Regulation of Blood Glucose Levels by Pancreatic Hormones

Description of the way blood glucose levels are managed in normal condition

In normal health condition, the blood glucose level is maintained by the release and stimulation of endocrine hormones from the pancreas. The key hormones responsible for controlling the blood sugar level are insulin, glucagon and somatostatin (Russell et al. 2016). The individuals after intake of carbohydrate containing food lead the digestive system to break it down into smaller units of glucose which then enters the blood lead the pancreas to increase production of insulin from the beta-cells and lower glucagon production. This is because insulin acts to prompt the body cells to absorb glucose from the blood and use it as energy to avoid increased blood sugar levels (Russell et al. 2016). The extra glucose on absorption from the bloodstream into the liver is converted into glycogen for future use. As the entire meal is digested, the blood glucose level initiates to fall which triggers the release of glucagon from the alpha-pancreatic cells. The increased level of glucagon stimulates the liver to convert stored glycogen into glucose to be released in the bloodstream to raising the falling blood sugar level and the process is known as glycogenesis (Russell et al. 2016). The somatostatin is released from the pancreatic delta cells and they are responsible in balancing glucagon and insulin level in the blood by assisting to turn off each of the opposing hormone based on the level of glucose in the blood to maintain normal blood sugar level (Russell et al. 2016).

Identifying the main features of inflammatory response in immunity

The inflammatory response by the immune system occurs as a result of injury to the tissue caused by any toxin, bacteria, toxin, heat or any others. The four typical signs of inflammatory response include heating, erythema, pain and swelling which result due to increased flow of blood and capillary permeability, tissues damage and influx of phagocytic cells. The increased blood flow occurs as a result of constricted blood capillaries which are responsible to carry blood away from the infected area and this condition leads to engorgement in the capillary constriction. It results in development of erythema along with increased temperature in the damaged tissue area (Nakayama, 2016). During this tissue injury, the chemicals such as histamine, bradykinin and others are released contributing to the leakage of fluid from the blood vessels near the surrounding tissue. The fluid leaked into the area has higher protein content compared to the fluid found in the tissue that leads to swelling (He et al. 2019). The other feature related inflammation is presence of large phagocytes in the form of immune cells that are attracted by cytokinesis present in the infected area. The neurophils are the earliest nature of phagocytic cell that enters the infected site which are classical markers of inflammation (He et al. 2019).

Description of process of gaseous exchange in lungs

The gaseous exchange in the lungs occurs as a result of expiration and inspiration in which the oxygen is picked from the lungs and carbon dioxide is released outside from the respiratory membrane. During inspiration, the oxygen enters the lungs and reaches the alveoli which are surrounded by network of capillaries. The deoxygenated blood is branched into the capillary network creating an environment for gaseous exchange (Vadász and Sznajder, 2017). The oxygen from the alveoli is picked up by the deoxygenated blood in the capillaries as a result of transfer of oxygen atoms. This transfer mainly occurs due to variation in partial pressure of oxygen in the alveoli versus the pulmonary capillaries. This is evident as the partial pressure of oxygen is 104 mm HG in the alveoli whereas it is 40 mm Hg in the capillaries. The increased difference in the partial pressure develops a strong pressure gradient which leads the oxygen to transfer from alveoli to the pulmonary capillaries. At the same time, the carbon dioxide from the blood is transferred to the alveoli from the capillaries through the fused basement membrane. This is also due to difference in partial pressure as the partial pressure of carbon dioxide in the alveoli is 40mm Hg whereas it is 45mm Hg in the capillaries. This relative difference in the concentration leads the carbon dioxide and oxygen to diffuse through the respiratory membrane in either way (Schittny, 2017).

Description of process of urine formation

There are three key steps of urine formation which are formation of glomerulus filtrate, reabsorption which is followed by secretion. In the kidney, various tiny structure known as nephron is present inside which the glomerulus is present that is the site for filtration of blood. As blood flows through the glomerulus, the pressure in the blood vessels of the capillaries leads the solutes and water from blood to be released inside the glomerulus through the filtration membrane initiating the formation of urine. The resulting filtrate apart from containing water and solutes also has presence of various other substances such as glucose, essential ions, smaller protein and amino acids. This filtrate then moves from the glomerulus capsule into the renal tubule which is duct present in the nephron (Lawrence et al. 2018). During movement of the filtrate, the other substances essential for the body is reabsorbed through the capillary walls surrounding the nephron tubules. At the same time, the hydrogen ions and other waste ions pass from the capillaries into the filtrate to be supported in formation of urine and this is known as secretion. The secreted ions on combination with the remaining filtrate form the urine and it flows into the collecting duct present outside the nephron to be released down the urinary bladder (Breshears and Confer, 2017).

