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The case study is about a 38-year-old Constantia and she is a marathon runner recently visited her general practitioner after the training session. She complains that she has experienced light-headedness, muscle pain after her training session and she also explained she also feel lethargic which feels like her heart is racing. She also explained she finds it difficult to climb stairs and she is unsteady on her feet that have increased her complications. The dietary intake of the patient reveals that her fluid and caloric intake is less than the daily routine but she is eating well. The physical examination result of the patient indicates her low blood pressure, underweight and 25 respiratory rates. Patient medical history reveals the presence of one caesarean delivery, a torn meniscus in right knee and amenorrhea for two years. The essay is going to analyse the patient condition and use literature to discuss patient’s case.
The uteri comprise glandular tissues in endometrium which plays an important role in the reproductive functioning of females (Spencer, 2015). There are both positive and negative aspects of the high trained exercise over the females and one of the issues arises is the irregular menstrual cycle. The increased exercise lead to increase secretion of ghrelin, orexin and NPY level that directly increase the chances for menstrual irregularly and ghrelin increased level is also directly associated with increased risk for amenorrhea that occurs due to the deficiency in the energy. The increase in exercise is also decreasing the chances to compensate for the energy cost with a diet that directly leads to a suppressive effect over the reproductive axis (Cho et al., 2017). This indicates that excessive exercise can directly affect her menstrual cycle and insufficient dietary intake and increased risk for amenorrhea that is evident from patient medical history.
Oestrogen is considered to be the main female hormone and they are secreted and synthesized from the ovary with some amount produced by other parts of the body like brain, bone tissue and adipose tissue. It is involved in many functions that are related to normal bodies functioning and one of the major functions is the regulation of the menstrual cycle. Some other function includes increase angiogenesis, vasodilatation, increased cell survival and anti-oxidant function (Iorga et al., 2016). The estrogen level may vary from the age that directly affects the normal body functioning of the individual. Oestrogen is considered to directly affect the normal brain functioning that leads to disturbance in normal functioning. The decreased oestrogen level leads to atrophy in the hippocampus and parietal lobe that is directly related to the memory (Khattar et al., 2015).
Kidney plays a major role in the osmoregulation that is involved in maintaining the reabsorption of the fluid by the glomerular filters. The fluid can be reabsorbed by the renal tubes that are directly modulated by the antidiuretic hormone (ADH). Three methods can be utilized by the kidney for osmoregulation which includes sympathetic, autoregulation and hormonal regulation (Chen & Khalili, 2020). ADH is considered to be the primary hormone in the regulation of tonicity homeostasis that is released by the hypothalamus. ADH is directly involved to secret during the increase osmoregulation that directly affects the kidney to improve the water reabsorption that helps to attain the setpoint (Cuzzo et al., 2020). Constantina is at risk for disturbance in the fluid homeostatic as she is having lower fluid intake that directly increase the need for the fluid homeostasis.
Urinalysis is the process that helps to provide general information about the individual health status. It is utilized to identify the general information about the hydration, renal and urinary tract. It helps to understand the presence of any disorder like liver, diabetes or urinary tract infection (Frazee et al., 2015). This test can help to understand the level of hydration and different body function to analyze Constantina condition. The specific gravity directly indicates the adequate intake of water which depict the accurate kidney functioning. The normal range for the specific gravity includes less than 1.010 but an increase in the specific gravity directly indicate decrease amount of the water and disturbance in the kidney functioning (Perrier et al., 2017). The increased specific gravity of the Constantina indicates that decreased fluid intake and kidney dysfunction. The increased specific gravity directly reveals a higher level of dehydration.
