Assignment: 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:

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 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.

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

· 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

To Complete

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.

USE RESOURCE BELOW FOR REFERENCES 

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

• Chapter 6, “Innate Immunity:      Inflammation and Wound Healing”

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 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.

• 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”

This chapter reviews genetic, environmental, behavioral, and diet-related risk factors for cancer. It also examines types of cancers that result from risk factors.

• Chapter 12, “Cancer in      Children and Adolescents”

This chapter focuses on the presentation and prognosis of childhood cancers. It examines the impact of genetic and environmental factors on these cancers.

• Chapter 38, “Structure and      Function of the Musculoskeletal System”

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.

Required Media

Zimbron, J.  (2008). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://www.medmaps.co.uk/beta/

Gastro-oesophageal reflux disease. [Image]. Used with permission of MedMaps.

This media provides examples of mind maps for dementia, endocarditis, and gastro-oesophageal reflux disease (GERD).

Write 3 pages describing the effective use of patient-care technologies, communication systems, and information systems across the care continuum of a health care system of your choice. Add a one-page executive summary your organization could use to disseminate these ideas.

Because a lack of knowledge when using technology can lead to errors in patient care, effective use of technology in health care is paramount to providing a safe health care delivery environment.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 3: Explain the use of information management tools and technologies to monitor and improve health care delivery and patient outcomes.
  • Describe effective use of technology across the care continuum in a health care setting.
  • Describe how to manage change and technology to improve positive outcomes.
  • Support description of effective patient care with current nursing and informatics theoretical ideas.
• Competency 4: Communicate in a manner that is consistent with expectations of a nursing professional.
  • Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics.

 

In the role of a nurse leader, describe the effective use of patient-care technologies across the care continuum in a chosen health care system.

Preparation

Choose any type of health care system, for example, acute, ambulatory, or home health or telehealth.

Directions

Submit the following for this assessment:

Technology Across the Care Continuum

Include the following in your 3page description:

• A brief overview of the care continuum in your selected health care system.
• Describe the types of patient-care technologies and how they are used across the care continuum in your system. Be sure to include communication and information systems.
• Identify strengths and weaknesses in the systems and describe how to manage change and technology to improve patient outcomes.
• Support your description of effective patient care with current nursing and informatics theoretical ideas.

Executive Summary

Based on the description above, add a 1-page executive summary that captures the following points:

• Current state of technology across the care continuum in your system.
• Proposed improvements.
• Risks of making or not making changes or improvements.
• Recommended next steps.

Additional Requirements

• Written communication: Ensure written communication is free of errors that detract from the overall message.
• APA formatting: Format resources and citations according to current APA style and formatting guidelines.
• Number of resources: Cite a minimum of four peer-reviewed resources.
• Length: Submit 4 typed, double-spaced pages.
• Font and font size: Use Times New Roman, 12 point.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
• Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

Purpose: To investigate & integrate knowledge of advanced nursing practice, scholarly inquiry, & leadership by examining a policy at the level of clinical practice, health care systems, or public/social health policy.Submit a paper between 5-8 pages long excluding title page and reference pages. Paper must be organized according to the guidelines below and should include all the identified sections as required. Paper must be completed in APA format and contain current scholarly sources dated from 2014 until current.

 

· Introduction: Generally define & describe the policy issue to be addressed. Identify the purpose of analysis, the targeted level of policy (i.e., clinical practice, health care systems, or public/social health) & significance of topic. Identify questions the policy analysis is intended to address.

· Background: Provide details of the issue or problem, including its nature/scope, relevant literature & history, & the context within which the issue exists. Describe existing policy addressing the issue, if any. Discuss strengths & shortcomings in existing policy. Identify & describe key stakeholders (individuals & groups) that are or will be affected by the policy & why.

· Analysis: Identify alternative policies to achieve objectives. Establish/identify criteria that will be used for selection of “best” policy. Evaluate each alternative & its potential impact relative to the healthcare & patient outcomes.  Assess the trade-offs between alternatives.

· Recommendations: Based on the analysis, identify the “best” alternative to address the current issue & policy situation.  Provide rationale for selection.  Describe possible strategies to implement selected alternative. Identify barriers to implementation of selected alternative. Describe methods to evaluate policy implementation.

· Discussion: Discuss analysis & recommendations relative to the original questions identified, & the level of policy it is intended to address (i.e., clinical practice, health care systems, or public).  Identify limitations of analysis. Discuss implications for practice, education, research, & policy-making.

· Conclusion: Summarize findings & recommendations of analysis  Identify questions to be addressed in future studies or policy analyses.

· References: List all references cited in paper. Must be completed in APA format.

Prepare a 10-15 slide PowerPoint presentation, with speaker notes, that examines the significance of an organization’s culture and values. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the Topic Materials for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning, and an additional slide for References at the end.

1. Outline the purpose of an organization’s mission, vision, and values.
2. Explain why an organization’s mission, vision, and values are significant to nurse engagement and patient outcomes.
3. Explain what factors lead to conflict in a professional practice. Describe how organizational values and culture can influence the way conflict is addressed.
4. Discuss effective strategies for resolving workplace conflict and encouraging interprofessional collaboration.
5. Discuss how organizational needs and the culture of health care influence organizational outcomes. Describe how these relate to health promotion and disease prevention from a community health perspective.

While APA style format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.