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Adaptive Response.

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


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. Adaptive Response

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. Adaptive Response

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

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. Adaptive Response

To Complete

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.

The changes in the activities of the brain meant to maintain performance and homeostasis make up the adaptive responses. These changes involve the degeneracy, neural reserve and the compensation component. Adaptive responses facilitate the destruction of toxic molecules and pathogens that invade the body causing illnesses. They are controlled to ensure that they recognize only the foreign materials to prevent self-harm of the body molecules. The adaptive response pathway involves the increase of enzymes metabolizing drugs through the activation of AHR in a ligand-dependent action by exogenous ligands (Watzl, 2018). This activity promotes the excretion and metabolic transformation of the activating c and compounds. As such, this paper seeks to examine the adaptive responses associated with disorders presented in the case studies provided. Adaptive Response

Scenario One: Tonsillitis

Scenario one describes the case of a 2-year-old female client who presents to the clinic running a temperature for three days. She has lost appetite and gotten fussy and as well lost interest in watching TV. She has hot and dry skin with slightly reddened tympanic membranes on the periphery, 4+ tonsils and diffuse exudates, erythematous throat, tender and readily palpable anterior cervical nodes and shows signs of a hurting throat. The vital signs of the patient include a pulse of 128 beats per minute, temperature of 102.8oF and a respiratory rate of 24 beats per minute. Adaptive Response

According to the symptoms presented by the client and the examination results, it is evident that she suffers from tonsillitis. This disorder is caused by a viral or bacterial invasion causing the swelling of the pharyngeal tonsils. The lingual and the adenoids tonsils may also be involved. More often than not, the infection is caused by methicillin-resistant Staphylococcus aureus (MRSA) and group A beta-hemolytic Streptococcus (GABHS) bacteria which make up between 15% and 30% of the disease cases. The prominent viral causes of the infection include measles virus, adenovirus, Epstein-Barr virus (EBV) and herpes simplex virus. Adaptive Response

The pathophysiology and alterations of tonsillitis is associated with the inflammation of the tonsils resulting from the viral or bacterial invasion of mucous membranes. The infection can extend to the sinuses, ears, nose, bronchi, trachea, and larynx. Peritonsillar abscess may be caused by the spread of the viruses or bacteria to the adjoining tissues (Shah & Meyers, 2014). Acute rheumatic fever and acute nephritis are possible complications of tonsillitis and chronic inflammation can occur from repeated acute infections. Adaptive Response

Adaptive responses for tonsillitis include sore throat, difficulty in swallowing, fever, malaise, and enlarged lymph nodes on both sides of the neck. Patients also lose appetite and have reddened tonsils, foul breath, odynophagia, headache, and dysphagia. This is evident in the client whose temperatures are running high at 102.8oF and presents swollen and reddened tonsils. She has also lost appetite and complains of sore throat. Adaptive Response

Scenario 2: Allergic Contact Dermatitis

Scenario two depicts the case of a 27-year-old male who presents with redness and irritation of his hands. The symptoms have lasted for 2 weeks and are characterized by redness and flakiness. He has no known allergies or traumatic injuries. However, he has been exposed to abrasive solvents and chemicals at work. Adaptive Response

Allergic contact dermatitis is caused by the interaction of the skin with allergic substances or neuronal responses. The pathophysiology of allergic contact dermatitis involves skin contact with the skin surface whereby they attach to the carrier protein creating a sensitizing. The antigen is then processed by Langerhans cells which transport it to T cells resulting in the antigen sensitization (Rustemeyer et al., 2019). Consequently, inflammatory cytokines are released causing dermatitis symptoms (Huether & McCance, 2012). Adaptive Response

The adaptive responses of allergic contact dermatitis are pain, itching, redness of the skin, fever and erythema. Considering the clients change in the skin site of allergen contact, it is evident they are suffering from allergic contact dermatitis following his contact with the abrasive solvents without gloves. Adaptive Response

Scenario 3: Depression

Scenario three describes the case of a 65-year-old woman having trouble sleeping, lost appetite and racing heartbeat with a medical history significant for hypertension. She has recently retired from her job and her 87-year-old mother moved into her home. Her mother has lost mobility and independence and needs to rely on her daughter for assistance with activities of daily living. She complains that she never dreamed about the kind of retirement she is having currently. Adaptive Response

Depression is serious mental condition characterized by negative changes in feelings, thoughts and actions leading to feelings of sadness and loss of interest in activities, loss of appetite, trouble sleeping and difficulties in thinking, concentration and decision-making among others as evident in the case study. It is caused by life circumstances, genetics, trauma, drug and alcohol abuse, environmental factors among others. The pathophysiology of depression involves the disturbance of the serotonin (5-HT) activity in the central nervous system (Jokela et al., 2016). The exact pathophysiology of depression is not clear and thus, the association of serotonin (5-HT) is attributed to the therapeutic efficacy of Selective serotonin reuptake inhibitors (SSRIs) during treatment. The adaptive responses for the client include change in sleeping patterns, loss of appetite, and racing heart. Adaptive Response

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