The gastrointestinal tract muscle performs a set motion for digestion that includes contraction and stretching of the muscles and this process is called peristalsis (Dimidi et al., 2017). The gut motility of the Constantina seems to be reduced that lead to pain. The segmentation is considered to be the contraction in the gastrointestinal muscle that is considered to be the slow progression of the gastrointestinal system (He et al., 2018). The segmentation of the gut movement is considered to be the disorder motility. The increased protein will help Constantina to improve the dietary intake that helps to support her health status and reduce complication that improves the quality of life. The improved dietary protein supports the deteriorated health status of the individual. The dietary protein helps to improve the growth of repair damaged cells and tissue. It is also involved to improve the synthesis of the hormone with increase metabolic activity that helps to improve the health status. The increased protein intake helps to increase the recovery rate of the individual by improving growth and maintaining body mass index. It also helps to improve the better immune system that can help to support health and increase power to fight with disorders (Lonnie et al., 2018).
To ease muscular pain, Constantina had used NSAID. There are many routes of administration for Voltaren Emugel (NSAID) that helps to reduce the pain of the individual. The first router of the administration includes oral that is most preferable following the patient. Other routes of administration include intramuscular, intravenous, transdermal and rectal and out of then intravenous is least preferred. The router of administration for medication should be following the patient preference (Altman et al., 2015). The pharmacokinetics of the Voltaren Emugel includes different aspect and it is considered to be well absorbed after administration and has bioavailability up to 60%. The drug leads to the first-pass metabolism when it attains about 50-60% of the circulation and peak plasma concentration is achieved after 1 hour. The relief associated with administration of the drug last about 8 hours that is directly affected by the dose. The distribution of the drug after the oral administration leads to synovial fluid and it is metabolized in the liver. The elimination route of the drug is urine faces up to 65% and 35% in biliary elimination as metabolites (De et al., 2019). The Voltaren Emugel is useful to reduce pain but one of the adverse effects of the drug includes liver injury that can increase the complication of the patient. The medicine considered to be as hepatic first-pass that can lead to serious complication and lead to the deteriorated health status of the patient (Schmidt et al., 2018).
Here, half of the medicine is directly related to its pharmacokinetics parameters that help to predict the time required by the medicine to reach plasma by reducing to half of its original value. It helps to maintain the dose time following the life of the drug to improve the health (Smith et al., 2017). Given that the half-life is 8 hours, the amount of the drug that will be present in her blood after 24 hours is 12.5%.
The mean arterial pressure of greater than 90 is required to maintain normal blood supply that helps to maintain the normal functioning. The mean arterial pressure greater than 105 can indicate hypertension that can increase the complication of the individual. The increased mean arterial pressure directly increases the risk for a blood clot, damage to heart or heart attack (Kundu et al., 2017). The mean arterial pressure is considered to have the regulation at the cellular level which is achieved by the interconnection between cardiovascular, renal and autonomic nervous system. The mean arterial pressure is directly involved to perfuse the blood to the body that helps to maintain the oxygen requirement of the different tissue. Increase in the mean arterial pressure can lead to serious complication which can increase the complication of the individual (DeMers & Wachs, 2020). The kidney is directly involved in the filtration process that is achieved through nephrons which are densely packed by the huge network of the blood vessel. The increase in blood pressure directly disturbed the kidney functioning as the artery in surrounding the kidney get stiff. The increase in blood pressure directly reduces the blood filtration capacity of the kidney and it also reduces aldosterone release that is considered to be one of the factors in regulating blood pressure. Eventually, persistent high blood pressure can lead to kidney failure (Ohno et al., 2016).
Therefore, the renin-angiotensin-aldosterone system plays an important role in regulation of blood pressure. One of the key features of the renin-angiotensin system is to maintain blood pressure homeostasis. It directly helps to maintain the normal blood pressure by activating at the time of deviation. The decreased blood pressure is sensed by the system that directly leads to the secretion of the angiotensin II that is involved to constriction of the blood vessel which increases the blood pressure to attain set value (de Souza et al., 2018).
Different aspect considered in the essay directly indicates that Constantina require urgent attention to her deteriorated health and she requires increasing her fluid intake to reduce chances of dehydration. The study discussed different aspect that can lead to the deteriorated health status of the patient.
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