NR 507
Week 1 Part 1, 2 & 3
Discussion Responses
Altered Immune and Inflammatory Responses
,Week 1: Altered Immune System and Altered Inflammatory Response
- Discussion Part One
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Discussion
This week's graded topics relate to the following Course Outcomes (COs).
1 Analyze pathophysiologic mechanisms associated with selected
disease states. (PO 1)
2
Differentiate the epidemiology, etiology, developmental
considerations, pathogenesis, and clinical and laboratory
manifestations of specific disease processes. (PO 1)
3
Examine the way in which homeostatic, adaptive, and
compensatory physiological mechanisms can be supported and/or
altered through specific therapeutic interventions. (PO 1, 7)
6 Distinguish risk factors associated with selected disease states.
(PO 1)
5 Describe outcomes of disruptive or alterations in specific
physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease states.
(PO 1)
7 Explore age-specific and developmental alterations in physiologic
and disease states. (PO 1, 4)
Discussion Part One (graded)
,John is a 19-year-old college football player who presents with sneezing, itchy eyes, and nasal
congestion that worsens at night. He states that he has a history of asthma, eczema and allergies
to pollen. There is also one other person on the football team that has similar symptoms. His
vitals are BP 110/70, P 84, R 18, T 100 F.
Write a differential of at least five (5) possible items from the most likely to less likely. For
each disease include information about the epidemiology, pathophysiology and briefly
argue why this disease fits the presentation and why it might not fit the presentation.
Responses
Rechel DelAntar 4/26/2016 7:11:48 PM
Introduction
Hello Professor and Class,
I would like to greet everyone a warm Hello and hope everyone is doing great. My name is
Rechel Delantar and I have been a nurse for what seems like ages (graduated 1990). I have
been in critical care and recovery room for most of my nursing career. The last 12 years I have
specialized in Cardiovascular Recovery Room caring for post Heart Assist device, ECMOs, open
hearts and organ transplant patients among others before moving to my current position as a
Heart transplant coordinator. I have always wanted to pursue my masters degree but found it
difficult with time and family and later on going back to school online became a little
intimidating. When my parents died I then decided to pursue my dream of obtaining my APN. I
have been blessed to have good instructors and classmates and I'm getting comfortable with
school.
It is a pleasure to meet everyone and good luck with class.
Rochelle Elayda 4/26/2016 9:49:02 PM
Discussion part 1
Allergic rhinitis
Epidemiology: Allergic rhinitis is a common chronic disease with a prevalence between five and
twenty-two percent in the United States (Khan, 2014). Many patients who have asthma also
have allergic rhinitis. Rhinitis is most common in patients ages 15-25, and it affects more boys
than girls (Batt, 2014). Allergic rhinitis is usually diagnosed before asthma and sensitization
occurs at a very young age when the immune system is still immature (Batt, 2014). Symptoms
include sneezing, itching, nasal irritation, and rhinorrhea. The symptoms occur when the patient
breathes in allergens such as pollen, dust, food, and pet dander.
Pathophysiology:
When the patient is exposed to an allergen, the allergen-specific T cells is activated and causes
the production of allergen-specific IgE (Batt, 2014). The IgE binds to receptors on mast cells
and basophils. The allergen causes cell degranulation and releases mediators such as histamine,
leukotrienes, and prostaglandins which causes the symptoms associated with allergic rhinitis
(Batt, 2014).
Argument:
I think that John could be suffering from allergic rhinitis. With his history of asthma and pollen
allergy as well as his symptoms of sneezing and nasal congestion, allergic rhinitis would be a
perfect fit.
Rhinosinusitis
Epidemiology: Rhinosinusitis is the inflammation of the paranasal sinuses and nasal mucosa.
About 31 million people are affected by sinusitis in the United States and is the fifth most
common diagnosis in which antibiotics are prescribed (Shoup, 2011). About $3-$5 billion dollars
of healthcare costs are due to patients with sinusitis.
, Pathophysiology:
Rhinosinusitis is either acute or chronic. Acute rhinosinusitis can be either bacterial or viral.
Viral rhinosinusitis is caused by exposure to viruses such as the rhinovirus, influenza A and B,
parainfluenza, respiratory syncytial virus, adenovirus, and enterovirus (Shoup, 2011). When
viruses enter the nasal passage, they attach to cell walls and activate several inflammatory
pathways which causes an excess of turbinate vasculature, intercellular leakage, and
seromucinous discharge (Shoup, 2011). Acute bacterial rhinosinusitis is commonly caused by
Streptococcus pneumonia, Haemophilus influenzaie, Moraxella catarrhalis, and Stapholocoous
aureus (Shoup, 2011). Chronic rhinosinusitis is caused by infection, allergies, genetics, or
systemic disorders. The inflammatory cells that are triggered are eosinophils (Shoup, 2011).
