Nursing homework help

Respond to both post below of your colleagues on 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

Scenario 1: A 16-year-old boy comes to clinic with chief complaint of sore throat for 3 days. Denies fever or chills. PMH negative for recurrent colds, influenza, ear infections or pneumonias. NKDA or food allergies. Physical exam reveals temp of 99.6 F, pulse 78 and regular with respirations of 18. HEENT normal with exception of reddened posterior pharynx with white exudate on tonsils that are enlarged to 3+. Positive anterior and posterior cervical adenopathy. Rapid strep test performed in office was positive. His HCP wrote a prescription for amoxicillin 500 mg po q 12 hours x 10 days disp #20. He took the first capsule when he got home and immediately complained of swelling of his tongue and lips, difficulty breathing with audible wheezing. 911 was called and he was taken to the hospital, where he received emergency treatment for his allergic reaction.

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

Strep Throat

Strep throat is one of a varied range of conditions caused by the bacterium known as group A Streptococcus (GAS). One study found that recurrent tonsillitis (RT) with pediatric group A Streptococcus (GAS) RT had smaller germinal centers, with an underrepresentation of GAS-specific CD4+ germinal center T follicular helper (GC-TFH) cells (Dan, et al., 2019). This translates to a smaller area in lymph organs where B cells proliferate, differentiate, and mutate their antibody genes. B cells/lymphocytes responsible for producing antibodies. B lymphocytes  and CD4+ T cells are important cells in the adaptive immune system. Some people have a genetically based weaker immune response to group A strep bacteria.

The GAS bacteria gained entry into the patient’s respiratory tract and multiplied. This triggered an inflammatory response. His tonsils became enlarged related to vasodilation, increased vascular permeability, which allowed white blood cells to adhere to the vessels and surrounding tissue (McCance, 2019, p. 195). This caused tonsilar edema/swelling. The cervical lymphadenopathy was caused as the immune system moved bacterial products, dead cells, and other inflammatory material through the lymph system’s channels (McCance, 2019, p. 195) The patient’s immune response produced the fever. Endogenous pyrogens create a beneficial host-defense reaction during infection (McCance, 2019, p. 291).

Anaphylaxis

The angioedema (swelling of tongue and lips) and wheezing were signs and symptoms of anaphylaxis. This is an acute and possibly life-threatening emergency. This was caused by a Type I  hypersensitivity reaction mediated by mast cells and basophils, most likely from the antibiotic. Sometimes the host response to an antigen is excessive, causing a damaging response while trying to be defensive. Anaphylaxis can occur immediately and can either be cutaneous or systemic (McCance, 2019, p. 256).

On a cellular level, anaphylaxis is a chain of events. IgE recognizes and binds to an antigen. The activated IgE fixates to mast cells and basophils, which initiates the release of chemical mediators such as histamine (Stone, Prussin, & Metcalfe). This then triggers a more intensified response, releasing more histamine. Respiratory distress occurs because histamine causes smooth muscle contraction, producing bronchial constriction; wheezing/stridor (McCance, 2019, p. 256). The tongue and lip swelling/angioedema are caused by the chemical mediators increasing vascular permeability, leading to fluids leaking from vessels (Theresa Capriotti, 2018).

Our text indicates that some people are genetically predisposed to have allergies, Type I in particular. This is called Atopic. If one parent has an allergy, 40% of offspring have a chance of allergies occurring, and 80% if both parents have allergies (McCance, 2019, p. 263).  This happens because atopic persons make more IgE and have more Fe receptors on their mast cells.

I did not read where gender would play any part in Step throat or anaphylaxis. The patient was listed as NKDA and food allergies; it might have been prudent to ask if siblings or parents were allergic to any medications or foods.

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now