Example Of Case Study On Clinical Assessment

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According to Kumar, Abbas and Aster (2015), when there is deprivation of protein and calorie in the body, muscular proteins are utilized to yield energy to keep functioning the cellular machinery. This leads to marked muscle wasting and give rise to the condition called as cachexia. It is more commonly seen in patients with long-standing debilitating inflammatory disease or with a neoplastic lesion nurturing inside the body.
According to Mohan (2010), cachexia manifests in individuals with advanced disseminated neoplastic lesion or chronic illness and it is brought about by certain cellular alterations. Cachectic patients are asthenic, emaciated, anorexic, anemic and have generalzed muscle wasting with increased skin laxity and dried skin. The author stated that exact mechanism of cachexia is yet to be discovered but it has been postulated that certain factors are involved. Cachectin, tumor necrosis factor-α (TNF- α), interleukin-1, proteases and elastases are thought to have central role in development of cachexia. It is therefore seen in cancer, chronic inflammatory disorders like tuberculosis and leprosy, certain autoimmune disorders like SLE, congestive cardiac failure (CCF), chronic obstructive pulmonary disease (COPD), full blown chronic kidney disease (CKD), cystic fibrosis, multiple sclerosis, Parkinson’s disease, dementia and HIV/AIDS.
Arensmeyer (2012) writes that patients with cachexia associated with significant weight loss and signs of malnourishment are associated with bad prognosis and adverse outcomes. Due to increased protein catabolism, muscular proteins are utilized unlike in normally starved individual. It may bring anxiety and distress to the patients and their families, both because it is perceived as a sign of rapid progression of the disease. Paramedics are therefore required to understand the gravity of the impact of this symptom because it is pivotal in the disease management which may alter the outcome advantageously. They should be able to counsel the patient regarding their illness and cachexia in particular to ease them. Regardless of the etiology of cachexia, it should be addressed seriously psychologically as well as physically. Paramedics should make record of patient’s weight, nutritional intake and assessment of physical appearance. Family should also be allowed to report any alteration they may have noticed.

References

Arensmeyer, K. (2012, January 17). Nursing Management of Patients with Cancer-Related Anorexia. Retrieved April 7, 2015, from http://www.oncolink.org/resources/article.cfm?id=1006
Kumar, V., Abbas, A., & Aster, J. (2015). CHAPTER 2; Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death. In Robbins and Cotran Pathologic Basis of Disease(Ninth ed., p. 36). Elsevier Saunders.
Mohan, H. (2010). Neoplasia. In Textbook of Pathology (6th ed., p. 230,245). New Delhi: Jaypee Brothers Medical (PVT) Ltd.