Assignment: Case Studies Mechanisms of Self Defense

Assignment: Case Studies Mechanisms of Self Defense

 

Instructions:
Add in text citations where appropriate in APA format. You may also have other referenced peer reviewed materials to reference for your answers. Acceptable additional references include peer reviewed journal articles within the last 5 years, textbooks from the nursing program within the last 5 years, national guidelines, or posted additional articles within this course.

 

Chapter 09: Alterations in Immunity and Inflammation

 

Case Study Anna Sanchez Assignment: Case Studies Mechanisms of Self Defense

 

CC: “I have a cold that I cannot seem to get rid of”

HPI: This is a 21-year-old female nursing student that presents to the on-campus clinic nurse practitioner with a 5 week history of itchy and watery eyes (clear drainage), nasal congestion with occasional watery clear nasal discharge. She reports the symptoms seems worse at night and right after she wakes up in the morning. She reports she has tried over the counter medications including Afrin nasal spray, eye drops, and Zyrtec. She reports a “tickling” cough that occurs at night and episodes of repetitive sneezing. She reports some of her dorm room friends have had colds as well over the last several weeks.

Physical Examination

Vital Signs
: T. 98.4 HR. 68 R. 12 B/P 128/74 SpO2 98% on room air.

General:
Well kempt

HEENT (Head, Eyes, Ears, Nose, and Throat)
: Normocephalic, Sclera injected red, irritated orbits with erythema and swelling; tearing clear drainage bilaterally; tenderness with palpation over maxillary sinuses; outer nares with erythema, irritated skin; internal nares erythematous, boggy, moist mucosa and one medium-sized polyp on each side; pharynx slightly erythematous with clear postnasal drainage.

(NOTE: Nasal polyps are common in allergic rhinitis. They are edematous protrusions of the mucosa that are infiltrated with neutrophils, eosinophils, and plasma cells.)

Skin
: Flaking erythematous rash on the flexor surfaces of both arms

Lungs
: Clear to auscultation and percussion

Injected conjunctiva

 

2. Nasal polyp and swollen turbinate left nare

 

Answer the questions about the patient and her condition.

 

What assessment questions would be useful to ask
Anna
about her medical and family history? Why? (1 point)

 

 

What evidence suggests that Anna does or does not have an acute severe infection? Explain your answer. (1 point)

 

 

What type of hypersensitivity reaction is involved with allergic rhinitis? Explain this type of hypersensitivity. (2 point)

 

 

A skin test indicates that Anna is allergic to cat dander. Two months ago, Anna’s roommate brought home a cat. Why didn’t Anna’s symptoms start when the cat entered the household, rather than 3 weeks later? (2 point)

 

 

What class of antibodies bound to the mast cells? (1 point)

 

 

What physiological mechanisms caused the redness of Anna’s nasal mucosa? (1 point)

 

 

Anna’s skin rash is consistent with atopic dermatitis, which is common in young people with allergies. What type of hypersensitivity reaction causes atopic dermatitis? (1 point)

 

 

Why are there a lot of eosinophils in nasal polyps in allergic rhinitis? (1 point)

 

 

What mechanisms caused Anna’s clear postnasal drainage? (1 point)

 

 

ORDER HERE

 

Chapter 10: Infection- Assignment: Case Studies Mechanisms of Self Defense

 

Case Study

Joan Silva, age 35, comes to her primary care provider with a history of recurrent vaginal infections
. She also mentions weight loss and generalized fatigue that has been worsening over the past 4 months. She has been previously healthy, takes no medications other than oral contraceptives and calcium supplements, and has no other significant medical history. Joan states that she became sexually active at the age of 19 and that she has had four sexual partners in her lifetime. She has never used any form of barrier protection during intercourse. She is currently in a 4-year monogamous relationship with a 37-year-old man who is in good health.

 

Physical Examination

 

Thin, anxious woman in no distress

Temperature 38°C (100.4°F) orally; pulse 96 and regular; blood pressure 138/76 sitting; respiratory rate 15

Head/Eyes/Ears/Throat
:
No alopecia; pupils equal and reactive; fundi without lesions; tympanic membranes clear; cheesy white exudate on tongue and pharynx

Neck
:
Mild anterior cervical adenopathy; no thyromegaly

Lungs
:
Clear to auscultation and percussion

Cardiac
:
Regular rate and rhythm without murmurs or gallops

Abdomen
:
Nontender, without masses

Pelvic
:
Thick, white vaginal discharge; venereal warts present

Extremities
:
Without edema; pulses full throughout

Neurologic
:
Cranial nerves, strength, sensation, reflexes, and gait all intact

 

Laboratory Results

 

HIV antibody test
: Positive, confirmed by Western blot

Complete blood count
: Decreased lymphocytes, CD4
+
= 170 cells/µL

Potassium hydroxide preparation of oral and vaginal exudate
: yeast

 

Answer the questions about Joan Silva and her condition.

 

Does Joan meet the diagnostic criteria for AIDS? Explain your answer. (1 point)

 

 

Why does Joan have oral and vaginal candidiasis? What is the pathophysiologic process that leads to the candidiasis? (2 point)

 

 

What does the term opportunistic infection mean? Why does it happen? Name one opportunistic infection that could happen in this case. (2 point)

 

Why does her low CD4+ cell count put Joan at high risk for opportunistic infections? (1 point)

 

Chapter 11: Stress and Disease

Explain the relationship between stress and disease. Include the pathophysiologic processes involved. (2 point)

 

How does a patient’s coping responses affect treatment and or recovery? (1 point) Assignment: Case Studies Mechanisms of Self Defense