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.

· 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)”. (Google Mind Map)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 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.

This Assignment is due. 12/08/17 @1400Hrs

elect two social, cultural, and environmental theories. Compare and contrast the two theories. Explain how each theory works to include its benefits and challenges. Describe a public health issue that could be addressed by each theory. (Note: This list of theories mentioned in the text and lectures is not exhaustive. There are other theories outside of what was mentioned). For the theories you have identified:

• Define each theory to include a brief overview of the history.
• Explain how each theory works by using a public health issue as an example.
• Discuss the benefits and challenges of using each theory.
• Compare and contrast the theories.
• Comment on the postings of at least two peers

Evaluation Criteria

• Identified two theories and described each theory.
• Provided examples of how each theory works, using a public health issue.
• Explained the benefits and challenges of using each theory.
• Compared and contrasted the two theories.
• Justified answers with appropriate research and reasoning by using appropriate examples and current references from textbooks, the South University Online Library, and other acceptable references—citing the sources in APA format.
• C

Your scholarly paper is a comprehensive evaluation of an elderly client. You can select a client in any setting. This will be your scholarly paper for this class. It should be submitted in APA format. Your references should not be greater than 5 years old. You must use scholarly references. Throughout your paper you should consider age-related changes (physiological). Please do not write this paper as a health history as in health assessment classes this should be written as a narrative format. It is worth 15% of your grade

Information to be included:
1. Give a brief history of the client, include the medical history, social history
2. Explain the individual’s acute or chronic medical issues. If the individual

has an acute medical problem, explain how it is exacerbated by the aging

process (physiologic age-related changes). If your client does not have any

medical concerns discuss how they are maintaining their health. Use rearch

to support your findings.
3.  Review the medications that the individual is taking, including any over the

counter drugs. Are any of these drugs a problem? Many medications are

problems in the older adult. Explain the issues.
4. Explain the functional status? (ADL and IADL) What is their mobility and

ability to perform everyday activity? If there are any issues or concerns,

explain.
5. Look at the mental health and cognitive ability. Is there any impairment? Is

there a concern and if so is it being addresses? Also consider their daily

activities including social.
6. Evaluate the living situation. Is it a problem or potential problem? (living

alone, with family or a facility) Is it a problem or a good fit? Are there safety

issues or concerns? Explain. If you r client is from the hospital you should

be considering their home situation. How will it be impacted due to the

illness.
7. What  are your recommendations to improve the quality of life for this

individual.

References 

Please use a minimum of 5 resources (textbooks may be used but are not considered as the 5 resources., no more than 5 years old. Make use of journals, that is where your most up-to-date information will be.

No Plagiarism please, assignment will be checked with Turnitin. 

Will need 5 full pages, double spaced all throughout the page for the case study, APA Style, Times New Roman, font 12, Title Page and a Reference page. 

Topic: Respiratory Issues Complicated by Economic Disadvantage

A mother brings her 8-year-old child to the clinic, stating the child “just isn’t breathing right, doesn’t want to play, just lies on the couch — this happens all the time.”

The appearance of both mother and child is disheveled. The child’s wheezing can be heard across the room. When asked if the child is better at any certain time of the day, the mother responds, “It’s like this all the time and has been for the past year — we saw a doctor last year who diagnosed asthma but we don’t have any money for drugs or to come back to the clinic.”

Directions:

APA formatted paper of no more than five (5) pages excluding title page and references.

· Identify the resources currently available in your state to support this family in the care of this child, including assistance programs for costs of health care follow-up and pharmaceutical treatment agents.

· Create a communication plan for mother and child for both prescriptive and non-prescriptive drug therapies.