Nurses are the first point of contact for most patients entering a health care facility. If the patient’s medical condition allows for them to communicate, the first thing nurses do is collect their information. Maintaining detailed records about a patient’s medical history and symptoms is among a nurse’s most crucial responsibilities.

Nurses are also trained in evaluating and assessing patients. Without an accurate assessment of a patient’s condition, it’s difficult to determine a proper course of treatment. Aside from the risks to patient safety, inaccurate assessments can also waste valuable time and resources. To make correct assessments, nurses apply the study of pathophysiology.

What is pathophysiology in nursing? It is the key strategy that nurses rely on when diagnosing acute and chronic conditions in patients and one of the many areas of study in nursing school.

Pathophysiology is the study of how a disease, injury, or other condition affects a patient, including both the physical and functional changes that occur.

Pathophysiology combines two major disciplines — pathology and physiology. Pathology is the study of the causes and effects of injuries and diseases. Physiology is the study of the human body’s systems and various functions, such as breathing and digestion.

Pathophysiology involves the following four interrelated components:

• Etiology: The study of the causes of diseases and other health conditions
• Pathogenesis: The process or manner in which a health condition develops
• Clinical manifestations: The visible or detectable signs and symptoms of a health condition
• Treatment implications: The implication that a particular treatment may prove beneficial when considering pathogenesis, etiology, and potential clinical consequences

With a firm grasp of pathophysiology and its components, nurses can properly assess a patient’s injury or illness and its stage of development. The application of pathophysiology is what enables nurses to accurately assess patients, which leads to proper treatment and better outcomes.

Nurses use pathophysiology to assess what stage health conditions — such as a bacterial infection or a wound — have progressed to, which ultimately informs treatment. For instance, Lyme disease occurs in three distinct phases; stage one Lyme disease (when bacteria remains localized) is treated differently than stage three (the most severe stage).

Applying pathophysiology in nursing care allows nurses to understand the various stages and manifestations of an illness or injury, which is vital to determine the proper course of treatment. The following are examples of health conditions where nurses and other health care providers may apply the concepts of pathophysiology to understand a patient’s condition.

Infection is defined as the instance in which a bacterium or virus invades the body. The five stages of infection include:

• Incubation: The period occurring between initial exposure and the onset of symptoms. During this time, bacterial particles replicate.
• Prodromal: Bacterial particles continue to replicate, and infected individuals are at risk of transmitting their infection. The prodromal period occurs after incubation but before the main symptoms of infection occur.
• Illness: During the illness phase, the infected will begin to exhibit characteristic symptoms of their infection. Symptoms may include anything from fever and fatigue to vomiting and stomach pain, depending on the type of infection.
• Decline: The stage in which the immune system creates a defense, resulting in a decline in symptoms. However, the virus is still transmissible, and secondary infections are still possible.
• Convalescence: This is the final stage of infection. The individual returns to feeling normal, and their symptoms fully diminish.

Inflammation can be caused by a wide variety of diseases, infections, and injuries. Acute inflammation is short-term, subsiding when the body has successfully healed or defended itself from infection. Chronic inflammation is long-term and is usually caused by chronic illnesses such as arthritis, asthma, and eczema.

The five main signs of inflammation include:

• Pain: Pain can be experienced in both acute and chronic cases of inflammation. It is caused by nerve-ending stimulation via inflammatory chemicals in the muscles or joints.
• Heat: Due to higher than normal blood flow to affected areas, individuals experiencing inflammation may feel warmth in their muscles or joints.
• Redness: Inflammation is characterized by redness of the skin, which is caused by the blood vessels in affected areas opening wider than normal.
• Swelling: Inflammation causes fluid to accumulate in affected areas, resulting in expanding skin or joints.
• Loss of function: Certain types of inflammation have the potential to compromise function. An inflamed joint, for instance, may cause a lack of mobility.

