Whether a person realizes it or not, his or her body regularly uses compensatory mechanisms such as adaptive and maladaptive responses. These compensatory mechanisms help the body respond to stressors or triggers. Perhaps you have heard a patient complain that his or her food “just didn’t go down right,” resulting in a coughing spell. Maybe you have treated a child with scabs on his or her arms and legs. These are automatic physiological responses that a person cannot control and that may sometimes result in adverse health effects, such as hives. As an advanced practice nurse, it is important that you are able to identify the root of compensatory mechanisms and underlying responses. Which compensatory mechanisms are related to which disorders? Is the presenting mechanism positive and adaptive, or is it maladaptive and in need of control? What are appropriate management strategies?
- Compare maladaptive and physiological responses of immune disorders
- Evaluate the impact of patient factors on the pathophysiology of immune disorders
- Compare the pathophysiology of osteoarthritis and rheumatoid arthritis
- Evaluate the impact of patient factors on arthritis
- Analyze the pathophysiology of disorders
- Assess adaptive responses to alterations
- Evaluate clinical considerations of disorders
- Understand and apply key terms, concepts, and principles related to adaptive and compensatory mechanisms
- Understand and apply key terms, concepts, and principles related to alterations of the musculoskeletal, autoimmune, and integumentary systems
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Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
- Chapter 6, “Innate Immunity: Inflammation and Wound Healing”
- Chapter 7, “Adaptive Immunity”
- This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.
This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound healing process.
- Chapter 8, “Infection and Defects in Mechanism of Defense”
This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder—HIV/AIDS.
- Chapter 9, “Stress and Disease”
This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.
- Chapter 10, “Biology of Cancer”
This chapter explores the developmental process of cancer and factors that impact the onset of cancer at the cellular level. It also describes various treatment options.
- Chapter 11, “Cancer Epidemiology”
- Chapter 12, “Cancer in Children and Adolescents”
- Chapter 38, “Structure and Function of the Musculoskeletal System”
This chapter reviews genetic, environmental, behavioral, and diet-related risk factors for cancer. It also examines types of cancers that result from risk factors.
This chapter focuses on the presentation and prognosis of childhood cancers. It examines the impact of genetic and environmental factors on these cancers.
This chapter covers the structure and function of bones, joints, and skeletal muscle. It also explores effects of aging on the musculoskeletal system.
- Chapter 39, “Alterations of Musculoskeletal Function”
- This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of bone, joints, and skeletal muscle disorders. Additionally, it explores musculoskeletal tumors, osteoarthritis, and rheumatoid arthritis.
- Chapter 40, “Alterations of Musculoskeletal Function in Children”
This chapter includes musculoskeletal disorders that affect children, such as congenital defects, bone infection, juvenile idiopathic arthritis, muscular dystrophy, musculoskeletal tumors, and nonaccidental trauma.
- Chapter 41, “Structure, Function, and Disorders of the Integument”
This chapter begins with an overview of the structure and function of skin. It then covers effects of aging on skin, as well as disorders of the skin, hair, and nails.
- Chapter 42, “Alterations of Integument in Children”
This chapter covers alterations of the integument that affect children. These include acne vulgaris, dermatitis, infections of the skin, insect bites and parasites, vascular disorders, and other skin disorders.
Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.
- Chapter 3, “Disorders of the Immune System”
This chapter explores the anatomy and physiology of the immune system. It also explores the pathophysiology of various immune disorders such as primary immunodeficiency diseases and AIDS.
- Chapter 8, “Diseases of the Skin”
This chapter begins with an overview of the anatomy and physiology of skin. It also explores the pathophysiology of various types of skin lesions and inflammatory skin diseases.
- Chapter 24, “Inflammatory Rheumatic Disease”
This chapter explores the pathogenesis of inflammation and its role in rheumatic diseases. It also examines the clinical presentation, etiology, pathophysiology, and clinical manifestations of rheumatic diseases such as gout and rheumatoid arthritis.
This media provides examples of mind maps for dementia, endocarditis, and gastro-oesophageal reflux disease (GERD).
ASSIGNMENT 1: Maladaptive Responses to Immune Disorders
Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.
Consider immune disorders such as HIV, psoriasis, inflammatory bowel disease, and systemic lupus E. What are resulting maladaptive responses for patients with these disorders?
Review Chapter 6 and Chapter 8 in the Huether and McCance text. Reflect on the concept of maladaptive responses to disorders.
- Select two of the following immune disorders: HIV, psoriasis, inflammatory bowel disease, or systemic lupus E (SLE).
- Identify the pathophysiology of each disorder you selected. Consider the compensatory mechanisms that the disorders trigger. Then compare the resulting maladaptive and physiological responses of the two disorders.
- Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor might impact your selected immune disorders.
WRITE a brief description of the pathophysiology of your selected immune disorders. Explain how the maladaptive and physiological responses of the two disorders differ. Finally, explain how the factor you selected might impact the pathophysiology of each disorder..
ASSIGNMENT 2: Arthritis
While arthritis impacts nearly 50 million adults in the United States, it is not a disease that is limited to adulthood. Consider the case of Ashley Russell. At the age of 14 months, Ashley was diagnosed with juvenile rheumatoid arthritis. As a baby, her parents noticed that her knee was always swollen and that she often wanted to be carried instead of walking on her own (Cyr, 2012). After seeking medical care, Ashley’s underlying disorder was discovered. Arthritis in children is not uncommon. According to the CDC (2011), an estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition. Due to the prevalence of the disorder in both children and adults, you must understand the pathophysiology and symptoms of arthritis in order to properly diagnose and prescribe treatment.
- Review Chapter 37 in the Huether and McCance text and Chapter 24 in the Hammer and McPhee text. Identify the pathophysiology of osteoarthritis and rheumatoid arthritis. Consider the similarities and differences of the disorders.
- Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology of the disorders, as well as the diagnosis of and treatment for the disorders.
WRITE a description of the pathophysiology of osteoarthritis and rheumatoid arthritis, including the similarities and differences between the disorders. Then explain how the factors you selected might impact the pathophysiology of the disorders, as well as the diagnosis of treatment for the disorders.
ASSIGNMENT 3: 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:
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.
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.
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.
- 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
Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:
- 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.
Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the School Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting