Case Study One – Bad Fish: A Case on Nervous Tissue

One evening during a recent trip to Indonesia, Dr. Marshall Westwood sat down to a meal of puffer fish and rice. Within an hour of returning to his hotel room, Dr. Westwood felt numbness in his lips and tongue, which quickly spread to his face and neck. Before he could call the front desk, he began to feel pains in his stomach and throat, which produced feelings of nausea and eventually severe vomiting.

Fearing that he had eaten some “bad fish” for dinner, Dr. Westwood called a local hospital to describe his condition.  The numbness in his lips and face made it almost impossible for him to communicate, but the hospital staff managed to at least understand the address he gave them and they sent an ambulance. As Dr. Westwood was rushed to the hospital, his breathing became increasingly labored.

The patient presented in the ED with diaphoresis, motor dysfunction, paresthesias, nausea, and an ascending paralysis that started in his legs and spread to the upper body, arms, face, and head. The patient was cyanotic and hypoventilating. Within 30 minutes of presenting in the ED, Dr. Westwood developed bradycardia with a BP of 90/50 mmHg. Atropine was administered in response to the bradycardia. Intravenous hydration, gastric lavage, and activated charcoal followed a presumptive diagnosis of tetrodotoxin poisoning that was based on the clinical presentation in the ED. Five hours after treatment, the following vital signs were noted:

•        BP 125/79 mmHg

•        HR 78 bpm

•        Oxygen saturation: 97% on room air

After discussing his case with his physician, he learned that he had probably been the victim of puffer fish poisoning. The active toxin in the tissues of this fish is a chemical called tetrodotoxin (TTX). Tetrodotoxin is in a class of chemicals known as neurotoxins because it exerts its effects on neurons. The specific action of tetrodotoxin is that it blocks voltage-gated sodium ion channels.

1. Define the following phrases and terms associated with the signs and symptoms of Dr. Westwood’s TTX poisoning:
   1. diaphoresis
   2. motor dysfunction
   3. paresthesias
   4. cyanotic
   5. hypoventilating
   6. bradycardia
   7. gastric lavage
   8. oxygen saturation
2. As mentioned in the case description, tetrodotoxin is a molecule that blocks voltage-gated sodium ion channels. What is a voltage-gated sodium ion channel and what is its function?
3. When nerve cells are at rest, there is an unequal amount of positive and negative charges on either side of a nerve cell membrane. This charge difference creates an electrical potential. Describe how the resting membrane potential (resting potential) is generated.
4. What is happening to the electrical potential of a neuron when it generates an action potential? What is the function of the action potential in neurons?
5. Describe the role of sodium ions and sodium channels in generating an action potential.
6. What would happen to a neuron if it was exposed to tetrodotoxin? Be specific regarding its effect on the ability of a neuron to communicate.
7. Now that you have addressed some of the basic biology of this case, explain why Dr. Westwood experienced numbness after eating the puffer fish meal.
8. Paralysis is a term used to describe the loss of muscle function. If tetrodotoxin’s effect is on neurons, why did Dr. Westwood experience paralysis?

 

Length: 1500-2000 words

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

Format: Save your assignment as a Microsoft Word document (.doc or .docx).

Complete case study 14-8, “Conflict Handling Styles,” located on page 323 of Organizational Behavior in Health Care.

Prepare this assignment according to the guidelines found in the 7TH EDITION APA Style Guide

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MS Health Care Admin

Implement effective conflict management strategies based on situational analysis

1. Set the Margins to One Inch

Basics

The margins of the paper should be set to 1″ (one inch) all around.

Step-by-Step Directions

1. Go to the Page Layout or Layout tab

2. Click Margins

3. Select the Normal option

 

2. Set the Spacing to Double

Basics

The line spacing for the paper should be set to double (2.0).

Step-by-Step Directions

1. Go to the Home tab

2. In the Paragraph box, click the icon that looks like two up/down arrows with text to the right

3. Pick 2.0

4. Alternate Method: You can also press the Control Key along with the number 2 to quickly double space.

 

 

3. Create a Title for Your Paper

Basics

Your title should summarize the main topic of your paper. Try not to be too wordy or off-topic. While there is no word limit for titles, “short but sweet” is the goal. The APA Style Blog has further information on titles: Five Steps to a Great Title. Use title case for paper titles.

Example Titles

· Attitudes of College Students Towards Transportation Fees

· Effect of Red Light Cameras on Traffic Fatalities

· Juror Bias in Capital Punishment Cases

4. Add Page Numbers to the Header

Basics

Insert the page number in the right area of the header. Use the built-in page numbering system; do not attempt to type each page number manually.

Step-by-Step Directions

1. Go to the Insert tab

2. Under Header, select Edit Header (at the bottom)  

 

3. Press Tab once or twice to go to the far right

4. Click Page Number

5. Click Current Position

6. Click Simple / Plain Number 

5. Create the Title Page

Basics

On the first page you will include the following information:

· Title of Your Paper

· Your Name

· Santa Fe College

· Course Number: Course Name

· Instructor

· Due Date

This information will be centered, and will be a few lines down from the top.

Step-by-Step Directions

1. Go to the top of the first page

2. Press Enter 3-4 times times

3. Center your text

4. Type in the title of your paper, in bold.

5. Press Enter twice, in order to have one blank line between the title and the next element.

6. On the next line, type your full name

7. On the next line, type Santa Fe College

8. On the next line, type your course number, a colon, and your course name

9. On the next line, type your instructor’s name.

10. On the next line, type the due date of the paper.

Example

 

 

6. Set Up the References List

The references list should be on a new page and should be the last section of your paper.

Heading of Reference List

The heading at the top of the reference list should say References at the top (not Bibliography or Works Cited, unless your instructor tells you otherwise) and bolded.

Hanging Indent

All reference lists should have a hanging indent. An example of a hanging indent is shown below:

George, M. W. (2008). The elements of library research: What every student needs to know. Princeton University Press.

To create a hanging indent in Word, you can press the Control key along with the letter T.

 + 

Spacing

Line spacing in the reference list should be set to double (2.0).

Alphabetizing

When organizing your references list, you must alphabetize your references. Generally, you will organize by the author’s last name. Go letter by letter and ignore spaces, hyphens, punctuation etc.

If a work has no author, use the title to alphabetize. You will use the first significant word to alphabetize; this means you skip words like the, a, and an.

Example of Proper Order:

1. Alcott, L. M. (1868)…

2. Alcott, L. M. (1893)…

3. Anonymous. (1998). Beowulf…

4. Centers for Disease Control and Prevention. (n.d.).

5. Centers for Disease Control and Prevention. (2017).

6. Etiquette in Florida. (n.d.).

7. Grammar Girl. (2009, May 21)…

8. Johnson, C. L., & Tuite, C. (Eds.). (2009)…

9. Johnson, S. K. (2003)…

10. Oxford English dictionary (2nd ed.). (1989)…

11. A prescription for health care. (2009). Consumer Reports…

12. Southeast Asia. (2003). In The new encyclopaedia Britannica…

For more information on creating and formatting references, go to the Reference Components page.

Source: Publication Manual, 2.12; 9.44-9.49

But What About…?

The Font?

APA does not specify a specific font or size, just that it must be legible. Their only guidelines is that the same font should be used throughout the paper. Some suggestions are 11-point Calibri, 11-point Arial, 10-point Lucida Sans Unicode, 12-point Times New Roman, and 11-point Georgia.

If your instructor has specified a font or font size, follow those guidelines.

Source: Publication Manual, 2.19

The Running Head?

Student papers do not need a running head.