Guiding Principle Of Diagnosing Alterations In The Immune System

The Guiding Principle

1. Name 4 possible causes of SIADH. The SIADH is caused by different factors. Some of the common causes however include abscesses, encephalitis, meningitis and finally the brain injuries.
2. Compare and contrast the symptoms of hyperthyroidism and hypothyroidism. The symptoms for hypothyroidism include fatigue, weight gain, depression, dry skin, slow heart rate, sensitivity to cold and constipation. The symptoms of hyperthyroidism on the other hand include racing heartbeat, shakiness, and itchy red skin, sweating spells and feeling hot frequently. There is also fine hair loss. The common symptom between them is hair loss and dry hair. The other signs and symptoms are however contrary to each other.
3. What is Addison’s disease? What may treatment involve? Addison’s disease is a condition in which the adrenal glands produce insufficient cortisol and aldosterone. The best treatment option in this case involves steroid replacement therapy for the entire life. This is just to replace cortisol and aldosterone that the body does not produce.
4. How does Vasopressin work? Vasopressin works by regulating the volume of the extracellular fluids through regulating the renal absorption of water. It also works by acting on the renal collecting ducts through the V2 receptors so as to increase water permeability.
5. Discuss, with examples, the pharmaceutical therapy used for hypothyroidism. Include the effect, side effects and patient education .The treatment option for hypothyroidism include the use of the synthetic thyroid hormone called levothyroxine. This medicine works by restoring adequate hormone levels. The side effects include headaches, irritation, fever, hot flashes, sweating and finally insomnia. The patient education includes the right dosage.
6. Discuss the Cause, Progression, Outcome and Treatment of :
   • Syndrome of Inappropriate Anti-Diuretic Hormone .This condition is caused mostly through the injury to the brain. Other notable causes include meningitis, HIV and certain medications. The best treatment option include the use of vasopressin. The outcome includes coma, death, seizure, respiratory failure and finally hallucinations.
   • Diabetes Insipidus. Diabetes insipidus is a condition in which the body does not regulate fluids properly. It is a genetic disease. This disease progress and leads to inability of the body to balance the electrolytes. The outcome is excessive accumulation of fluids in the body thus leads to frequent urination. Treatment is through the use of synthetic hormone known as desmopressin.
   • Hyperthyroidism (specifically Graves Disease). Graves’ disease is a condition that is caused by impairment in the ability of the body to fight against infection. Some of the risk factors include gender where women are likely to be affected more than men. Age is another factor as well as emotional and physical stress. Smoking is another possible cause. Treatment is by use of drugs called Methimazole and propylthiouracil.
   • Hypothyroidism (specifically Hashimoto’s Disease).Hypothyroidism is where the thyroid gland produces insufficient hormones. Hashimoto disease is a condition in which the immune system attacks the thyroid gland impairing its functions. The risk factors and causes of the disease include sex, age, heredity and other autoimmune diseases like the lupus. The disease progress and impairs the thyroid ability to secrete hormone. Levothyroxine is the drug of choice in treating the Hashimoto disease.
   • Hypercortisolism (specifically Cushing’s syndrome).This is a condition that result when the body is exposed to cortisol for a very long time .The disease is caused by excessive levels of cortisol .The disease would progress and lead to loss of muscles and type 2 diabetes .It also leads to frequent infections and high blood pressure. The treatment include reducing use of corticosteroids and surgery as well.
   • Hypoadrenalism (specifically Addison ’s disease) This is a condition in which the body or the adrenal gland does not produce cortisol hormone. The end result is stress due to the absence of cortisol. Steroid replacement therapy is the best treatment option for the disease.
7. Differentiate between Type 1 and Type 2 Diabetes in terms of – age affected, risk factors, causes, signs and symptoms, Pathophysiological changes, and treatment. Type 1 diabetes is where the body does not produce insulin while type 2 diabetes is where the body cannot respond to diabetes(Chamberlain, Rhinehart, Shaefer, & Neuman, 2016). Type 2 diabetes affects people with over 45 years while type 1 diabetes can affect anyone. Risk factors for type 1 include family history, age and genetics .For type 2, the risk factors include physically inactive, above 45 years, previous history of gestational diabetes and belly fat. Treatment for type 1 is through regular injection of insulin while type 2 can be controlled through exercise and diet. The symptoms for all the diabetes include frequent urination, hunger, fatigue and blurry vision.
