Adaptive Response Essay Assignment
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 Adaptive Response Essay. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.
Consider the following scenarios:
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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. Adaptive Response Essay. 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 Essay.
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.
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
Write a 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.
Please include introduction, summary and in text citations should have page number or paragraph number. Reference should be within the last five years.
Adaptive Response
Introduction
Adaptive response comprises of cell-mediated and antibody response that is facilitated by T-cells, B-cells and lymphocyte cells. The three cell types present antibodies that circulate in the lymph and plasma where they come into contact with and bind the antigen from the foreign material. When the antibody binds the antigen, it inactivates the foreign material (such as microbial toxins and viruses) by obstructive its capacity to bind host cell receptors. The antibodies produced by B-cells, also referred to as immunoglobulin, have a Y-shaped protein structure that is comprised of two light and two heavy chains. Typically, three types of immunoglobulin exist to include IgA, IgD, IgE, IgG, and IgM. Each type is differentiated by structure and function, having evolved to handle specific antigens. Humoral immunity (response mounted by antibodies) is just one type of adaptive response. Another type of adaptive response is cell-mediated immunity from T-cell activation that fights against foreign antigens on the host cell’s surface. Besides that, T-cells are present signal molecules that release cytokines, and activate antigen-specific cytotoxic T-lymphocytes, NK, and macrophages (Coico & Sunshine, 2015). As such, it is clear that the adaptive response mounted is dependent on the specific foreign material that gains access to the body and the antigen that it produces. The present paper explains the concept of adaptive response by explaining the pathophysiology, associated alterations, and the patients’ adaptive response of different disorders as presented.
Scenario 1
Jennifer appears to be suffering from tonsillitis, a tonsils inflammation that results from respiratory issues, allergies or bacteria. Once the tonsils are inflamed, they turn red in color and become swollen with yellowish or grayish surface coating. The conditions first presents as a sudden sore throat that then swells up. This makes it difficult to swallow. From the throat, the tonsils also well up and obstruct respiration. The condition typically occurs in children younger than six years of age with incidences among adults and teenagers very rare. An adaptive response occurs in this case when T-cells and B-cells are activated to eliminate the homeostatic change and return the body to normal (Parham, 2014).
Scenario 2
Jack appears to be suffering from dermatitis. This a common non-immunological mediated inflation that results from the keratinocytes in the skin cells releasing pro-inflammatory cytokines in response to chemical stimuli that include soap detergents and cleansers. The major pathophysiological change from the condition is cytokines being releases, changes to the epidermal cells and disruption of the skin barrier. 40% of reported cases of dermatitis are resultant of occupational hazards thus explaining why skin appearance and work history is important before making this diagnosis. Jack’s treatment will entail using topical agents that prevent additional skin irritation to include corticoid skin moisturizers, emollients, and creams (Gaspari, Tyring & Kaplan, 2017).
Scenario 3
Martha appears to be suffering from stress. This is a condition typically referred to as stress response whereby the body undergoes adaptations that are mobilized in the body to correct allostatic imbalance. The imbalance is from endocrine and neural changes to include secretion of norepinephrine and catecholamines-epinephrine from the sympathetic nervous system, particularly the nerve endings. The secretions induce vasoconstriction that increase the blood pressure and heart rate. They also increase oxygen and nutrient availability in the muscles. Additionally, glucocorticoids are secreted as steroid hormones by the adrenal glands. Although a lot of hormone changes occur in the body to constitute a stress response (such as decrease in reproductive hormones and insulin, and increase in beta-endorphin, prolactin and glucagon), the most significant changes involve sympathetic nervous system activation and glucocorticoids secretion. When the changes occur in the body, symptoms will present to include insomnia, depression, poor appetite, chest pains, and elevated heart rate. Once stress presents in a body, an adaptive response is initiated that prepares the body for either a flight or fight response as a strategy for correcting the imbalance (Copstead-Kirkhorn & Banasik, 2014).
