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 later 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, 
• 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 constructing 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 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.
• APA citation 3 to 4 references within 5 years

Purpose

This week’s graded topic relates to the following Course Outcome (CO).

CO6: Plans clinical practice activities that integrate professional nursing standards in accordance with the Nursing Code of Ethics and the ANA standards of practice (PO#6).

Discussion

Go to the link https://www.thinkculturalhealth.hhs.gov/clas/standards (Links to an external site.).

View the National Culturally and Linguistically Appropriate Services Standards (CLAS) categories aimed at equity and quality care (HHS, n.d.). Notice how these standards overlap with many of the expectations and standards in professional nursing practice!

• In what ways are you and your peers using these standards in your areas of nursing practice?
• Discuss one nursing action you might incorporate to improve cultural competence in your organization.

professor’s comment: Class, please review the above website and discuss the CLAS categories.

references: American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.

American Nursing Association [ANA]. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: American Nurses Publishing.

 

Journal your experiences and in addition, include the following areas:
1. Evaluation of selected goals and objectives for Capstone Practicum.

2. Evaluate how the agency integrates best current evidence with clinical expertise and delivery of optimal health care.

3. Agency assessment on its use of information and technology to communicate, manage knowledge, mitigate error, and support decision making.

 

Journal your experiences and in addition, include the following areas:
1. Evaluation of selected goals and objectives for Capstone Practicum.

2. Evaluate how the agency integrates best current evidence with clinical expertise and delivery of optimal health care.

3. Agency assessment on its use of information and technology to communicate, manage knowledge, mitigate error, and support decision making.

Your nurse manager has asked you to form a small team to explore incorporating patient care technology in the care of patients with pulmonary disease. He has asked that your team prepare a presentation for the nurses on the following topics: asthma and COPD.

Discuss at least two patient-care technologies that would assist in the care of patients suffering from asthma and COPD. Please include in-text citations to support your response.