Adaptive responses are the brain activity changes aimed at sustaining body’s performance and homeostasis where possible. The changes include neural reserve, compensation, and degeneracy ( Huether, & McCance, 2017). They are appropriate body translations to respond to the environmental disturbances. The advanced practice nurse has to identify changes that suggest body homeostasis imbalances to assist in accurate diagnosis and treatment of the disorder ( Mosby Hammer & McPhee, 2014). This paper aims to discuss the pathophysiology, related changes, and the adaptive responses of the patient to the alterations caused by stress responses, contact dermatitis and tonsillitis disease processes. It will also provide stress response mind map that will consists, its pathophysiology, epidemiology, clinical presentation, risk factors, correct diagnosis and the patient’s adaptive responses towards the alterations.
Tonsillitis
Jennifer is two years old female. In scenario 1, her mother informs the office of the child's symptoms. She explains; a fever that goes off and on for the past three days recording a high temperature of 103.2 0F today, she has become choosy and is unable to eat. The mother claims that she has always been in good health before until last three days. The physical examinations display an erythematous throat having 4+ swollen tonsils in addition to the diffuse exudates, slightly reddened tympanic membranes at the periphery although they exhibit usual look, she has a dry and hot skin, and the anterior cervical nodes feel tender and palpable while touching. Jennifer complains of a painful throat and swallowing hurts. She records VS temperature of 102.80F, a heartbeat of 128 per minute, and her respiratory rate per minute is 24 beats. She is diagnosed with Acute Tonsillitis, and proper treatment choices are discussed.
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Pharyngeal tonsils inflammation is commonly known as Tonsillitis. Some immunological factors can cause the inflammation to extend to the sinuses, nose, ears, bronchi, trachea, and larynx. Usually, the disease is caused by mucous membrane attack by microorganisms, for example, hemolytic streptococci and other viruses (Encyclopedia Britannica, 2018). However, Herpes simplex virus, Cytomegalovirus, Epstein-Barr virus (EBV), other herpes viruses, Measles virus and the Adenovirus are the leading causes of the disorder.
The group A beta-hemolytic Streptococcus pyrogens (GABHS), causes bacterial Tonsillitis as the bacteria stick to the bond of the receptors found in the tonsils’ epithelium. Such organisms attack the tonsils mucosal lining resulting in an inflammatory reaction. The swelling is among the adaptive responses of the body towards the disorder process. Exudates, fever, erythema, and swelling of the lymph nodes are additional body adaptive responses to the disorder. Antibiotic therapy is the correct treatment options for bacterial tonsillitis, NSAIDs for fever and pain (Encyclopedia Britannica, 2018; Mayo Clinic, 2018). Sufficient fluid hydration and rest help to minimise the pain and Tonsillectomy in complex or recurring cases.
Contact dermatitis
Jack is a 27-year-old male. In scenario 2, He visits the office having symptoms happening the last two weeks of flaky hands that appear red. He denies discomfort or pain. Besides, he asserts that sometimes his hands become slightly hot. As maintenance engineer, Jack often deals with harsh chemicals and solvents. Usually, he wears gloves while working but recently there has been a shortage, and he is forced to work sometimes with his bare hands. He is diagnosed with Irritant Contact Dermatitis, and correct treatment choices are discussed.
The skin is the protective blockade against disease and desiccation. It works by keeping pathogens out and moisture in (Hammer & McPhee, 2014). Skin is among the first line defence of the body.
A non-immunological mediated inflammatory reaction of the skin, when exposed to chemical irritants, is known as Irritant Contact Dermatitis. The epidermal cells are damaged and inflammation results when such contacts occur ( Huether & McCance, 2017). Therefore, inflammation of the second line of defense and can be observed as redness, swelling, heat, loss of function and pain. Vasodilations are adaptive responses to contact with irritants. It l increases blood flow towards the injured place, increased vascular permeability which transports plasma proteins, leukocytes, and other mediators which are biochemical towards the injury position. The damage acuteness relates directly to the irritant strength and the exposure time length. Avoiding further contact with the irritant, applying hypo-irritating lotions and cleansers and topical steroid ointment on the hands are treatment recommendations for jack.
Stress Response
A 65-years old female by the name Martha, in scenario 3, visits the office complaining that he is experiencing insomnia, increased heartbeat and have lost appetite. Martha has a history of HTN but her case is being appropriately controlled through medication. For the last five years, she has been taking caring of her aged mother who endured a hip fracture lost mobility. Martha is diagnosed with Stress Response. Substantial life changes for example abuse, fired from a job, a death of a relative, and trauma can lead to stress. In Martha's case, she retired from work, and no one was there to care for her sick mother.
A diagnosis is made of Stress Response. Stress in human beings can be caused by a number of factors including drug abuse and physical trauma (Huether & McCance, 2017), in this case, Martha lost her job leading to overthinking of problems that would arise from the new development. She did not have any activity after the trauma to relieve her of the tension and pressure. Her body acting on stimuli in the brain caused the sympathetic nervous system to release catecholamines into the bloodstream which causes problems with the cardiovascular system such as high blood pressure and an increase in heartbeat. When in excess, Glucocorticoid hormones negatively affect cognition, memory, sleep and mood (Huether & McCance, 2017). Coping responses to stress differ from person to person. The patient can best be helped by psychological support including counselling, support groups and promoting more activities for socialising other than contact with her mother.
In conclusion, the paper has shed light on the associated diseases by concentrating on the pathophysiology, adaptive responses of the illness and associated alterations caused by the infection. The disorders discussed include Tonsillitis, Contact Dermatitis and Stress Response in scenario one, two and three respectively. A mind map of Stress response has also been presented which highlighted the key aspects of the condition including, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder.
References
Encyclopedia Britannica. (2018). Tonsillitis: Pathology. Encyclopædia Britannica, Inc . Retrieved on 27 May 2018, from https://www.britannica.com/science/tonsillitis.
Golden, S. & Shaw, T. (2013). Hand dermatitis: Review of clinical features and treatment options. Seminars in Cutaneous Medicine and Surgery, 32 (3), 147-57.
Hammer, G. G. & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine (7 th ed.) New York, NY: McGraw-Hill Education.
Hogan, D., & Elston, D. M. (2013). Irritant contact dermatitis. Medscape . Retrieved on 27 May 2018, from https://emedicine.medscape.com/article/1049353-overview.
Huether, S. E., & McCance, K.L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Mayo Clinic. (2018). Tonsillitis. Mayo Foundation for Medical Education and Research (MFMER) . Retrieved on 27 May 2018, from https://www.mayoclinic.org/diseases-conditions/tonsillitis/symptoms-causes/syc-20378479.