Identifying features of synovial joint and the articulation in the joints

The synovial joint is referred to the nature of joint that is present between the bones which move against one another such as those in the hip, elbow, shoulder and others (Kubiak and Ditzel, 2016). The synovial joint consist cartilage which is smooth gristly material that is found to cover the surface area of the bones. The cartilage acts in the form of bone absorber and lowers friction between the bones when they move against one another. The joint capsule acts as the fibrous material which encloses the area in the joint and together with tendons, muscles and ligaments the capsule helps to keep the bones in the right place within the joints. The synovial fluid is present in the areas between the bones in the joint. This is a sticky substance which fills the cavity between the bones and provides nourishment along with lubricates the surface of the cartilage which moves against one another during movement. The synovial membrane is the specialised layer of cell which lines the capsule of the joint and creates production of synovial fluid in the synovial cavity (Kubiak and Ditzel, 2016). The moving parts in the synovial joints make them prone to experience injury out of which most common are bone dislocation, stretched or torn ligaments and others (de Boer et al. 2020).

Identifying inequality in health on the basis of bio-psychosocial model of health

In health and social care, the bio-psychosocial model of health is referred to the framework which mentions the way interactions between biological, psychological and social components are responsible to cause disease manifestation along with outcomes of wellness (Lowry et al. 2019). The model is used by the health professionals in managing people with physical, emotional and psychological health issues (Lowry et al. 2019). The effective healthcare management by following healthcare framework is important for well-being of patients but various inequalities are faced by individuals that hinder effective health outcome. In this essay, based on the bio-psychosocial model of health, the health inequalities which impact well-being children in child nursing field is to be discussed.

The biological characteristics like genes are responsible for presence of different healthcare issues among the individual. This is because genetic differences among people create varied outcomes for individuals in different environmental condition (Selita and Kovas, 2019). For instance, Down syndrome occurs among children as a result of presence of extra-pair or single copy of 21st chromosome. This chromosome is mainly responsible for producing proteins that support development but the presence of extra-pair creates changes in development and physical features of individuals (Thomas et al. 2020). The mutated genes for Down syndrome are mainly passed from the parents to the children through heredity (Thomas et al. 2020). Thus, this creates genetic inequality where children with parents having Down syndrome are ensured to suffer from the disease whereas those children with normal parents are not prone to face the health issue. The other genetic disorder suffered among children such as Thalassemia, Sickle Cell Anaemia and others are also due to genetic inequality where the children due to presence defective genes in their parents suffer from the disorder whereas those with normal parents do not suffer from the hindered health consequences (Emechebe et al. 2017).

The social factors indicated in the biopsychosocial model of health include family relationship, social support, education, socioeconomic status, employment and others which are responsible in ensuring access to healthcare (Ursache et al. (2016). As asserted by Lawson et al. (2018), presence of timely care and safe support environment for children is required to ensure them effective health condition. This is because it allows the children avail the delicate support required by them to overcome the complex health issues. In availing effective healthcare by the children in child nursing, the parents require to invest increased amount of finances to avail intervention for the children to ensure them good health. However, children from poor socio-economic background do not have adequate financial support from their family members and parents to help them avail costly and timely care to overcome health issues through appropriate treatment (Lawson et al. 2018). As argued by Ursache et al. (2016), the children belonging from higher socio-economic background have adequate facility such as safe living environment along with adequate financial support from the parents. This helps them avail timely and appropriate care intervention required to overcome or manage any health issues. Thus, the socioeconomic status of family is responsible to create health inequality in which the children from deprived classes face hindered care environment and opportunity to avail effective nursing care.

In relation to childhood obesity, for instance, it is seen that nearly 40% of children in England who belong from the most deprived areas are obese due to hindered healthcare availability whereas only 27% of the children are obese in affluent areas (RCPCH, 2018). This indicates that the children living in deprived areas in the UK who usually belong from poor socio-economic background suffered from increased health complication such as obesity and others compared to people in the affluent areas as they are unable to avail effective food and diet to maintain enhanced health out of lack of finances. As mentioned by Shamohammadi et al. (2019), poor employment status of the parents in the deprived areas is responsible to create social inequalities of health for the children in availing care support. This is because the children are mainly supported to be cared by the parents but the lack of any form of earning due to unemployment leads the family incapable to have finances in supporting care from the nurses. It results in avoiding the child to deprive of required nursing care making them suffer hindered health consequences.

The education is one of the social factors in child nursing that creates health inequality for the children required to avail care support. This is because lack of appropriate health education among the parents and children are seen to make them unable to have effective skills and knowledge regarding the way to avail care service and support their health condition. It leads the children from uneducated background unable to avail timely care and suffer negative health consequences (Shamohammadi et al. 2019). However, parents and children with effective educations are seen to use their knowledge and skills in managing a safe care environment and avail services by identifying and asking appropriate healthcare authorities to support their health condition (Shamohammadi et al. 2019).

