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Adaptive Response
Assignment: 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.
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.
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.O
| Subject | Nursing | Pages | 3 | Style | APA |
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Answer
Adaptive Response
It is important to know normal body functions so as to identify the times or incidences in which the body is reacting to changes. The purpose of this paper is to review three provided case scenarios, develop appropriate diagnosis, and a mind map (Refer to Appendix 1) for diagnosis made in scenario one. The diagnoses made in scenario 1 to 3 include the tonsillitis, irritant contact dermatitis, and depression respectively. The adaptive responses for each disorder are as discussed below.
Scenario 1: Tonsillitis
Provided signs and symptoms such as an erythematous throat, reddened tympanic membrane, inflamed tonsils (4+), palpable anterior cervical nodes, diffuse exudates, and swallowing difficulties is consistent with tonsillitis diagnosis. Type A Streptococcus spp. is known to cause tonsillitis and may result in any of the above symptoms (Huether & McCance, 2017). Tonsillitis is more common in teenagers and children than in adults. Signs and symptoms of acute tonsillitis include reddened and swollen tonsils with a yellowish coating, difficulty swallowing, headache, fever 100.4 °F, fatigue and tiredness, bad breath, loss of appetite, and painful and swollen lymph nodes in the neck. Viral tonsillitis is ruled out due to absence of typical cold symptoms such as a stuffy nose and/or a cough. However, bacterial tonsillitis is more common than viral tonsillitis. Risk factors include contact with other people’s mucous membranes and proximity to an infected person when she/he sneezes or talks (InformedHealth.org, 2019). It is diagnosed through history taking, physical examination and culturing of throat swabs (Huether & McCance, 2017). As a result of the infection, Jennifer presents with a number of adaptive responses. These include a rise of body temperature to control the infection, increased heart rate to increase the rate of supply of white blood cells and other defense mechanism to the affected area, inflammation to contain the infection and attract phagocytic leukocytes, and diffuse exudates, which indicates the body’s attempt to clear the infection. Tonsillitis may have as well impacted on respiratory function, thus, respiratory rate has been increased as a compensatory mechanism. A dry skin is an indication of dehydration caused by hyperventilation. Refer to Appendix 1.
Scenario 2: Allergic Contact Dermatitis
Jack presents with an acute direct exposure to abrasive solvents and cleaning fluids due to shortage of gloves in his place of work. The signs and symptoms such as redness of the hands and flacking of the skin especially on the exposed area indicate allergic contact dermatitis (Huether & McCance, 2017). Acute disease is characterized by signs and symptoms such as oozing, erythema, crusting, vesicles or pustules, and tenderness. Sub-acute phase is associated with scales, crusts, and hyperpigmentation; whereas in the chronic phase the condition is characterized by lichenification. Contact dermatitis is caused by metal ions and chemicals, which can exert toxic effects on the skin cells, thus, leading to a T-cell response. Production of dermatitis lesions is an adaptive response or an attempt to eliminate damaged cells to give room for multiplication of new healthy skin cells (Nair & Atwater, 2019).
Scenario 3: Depression
Of late, Martha has been experiencing increasing life demands that have pushed her into depression. She is disturbed by the fact that her elderly mother is now completely dependent on her. It includes for more attention, time as well as financial implications. Martha is unable to adapt well to increasing life demands, which puts her into a depressed state. She presents with signs and symptoms of depression such as lack of appetite, lack of sufficient sleep, and seeking for medical attention (Huether & McCance, 2017).
Summary
The body tends to response to change in order to control the change or adapt with the change. In scenario 1, the patient is responding to an infection in order to control the infection as well as reduce the spread/extend of damage caused by, perhaps, the bacterial infection. In scenario 2, the patient has developed contact dermatitis as a way to facilitate elimination of damaged skin cells and thriving of the new ones. Lastly, but not the least, the patient in scenario 3 has decided to seek medical attention for management of her depression triggered by increased life demands that she seems to cope well.
References
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Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
InformedHealth.org. (2019). [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Tonsillitis: Overview. 2013 Mar 27 [Updated 2019 Jan 17]. Retrieved on Jun 10, 2019 from, https://www.ncbi.nlm.nih.gov/books/NBK401249/
Nair, P.A., & Atwater, A.R. (2019). Contact Dermatitis. [Updated 2019 Apr 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Retrieved on Jun 10, 2019 from, https://www.ncbi.nlm.nih.gov/books/NBK459230/