8. Discuss the complications of diabetes – what they are and how they occur? Some of the complications of diabetes are hypoglycaemia. This is due to the fact that injection of insulin can breakdown more glucose leading to hypoglycaemia(“13. Management of Diabetes in Pregnancy:Standards of Medical Care in Diabetes—2018,” 2017). Another complication is the microvascular complications which are due to destruction of the blood vessels by the excess glucose.
9. Compare and contrast between Diabetes Ketoacidosis and Hyperosmolar hyperglycaemic non ketotic syndrome. The common underlying mechanism for both the conditions is the fact that they affect the levels of the circulating insulin.
10. Discuss the five types of insulin – appearance, time taken to take effect, example of the type and nursing considerations. The types of insulin include rapid acting, short acting, intermediate acting and finally the long acting insulin. Rapid acting take 10-30 minutes while the short acting take 30 minutes. Intermediate acting take 1.5-4 hours while the long acting take 0.8-4 hours. The type of nursing considerations is that they should be subjected to a meal that is the patient after injection so that the level of glucose does not go down.
11. Discuss the 5 classes of oral hypoglycaemic agents used to treat type 2 diabetes – example, action, side effects, contra indications, and nursing considerations. The five classes of hypoglycaemic agents include sulfonylureas, Biguanides, Thiazolidinedione’s, Meglitinides and finally the Alpha-glucosidase inhibitors (Wolfsdorf et al., 2018). Alpha glucosidase cause bloating and diarrhoea while sulfonylureas cause skin rashes. Biguanides on the other hand lead to kidney complications. They both work by breaking down excess glucose to glycogen. Nursing contraindications include not to be used with alcohol.
12. Discuss the Cause, Progression, Outcome and Treatment of Type 1 Diabetes Mellitus. Type 1 diabetes is due to the failure of the body to produce a hormone called insulin. The outcome is that there will be high levels of glucose in the blood. There is no treatment of this condition but only management through regular injection of the insulin hormone. The causative agents are genetic factors.
13. Discuss the Cause, Progression, Outcome and Treatment of Type 2 Diabetes Mellitus .Type 2 diabetes is a condition in which the body is resistant to insulin .The causes include excess weight and environmental factors. The outcome is the impairment in the breakdown of excess sugar in the blood and this leads to frequent hunger and thirsty(Nyenwe & Kitabchi, 2016). Treatment of the condition is through regular exercise and proper diet that is full of cabbages.
14. Discuss the complications of poorly controlled diabetes mellitus. A poorly controlled diabetes will lead to the following conditions, cardiovascular disease, Nerve damage, foot damage and the Alzheimer’s disease. This is associated with excessive sugars that damage the different body parts.
15. Discuss the cause, progression, outcome and treatment of Diabetic Ketoacidosis. This is a condition in the body when there is no enough insulin and so the body uses fats as the source of energy. Breakdown of fats leads to build up of ketones and leads to chemical imbalance in the body. Treatment is through introduction of insulin.
16. Discuss the cause, progression, outcome and treatment of HHNK. This is a condition that is caused by excess glucose levels, dehydration and finally decreased alertness as well as consciousness. Treatment is through administration of what is known as the crystalloid solutions with the sole rationale of ensuring that the tonicity is up to the required levels.
17. What are the intrinsic and extrinsic factors that could affect wound healing? Discuss the stages in normal wound healing. The intrinsic factors that affect the process of wound healing include age, diabetes mellitus, suppressed immune system and then skin with reduced sensation. Extrinsic factors on the other hand include medication intake, poor nutrition, and smoking and finally stress. The stages of wound healing include vascular, cellular and finally repair. Vascular involve immediate constriction followed by dilation of the increased permeability of the blood vessels. Cellular involve WBCs rushing to the site affected.
18. List three common types of skin cancers. List their risk factors, clinical manifestations and treatment. The three skin cancers include melanoma, basal cell carcinoma and the squamous cell carcinoma. Their risk include exposure to the Ultra violet rays. Their common manifestations include lumps that appear under the skin. Treatment is by radiotherapy, chemotherapy and surgery to remove the lumps.
19. What are the three types of skin infections? Discuss each of these in relation to examples of disease conditions under each infection, causative organisms, clinical manifestations and treatment. Folliculitis is a common infection of the skin characterized by the inflammation of hair follicles. It is caused by aureus and it is best treated by the use of antibiotics cephalexin. Skin cancer is the other infections and they are caused by exposure to UV rays leading to lumps. It is treated by chemotherapy or radiotherapy. Acne is another skin infection that leads to development of acne.