On the basis of the biopsychosocial model of health, health belief acts as psychological factor which creates health inequality in child nursing. For example, few parents in England belief that vaccination is not safe for their children and avoids their child from getting vaccinated by the nurses after birth. This is evident as the five in one vaccine rate fell to 95.1% children in the UK in 2017 which is lowest since 2008 (BBC, 2018). The vaccination is essential for the children to improve their immunity in fighting deadly diseases such as polio, tetanus and others (BBC, 2018). Thus, the parents with the health belief that vaccination is bad for the children's health are creating inequality in the child nursing field to allow certain children remain deprived of the vaccination care which is essential to their health, in turn, exposing them to face hindered health consequences. The lifestyle factors act as key psychological behavioural factors in creating inequality in child nursing. This is because increased hindered lifestyle such as engaging in fast food, leading sedentary life and others that are instigated from different emotions and behavioural condition are causing children to suffer from hindered health consequences compared to others (Chang et al. 2017). As argued by Chang et al. (2017), children avoid having fast food and sedentary lifestyle contributes towards building up of normal basal metabolic index (BMI) rate. This is because exercise and intake of healthy food avoid deposition of extra fat in the body and contributes to manage the overall weight of the body that eventually normalises the BMI rate. Thus, the children leading healthy lifestyle are able to maintain effective BMI rate whereas those following hindered lifestyle are seen to suffering from negative health consequences.

The above discussion informs that according to biopsycosocial model of health, in the field of child nursing it is seen that the children suffer unequal health condition as a result of hindered education, lower socio-economic status and unemployment of their parents. Moreover, differences in genetic construct and lifestyle condition lead to create inequality towards children’s healthcare.

Explaining pathophysiology of atherosclerosis

Atherosclerosis is the condition in which cholesterol, fats and other substances get deposited in the form of plaque in the arteries that restricts flow of blood. The plaques are able to burst which may trigger blood clot creating hindered cardiovascular condition (Kianoush et al. 2017). In the study of Bergheanu et al. (2017), it is mentioned that hypercholesterolemia is one of the key towards triggering atherosclerosis. This is because increase in cholesterol levels in the plasma results towards changing permeability of arterial endothelial that leads the lipids mainly LDL-C to be passed into the arterial wall. The monocytes circulating in the arterial wall adhere to the endothelial cells which result to release adhesion molecules like selectins and vascular adhesion molecule-1 which then migrates into the subendothelial space through diapedesis (Bergheanu et al. 2017).

In the subendothelial space, the monocytes develop macrophage characteristics and change themselves into foamy macrophages. The LDL particles present in the subendothelial space are oxidised to lead them form chemoattractants. These processes are responsible to trigger accumulation of huge amount of intracellular cholesterol with the expression of CD36, B1, A, CD68 and others in the form of scavenger receptors by macrophages that bounds the modified lipoproteins along with anionic phospholipids. These cascades of reactions lead to vascular modifications such as intimal thickening which is thickening of the smooth muscle layers along with extracellular matrix of the arteries, fatty streak which is abundant deposition of macrophage foam cells along with smooth muscle cells on the intima, fibroatheromas and others (Bergheanu et al. 2017). The condition contributes to narrow the blood vessels and create acute symptoms of atherosclerosis.

In contrast, the study by Madsen et al. (2018) considered Hypertriglyceridaemia (HTG) to be an independent health risk factor towards causing atherosclerosis. This is because it triggers four key pathogenic conditions that contribute to the rise of risk for the disease. The condition includes lower serum HDL level of cholesterol, high level of remnant protein, high level of small dense LDL and higher thormbogenic condition. The lower High-Density Lipoprotein (LDL) which are responsible in absorbing cholesterol and carry it back to the liver leads to increased deposition of cholesterol in the wall of arteries contributing to narrow the arteries and result in atherosclerosis (Madsen et al. 2018). As argued by Kianoush et al. (2017), smoking leads to development of atherosclerosis among individuals. This is because the nicotine present in the cigarette smoke causes cell invasion that leads towards formation of plaque in the coronary arteries. The deposition of the plaque leads to build-up of waxy layers on the walls o the arteries causing narrowness of the arteries that leads to development of atherosclerosis (Kianoush et al. 2017). The high blood pressure in the arteries leads to development of atherosclerosis. This is because the high blood pressure provides increase force on the artery walls and overtime this pressure damages the arteries which makes them vulnerable towards build-up of plaque that is related with atherosclerosis (Miura et al. 2019). The diseases such as obesity also lead to develop atherosclerosis as extra fat in the body due to inappropriate lifestyle develops within the arterial walls making them get narrowed and develop hindrance in normal blood flow to the heart (Miura et al. 2019).

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