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Good Afternoon Dr. Giner and Classmates my designated system for this discussion is the cardiovascular system, one of my favorites.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. In the cardiovascular system, this autoimmune response can result in several pathophysiological processes:

• Pericarditis: Inflammation of the pericardium, the membrane surrounding the heart, is the most common cardiac manifestation in SLE patients. This condition can cause chest pain and may lead to pericardial effusion. 
• Accelerated Atherosclerosis: SLE is associated with an increased risk of premature atherosclerosis, leading to coronary artery disease. Chronic inflammation and immune complex deposition contribute to endothelial damage, promoting plaque formation. 
• Libman-Sacks Endocarditis: This nonbacterial form of endocarditis involves the formation of sterile vegetations on heart valves, particularly the mitral and aortic valves. These vegetations can lead to valvular dysfunction and increase the risk of thromboembolic events. 

Cardiovascular involvement in SLE can present with different symptoms like Chest Pain Often resulting from pericarditis, patients may experience sharp, pleuritic chest pain that worsens with deep breaths or lying down. Dyspnea can occur due to pericardial effusion or heart failure secondary to myocarditis or coronary artery disease and  Palpitations with Arrhythmias may arise from myocardial involvement or valvular disease.

These cardiovascular manifestations can significantly impact a patient’s daily functioning and quality of life, leading to reduced exercise tolerance, have chronic pain, and anxiety. In addition, cardiovascular complications can affect renal function by altering hemodynamics or contributing to cerebrovascular events by causing embolisms.

Diagnosing cardiovascular involvement in SLE involves a combination of clinical evaluation and diagnostic testing:

• Echocardiography is  important and essential for pericardial effusion, valvular vegetations indicative of Libman-Sacks endocarditis, and assessing myocardial function.
• Electrocardiogram (ECG) is  useful for identifying arrhythmias, conduction Issues, and abnormalities, or signs of myocardial ischemia.
• Cardiac MRI can provide detailed imaging to assess myocardial inflammation, fibrosis, and pericardial involvement.
• Coronary Angiography is sometimes indicated when there is suspicion of coronary artery disease to evaluate the extent of atherosclerosis.

Challenges in diagnosing SLE-related cardiovascular complications include the overlap of symptoms with other conditions, such as infections or primary cardiac diseases.

Current Treatments and Management of cardiovascular manifestations in SLE focuses on controlling inflammation, preventing disease progression, and addressing specific cardiac issues:

• Anti-inflammatory and Immunosuppressive Therapies: Medications such as corticosteroids and immunosuppressants are used to reduce systemic inflammation and autoantibody production,  mitigating cardiovascular involvement. 
• Hydroxychloroquine: Has been shown to have cardioprotective effects in SLE patients, reducing disease flares and potentially decreasing the risk of thrombosis.
• Cardiovascular Risk Management: Addressing traditional risk factors through lifestyle modifications, statin therapy for dyslipidemia, antihypertensive treatment, and antiplatelet agents can help prevent atherosclerosis progression.
• Surgical Interventions: In cases of severe valvular disease due to Libman-Sacks endocarditis, surgical repair or replacement may be necessary.

The goal of these treatments is to control disease activity, prevent organ damage, and improve overall survival. While advancements in therapy have improved outcomes, cardiovascular disease remains a leading cause of morbidity and mortality in SLE patients, highlighting the need for ongoing monitoring and comprehensive care.

References:

 Hopkins Lupus. (n.d.). How lupus affects the cardiovascular system. Johns Hopkins Lupus Center. Retrieved from https://www.hopkinslupus.org/lupus-info/lupus-affects-body/lupus-cardiovascular-system/

Ibrahim, A. M., & Siddique, M. S. (2023). Libman-Sacks Endocarditis. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532864/Links to an external site.

