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 3- to 4-page paper excluding the title page, reference page and Mind Map that addresses the following:

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• 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.