Mind Map for
Scenario 2 – Dermatitis
Figure 1. Mind map for dermatitis
Epidemiology
Dermatitis commonly occurs as an occupational hazard for persons whose skins come into regular contact with chemical irritants. Examples of occupations at high risk of dermatitis include hair stylists, medical personnel, and maintenance workers. The condition is significantly more common among females and blamed on environmental factors instead of genetic factors
(Gaspari, Tyring & Kaplan, 2017)
.
Pathophysiology
Dermatitis is an inflammation that is non-immunologically mediated by the skin cells releasing pro-inflammatory cytokines when it comes into contact with chemical stimuli. Some of the pathophysiological changes that occur include release of cytokines and modifications to the epidermal cells
(Gaspari, Tyring & Kaplan, 2017)
.
Risk factors
Dermatitis is an occupational hazard for persons whose skins come into regular contact with chemical irritants. This is seen in persons who work in the agricultural industry, mechanics, nurses and cleaners
(Gaspari, Tyring & Kaplan, 2017)
.
Clinical presentation
Dermatitis presents as skin fissures, dryness, inflammation, cracking and erythematous plaques. It begins with web spaces that extend to the ventral and dorsal surfaces of the fingers. Other symptoms include pain, burning sensation, stinging and mild pruritus
(Gaspari, Tyring & Kaplan, 2017)
.
Diagnosis
Diagnosis occurs through the history and clinical examination that includes the dermatitis distribution in the fingernails, web spaces, abdomen, face, dorsal and palmar, as well as extension to wrist and forearms. The history focuses on the possibility of occupational hazards and whether the patient regularly handles chemical irritants
(Gaspari, Tyring & Kaplan, 2017)
.
Adaptive responses to alteration
The skin hardens as an adaptation to the expression of inflammatory mediators and cytokines. Also, an inelastic accommodation could occur in the skin where a thicker, mildly scaly, and glossy stratum granulosum occurs to replace normal skin
(Gaspari, Tyring & Kaplan, 2017)
.
Summary
Adaptive response represents a natural reaction that the body mounts to counter a homeostatic imbalance. In fact, it occurs to offer protection and terminate infection from pathogens, a process that evolves over an individual’s lifetime even as the lymphocyte population changes. It is notable that the response is not passed on in the genes or inherited, rather it is developed during an individual’s lifetime to determine fitness level and disease susceptibility. In inability to successfully develop adaptive response leaves the body susceptible to pathogenic infection. Still, it is notable that the immunity resultant from adaptive response is important to the body, acting as a line of defense that eliminates pathogens. Once pathogens breach the external barrier and find an activated compromised immunity, the body mounts an adaptive response that is specific and slow with an inflammatory response that has memory to recognize the signature antibodies for the pathogen. Overall, adaptive response allows the body to destroy infectious pathogens that are inflammation-resistant even as it offers long-term protection that protects the body against future infection by the same pathogenic agents.
References
Coico, R. & Sunshine, G. (2015).
Immunology: A short course
(7
th
ed.). Hoboken, NJ: Wiley Blackwell.
Copstead-Kirkhorn, L. & Banasik, J. (2014).
Pathophysiology
(5
th
ed.). Amsterdam: Elsevier Health Sciences.
Gaspari, A., Tyring, S. & Kaplan, D. (2017).
Clinical and Basic Immunodermatology
(2
nd
ed.). Cham: Springer International Publishing Switzerland.
Parham, P. (2014).
The Immune System
(4
th
ed.). New York, NY: Garland Science, Taylor & Francis Group.
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. Adaptive Response Essay. 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 Essay.
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 Adaptive Response Essay. 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 Essay.
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. Adaptive Response Essay. 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.
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 Adaptive Response Essay
Write a 2- to 3-page Adaptive Response Essay 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.
Scenario 1
Disease identification
The underlying condition in Jennifer’s case presents clinical manifestations of pharyngitis. According to Cohen and colleagues (2017) children with beta-hemolytic streptococci ( GABHS) pharyngitis manifest symptoms such as elevated fever( above 101.O F), tender and palpable anterior cervical lymph nodes, increased heart rate and complaint of a sore throat (Cohen et al., 2017). Further, upon physical examination, Jennifer’s skin is hot and dry a symptom associated with the disease. Notably, the physical examination confirmed the clinical manifestation of staphylococcus pharyngitis.
