NURS6501 Week 2 Application

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.

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 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.

By Day 7

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