I need help with peer review.. My instructor want me to review myclassmate case study and reply with

I need help with peer review.. My instructor want me to review myclassmate case study and reply with add more information that she did not mention in it.. I will also paste the instruction and resources that she wants us to use in peer reviews. First I am going to paste instruction and resources.Resources.  It’s highly recommended you use the Yuba College Library resources for your discussions and case.  From the Announcement about Help From a Librarian, you can access information independently or with help from a librarian.  To get started:Go to the library’s Online Databases page at: https://yc.yccd.edu/academics/library/databases/.  Click on the blue square “Library Databases.”  Enter your YC credentials, and from the list of databases click on EBSCO (all databases)CINAHL Complete: (6th down) click on “choose databases” and checkHealthSource – Nursing/Academic EditionMedlineGALE Virtual Reference LIbrary: Username: yubalibraryUnder “Browse Collections” click “Medicine”Many encyclopedias to choose from (avoid pediatrics since this course focuses on adult health)Recommended: Nursing and Allied Health, 4th Edition for most casesUse the Search feature for topics on your caseOVID Journals Database: Username: yubc999 Password: useovidYou can do a basic search, or narrow your returns by selecting advanced search.  A Multi-Field Search you can select for very specific information by topic, author, etc.)Google Scholar (Links to an external site.)Google Scholar Search Tips (Links to an external site.)Course TextbookMedlinePlus (Links to an external site.) must for any research and discussion about medications.Patient Websites:  The websites you recommend for your patients should be focused on information for the lay person or consumer and written in plain, not medical, language.  Allowed: CDC (Links to an external site.), Mayo Clinic (Links to an external site.), MedlinePlus (Links to an external site.), National LIbrary of Medicine (Links to an external site.), or other authentic websites that meet the criteria in Authentic Web Research / Correct Citation.Not allowed for any portion of the case (use of these will result in a point reduction for any written work): WebMD (Links to an external site.), Healthline (Links to an external site.), or any websource that ends in dot com (.com).NOTE: Citing from encyclopedias, dictionaries, Wikipedia, etc. or any websource or research source not included in the above list is not allowed for this assignment.  Use of these will result in a point reduction for any written work.Peer Review Directions: Post your response to your peer’s case study to the same board as your own case.   Similar to the case study, your review must only use the resources listed above.  Your peer review may contain only six in-text citations in total from these sources.For the peer review, your task will be to find some new aspect of treatment, medications, resources and/or diagnostics for their patient’s problems .This response should add to the body of healthcare knowledge and avoid personal stories, opinions, and discussion of how much you personally liked or didn’t like your peer’s report.  These “conversational” statements will not be considered in the minimum word count because they do not contribute to the knowledge base.  Now I am going to paste my classmate case study which i want to reply.. Instructor also ask for citation in the answer and citation list at the end.  Case Study #56- Tuberculosis Vladimir, age 46 years, has had a persistent unproductive cough for several months that did not respond to cough medications.  Recently, he has developed a productive cough accompanied by fatigue, anorexia, and night sweats.  Examination in the ER indicated abnormal chest sounds and weight loss.  A chest X-ray showed a small cavity and infiltrate.Discussion QuestionsDiscuss the pathologic changes occurring during the development of active tuberculosis at the cellular level.Discuss how TB is transmitted and identify the conditions that lead to the development of TB.List and discuss the common lab tests and diagnostic tools used to diagnose TB.  Which one(s) is/are definitive, meaning, unmistakable?List and discuss medications and medication regimens for patients with respiratory TB that the PCP will likely prescribe?  Remember the PCP (primary care provider) can be an MD, a nurse practitioner or a physician’s assistant.What side effects of medications and teaching will you as a member of the healthcare team teach Vladimir and his family prior to discharge from the hospital?Identify and discuss the precautions involved for family, friends and health care personnel coming into contact with this patient.Provide at least two authentic patient centered websites that Vladimir can use to inform himself about his infection and how to manage it.  Briefly discuss key information to inform your reader about these web sources.Describe at least two things you learned because of the research you did on this case and how you feel it will impact your future actions in healthcare.Pathogenesis of active tuberculosis proceeds in steps from initial infection of macrophages to TH1 response that contain the bacteria and cause tissue damage. The following are the cellular changes that occur during the active tuberculosis entry to macrophages. Tuberculi bacilli enter the macrophages where the macrophages either kill the bacilli or get killed. The bacterial bacillus prevents the macrophages mediated cellular killing and destroys the macrophages. They do so by inhibiting the maturation of the phagosomes and block formation of phagolysosomes which allow the The Activation of innate immunity, multiple pathogens associated molecular pattern of tuberculosis including lipoprotein and glycoprotein are recognized by the innate immunity which cause the TH1 response, about 3 weeks after the infection a t helper 1 response is mounted that activate macrophage enabling them to become bactericidal. The response is initiated by the m bacilli entering the lymph nodes. The TH1 differentiation depends on interleukin 12, this IL 12 is produced by antigen presenting cells which have encountered by the mycobacterium. The bactericidal action of the immune system, T cells synthesize interferon g (gamma) which