The human body has both the adaptive and innate immune responses. These responses help fight pathogens and counteract the body changes to maintain homeostasis. Advanced Practice Nurses must recognize the symptoms and reactions that interfere with the body's normal functioning (Huether & McCance, 2012). Therefore, it is essential to analyze the disease processes through pathophysiology, associated alterations and adaptive responses of tonsillitis, irritant contact dermatitis, and stress. A mind map is also essential to show the alterations of adaptive response in tonsillitis.
Tonsillitis refers to pharyngeal tonsils' inflammation, which extends beyond the lingual and adenoid tonsils. The tonsils size changes in size as a result of one's growth and development. Tonsils grow to the fullest between the age of four and eight (Mayo Clinic, 2012). This means that large tonsils may not result from infections, but most of pharyngitis and tonsillitis are viral in origin. Tonsillitis may develop due to bacterial or viral infections. Beta-hemolytic Streptococcus pyogenes cause bacterial tonsillitis (Mayo Clinic, 2012). However, viral tonsillitis are caused by virus infections such as measles virus, adenovirus, Epstein-Barr virus, cytomegalovirus and herpes simplex virus that lead to acute tonsillitis or acute pharyngitisThe associated alterations linked to tonsillitis include peritonsillar abscess, bad breath, obstructive sleep apnea, fever, lymph nodes, difficulty breathing, difficulty swallowing, headache and tonsillar cellulitis (Mayo Clinic, 2012). These alterations, when left untreated, may also cause post-streptococcal glomerulonephritis and rheumatic fever.
The inflammatory response caused by the invasion of bacteria or viruses into the tonsils epithelium or mucosal films of nasal cavity cause an adaptive response. Bacterial tonsillitis that is recurrent is primarily caused by Staphylococcus aureus, which infiltrates into the non-phagocytic cells through beta-integrins and fibronectin-binding protein (Mayo Clinic, 2012). The invasion leads to the regulation of cytokines that causes tonsillitis. Such adaptive responses also lead to erythema, lymph node development, and exudates in response to the inflammation (Mayo Clinic, 2012). Treatment options include fluid hydration, antibiotic therapy for bacterial tonsillitis and Tonsillectomy.
Irritant Contact Dermatitis
Irritant Contact Dermatitis (ICD) is a delayed or cell-mediated inflammation that occurs from the cytokines. The cytokines are released from skin cells called keratinocytes due to stimuli or neuron responses from various chemical agents such as soap detergents and cleansers (Golden & Shaw, 2013). These irritants cause inflammation and damage the epidermal cells. When the skin is exposed to these irritants, a protein carrier binds to an allergen and forms an antigen. The antigen is then processed and transported to the T cells leading to the release of dermatitis signs and symptoms (Golden & Shaw, 2013). Such changes lead to the release of cytokines, epidermal cellular changes and the disruption of the skin barrier.
The associated alterations caused by dermatitis leads to fissuring, scaly erythematous plaques, skin dryness, skin inflammation, and cracking of the skin. The disease also shows web spaces, which extend past the ventral and dorsal parts of the fingers and hands (Golden & Shaw, 2013). This leads to pain, heat, swelling, redness, and loss of skin functioning. Although vesicles are likely to form burning and stinging is common.
The most adaptive response after one is exposed to irritants involves the vasodilatation of the body veins to increase the flow of blood, increase the permeability of the body veins to deliver plasma, leukocytes, and lymphocytes (Golden & Shaw, 2013). Another adaptive response is the swelling of vesicular lesions and erythema on the part of the skin that was in contact with the irritant (Golden & Shaw, 2013). The damage is based on the exposure of the chemical irritants. It is recommended that people need to put on gloves when handling chemicals to prevent chronic dermatitis. Dermatitis can be treated using lesions, steroid creme, and corticosteroid.
The pathophysiology of stress is difficult to understand. Research shows that it begins with the disruption of the activity of central nervous system serotonin (5-HT). The stimuli perceived by the brain releases neurotransmitters such as brain-derived neurotrophic factor, dopamine, norepinephrine to act as body defenses (Pepper, Akuthota, & McCarty, 2006). The release of these neurotransmitters causes to the adrenal gland to catecholamines that influence the cardiovascular system. The response of the stimuli may lead to either adaptation or flight response that tries to restore the body homeostasis.
The main associated alterations involve insomnia, chest pain, poor appetite, increased heart rate, inability to concentrate, feelings of worthlessness, and fatigue, psychomotor agitation, and headache (Pepper, Akuthota, & McCarty, 2006). Such alterations need coping strategies that can help in managing the situation. The adaptive response also alters the body changes by responding to correct the imbalance of the body homeostasis process.
The adaptive response during stress involves a binding mechanism aimed to manage stress. These adaptive strategies lead to behavioral changes and coping strategies that look into the problem and seek social support that could lead to the reduction of the perceived stress. The best method of managing stress is by promoting interaction and socialization through support groups and counseling individuals undergoing similar problems (Pepper, Akuthota, & McCarty, 2006).
Understanding pathophysiology, associated alterations and adaptive responses of disorders are essential developing the most effective treatment. An adaptive immune response can protect the body against infections. The failure of the body to respond to specific changes in the body's homeostasis may lead to the ability of bacteria or viruses to subvert the immune system. Therefore, Advance Practice Nurses should understand adaptive responses of diseases during diagnosis and treatment to prevent chronic infections, even death.
Golden, S. & Shaw, T. (2013). Hand dermatitis: Review of clinical features and treatment options. Retrieved from www.cutis.com/fileadmin/content.../SCMS_vol32_No3_Golden.pdf
Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.
Mayo Clinic. (2012). Tonsillitis. Retrieved from www.mayoclinic.org/diseases.../tonsillitis/.../con-20023538Pepper, M., Akuthota, V., & McCarty, E. C. (2006). The pathophysiology of stress fractures. Clinics in sports medicine, 25(1), 1-16.
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