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Discussion 1 – Week 5

Discussion 1:
Cardiovascular Disorders

At least once a year, the media report on a seemingly
healthy teenage athlete collapsing during a sports game and dying of heart
complications. These incidents continue to outline the importance of physical
exams and health screenings for teenagers, especially those who play sports.
During these health screenings, examiners check for cardiovascular alterations
such as heart murmurs because they can be a sign of an underlying heart
disorder. Since many heart alterations rarely have symptoms, they are easy to
miss if health professionals are not specifically looking for them. Once
cardiovascular alterations are identified in patients, it is important to refer
them to specialists who can further investigate the cause.

Consider the following scenario:

A 16-year-old male presents for a sports participation
examination. He has no significant medical history and no family history
suggestive of risk for premature cardiac death. The patient is examined while
sitting slightly recumbent on the exam table and the advanced practice nurse
appreciates a grade II/VI systolic murmur heard loudest at the apex of the
heart. Other physical findings are within normal limits, the patient denies any
cardiovascular symptoms, and a neuromuscular examination is within normal
limits. He is cleared with no activity restriction. Later in the season he collapses
on the field and dies.

To prepare:

· Review the
scenario provided, as well as Chapter 24 in the Huether and McCance text.
Consider how you would diagnose and prescribe treatment for the patient.

· Select one
of the following patient factors: genetics, ethnicity, or behavior. Reflect on
how the factor you selected might impact diagnosis and prescription of
treatment for the patient in the scenario.

By Day 3

Post a description of how you would diagnose and prescribe
treatment for the patient in the scenario. Then explain how the factor you
selected might impact the diagnosis and prescription of treatment for that
patient.

Read a selection of your colleagues’ responses.

By Day 5

Respond to at least two of your colleagues who selected a
different factor than you, in one of the following ways:

· Make a
suggestion based on additional evidence drawn from readings or after synthesizing
multiple postings.

· Share
insights based on your own experience and additional research.

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entering your message. Then click on the Submit button to post your message.

Discussion 2 – Week 5

Discussion 2: Anaphylactic
Shock

The treatment of anaphylactic shock varies depending on a
patient’s physiological response to the alteration. Immediate medical
intervention and emergency room visits are vital for some patients, while
others can be treated through basic outpatient care.

Consider the January 2012 report of a 6-year-old girl who
went to her school nurse complaining of hives and shortness of breath. Since
the school did not have any medication under her name to use for treatment and
was not equipped to handle her condition, she was sent to an emergency room
where she was pronounced dead. This situation has raised numerous questions
about the progression of allergic reactions, how to treat students with severe
allergies, how to treat students who develop allergic reactions for the first
time, and the availability of epinephrine in schools. If you were the nurse at
the girl’s school, how would you have handled the situation? How do you know
when it is appropriate to treat patients yourself and when to refer them to
emergency care?

To prepare:

· Review
“Anaphylactic Shock” in Chapter 23 of the Huether and McCance text,
“Distributive Shock” in Chapter 10 of the McPhee and Hammer text, and the
Jacobsen and Gratton article in the Learning Resources.

· Identify the
multisystem physiologic progression that occurs in anaphylactic shock. Think
about how these multisystem events can occur in a very short period of time.

· Consider
when you should refer patients to emergency care versus treating as an
outpatient.

· Select two
patient factors different from the one you selected in this week’s first
Discussion: genetics, gender, ethnicity, age, or behavior. Reflect on how the
factors you selected might impact the process of anaphylactic shock.

By Day 4

Post an explanation of the physiological progression that
occurs in anaphylactic shock. Then, describe the circumstances under which you
would refer patients for emergency care versus treating as an outpatient.
Finally, explain how the patient factors you selected might impact the process
of anaphylactic shock.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues who selected at
least one different factor than you in one of the following ways:

· Share insights
on how the factor your colleague selected impacts the pathophysiology of
anaphylactic shock.

· Offer and
support an alternative perspective using readings from the classroom or from
your own research in the Walden Library.

· Validate an
idea with your own experience and additional research.

Click on the Reply button below to reveal the textbox for
entering your message. Then click on the Submit button to post your message.

Reference:

Moisse, K. (2012). Death of allergic student raises
questions about school’s responsibility. Retrieved from
http://abcnews.go.com/Health/AllergiesFood/year-virginia-girl-dies-allergic-reaction-school/story?id=15295949#.T7qD0sWPRBk