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Analysis of a Case with Protein Malnutrition – Nursing 6501, Week 2 Assignment
The Task (1- to 2-page analysis of a case study)
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Compose a case study analysis that’s 1 to 2 pages long. In this analysis:
1. Clarify why you believe the patient is showing the described symptoms.
2. Point out the genes that might be linked to the disease’s development.
3. Describe the process of immunosuppression and its impact on the body’s systems.
In this case, we’re looking at how older adults, especially those over 65, often suffer from poor nutrition and malnutrition. This is a big problem worldwide. When older people don’t get the right nutrition, it can lead to health problems, and they may even die sooner. They might need to go to a nursing home early or not be able to think clearly or move well. They may also end up in the emergency room a lot (Evans, 2018). So, it’s important to regularly check the nutrition of older people, especially those living in nursing homes (Mathewson et al., 2021).
For this assignment, we’re going to study a case where an older person goes to the emergency room with swollen belly and limbs. After checking the person’s history, we find out that this 83-year-old has protein malnutrition. This patient also has no dentures, which makes it hard to eat, and has a history of malabsorption syndrome.
Normally, when we eat food, our bodies break it down in the stomach and intestines, and the nutrients go into our blood. But sometimes, things can go wrong. In this case, the person’s body is not absorbing enough nutrients, especially proteins. This is because of a problem called malabsorption. When we eat food, it gets broken down into smaller pieces in the stomach and intestines. Then, these pieces go into the blood. But for some people, like this 83-year-old, the body can’t do this properly (Coulthard, 2015).
One important protein in the blood is called albumin. It helps keep the right amount of fluid in our blood vessels. But when albumin is too low, like in this patient, the body starts to keep too much fluid in the body. This can lead to swelling in the belly and limbs. It’s like when you blow up a balloon with too much air, it gets big and round. In this case, the belly and limbs are getting bigger because of all the extra fluid (Avelino-Silva & Jaluul, 2017). Also, not having dentures makes it even harder for this person to eat and get enough protein.
Sometimes, genes can play a role in why someone has trouble absorbing proteins. In this case, the 83-year-old might have celiac disease, which is a problem with eating foods that have gluten. Gluten is found in things like rye, barley, and wheat. When someone with celiac disease eats gluten, it causes inflammation in their intestines. This inflammation makes it hard for the body to absorb nutrients, including proteins (Cecilio & Bonatto, 2017).
Celiac disease is linked to certain genes, like HLA DQ2 and HLA DQ8. These genes make the body react to gluten in a bad way. When someone with these genes eats gluten, it causes their immune system to attack their intestines. This attack makes the intestines swell up and not work well. As a result, the body can’t absorb proteins and other nutrients like it should (Sallese et al., 2020). So, genes can be a reason why this 83-year-old has trouble with protein absorption.
Sometimes, doctors use a treatment called immunosuppression. This means they use medicines to lower the body’s immune system. They do this on purpose to help people with certain diseases. For example, if someone has celiac disease, like our 83-year-old patient, doctors might give them immunosuppressant medicine. This medicine helps calm down the body’s immune system so it doesn’t attack the intestines when the person eats gluten (Iqbal et al., 2017). This way, the body can absorb nutrients better.
Immunosuppression can help in other situations too. Sometimes, people get immunosuppressant medicine when they have an organ transplant. This helps their body accept the new organ and not attack it. So, immunosuppression can be a useful treatment in certain cases (McSorley et al., 2017).
Avelino-Silva, T. J., & Jaluul, O. (2017). Malnutrition in hospitalized older patients: Management strategies to improve patient care and clinical outcomes. International Journal of Gerontology, 11(2), 56–61.
Cecilio, L. A., & Bonatto, M. W. (2017). The prevalence of HLA DQ2 and DQ8 in patients with celiac disease, in families, and the general population. Arquivos Brasileiros de Cirurgia Digestiva, 28(3), 183–185.
Coulthard, M. G. (2015). Edema in kwashiorkor is caused by hypoalbuminemia. Pediatrics and International Child Health, 35(2), 83–89.
Dunne, M. R., Byrne, G., Chirdo, F. G., & Feighery, C. (2020). Coeliac disease pathogenesis: The uncertainties of a well-known immune-mediated disorder. Frontiers in Immunology, 11(July), 1–14.
Evans, C. (2018). Malnutrition in the elderly: a multifactorial failure to thrive. The Permanente Journal, 9(3), 38–41.
Iqbal, U., Chaudhary, A., Karim, M. A., Anwar, H., & Merrell, N. (2017). Refractory celiac disease was successfully treated with Azathioprine. Gastroenterology Research, 10(3), 199–201.
Mathewson, S. L., Azevedo, P. S., Gordon, A. L., Phillips, B. E., & Greig, C. A. (2021). Overcoming protein-energy malnutrition in older adults in the residential care setting: A narrative review of causes and interventions. Ageing Research Reviews, 70(January), 101401.
McSorley, H. J., Gaze, S., Daveson, J., Jones, D., Anderson, R. P., Clouston, A., Ruyssers, N. E., Speare, R., McCarthy, J. S., Engwerda, C. R., Croese, J., & Loukas, A. (2017). Suppression of inflammatory immune responses in celiac disease by experimental hookworm infection. PLoS ONE, 6(9), 3–9.
Sallese, M., Lopetuso, L. R., Efthymakis, K., & Neri, M. (2020). Beyond the HLA genes in gluten-related disorders. Frontiers in Nutrition, 7(November), 1–7.
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