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Respond to at least two of your colleagues on 2 different days and respectfully

by | Sep 2, 2022 | Nursing | 0 comments

 

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Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not
Post 1
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Cellular Process and Genetic Enviroment
Acute pharyngitis , also known as Group A Streptococci ( Streptococcus pyogenes, GAS) is the most commonly diagnosed bacterial infection. The need for antibiotic is greater in Group A then in Group C and G. ( Stefaniuk, et all. , 2017). A positive strep test and cervical adenopathy are indicative of this bacterium Streptococcus pyogenes. The complications from Strep A are, rheumatic fever, and peritonsular abscess. Thus treating with antibiotics is plan of care.
The Role Genetics Plays in the Disease
The commonality of recurrent strep throat is evident that there is a genetic link. The connection of the HLA region ( Huma Leukocyte Antigen) this is the area on the chromosome to determine immune inherited disease. Two unspecified genes that are located in this region are connected to developing Strep A infection or having increased protection to the infection. The sample of tissue from children with recurrent Strep A and there was a significant decrease in B cells and helper T cells. These specific cells are located in the tonsil tissue called germinal centers. The children with smaller germinal centers continued to have recurrent tonsilitis.
Why the Patient is Presenting with Specific Symptoms
The patient has a current Strep A infection. The presentation of a low grade fever is a sign of a inflammatory process. The four macro systems are activated (redness, swelling heat and pain. ) Thus denoting a reddened posterior pharynx. Strep A can be spread easily through droplets . Drinking or eating from an infected individual is a definite route of infection. Impetigo is one skin infection that if touched can spread easily. The age of this patient can reflect easy transmission.
The Physiologic Response and Cells Involved.
The inflammatory process is responsible for the infection process. On the opposite process immune system of T cells will initiate a defense against the compliment system.
POST 2
In this week’s case study, we see a patient displaying potential signs and symptoms of a type one allergic reaction to the prescribed amoxicillin. Angioedema, pharyngeal edema, and bronchoconstriction are signs of an immunoglobulin E (IgE) mediated reaction. IgE-mediated reactions the person has had previous exposure to the antigen source, in this case, amoxicillin, and developed a sensitivity to this medication. Immune responses that are exaggerated to the antigen are classified as hypersensitivity reactions. Type one or an anaphylactic reaction responds to a trigger or allergen. In the anaphylactic response, the immune system produces IgE antibodies. The IgE antibodies then bind to basophils and mast cells that contain histamine granules which are then released causing inflammation. Anaphylaxis is a life-threatening medical emergency and can lead to respiratory failure (Justiz et al., 2019).
Role of Genetics
Genetics does not directly correlate to a person having allergies, so my response would stay the same. There, however, is a link with the response to the allergen as it relates to the specific antigen that the person was exposed to. There first must be an initial exposure to the antigen that initiates the sensitization response. Without this exposure, genetics will not be able to cause the initiation of antigen sensitization. Amongst different ethnic groups, there are some similarities in food-related allergies this shows there may be some genetic factors that increase the likelihood of similar allergens and or antigen responses. The previous thought process on avoidance of early introduction to food type allergies has slowed research, and clear guidelines for clinical practice have not been set (Chang et al., 2020).
Why is the patient presenting with the specific symptoms described?
The patient is presenting with symptoms of an anaphylactic reaction. The reaction appears to be caused by an antigen response to antibiotics prescribed for strep. Anaphylaxis is a rapid and life-threatening condition caused by exposure to an antigen after an initial sensitization.
The physiological response to the stimulus presented in the scenario and why you think this response occurred?
Three main criteria should be assessed when looking for anaphylaxis. First is generalized skin and mucosal involvement with flushing that occurs rapidly after exposure to the antigen. This will also include hives, edema, pruritis, and at least one respiratory symptom such as wheezing or dyspnea, hypotension, or signs of end-organ dysfunction such as syncope, hypotonia, and or incontinence after exposure to the allergen. Secondly, diarrhea, abdominal pain, and vomiting post-exposure are likely. Finally, there may be a drop in blood pressure several minutes to hours post-exposure to the allergen (De Feo et al., 2018
The Cells that are involved in the process?
Dendritic cells and macrophages are the antigen-presenting cells in the primary IgE response. The foreign molecule is presented to the T-Cell and then identified as an antigen. After recognition, the T-cells release cytokines which tell the B cells to produce and release IgE antibodies to the antigen. Due to the short life span of the IgE antibodies, they must bind to receptors of the mast cells; this process is known as the sensitization phase (McCance & Huether, 2019).
The secondary response occurs after the sensitization phase. In the secondary response, the patient’s immune system responds to the antigen-specific antibody bound with the mast cells in anticipation of the antigen returning. which appears to be what is happening in the case study. With reintroduction, the now sensitized mast cell binds with the antigen. When there are two or more bound together, this completes the link, and the mast cells start to release mediators into the bloodstream Histamine is one such mediator that binds to Histamine 1 (H1) and triggers smooth muscle contractions. Smooth muscles in the bronchioles contract causing dyspnea and decreased oxygen to the body. This reaction will manifest in the patient having difficulty breathing and wheezing. H1 also causes dilation of the blood vessels and increases leakage into the interstitial space, which is the cause of edema often noted in the lips, face, and tongue (McCance & Huether, 2019).
In this case the patient presents with what appears to be signs and symptoms of an anaphylactic reaction. The focus of care should be based on these presenting symptoms to ensure the safety of the patient and protect their life.

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