Johansson, A., & Gustafsson, J. T. (2022). Systemic lupus erythematosus and cardiovascular disease: Mechanisms and clinical implications. Journal of Internal Medicine, 291(2), 189-208. https://doi.org/10.1111/joim.13557

MedlinePlus. (n.d.). Systemic lupus erythematosus (SLE). U.S. National Library of Medicine. Retrieved from https://medlineplus.gov/ency/article/000435.htm

• Reply to post from Katia Pena Morales
   

Attached 

This is the discussion post:

The St. Fleur family is well respected in the Haitian community because they are religious with great moral values. They moved to the United States because of political issues in Haiti. Ronald, the youngest son of this family, is 27 years old and lives at home with his mother and father. Recently, he began having fevers and subsequently developed pneumonia. He was admitted to the hospital, where laboratory tests were HIV positive. Ronald was in shock when the doctor informed him that he was HIV positive. He confessed to the doctor that he was gay but he could not tell his family. He said that he did not want to bring shame to the family. Because he couldn’t be in a formal relationship owing to his family and the Haitian community’s view of homosexuality, he has been very promiscuous over the years.

1. What are Haitians’ dominant cultural views of homosexuality?
2. If Ronald’s parents were to learn of his positive HIV status, how might they react if they are religious and traditional?
3. Identify three specific culturally congruent strategies to address in designing HIV-prevention practices in the Haitian community.

– I have to respond to two lead postings. Each response must have a reference that does not come from the textbook. 

-Below I will attach the 2 posts I will reply to. 

What is the most likely diagnosis for a patient with the following CBC findings? WBC: 8.8 × 103/µl; RBC: 3.01 × 103/µl; Hgb: 10.3 g/dL; Hct: 32.2%; MCV: 74 fL; MCHC: 28.3 g/dL; Plt: 400 × 103/µl; RDW: 18.4%; Reticulocytes: 2.1%.

Identify which anemia is the patient experiencing, which tests should be ordered and what type of treatment should be followed.

Include References, APA style and 250 words or more.

1. Describe causes of Upper respiratory infections and drug therapy 
2. Discuss triggers of asthma and treatment options
3. Discuss corticosteroids 
4. Describe chronic bronchitis and treatment options

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources.

1. Describe health and illness practices that may augment problems associated with the treatment of hypertension for Chinese-American clients. 
2. Describe the locus-of-control variable that some Filipino Americans have that may influence health-seeking behavior.
3. Describe the importance of folk medicine and folk healers to Vietnamese Americans. 

Submission Instructions:

• Your initial post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources.  

 a critical appraisal of the literature that demonstrates an understanding of qualitative research.

Chapter 7 Critiquing Criteria for Qualitative Research, write a critique of a qualitative research article that you have read related to your clinical practice

*** is to be clear and concise, and students will lose points for improper grammar, punctuation, and misspellings.

• per the current APA and 2-3 pages in length, excluding the title page, abstract, and references page.

**plagiarism through Turnitin report, NO AI  Book attached **

Vitamins are energy-building nutrients that contribute to sound nutritional health. Water, on the other hand, is responsible for carrying necessary nutrients and removing waste products throughout our body. A human body is made out of mostly water and is critical to our health. Similarly, minerals and electrolytes are essential to human health and can be obtained in our diet from different foods. When humans are too sick to consume a regular diet, digestion and absorption may impact the supply of necessary nutrients, requiring specialized nutritional support to meet their nutritional needs.

After studying Module 4: Lecture Materials & Resources, read the case study and answer the prompts:

Sharyn Bartell is a 24-year-old student who suffered multiple fractures when she fell from a cliff when hiking. As a result of the accident, she is immobile, in traction, and had a small bowel resection. She is able to keep her head up to 45 degrees. Sharyn used to weigh 140 pounds but has lost 8 pounds since the accident. The healthcare team agrees that Sharyn will need a feeding tube before her nutritional status deteriorates any further.

1. Navigate the web, research a high protein formula that can be administered via feeding tube and share 1) name of formula, 2) nutrient composition, and 3) indications for use.
2. Navigate to the Oley Foundation: Dietary Recommendations for Patients with Intestinal Failure – Oley FoundationLinks to an external site., read “Physiological Considerations” and discuss in at least one paragraph with two (2) effects of the small bowel resection on Sharyn’s fluid and electrolyte balance.
3. Navigate to the Oley Foundation: Living with Enteral Feeds – Oley FoundationLinks to an external site. and provide two (2) physical or psychosocial adjustments Sharyn will have to make when living with a feeding tube.

Submission Instructions:

• Your initial post should be at least 400 words, formatted, and cited in the current APA style with support from the textbook and sources provide

** need turnitin report , NO AI***