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 todays 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
1. Review the three scenarios, as well as Chapter 6 in the
Huether and McCance text. 2. Identify the pathophysiology of the
disorders presented in each of the three scenarios, including their
associated alterations. Consider the adaptive responses to the
alterations. 3. Review the examples of Mind MapsDementia,
Endocarditis, and Gastro-oesophageal Reflux Disease (GERD) media
in this weeks 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. 4. Review the Application
Assignment Rubric found under Course Information
To Complete
Write a 2- to 3-page paper excluding the title page, reference
page and Mind Map that addresses the following:
1. 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. 2. 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.

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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 todays 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
1. Review the three scenarios, as well as Chapter 6 in the
Huether and McCance text. 2. Identify the pathophysiology of the
disorders presented in each of the three scenarios, including their
associated alterations. Consider the adaptive responses to the
alterations. 3. Review the examples of Mind MapsDementia,
Endocarditis, and Gastro-oesophageal Reflux Disease (GERD) media
in this weeks 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. 4. Review the Application
Assignment Rubric found under Course Information
To Complete
Write a 2- to 3-page paper excluding the title page, reference
page and Mind Map that addresses the following:
1. 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. 2. 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.
Note: The School of Nursing requires that all papers submitted
include a title page, introduction, summary, and references. The
Sample Paper provided at the Walden Writing Center provides an
example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers
submitted must use this formatting

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