20. What is eczema? List the triggers for eczema. Discuss treatment of eczema. Eczema is the irritation of the skin and triggers for the condition include genetics, abnormal functions of the immune system, environment and defects in the barriers of the skin. The best treatment of eczema is the corticosteroids.
21. Discuss the process of wound healing including: acute inflammation, reconstructing phase and the maturation phase. Inflammation is the first phase in wound healing where swelling at the injured site occurs to control bleeding and infection. The accumulation of fluids makes it possible for healing and repairing cells to move to the site. Recon structuring is the next phase and it involves manufacturing of new tissues by the use of collagen and extracellular matrix. Maturation is the final step and it involves remodelling collagen until the wound finally closes.
22. Discuss the 3 main types of skin infection including cause, progression, outcome and treatment. The three main types of skin infection include impetigo, cellulitis and then erysipelas. Impetigo is caused by staphylococcus aureus bacteria. The best drugs for impetigo are antibiotics that include mupirocin and fusidic acid.
23. Discuss the cause, progression, outcome and treatment of inflammatory disorders of the skin (namely, eczema) There are different causes of eczema and they include genetics, impairments in the functioning of the immune system, environment and defects in the skin barriers. The outcome is that there is irritation of the skin which resembles an allergy. Eczema treatment is achieved through the use of hydrocortisone steroids.
24. Discuss the similarities and differences of cause, outcome and treatment of Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma. Squamous cell carcinoma is as a result of abnormal growth of squamous cells of the epidermis. Basal cell carcinoma on the other hand is a cancer that begins in the basal cells of the skin. Melanoma on the other hand is a type of cancer that attacks the melanocytes in the skin. The basic similarity is that they both attack the skin. The outcome is that there is abnormal growth of cells and leads to development of lumps. The treatment options are similar in that there is radiotherapy, chemotherapy and finally surgery to remove the lumps.
25. Discuss the difference between acute and chronic pain. Acute pain is the one with immediate onset and it is caused by an injury. Chronic pain on the other hand persists for long enough and is due to underlying conditions like arthritis.
26. Discuss the types, stimuli and role of nociceptors. There are different types of nociceptors and they include the skin, joint and the visceral nociceptors. Skin nociceptors respond to external stimuli to the skin for example punch and send signals to the brain for response. The joint nociceptors response to stimuli of motion and leads to effective response in motion. Finally the visceral nociceptors convey noxious information to the CNS.
27. Discuss one type of pain receptor, indicating what kind of sensation it detects and what pain it could indicate. One example of a pain receptor is the thermal receptor. This receptor is sensitive to thermal stimuli and one kind of pain it would indicate is the pain as a result of heat for example form fire.
28. Benign prostate hyperplasia could cause bladder obstruction. Discuss how this would occur. According to different studies, it has been established that benign prostrate hyperplasia leads to obstruction of the bladder. This is because in prostrate hyperplasia, there is rapid multiplication of cells to replace the worn out cells due to aging. The resultant multiple cells instead forms a lump in the prostrate which then blocks the bladder.
29. When would Osmotic diuretics be used? Osmotic diuretics are used when the body has excess water that is associated with both intracranial and the intraocular pressure. They extract water from intracellular compartments through osmosis.
30. What are the three different “types” of AKI, in terms of area of dysfunction? There are three types of AKI and they include Prerenal ARF, the Post renal ARF and finally the intrinsic renal ARF.
31. Describe what RIFLE is.RIFLE is basically a classification system of the acute kidney Disease. It is an acronym for Risk, Injury, Failure and Loss of Kidney functions. The classification is based on the SCr and the UO variations.
32. Discuss the effect of Chronic Renal Failure/Disease on 2 body systems. Focus on the manifestation (what occurs), mechanism (how it occurs) and the treatment. Chronic kidney disease has an effect on several body systems. One of the body system affected is the cardiovascular system where lack of excretion of fluids causes them to accumulate in the lungs and the heart. Accumulation of urea causes inflammation of the pericardium. Additionally, accumulation of salts and fluids damages blood vessels High blood pressure is treated by the use of Thiazide diuretics and the Angiotensin converting enzyme inhibitors. The end results are hypertension and stroke. Chronic kidney disease also affects the digestive system whereby there is accumulation of urea in the body leading to problems in the GIT like poor appetite, nausea and vomiting. The treatment option in this scenario involves the use of anti-acids.
33. Discuss two treatments for hepatic encephalopathy. One of the treatment options in Hepatic encephalopathy include the use of probiotics. Probiotics act by reducing the amount of ammonia produced in the intestines. They achieve this by enterocyte glutamines and the reducing on the translocation of bacteria. The second treatment option is the use of purgatives which are agents that help in cleaning the bowel through increasing the evacuation of the luminal contents.