Pathophysiology
Pharyngitis is a disease resulting from type 2 hypersensitivity reaction in the body. According to Ivaska and colleagues (2015), the pharyngitis causing beta hemolytic staphylococcal bacteria invades the pharyngeal mucosa resulting in a hypersensitivity response. In this regard, the bacterial invasion triggers a local inflammation response at the site of infection, which, primarily emanates from the immune system producing antibodies against extracellular fluids. Therefore, the inflammation response in the affected pharynx nodes is responsible for pharyngitis in children. Further, Somro et al. (2012) pinpoint that the M protein fragments of GAS serotypes may result in rheumatoid fever if the underlying disease in children is not treated. Adaptive Response Essay.
Disease-associated alterations
Upon invasion by staphylococcus bacteria, the resultant inflammation response in the affected throat tissues stimulates the body to increase blood flow to the throat. In this regard, the patient experiences episodes of increased heart rate. Consequently, there is increased lymphocytes production in the blood circulating to the throat since the body’s immune system responds to the invasion, resulting to redness and pain in the throat (Somro et al., 2012). In this regard, an alteration in the body normal function is an indication that the immune system is fighting back the invasion by the disease-causing pathogens Adaptive Response Essay.
Patients’ adaptive responses
Patients’ adaptive response is subject to early and late activation of the immunological memory cells. According to Somro et al. (2012), previous exposure of the body’s immune system to pharyngitis causing staphylococcus, either by immunization or previous infection, stimulates the production of antigen-specific antibodies in the body. In this regard, when a patient is re-infected by the disease-causing pathogen, the immune system is induced to rapidly initiate a fast response in fighting the pathogen (Somro et al., 2012). As such, during reinfection by the pathogens, the disease-associated alterations in the body tend to minimal Occurs more rapidly as compared
Scenario 2
Disease identification
In this scenario, Jack’s underlying condition would be irritant-induced contact dermatitis (ICD) resulting from a type 4 hypersensitivity allergic reaction. According to Shrotriya, Ranpise, and Vidhate (2017), the clinical manifestations of ICD include redness in the affected skin, itchiness and dryness in the affected areas. Notably, the allergic hypersensitivity resulted from exposure the exposure of Jack’s hand to chemicals such as poison ivy. In this regard, upon exposure to the chemical s, the body’s immune system became activated resulting in eczema.
Pathophysiology and associated alterations
Irritant contact dermatitis (ICD) results from activation of the innate immune system primarily due to exposure to chemical irritants. Shrotriya, Ranpise, and Vidhate (2017) assert that the condition emanates from the activation of cytokines and macrophages on initial exposure to a chemical allergen. Notably, ICD triggers the release of release of T cells ( CD8) which destroy the target cells, while macrophages release hydrolytic enzymes that hydrolyze target cells upon contact.immune system In this regard, ICD causes alterations in the layers of the skins, notably. Further, practices such as repeated hand washing upon chemical exposure facilitate the occurrence of ICD (Shrotriya, Ranpise, & Vidhate, 2017). The research also attributes the occurrence to the removal of essential components of the skin layers such fats and oils thus facilitating skin susceptibility to toxic chemicals (Shrotriya, Ranpise, & Vidhate, 2017).
Adaptive response
Irritant-induced inflammatory response results to the release of allergen-specific cells. Notably, Jung et al. (2018) observe that the body keeps an immunological memory on initial exposure. Therefore, upon re-exposure to the allergens, the T effector cells are rapidly stimulated which results in allergic contact dermatitis (ACD). Adaptive Response Essay. In this regard, Jung et al. (2018), assert that continuous exposure to ICD allergens facilitates pathogenesis of ACD. However, Shrotriya, Ranpise, and Vidhate (2017) assert that other cells including the Natural killer cells and mast cells play a role in facilitating the pathogenesis of ACD when a patient is repeatedly exposed to ICD allergens Adaptive Response Essay.
