Adaptive Response in Advanced Pathophysiology
Adaptive Response
As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.
Adaptive Response in Advanced Pathophysiology
Consider the following scenarios:
Scenario 1:
Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell. Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.
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Scenario 2:
Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.
Scenario 3:
Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.
Adaptive Response in Advanced Pathophysiology
To Prepare
· Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.
· Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.
· Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.
· Review the Application Assignment Rubric found under Course Information
To Complete
Ace my homework – Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:
· For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes. You are required to discuss all three scenarios within the paper component of this assignment.
· Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.
Adaptive Response in Advanced Pathophysiology Learning Resources
Required Readings
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Chapter 6, “Innate Immunity: Inflammation and Wound Healing”
This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound healing process.
Chapter 7, “Adaptive Immunity”
This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.
Chapter 8, “Infection and Defects in Mechanism of Defense”
This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder—HIV/AIDS.
Chapter 9, “Stress and Disease”
This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.
Chapter 10, “Biology of Cancer”
This chapter explores the developmental process of cancer and factors that impact the onset of cancer at the cellular level. It also describes various treatment options.
Chapter 11, “Cancer Epidemiology”
This chapter reviews genetic, environmental, behavioral, and diet-related risk factors for cancer. It also examines types of cancers that result from risk factors.
Chapter 12, “Cancer in Children and Adolescents”
This chapter focuses on the presentation and prognosis of childhood cancers. It examines the impact of genetic and environmental factors on these cancers.
Chapter 38, “Structure and Function of the Musculoskeletal System”
This chapter covers the structure and function of bones, joints, and skeletal muscle. It also explores effects of aging on the musculoskeletal system.
Chapter 39, “Alterations of Musculoskeletal Function”
This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of bone, joints, and skeletal muscle disorders. Additionally, it explores musculoskeletal tumors, osteoarthritis, and rheumatoid arthritis.
Chapter 40, “Alterations of Musculoskeletal Function in Children”
This chapter includes musculoskeletal disorders that affect children, such as congenital defects, bone infection, juvenile idiopathic arthritis, muscular dystrophy, musculoskeletal tumors, and nonaccidental trauma.
Chapter 41, “Structure, Function, and Disorders of the Integument”
This chapter begins with an overview of the structure and function of skin. It then covers effects of aging on skin, as well as disorders of the skin, hair, and nails.
Chapter 42, “Alterations of Integument in Children”
This chapter covers alterations of the integument that affect children. These include acne vulgaris, dermatitis, infections of the skin, insect bites and parasites, vascular disorders, and other skin disorders.
Hammer, G. G. , & McPhee, S. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.
Chapter 3, “Disorders of the Immune System”
This chapter explores the anatomy and physiology of the immune system. It also explores the pathophysiology of various immune disorders such as primary immunodeficiency diseases and AIDS.
Chapter 8, “Diseases of the Skin”
This chapter begins with an overview of the anatomy and physiology of skin. It also explores the pathophysiology of various types of skin lesions and inflammatory skin diseases.
Chapter 24, “Inflammatory Rheumatic Disease”
This chapter explores the pathogenesis of inflammation and its role in rheumatic diseases. It also examines the clinical presentation, etiology, pathophysiology, and clinical manifestations of rheumatic diseases such as gout and rheumatoid arthritis.
Required Media
Zimbron, J. (2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://www.medmaps.co.uk/beta/
Gastro-oesophageal reflux disease. [Image]. Used with permission of MedMaps.
This media provides examples of mind maps for dementia, endocarditis, and gastro-oesophageal reflux disease (GERD).
Optional Resources
Arthritis Foundation. (2014: 2024 – Essay Writing Service. Custom Essay Services Cheap). Retrieved from http://www.arthritis.org/
Lupus Foundation of America. (2014: 2024 – Essay Writing Service. Custom Essay Services Cheap). Retrieved from http://www.lupus.org/newsite/index.html.
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Pathophysiology, Adaptive Responses, and Mind Map for Selected Disorder
Scenario 1:
In this scenario, Jennifer, a 2-year-old female, presents with a fever and symptoms of a sore throat. The pathophysiology of her condition involves an acute infection of the tonsils, which leads to tonsillitis. The associated alteration is inflammation and infection of the tonsils caused by a pathogenic microorganism, most commonly bacteria.
The adaptive responses of Jennifer’s body to this alteration include an increase in body temperature (fever) as a defense mechanism against the invading microorganisms. Fever helps to inhibit the growth of bacteria and stimulate the immune system. Additionally, Jennifer’s increased heart rate and respiratory rate are adaptive responses to the fever and inflammation, helping to deliver oxygen and nutrients to the affected area.
Scenario 2:
Jack, a 27-year-old male, presents with redness and irritation of his hands. The pathophysiology of his condition involves contact dermatitis, which is an inflammatory response of the skin to irritants or allergens. The associated alteration is the immune system’s response to the exposure of Jack’s hands to abrasive solvents and chemicals.
The adaptive response of Jack’s body is the inflammatory response, which is characterized by redness, heat, and swelling. The inflammation is the body’s attempt to remove the irritants and initiate the healing process. Jack’s statement that his hands feel “a little bit hot” indicates the localized vasodilation that occurs during inflammation. The protective gloves that Jack normally wears act as a preventive measure, but the lack of their availability has contributed to his condition.
Scenario 3:
Martha, a 65-year-old woman, presents with trouble sleeping, a racing heartbeat, and loss of appetite. The pathophysiology of her condition involves stress-related disturbances in the neuroendocrine system, specifically the hypothalamic-pituitary-adrenal (HPA) axis. The associated alteration is an overactivation of the stress response, leading to changes in sleep patterns, heart rate, and appetite.
The adaptive response of Martha’s body to chronic stress is the activation of the HPA axis and the release of stress hormones such as cortisol. Increased heart rate and changes in appetite are common responses to stress. Martha’s decreased sleep may be attributed to the hyperarousal state associated with chronic stress.
Mind Map: Gastroesophageal Reflux Disease (GERD)
Epidemiology:
Prevalence: Common gastrointestinal disorder affecting a significant portion of the population
Risk factors: Obesity, hiatal hernia, pregnancy, smoking, certain medications
Pathophysiology:
Lower esophageal sphincter (LES) dysfunction: Weakness or relaxation of the LES, leading to reflux of gastric contents into the esophagus
Esophageal tissue damage: Repeated exposure to gastric acid and digestive enzymes causes inflammation and erosion of the esophageal mucosa
Clinical Presentation:
Heartburn: Burning sensation in the chest that worsens after meals or when lying down
Regurgitation: Sour or bitter taste in the mouth due to the backflow of gastric contents
Dysphagia: Difficulty swallowing, especially solid foods
Chest pain: Can mimic cardiac-related pain, but typically relieved with antacids or changes in position
Diagnosis:
History and physical examination
Esophageal pH monitoring: Measures the frequency and duration of acid reflux
Upper gastrointestinal endoscopy: Allows direct visualization of esophageal mucosa and assessment of tissue damage
Barium swallow: Radiographic examination to detect structural abnormalities and assess esophageal motility
Adaptive Responses to Alterations:
Increased production of mucus by esophageal epithelial cells to protect against gastric acid
Activation of salivary glands to provide temporary relief from acid reflux
Acid-neutralizing effect of saliva and bicarbonate-rich secretions from the duodenal glands
References:
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Hammer, G. G., & McPhee, S. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Pathophysiology of disease: An introduction to clinical medicine (7th ed.). New York, NY: McGraw-Hill Education.
MedMaps. (2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://www.medmaps.co.uk/beta/