produces nitrogen sunshade enzymes which further result in synthesize of NO NO2 HNO3 and free radicals these components destroy the AFB ( acid fast bacillus ). The epithelioid granuloma formation, macrophages activated by Interferon gamma (INF-G) changes to the epithelioid histiocytes that aggregate and form the granuloma . Some of the epithelioid cells fuse and form multinucleated giant cells such as foreign body giant cells and langerhans type giant cells. The epithelioid cells are surrounded by the giant cells which are surrounded by the lymphocytes cells and thus formation of granuloma occurs . The granuloma formed is called hard tubercle which with central caseous necrosis is known as soft tubercle. The activated macrophages also produce more TNF (tumor necrosis factors ) which further cause change of macrophages to the epithelioid cells. The importance of TNF is understood by the fact that the person who is treated with TNF antagonist in rheumatoid arthritis causes reactivation of tuberculosis. The role of other immune cells, NKT cells, also recognize mycobacterium antigen which are bound to CD1 cells of the t cells , this further causes release of INF -G (GAMMA ). The role of TH1 cells has the central role in this process. To summarize the process it is clear that immunity to m tuberculosis is primarily mediated by TH1 CELLS which stimulate macrophages to kill the bacterium. The formation of granulomatous inflammation is a characteristic feature of active tuberculosis. Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attacks the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with TB bacteria becomes sick, tuberculosis is transmitted through the air, not by surface contact. Transmission occurs when a person inhales droplet nuclei containing M. tuberculosis, and the droplet nuclei traverse the mouth or nasal passages, upper respiratory tract, and bronchi to reach the alveoli of the lungs. According to The Mayo Clinic, “Tuberculosis can also affect other parts of your body, including the kidneys, spine or brain. When TB occurs outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine might cause back pain, and tuberculosis in your kidneys might cause blood in your urine…. Tuberculosis is also caused by bacteria that spreads from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings. Although tuberculosis is contagious, it’s not easy to catch.” Some of the common lab tests and diagnostic tools used to diagnose TB are sputum microscopy, skin test, IGRAs. These tests such as the culture test, the skin test, TB Interferon gamma release assays (IGRAs), sputum smear microscopy as a test for TB, serological tests as a test for TB, and molecular tests are all tests that can diagnose tuberculosis. The accuracy of these tests are based on how they are performed. Medications and medication regimens for patient with respiratory tuberculosis that the primary care provider would prescribe for drug regimen are isoniazid, rifampicin, pyrazinamide, and either streptomycin or ethambutol and if the patient is susceptible for ethambutol then it can be discontinued. These are the main medications that can be prescribed by the primary care provider of a patient diagnosed with respiratory tuberculosis. As a member of the healthcare team one would teach Vladmir and his family about all the side effects of medications and other information that needs to be provided to Vladmir and his family prior to him being discharged from the hospital. Those side effects of the medications can include pain in the lower abdomen, nausea, vomiting, dark or bright red colored urine due to the use of rifampicin, itching, and rashes. Some of the other side effects may include the discoloration of skin such as a yellowish color, there could also be tingling and numbness, fatigue, weakness, and maybe even a burning sensation in the hands and feet. These are the many side effects from the medications prescribed for tuberculosis that Vladmir and his family should be aware of prior to Vladmir being discharged from the hospital. When one is diagnosed with tuberculosis it generally takes up to a few weeks of treatment to stop the contagiousness, in order to prevent spreading it to others one should take multiple precautions to protect family, friends, and anyone around the patient in that case. Some of those precautions include staying at home in an isolated room away from others, ventilating the room because in a closed where air is still it is easier for germs to spread more, use a tissue every time one sneezes, laughs, and coughs and then sealing the tissue in a bag and throwing it away, and always wear a face mask when with other people. These are some of the many methods of preventing the spread of tuberculosis. Two authentic patient centered websites that Vladmir can use to inform himself about his infections and how to manage it can include the Mayo Clinic website which is built for patients to be able to research on their illness or disease. The Mayo Clinic website provides readers with the causes, symptoms, possible treatments, risks, basically anything one would need to know about an illness or disease, One of the other websites that Vladmir would find helpful would be WebMD website as well.  After doing my research on tuberculosis I have learned many things that I had not known before. For example, I learned that tuberculosis can be spread by even just talking to someone without having one’s mouth covered. Another thing that I learned is the intensity of how bad tuberculosis can become if it goes undiagnosed and how many people can be affected by it, although it is hard to be diagnosed with TB it is easy to spread because of how contagious it is, I believe by knowledge from my research will teach me to be a better nurse in the future due to all the multiple methods of treatment I learned about for one illness. This teaches me to know many methods of treatment and ways to assist patients with all of their needs.  Work Cited:The Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250 (Links to an external site.)WebMDhttps://www.webmd.com/ (Links to an external site.)HealthlinkBChttps://www.healthlinkbc.ca/healthlinkbc-files/home-isolation-tuberculosis Health Science Science Nursing NURS 36 Share QuestionEmailCopy link Comments (0)

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