Scenario 3
Disease identification
In the third scenario, the clinical manifestations reveal that Martha has developed a posttraumatic stress disorder. According to Joshi et al. (2017), PTSD is a psychological condition that develops in individuals who have experienced a traumatic event. On the other hand, Shalev, Liberzon, and Marmar (2017) assert that fear, sleep disturbance, hyper-vigilance and a frequent flashback of traumatic events as some of the clinical manifestations of PTSD. In this regard, considering that Martha’s recent turn of events was traumatic, I can attribute the clinical manifestations in the scenario to PSTD.
Pathophysiology
Pathophysiology of PSTD reveals endocrinological alterations emanating from the disease facilitates hormonal imbalance in patients. According to Joshi et al. (2017), recent studies reveal that PSDT results in a decreased volume in the hippocampus left amygada and cingulate cortex in patients. On the other hand, studies by Shalev, Liberzon, and Marmar (2017), revealed that PSDT patients have increased norepinephrine levels in their body. Further, there inhibition in the activity of adrenergic receptors in the body and consequently increased activation of glucocorticoid receptors. In this regard, hormone imbalance is a common occurrence in Patients with the disease revealing the underlying causes of the disease clinical manifestations (Shalev, Liberzon, & Marmar, 2017). Adaptive Response Essay.
Disease alterations
PSTD facilitates the release of the Adrenocortropicoid hormone (ACTH) in the brain, which results in illness disorder in patients. According to Joshi et al. (2017), the patients tend to be more concerned about their health condition and in most cases, most end up developing emotional distress. In this regard, uncertainty and dissatisfaction predominantly facilitate development misperceptions in the normal body functioning such as loss appetite. Furthermore, Joshi et al. (2017), asserts that illness disorders in PSTD may progress to a life-threatening condition, such as the development of suicidal thoughts Adaptive Response Essay.
Adaptive response
The body responds by realizing the flight or fight hormone when confronted with a dangerous situation. In this regard, PSTD patients tend to release the release the two hormones when exposed to traumatic events. However, as Joshi et al. (2017), observes in some cases PSTD patients are unable to recover from traumatic events. As such, when exposed to stressors, patients respond differently depending on novelty, level of trauma and the predisposing environmental factors.
Pharyngitis Mind Map
References
Cohen, J. F., Cohen, R., Bidet, P., Elbez, A., Levy, C., Bossuyt, P. M., & Chalumeau, M. (2017). Efficiency of a clinical prediction model for selective rapid testing in children with pharyngitis: A prospective, multicenter study. PloS one, 12(2), e0172871.
Ivaska, L., Niemelä, J., Vuorinen, T., Waris, M., Rantakokko-Jalava, K., & Peltola, V. (2015) Viral and Bacterial Etiology of Acute Pharyngitis in Children. In Open Forum Infectious Diseases Infectious.
Diseases Society of America
1(2),1769
Joshi, M., Bartter, T., Joshi, A., Glare, P. A., Nicholas, M. K., & Blyth, F. M. (2017). Post-Traumatic Stress Disorder.retrieved from http://78.39.227.9/handle/Hannan/110235 Adaptive Response Essay
Jung, Y., Kim, J. C., Park, N. J., Bong, S. K., Lee, S., Jegal, H., … & Kim, S. N. (2018). Eupatilin, an activator of PPARα, inhibits the development of oxazolone-induced atopic dermatitis symptoms in Balb/c mice. Biochemical and Biophysical Research Communications.
Shalev, A., Liberzon, I., & Marmar, C. (2017). Post-traumatic stress disorder.
New England Journal of Medicine,
376(25), 2459-2469.
Shrotriya, S. N., Ranpise, N. S., & Vidhate, B. V. (2017). Skin targeting of resveratrol utilizing solid lipid nanoparticle-engrossed gel for chemically induced irritant contact dermatitis.
Drug delivery and translational research
,
7
(1), 37-52.
Somro, A., Akram, M., Khan, M. I., Asif, H. M., Sami, A., Shah, S. A. M., … & Rehman, R. U. (2012). Pharyngitis and sore throat: A review.
African Journal of Biotechnology
,
10
(33), 6190-6197 Adaptive Response Essay.