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Advanced Practice Registered Nurses

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Advanced Practice Registered Nurses (APRNs) are responsible for providing both primary and acute care in addition to conducting complete assessments which they use to formulate diagnoses and recommend treatments for a variety of illnesses and in a variety of settings (ANA, 2016). Nurse Practitioners will be presented with an assortment of scenarios for both routine physical examinations and to determine the cause of an abnormality. Therefore, it is essential that nurse practitioners receive training that provides knowledge of normal pathophysiology to distinguish alterations and diagnose adaptive responses to changes. The purpose of this paper is to identify clinical conditions based on case scenarios with descriptions of the pathophysiology of each condition, identify the alterations, and discuss the adaptive responses of the patients to the alterations in normal body functions.
Scenario One
Pathophysiology
The tonsils are found in the rear of the oral cavity on either side of the uvula and function to assist with the immune system in warding off bacterial and viral infections (Stelter, 2014). The acute inflammation of the tonsils, which can become recurrent and lead to chronic inflammation, is referred to as tonsillitis (Bartlett, Bola, and Williams, 2015). Acute tonsillitis can have a multitude of other causes which may include HIV, rubella, and hepatitis A (Georgalas, Tolley, and Narula, 2014). During the acute phase of tonsillitis, the tonsils become enlarged and can lead to painful swallowing (Bartlett, Bola, and Williams).

Associated Alterations
Tonsillitis can lead to additional health complications such as peritonsillar or parapharyngeal abscess, rheumatic fever, and glomerulonephritis (Georgalas, Tolley, and Narula, 2014). Tonsillectomy remains the most commonly performed surgical procedure on children (Stelter, 2014).

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Adaptive Responses
When pathogens such as bacterial or viruses invade the tissue of the tonsils, the immune system of the host kicks in and begins the inflammatory response ( ). Fever will usually present with tonsillitis as the body temperature increase is a means of fighting infection ( ). Additionally, enlarged lymph nodes and exudate are also adaptive responses to the inflammation of the tonsils ( ). Scenario Two
Pathophysiology
Contact Dermatitis is a skin rash marked by itching, swelling blistering oozing and scaling. It is caused by direct contact between the skin and a substance to which the person is allergic or sensitive. The rash usually occurs only on that area of the body that has come into contact with the irritating substance. The most common form of contact dermatitis is that caused by poison ivy, oak, or sumac. Other plants too sometimes cause an allergic reaction. Contact dermatitis may also be cause by industrial oils, medicines, cosmetics perfumes mouthwashes deodorants rubber plastics metals and clothing made of various materials and treated with certain preservatives and dyes. A nonallergic form, primary irritant dermatitis may be induced by a substance acting as an irritant rather than as a sensitizer or allergen. Some soaps, detergents and other cleansing products can cause a condition of the hands, often referred to as “housewife dermatitis”. Or popularly called dishpan hands.
Associated Alterations
Adaptive Responses
Scenario Three
Pathophysiology
Stress response is the sum of biological reactions ot any adverse stimulus physical mental or emotional internal or external that tends to disturb the homeostasis of an organisms. Should these reactions be inappropriate they may lead to disease states. The term is also used to refere to the stimuli that elicit the reactions. Just as a bridge is structurally capable of adjusting to certain physical stresses, the human body and mind are normally able to adapt to the stresses of new sitautions. However, this ability has definite limits beyond which continued stress may cause a breakdown, althorugh this limit varies from person to person.
Associated Alterations
Adaptive Responses

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