34. Discuss the cause, progression, outcome and treatment of:
    • Obstructive disorders in terms of their effect on the renal physiology (focus on prostate hyperplasia and renal calculi).Prostrate hyperplasia is the enlargement of the prostrate and this usually happens whenever the cells of the prostrate begin to multiply rapidly .The leading cause of the condition is aging especially when is above 80 years old. The most common drugs used in treatment include the Alpha-1 Blockers that include doxazosin, prazosin, alfuzosin and finally the terazosin. Renal canaliculi is a condition in which there are stones in the kidney. It is commonly caused by dehydration as well as imbalance in metabolism. Treatment options include the use of the extracorporeal shock wave lithotripsy and the cystoscopy and finally the lithotripsy.
    • Glomerular disorders (focus on acute glomerulonephritis and nephrotic syndrome) acute glomerulonephritis is a condition that is usually caused by other infections that include the lupus, The Good Pastures syndrome, the Wegener’s Disease and finally the polyarthritis nodosa. The best treatment options for the condition include the use of corticosteroids like the prednisone. Other drugs include the cyclophosphamide. A low salt diet, diuretics and finally blood pressure medications can also be used.
    • Acute Kidney Disease. Acute kidney disease is a condition in which the kidney loses its ability to effectively eliminate excess wastes from the blood. This leads to accumulation of wastes to dangerous levels. Some of the leading risk factors or the causes include urinary tract obstruction, toxic kidney injury that can arise from poisons, severe dehydration and the acute tubular necrosis(Chawla, Eggers, Star, & Kimmel, 2014). The general outcome in the disease includes impairments in the excretion of excess wastes from the body. The best treatment option include the use of antibiotics. Diuretics also come in handy to eliminate excess fluids in the body while calcium as well as insulin assists in regulation of blood potassium levels.
    • Chronic Kidney Disease. The major causes of chronic kidney disease include diabetes and the High Blood Pressure. Excessive glucose in the body damages the filters in the kidney while High blood pressure affects the blood vessels in the kidney. Other causes include genetic disorders, renal artery stenosis and drugs that might be toxic to the kidneys. The disease usually progress through five main stages that include stage 1,stage 2,stage 3,stage 4 and finally the stage 5.The stages are arranged according to the Glomerular filtration rates(Mencarelli, Busutti, & Montini, 2014) .The general outcome for chronic kidney disease include impairment in the filtration process. Currently, there are no medications for CKD but one can treat the causes which include diabetes and high blood pressure.
    • Urinary tract infections. Urinary tract infections include any form of disease or infection that affects the kidney or the urinary tract system. The major risk factor or cause of urinary tract infections is the bacteria which enter the urethra and later on begin to multiply in the bladder. This mostly happens if the lines of defence against the invading bacteria fails. The general outcome is the infection of the bladder or rather cystitis and infection of the urethra which is also known as urethritis. Urinary tract infections are best treated through the use of antibiotics. The most commonly used antibiotics include, Amoxicillin, Ceftriaxone, Levofloxacin,   Fosfomycin and the Ceftriaxone.
35. -Discuss the outcomes of liver cirrhosis. Cirrhosis is a condition in which the liver loses its structure and function. It is mostly caused by excessive consumption of alcohol and smoking. Liver cells in this case die and leads to scarring of the liver. The liver cells that do not die on the other hand multiply quickly to form new liver cells that are in clusters or regenerative nodules.
36. – What is the diet restriction in treating hepatic encephalopathy, discuss reason for these restrictions. Whenever an individual is suffering from hepatic encephalopathy, they are restricted not to consume excess proteins. The rationale behind this is to prevent excessive production of ammonia in the intestines so as not worsen the condition.
37. -What are the types, modes of transmissions and treatment of viral hepatitis C and A? According to several research, it has been established that the modes of transmission for Hepatitis C is mostly through parental via blood products. Another mode of transmission include repetitive exposure to intravenous drugs(Chen et al., 2015). Hepatitis A on the other hand is transmitted through the faecal oral route whereby if an infected person ingests food or water that is infected by the virus and then deposits the faeces which are later ingested by another person.
38. -List the various liver function tests and indications for abnormal values. There are various liver function tests and they include Albumin (3.5-5 g/dl), Alanine transaminase (7-55U/L), Aspartate transaminase (8-48U/L) alkaline phosphatase (45-115 U/L) and the gamma-glutamyl Trans peptidase (9-48 U/L). Bilirubin (0.1-1.2 mg/dl) and prothrombin time test (9.5-13.8 seconds).