Argument:
Symptoms of rhinosinusitis are cough, sneezing, rhinorrhea, nasal congestion, facial pain or
pressure headache, and sore throat (Shoup, 2011). John has some of these symptoms but does
not have a headache or facial pain which is a significant feature of rhinosinusitis. There is really
no connection between rhinosinusitis and asthma or allergies to pollen.
Rochelle
Reference:
Batt, R. (2014). Treatment of seasonal allergic rhinitis and impact on the adolescent. Nurse
Prescribing, 12(3), 120-126. Retrieved
from http://www.nurseprescribing.com/cgi-bin/go.pl/library/article.html?
uid=103680;article=NP_12_3_120_126
Kahn, D. (2014). Allergic rhinitis and asthma: epidemiology and common pathophysiology.
Allergy and Asthma Proceedings, 35, 357-
361. doi: 10.2500/aap.2014.35.3794
Shoup, J. (2011). Management of adult rhinosinusitis. The Nurse Practitioner, 36(11), 23-26.
Retrieved from http://www.tnpj.com
Rochelle Elayda reply to Rochelle Elayda 5/2/2016 4:32:42 PM
RE: Discussion part 1
Continuation of original post:
The Common Cold (Rhinovirus Infection): The common cold was discovered in 1956
by Dr. Winston Price where he was able to isolate the rhinovirus (Kennedy, Turner,
Braciale, Heymann, & Borish, 2012). Adults experience two to three colds per year and
children experience an average of eight to twelve per year. The virus affects the upper and
lower airways. There is no cure for the common cold, but palliative relief help with
symptoms. The common cold is largely responsible to loss of productivity, high healthcare
costs, and triggering other illnesses (Witek, Ramsey, Carr, & Riker, 2014).
Pathophysiology: The rhinovirus, which is the main virus that causes symptoms of the
common cold, is a single-stranded non-enveloped RNA virus that has over 100 serotypes
(Kennedy et al., 2012). When the RV enters the cell, the viral genome is translated into a
polyprotein, which goes through a process called proteolytic cleavage which produces the
structural and non-structural gene products (Kennedy et al., 2012).
Argument: Symptoms of the common cold are sneezing, headache, malaise, chilliness,
nasal discharge, nasal obstruction, sore throat, and cough. Although this diagnosis could
be a possibility, John does not have many of those symptoms and does not feel malaise.
Seasonal allergy:
Epidemiology: Allergies affect approximately 15-20 percent of the population and has
Week 1 Part 1, 2 & 3
Discussion Responses
Altered Immune and Inflammatory Responses
,Week 1: Altered Immune System and Altered Inflammatory Response
- Discussion Part One
Loading...
Discussion
This week's graded topics relate to the following Course Outcomes (COs).
1 Analyze pathophysiologic mechanisms associated with selected
disease states. (PO 1)
2
Differentiate the epidemiology, etiology, developmental
considerations, pathogenesis, and clinical and laboratory
manifestations of specific disease processes. (PO 1)
3
Examine the way in which homeostatic, adaptive, and
compensatory physiological mechanisms can be supported and/or
altered through specific therapeutic interventions. (PO 1, 7)
6 Distinguish risk factors associated with selected disease states.
(PO 1)
5 Describe outcomes of disruptive or alterations in specific
physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease states.
(PO 1)
7 Explore age-specific and developmental alterations in physiologic
and disease states. (PO 1, 4)
Discussion Part One (graded)
,John is a 19-year-old college football player who presents with sneezing, itchy eyes, and nasal
congestion that worsens at night. He states that he has a history of asthma, eczema and allergies
to pollen. There is also one other person on the football team that has similar symptoms. His
vitals are BP 110/70, P 84, R 18, T 100 F.
Write a differential of at least five (5) possible items from the most likely to less likely. For
each disease include information about the epidemiology, pathophysiology and briefly
argue why this disease fits the presentation and why it might not fit the presentation.
Responses
Rechel DelAntar 4/26/2016 7:11:48 PM
Introduction
Hello Professor and Class,
I would like to greet everyone a warm Hello and hope everyone is doing great. My name is
Rechel Delantar and I have been a nurse for what seems like ages (graduated 1990). I have
been in critical care and recovery room for most of my nursing career. The last 12 years I have
specialized in Cardiovascular Recovery Room caring for post Heart Assist device, ECMOs, open
hearts and organ transplant patients among others before moving to my current position as a
Heart transplant coordinator. I have always wanted to pursue my masters degree but found it
difficult with time and family and later on going back to school online became a little
intimidating. When my parents died I then decided to pursue my dream of obtaining my APN. I
have been blessed to have good instructors and classmates and I'm getting comfortable with
school.
It is a pleasure to meet everyone and good luck with class.
