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Adaptive Response Paper
It is necessary that as an advanced practice nurse that we are educated on disorders that exist in today’s society. Our knowledge on numerous disorders, will eventually influence our practice in a positive fashion. Being competent in properly diagnosing individuals and providing the correct treatment plan have a tendency to heighten the individual’s outcome. In this assignment three scenarios will be reviewed. After reviewing each scenario, a diagnosis will be constructed and the pathophysiology description of each disorder will be stated.
In Scenario 1 the child has a Tonsillar infection known as Tonsillitis. Tonsillitis is a common infection in children. Furthermore, the spike in the child’s temp is a tell-tell
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Kutzscher (2012) “Contact Dermatitis is found to be more common in patients age 50 and older (because of slowed epidermal cell regeneration) and in women who are employed in occupations with frequent hand washing, such as nursing and hairdressing”. Jack is presented with redness and irritation of his hands which supportive of the diagnosis. Huether & Mccance (2017) “Allergic contact dermatitis is a common form of T-cell-mediated or delayed hypersensitivity. The response is an interaction of the skin functional barrier, reaction to irritants, and neuronal responses, such as pruritus. Genetic susceptibility involves several genes including loss-of-function mutations in the gene encoding the epidermal protein filaggrin”. Allergic Contact Dermatitis presents many symptoms, some are noted in the scenario. Huether & Mccance (2017) “The manifestations of allergic contact dermatitis include erythema and swelling with pruritic vesicular lesions in the area of allergen contact”. Jack should be advised to wear gloves while on the job to protect his skin from known
Arch Dermatol. 2007;143(1):124–125. Puchenkova, S. G. (1996). "
Smith brings his 4-year-old to your office with chief complaints of right ear pain, sneezing, mild cough, and low-grade fever of 100 degrees for the last 72 hours. Today, the child is alert, cooperative, and well hydrated. You note a mildly erythemic throat with no exudate, both ears mild pink tympanic membrane with good movement, lungs clear. You diagnose an acute upper respiratory infection, probably viral in nature. Mr. Smith is states that the family is planning a trip out of town starting tomorrow and would like an antibiotic just in case.
The physician will question the patient about any stressors she may be contending with at home or work prior to her entering the hospital. The physician will order lab tests and speak with the patient to understand the psychological factors; a referral will be made for making a final diagnosis. After the physician reviews both lab tests and the psychological factors, a referral will be made for the patient to see a clinician. The referral will focus on obtaining support and stabilization. The clinical assessment will gather information using written forms as a first step, including releases to speak with family members. The second step would be to invite the family along with the client in an effort to obtain a better understanding of existing medical conditions along with any past mental disorders. Abuse as a child or abuse as an adult will be determined. The clinician will evaluate if the client is portraying any signs due to alcoholism or a drug addictions. An example of one question her clin...
Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days. His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and inspiratory crackles on chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) to Liam due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010). Moreover, Liam has fever and conjunctiva injection which could be a result of infection, as evidenced by high temperature (38.6°C) and bilateral tympanic membra...
St. Louis, MO: Elsevier Ackley, B.J., Ladwig, G.B., & Flynn Makic, M. (2017). Nursing diagnosis handbook (11th ed.). St. Louis, MO: Elsevier University.
There has been great debate and controversy in trying to determine the appropriate methods in attaining an accurate temperature in pediatric patients. In light of new technological advances to find innovative ways to attain exact temperatures in this population, there are hospitals and affiliated medical centers that still assess pediatric temperature through traditional means, which is rectal thermometer. Even more disturbing is the continued use of glass mercury-filled thermometers in the health care setting. These add additional risks of metal toxicity from the leakage of mercury and possible rectal perforation (Chiappini, Sollai, Longhi, Morandini, Laghi, Osio, Persiani, Lonati, Picchi, Bonsignori, Mannelli, Galli, & de Martino, 2010; Teran, Torrez-Llanos, Teran-Miranda, Balderrama, Shah, & Villarroel, 2011). Other means of assessing core temperature in terms of accuracy include obtaining a temperature through the pulmonary artery, tympanic membrane, esophagus, and urinary bladder (Braun, 2006). All of these are quite invasive techniques and are not well tolerated amongst the pediatric population. However, the most accurate noninvasive method can be quite confusing amongst the medical professional in the provisions of care and assessment.
D. standing near her room, breathing sharply. While asked what has just happened, she answered, ‘I feel dizzy and can faint!’ Mrs. D. then explained that she rose up from her chair in the television room and felt lightheaded. I decided to bring her to the room hoping she would feel less dizziness if she could sit. After consultation with my mentor and third year unit nursing student, I decided to perform measurement of her vital signs. Since only electronic sphygmomanometer was available for me that time, I had to use it for my procedure. Gladly, I discovered that I have already used such equipment in my previous nursing practice. Using the standard sized calf, I found that her blood pressure was 135/85, respirations were 16, and her pulse was 96 beats per minute (bpm). However, I decided to recheck the pulse manually, founding that it was irregular (78 bpm). The patient stated that she felt better after rest. Immediately after the incident I made a decision to explore carefully the medical chart of Mrs. D., along with her nursing care plan. That helped me to discover multiple medical diagnoses influencing her
Potter, P. A., & Perry, A. G. (2005). Fundamentals of nursing (6th ed.). St. Louis, MO: Mosby,
For the outcome, Clinical Competence I have learned the importance of the nursing process in my current class, Skills and Concepts. This information is relatively new to me, so I know I have plenty of room to grow in this area. I have learned how to utilize the resources that I am provided. One resource in particular is my pocket guide. This has been a useful tool in helping learn and write a nursing diagnosis based upon a given situation. As I progress through the rest of this class; I hope by the end to be more competent in ways of providing the best possible care while utilizing the nursing process.
Spark Ralph, S. & Taylor, C. M. (2011). Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing:
Some symptoms which have been known to appear in a patient with a factitious disorder are unbelievable, inconsistent, and have a long medical history in different hospitals or clinics.
Gordon, M. (2007). Manual of nursing diagnosis: including all diagnostic categories approved by the North American Nursing Diagnosis Association (11th ed.). Sudbury, Massachusetts: Jones and Bartlett.
These goals and objectives can be accomplished through the use of the nursing diagnostic and treatment process proposed through the model (Masters, 2014). The diagnostic and treatment process includes four essential elements; problem identification, problem classification, problem management, and assessment of behavioral system balance and stability. Hence, the model facilitates assessment and planning, implementation, and evaluation of behavioral
The patient has high temperature, and extreme sweating as well as visible chills on body.