Application: Adaptive Response
13
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.
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 1010F and today's high of 103.20F. Mom has
been giving her ibuprofen, but when the fever went up to 103.20F
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 102.80F, a pulse of 128 beats per
minute, and a respiratory rate of 24 beats per minute.
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 the
scenarios, including their associated alterations. Consider the
adaptive responses to the alterations.
• Review the “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.
To complete:
.
Write a 2- to 3-page paper that addresses the following:
Explain the pathophysiology of the disorders depicted in the
scenarios, including their associated alterations. Be sure to
describe the patients' adaptive responses to the alterations.
• Construct a mind map of your selected disorder. Include the
epidemiology, pathophysiology, risk factors, clinical
presentation, and diagnosis of the disorder, as well as any
adaptive responses to alterations.
Application: Adaptive Response
13
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.
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 1010F and today's high of 103.20F. Mom has
been giving her ibuprofen, but when the fever went up to 103.20F
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 102.80F, a pulse of 128 beats per
minute, and a respiratory rate of 24 beats per minute.
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 the
scenarios, including their associated alterations. Consider the
adaptive responses to the alterations.
• Review the “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.
To complete:
.
Write a 2- to 3-page paper that addresses the following:
Explain the pathophysiology of the disorders depicted in the
scenarios, including their associated alterations. Be sure to
describe the patients' adaptive responses to the alterations.
• Construct a mind map of your selected disorder. Include the
epidemiology, pathophysiology, risk factors, clinical
presentation, and diagnosis of the disorder, as well as any
adaptive responses to alterations.
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