Rochelle Elayda 4/26/2016 9:49:02 PM
Discussion part 1
Allergic rhinitis
Epidemiology: Allergic rhinitis is a common chronic disease with a prevalence between five and
twenty-two percent in the United States (Khan, 2014). Many patients who have asthma also
have allergic rhinitis. Rhinitis is most common in patients ages 15-25, and it affects more boys
than girls (Batt, 2014). Allergic rhinitis is usually diagnosed before asthma and sensitization
occurs at a very young age when the immune system is still immature (Batt, 2014). Symptoms
include sneezing, itching, nasal irritation, and rhinorrhea. The symptoms occur when the patient
breathes in allergens such as pollen, dust, food, and pet dander.
Pathophysiology:
When the patient is exposed to an allergen, the allergen-specific T cells is activated and causes
the production of allergen-specific IgE (Batt, 2014). The IgE binds to receptors on mast cells
and basophils. The allergen causes cell degranulation and releases mediators such as histamine,
leukotrienes, and prostaglandins which causes the symptoms associated with allergic rhinitis
(Batt, 2014).
Argument:
I think that John could be suffering from allergic rhinitis. With his history of asthma and pollen
allergy as well as his symptoms of sneezing and nasal congestion, allergic rhinitis would be a
perfect fit.
Rhinosinusitis
Epidemiology: Rhinosinusitis is the inflammation of the paranasal sinuses and nasal mucosa.
About 31 million people are affected by sinusitis in the United States and is the fifth most
common diagnosis in which antibiotics are prescribed (Shoup, 2011). About $3-$5 billion dollars
of healthcare costs are due to patients with sinusitis.
, Pathophysiology:
Rhinosinusitis is either acute or chronic. Acute rhinosinusitis can be either bacterial or viral.
Viral rhinosinusitis is caused by exposure to viruses such as the rhinovirus, influenza A and B,
parainfluenza, respiratory syncytial virus, adenovirus, and enterovirus (Shoup, 2011). When
viruses enter the nasal passage, they attach to cell walls and activate several inflammatory
pathways which causes an excess of turbinate vasculature, intercellular leakage, and
seromucinous discharge (Shoup, 2011). Acute bacterial rhinosinusitis is commonly caused by
Streptococcus pneumonia, Haemophilus influenzaie, Moraxella catarrhalis, and Stapholocoous
aureus (Shoup, 2011). Chronic rhinosinusitis is caused by infection, allergies, genetics, or
systemic disorders. The inflammatory cells that are triggered are eosinophils (Shoup, 2011).
Argument:
Symptoms of rhinosinusitis are cough, sneezing, rhinorrhea, nasal congestion, facial pain or
pressure headache, and sore throat (Shoup, 2011). John has some of these symptoms but does
not have a headache or facial pain which is a significant feature of rhinosinusitis. There is really
no connection between rhinosinusitis and asthma or allergies to pollen.
Rochelle
Reference:
Batt, R. (2014). Treatment of seasonal allergic rhinitis and impact on the adolescent. Nurse
Prescribing, 12(3), 120-126. Retrieved
from http://www.nurseprescribing.com/cgi-bin/go.pl/library/article.html?
uid=103680;article=NP_12_3_120_126
Kahn, D. (2014). Allergic rhinitis and asthma: epidemiology and common pathophysiology.
Allergy and Asthma Proceedings, 35, 357-
361. doi: 10.2500/aap.2014.35.3794
Shoup, J. (2011). Management of adult rhinosinusitis. The Nurse Practitioner, 36(11), 23-26.
Retrieved from http://www.tnpj.com
Rochelle Elayda reply to Rochelle Elayda 5/2/2016 4:32:42 PM
RE: Discussion part 1
Continuation of original post:
The Common Cold (Rhinovirus Infection): The common cold was discovered in 1956
by Dr. Winston Price where he was able to isolate the rhinovirus (Kennedy, Turner,
Braciale, Heymann, & Borish, 2012). Adults experience two to three colds per year and
children experience an average of eight to twelve per year. The virus affects the upper and
lower airways. There is no cure for the common cold, but palliative relief help with
symptoms. The common cold is largely responsible to loss of productivity, high healthcare
costs, and triggering other illnesses (Witek, Ramsey, Carr, & Riker, 2014).
Pathophysiology: The rhinovirus, which is the main virus that causes symptoms of the
common cold, is a single-stranded non-enveloped RNA virus that has over 100 serotypes
(Kennedy et al., 2012). When the RV enters the cell, the viral genome is translated into a
polyprotein, which goes through a process called proteolytic cleavage which produces the
structural and non-structural gene products (Kennedy et al., 2012).
Argument: Symptoms of the common cold are sneezing, headache, malaise, chilliness,
nasal discharge, nasal obstruction, sore throat, and cough. Although this diagnosis could
be a possibility, John does not have many of those symptoms and does not feel malaise.
Seasonal allergy:
Epidemiology: Allergies affect approximately 15-20 percent of the population and has
