Week 1 second part of case study 2

racey Allen posted Oct 30, 2020 6:21 PM
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Morphology

Cells are the basic structure of all living things. Cells can operate on their own as observed in some bacteria or they cooperate with other cells to become an organism such as humans. Multiple cells come together to form tissues. These group of tissues forms organs and the group organs form systems in living things which collectively make up an organism (Dlugasch & Story, 2021). Cells depend on each other to function and it is important for them to communicate and work with each other. When they fail to do so, it may result in diseases and other complications. Multicellular organisms however are cells with different structure and functions that have come together and work collectively and most cells can produce energy and reproduce on their own using structures such as mitochondria and nucleus respectively (Dlugasch &Story, 2021).

Cells are enclosed by a plasma membrane which allows nutrients to enter and waste products to leave the cells. The cell membrane is also very critical in creating and maintaining cell structure. Cells may assume different shapes to fit the specific function they perform within an organism. Some cells have membranes have very fluid membranes especially when they help in locomotion. For example, Pseudomonas aeruginosa. Most plant cells outside their cell membranes also possess cell walls which are rigid, adapted for protection. Some bacteria may take up different forms including cocci, spiral, and bacilli and these shapes are usually indicative of the type of effect they may have on a host cell and also in determining its taxonomy.

Case Study

Windshield washer fluid is a brightly colored liquid composed of methanol and often with addition of ethylene glycol. Many brands of windshield washer fluids are a diluted version of methanol; however, they still can cause permanent multiple organ damage if swallowed. Methanol (methyl alcohol) is poisonous alcohol (Ashurst & Nappe, 2020). Just one ounce of methanol proved to be deadly to a child and amount more than two ounces – for an adult (National Institute of Health, 2019). The result of methanol poisoning can be the serious effect on to the body and its functioning as difficulty breathing, blindness, headache, dizziness, confusion, seizures, coma, nausea, vomiting, diarrhea, hematemesis, melena, jaundice, cardiopulmonary arrest, and severe metabolic acidosis.

Methanol poisoning is an emergency and requires immediate attention. The local medical emergency service has to be contacted along with Poison Help hotline that is available 24 hours a day 7 days a week (National Institute of Health, 2019). The consequence of poisoning is related to amount of ingested methanol and time before treatment was initiated. In the hospital, after detailed physical assessment, diagnostics will be implemented that can involve blood and urine tests, chest x-ray, computerized tomography scan, electrocardiogram (Ashurst & Nappe, 2020). The prompt treatment is advised and may include the antidotes (fomepizole or ethanol) to reverse the effect of methanol, intravenous fluids, nasopharyngeal tube for decompression, dialysis, and intubation to manage respiratory failure and metabolic acidosis (Ashurst & Nappe, 2020). The outcome of the windshield washing fluid poisoning depends not only on how much and how long-ago fluid was ingested but on professionalism of providers and swift treatments implemented.

A 15-year-old male presents after ingesting windshield wiper fluid to get high. Explain what will happen to the following:

Osmolarity

Sodium levels

Oncotic pressure

Windshield wiper fluid consists of methanol or ethylene glycol, both of which are toxic alcohols that cause blurry vision and can progress to metabolic acidosis, acute kidney failure, and respiratory failure without treatment (Ashurst & Nappe, 2020). Specifically, resulting in both optic nerve and CNS damage that will cause organ damage. Within 24 hours, the methanol turns to formaldehyde and then to formic acid, which can be absorbed through the skin, ingested, or inhaled (Ashurst & Nappe, 2020). The ethylene glycol causes metabolic acidosis as it turns to lactic acid and oxalic, causing an osmolar gap (Norris, 2019). Osmolarity is the concentration of solvents (sodium) in a solution, and fluid will shift to a higher concentration of solvents, increasing the oncotic pressure (Norris, 2019). The poisons in the plasma increase the osmolarity and create a shift of “solvents” from the bloodstream to the cells, becoming life-threatening (Singh et al., 2016). Early medical intervention is the key to saving patients’ life.

References

Ashurst, J. V., & Nappe, T. M. (2020, June 26). Methanol toxicity. NCBI https://www.ncbi.nlm.nih.gov/books/NBK482121/

Dlugasch, L. Story, L. (2021). Applied pathophysiology for the advanced practice nurse. Jones & Bartlett, MA.

National Institute of Health. (2019, January 12). Windshield washer fluid. MedlinePlus. https://medlineplus.gov/ency/article/002803.htm

Norris, T. L. (2019). In Porth’s essentials of pathophysiology (5th ed.). Wolters kluwer.

Singh, R., Arain, E., Buth, A., Kado, J., Soubani, A., & Imran, N. (2016). Ethylene glycol poisoning: An unusual cause of altered mental status and the lessons learned from management of the disease in the acute setting. Hindawi. Retrieved October 29, 2020, from https://www.hindawi.com/journals/cricc/2016/9157393/