39. Describe Pathophysiological principles of alterations of the Hepatic System. The hepatic system involves the liver and other related organs. The pathophysiological principles in the alterations of the hepatic system basically involves any issues that can affect the normal functioning of the kidney(Peleg et al., 2018). Some of the factors include abnormalities in the flow of blood, congestive heart failure and cancers. Alcohol and exposure to other chemical factors are some of the leading risk factors.
40. Describe Pharmacological management of alterations of the Hepatic System. Pharmacological management of alterations of the hepatic system include the use of neomycin for the acute phase(Qiao et al., 2016). During the maintenance phase, the best drug include Lactulose. Metronidazole is also a common drug used to treat the alterations of the hepatic system.
41. Describe Diagnostic principles of alterations of the Hepatic System. The hepatic system basically involves the liver and other associated organs. The functions of the liver include but are not limited to manufacture of triglycerides, cholesterol as well as bile(Weiss et al., 2015). The diagnostic principle of the alterations of the hepatic system involves determining the level of the above mentioned products .Incase the levels are not within the normal range, then that simply means that there are some defects in the liver or the hepatic system.
42. A reaction to peanuts is what kind of reaction? Why? A reaction to peanuts is called an allergic reaction and it is due to autoimmune diseases whereby the body reacts to its organs.
43. Discuss an example of a primary immune deficiency. Include the cause (what part of the immune pathway is effected) and the effect on the individual with this condition. An example of the primary immune deficiency is the X-linked agammaglobulinemic. The immune pathways affected include the liver and the spleen. The effects on the person include infections such as colds, pneumonia as well as the yeast infections.
44. Using your understanding of the adaptive immune response, discuss how vaccines work (include antigen, memory cells and primary/secondary exposure in your answer) Vaccines are dead or weakened forms of a pathogen. The body fights infections by producing antibodies and this usually takes time. In case the body does not respond on time to produce antibodies like in the case of nasty viruses like the measles, the individual is bound to die(Jefferson, Rivetti, Di Pietrantonj, & Demicheli, 2018). Therefore vaccines work by stimulating the body to produce antibodies early enough in preparedness for the impeding attack by the pathogens.
45. What kind of response would giving an incorrect blood type produce in the body? There are two responses if an individual gets the wrong blood type. The responses are humoral and cellular. Humoral response is where patient’s antibodies bind to the foreign antigens which are the Red blood cells(Carson et al., 2015). Cellular response is through the action of cells where macrophages from the liver attack the foreign antigens.
46. Where do T cells and B Cells originate? Both the T and the T cells usually originate from the Bone marrow. However, the precursors of the T cells are the one that are produced in the bone marrow and they leave to mature in the thymus(Suaudeau, 2015).
47. Describe Pathophysiological principles of alterations of the immune system. The role of the immune system in the body is to provide protection against foreign substances. There are three lines of defence or rather the immune system and they include the physical and the chemical barriers to infection and they include the skin and the mucous membranes(Pignata, D’Assante, & Sousa, 2015). The inflammatory response and finally the immune response which include innate immunity vs the adaptive immunity. The pathophysiological principle of alterations in the immune system involves any factors that alters the normal functioning of the three lines of defence. Infections and chemical factors are some of the risk factors that can lead to defects in the lines of defence.
48. Describe Pharmacological management of alterations of the immune system
    there are basically three pharmacological management of alterations of the immune system. They include immunoglobulin therapy, Gamma interferon therapy and finally the use of growth factors. Immunoglobulin therapy involves the injection of the immunoglobulin in the vein(Marsh et al., 2016). This form of therapy is needed after every few weeks. Gamma interferon on the other hand is a synthetic substances that is injected on the arms three times a week and it is used to treat chronic granulomatous disease (Postow, 2015). In case deficiency of the immune system is due to absence of WBCs, then growth factors therapy can actually be used to strengthen the white blood cells.
49. Describe Diagnostic principles of alterations of the immune system

During the diagnosis of the alterations in the immune system. There is always one guiding principle. Alteration in the immune system is characterized by the production of antibodies in response to the pathogen (Romano et al., 2017). The principle in this case therefore involves detecting of antibodies by the use of a known antigen. The principle generally is the use of antibodies or the antigens that are coated with an assayed enzyme that catalyses the reaction. Corresponding antibodies and antigens will then react to form a visible colour.

References

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