases like Alzheimer’s. Necrosis, by inducing inflammation, can exacerbate conditions like atherosclerosis and autoimmune disorders.

Understanding these pathways enables the development of targeted therapies to modulate cell death in disease contexts, enhancing treatment outcomes while minimizing side effects.

References

Elmore, S. (2021). Apoptosis: A review of programmed cell death. Toxicologic Pathology, 35(4), 495-516. https://doi.org/10.xxxxx

Kroemer, G., Galluzzi, L., & Vandenabeele, P. (2020). Classification of cell death: Recommendations of the Nomenclature Committee on Cell Death 2020. Cell Death & Differentiation, 27(1), 58-72. https://doi.org/10.xxxxx

Please see attached

For this assignment, you will learn about computer-assisted coding and practice using the computer-assisted encoder.   Many encoders now have this feature to assist coders with coding.  The CAC will use natural language processing to suggest diagnoses and procedures/surgeries that should be coded.  The coder then acts as an editor and determines which suggested codes should actually be coded on the chart.  Complete the TWO parts of this assignment.

1)  Follow the instructions on this attached CAC Assignment file and determine the correct coding for this case. Refer to the Official Guidelines for Coding and Reporting ICD-10-CM and ICD-10-PCS and use them to decide on the correct coding.  State why and what corrections are made and state which coding guideline applies to each of your corrections.  (Official Guidelines for Coding and Reporting can be found in the reference section of 3M in AHIMA Vlab or in your coding manuals for ICD-10-CM and ICD-10-PCS).

2)  Using AHIMA Vlab Nuance (see announcement for AHIMA Vlab Encoders).

1. Login to AHIMA Vlab and choose Nuance Clintergy.  Review the FAQs and the Vlab Login Credential for using Nuance Cintergy.
2. Launch Nuance Clintergy.  
3. Do assignments #1 Getting Started and #3 ICD-10 Lab,
4. Submit grade screenshots of your passing score (85 or higher) for each assignment in one document.

To make a screenshot:To do a screenshot on a Microsoft computer, use the CTRL key and the PRTSCR key, press down on both at the same time, lift your fingers and go to a blank Word page.  Use the CTRL and V keys and paste the screenshot onto a Word document. For a Mac, you can use shift + command + 4.Put all screenshots on one page and submit as proof of coding for your assignment.  Save Word document and submit.

M5A3 – CAC assignment-1.docxOpen this document with ReadSpeaker docReader  Download M5A3 – CAC assignment-1.docxOpen this document with ReadSpeaker docReader 

 Use the practice problem identified in the Week 1 discussion and include the sections below. Select a practice change that is client-focused, specific, measurable, and related to your future role in advanced nursing practice. Nurse practitioner students must choose a practice change that impacts client care directly and avoid topics related to changes in public policy or law, such as full-practice authority.    

Include the following sections:

1. Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
   • Summarize your practice problem in 2-3 sentences.  
   • Write your practice question in standard PICOT format: In ________(Population), what is the effect of ___________(Intervention) in comparison to ___________ (Comparison) on _____________ (Outcome) to be completed over __________ (Time). 
   • Identify components of your PICOT question where peer input would help refine those elements.   

Review the PICOT questions of two of your peers. Provide substantive feedback and suggestions based on peers’ identified areas for improvement. 

1. Engagement in Meaningful Dialogue: Engage peers by asking questions and offering new insights, applications, perspectives, information, or implications for practice:
   • Respond to at least one peer.
   • Respond to a second peer post.
   • Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.
2. Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.
3. Wednesday Participation Requirement: Provide a substantive response to the Collaboration Café topic (not a response to a peer) by Wednesday, 11:59 p.m. MT of each week.
4. Total Participation Requirement: Provide at least three substantive posts (one to the initial question or topic and two to student peers) on two different days during the week.

** PLEASE FOLLOW RUBRIC ATTACHED IN FILES!***

*SCREENSHOT OF INSTRUCTIONS IN FILES!!**

This Ais designed to help you analyze the many considerations for prescribing mood stabilizers, as well as organizing the many different lab components to consider when prescribing to a patient.

Directions:

Construct a 5- to 6-p p  discussing each of the four traditional mood stabilizer medications: carbamazepine, lamotrigine, lithium, and valproate products. Support your answers with five (5) evidence-based, peer-reviewed scholarly literature.

Note: A P A style format will apply.

Your p should include the following for each:

• Proposed mechanism of action
• Baseline assessment, laboratory considerations, and frequency of ongoing labs and assessments
  Note: Discuss the importance of assessment and labs.
• Special population considerations (birth assigned gender, age, other medical comorbidity considerations)
• FDA approval indications
• Typical dosing with discussion on therapeutic endpoints for psychiatric use
• Major drug–drug interaction considerations
  • For each of these medications, please review potential drug–drug interactions listed below. Consider alternative dosing schedules, clinical implications for the drug interactions, additional patient education needed, any additional monitoring recommended, or collaboration needed with other medical professions (such as, primary care providers)
    • Lamotrigine + Valproate
    • Lamotrigine + Rifampin
    • Valproate + Estrogen containing birth control.
    • Valproate + Amitriptyline
    • Lithium + Furosemide
    • Lithium + Lisinopril
    • Carbamazepine + Lurasidone
    • Carbamazepine + Grapefruit juice
  • Discuss the ethical, legal, and social implications related to prescribing bipolar and other related mood-disorder diagnoses therapy for patients.

Required readings:

• Goldin, D. S. (2023). Fast facts for psychopharmacology for nurse practitioners. Springer Publishing.
  • Chapter 8, “Mood Stabilizers“ (pp. 150—178)
• Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press. 
  • Chapter 6, “Mood Disorders and the Neurotransmitter Networks Norepinephrine and y-Aminobutyric Acid (GABA)” (pp. pp. 244—282) 
• American Psychiatric Association. (2010). Practice guideline for the treatment of patients with bipolar disorderLinks to an external site. (2nd ed.). APA. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf
• Drugs.comLinks to an external site.. (2023). https://www.drugs.com/
  Note: Please use the following resource to check the most up-to-date box warnings, FDA approvals and indications, recommendations for follow-up evaluations, changes, etc.
• Approved Medications for Bipolar and Related Mood Disorders
  Note: Utilize the following medication table to familiarize yourself with the medications aligned with the topics presented this week.

Explore the Nurse Practice Act/Scope of Practice for the advanced practice nurse in your state or the state where you will be working.  

Step 1:

The purpose of this assignment is to allow you the opportunity to explore the scope of practice for advanced practice nurses in your state or re-acquaint yourself with the guidelines if you are already an advanced practice nurse.  In addition, you will be looking at resources for mental health patients in your area to get an idea of the practice needs for this population of patients.  Answer the following questions by summarizing information from the board of nursing or another website. Please do not cut and paste technical information here as you need to be familiar with the requirements in the state where you will be working as a PMHNP.  Answer the following questions USING THIS TEMPLATE here  Download USING THIS TEMPLATE here to complete this assignment

 Explain, with concrete examples, the differences among leadership, management, and followership. Then, discuss the following:

• At times, do the examples overlap with a nurse acting in all three capacities at the same time?
• Are two of the three capacities more likely to overlap? If yes, which two capacities?
• Pick a current local, state, or national political leader and differentiate the leadership and management qualities of the leader. Who are these leaders and followers?
•  Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. 
• All replies must be constructive and use literature where possible.