Bacteria are single-celled organisms that are associated with numerous health risks. The most dangerous varieties of bacteria include listeria, norovirus, and tuberculosis, to name a few. Bacteria grows in four distinct phases:

• Lag: Lasting for approximately one hour, the lag phase consists of bacteria increasing in volume and synthesizing DNA in preparation for cell reproduction.
• Exponential growth: Cells of bacteria divide by binary fission, which causes the cell count to grow exponentially.
• Stationary: Environmental changes and lack of nutrients cause bacterial growth to significantly slow down or stop completely. Eventually, the number of dying cells will offset the number of new cells being created.
• Decline: The phase in which the number of bacteria cells dying exceeds the number of new cells being created.

A virus is an infectious microbe that invades and replicates within a living cell, resulting in a compromised host body. Some of the most common viruses include influenza, HIV, and COVID-19. The six phases of the viral life cycle include:

• Attachment: Viral particles make first contact with host cells by latching onto them.
• Penetration: Viral particles penetrate the cytoplasm via direct fusion, receptor-mediated endocytosis, or receptor-mediated endocytosis; penetration methods vary by virus.
• Uncoating: The virus sheds its protein shell, known as a capsid.
• Gene expression and replication: With its capsid no longer present, the viral genome is used for gene expression and replication.
• Assembly: Viral genomes and proteins assemble to create progeny virion particles.
• Release: Virion particles exit the cell and go on to infect other healthy cells.

Inflammation is a naturally occurring response to physical trauma and viral or bacterial infections. The inflammatory process breaks down into three distinct phases:

• Acute swelling (phase 1): The affected area displays the common symptoms of inflammation, which include pain, heat, redness, and swelling.
• Repair and regeneration (phase 2): Cells are deployed to the affected area, and the process of building new tissue begins.
• Remodeling and maturation (phase 3): New tissue remodels and strengthens as signs of inflammation wane. The growth of fibroblasts to fibrocytes denotes the maturation of tissue, while the assembly and shrinking of collagen fibers is a sign of remodeling.

A wound is defined as damage that occurs in soft tissue due to a physical blow, cut, or another injury that breaches the skin. The body handles wounds in four distinct stages:

• Hemostasis: Blood from the wound clots, and platelets combine to form a seal on the wound. This process begins within a minute of the wound occurring.
• Inflammatory: Swelling occurs due to injured blood vessels leaking, which ultimately helps slow down bleeding and prevent potential infections. White blood cells remove bacteria and other harmful elements from the wound.
• Proliferation: New skin begins to grow over the affected area, and the wound rebuilds itself. This stage can last upwards of three weeks, depending on the wound’s severity.
• Maturation: Collagen within the skin is remodeled, and the wound fully closes. As the area matures, the skin will gradually become stronger and more natural looking.

Pathophysiology in nursing care allows nurses to correctly assess patients. Providing optimal care goes beyond just identifying an illness or injury — nurses must also classify its phase or stage to determine treatment.

For instance, COVID-19’s illness phase may include symptoms such as fever, chills, body aches, sore throat, and coughing. This is when patients feel at their worst and will most benefit from aggressive treatments to mitigate symptoms. However, a patient in COVID-19’s decline phase is building defenses via their immune system, which results in symptoms that are far less severe. A patient in the decline phase is far less reliant on medical care compared to a patient at the height of their illness.

Nurses with an understanding of pathophysiology can identify a patient’s needs and significantly contribute to their treatment.

Successful nurses are well-versed in pathophysiology and its interrelated topics and disciplines. Having a firm grasp on this subject matter enables nurses to consistently deliver positive patient outcomes.

One of the best ways to learn about what pathophysiology in nursing entails and how it’s applied is by investing in education. The online post-master’s certificate in nursing program offered by Regis College covers many subjects that are fundamental to a successful nursing career, including:

• Advanced pathophysiology
• Concepts in nurse leadership
• Advanced clinical pharmacology
• Health promotion — disease prevention

Pursue your professional goals in health care by learning how Regis College’s certificate programs can help accelerate your career.