Pathophysiology & Clinical Findings of the Disease Essay

Pathophysiology & Clinical Findings of the Disease Essay

Case Study

1. Identify the correct hypersensitivity reaction:

The woman has a type 1 hypersensitivity reaction, also known as an allergic reaction. These reactions are associated with external/environmental allergens such as dust, pollen, food, and drugs. According to the history provided, the client has an allergy to cat fur. In normal cases, individuals do not react to cats far. The objective and subjective data from the case study confirm the identity of a hypersensitivity reaction type 1.

2. Explain the pathophysiology associated with the chosen hypersensitivity reaction:

The effects begin with the body’s exposure to an allergen (could be pollen, cat fur, dust, or other allergens) that do not trigger reactions in other individuals. The most common affected systems are the respiratory and digestive systems. Upon exposure, the body produces allergens-specific IgE antibodies which bind to mast cells and basophils (Dispenza, 2019). These antibodies then recognize the allergens on subsequent attacks, rapidly bind the mast cells, basophils, and allergens, and initiate the degranulation process. Dispenza et al. (2019) note that individuals do not develop symptoms during the first exposure because the body uses the opportunity to create antibodies against the antigen. The basophils and mast cells release inflammatory molecules (such as histamine). The reactions on the surfaces of membrane cells irritate them and cause bursting hence symptoms such as a runny nose, redness, swelling, watery eyes, hives, coughing, and wheezing (Dispenza, 2019). The symptoms can range from mild symptoms, such as runny nose, to complex symptoms, such as aphylactic shock. Type 1 hypersensitivity reactions should thus be treated promptly.

3. Identify at least three subjective findings from the case:

The client has an allergy to cats, according to the case study which she developed the condition 12 months ago. This period is synonymous with the time she acquired a cat pet. All the while, she had a dog but did not develop the allergy. The allergy “that never seems to go away” and only disappeared for a while (about two weeks) when she visited her relatives but ended soon as she got back around her cat. The allergic symptoms are persistent and do not seem to go away.

4. Identify at least three objective findings from the case:

On examination of the client, the “eyelid redness and swelling, conjunctival swelling and erythema, allergic shiners (lower lid venous swelling), Allergic crease (lateral crease on the nose), and inflamed nares.” These findings are vital to the patient’s management. These symptoms result from an allergic reaction, such as those identified above. According to Seidman et al. (2015), chronic rhinitis, which presents as a never-ending cold, results from persistent exposure to an allergen.

Management of the Disease

1. Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each:

Intranasal corticosteroids and antihistamines are strongly recommended drug classes (Seidman et al., 2015). These medications are the first-line medications for allergic rhinitis. An example of an intranasal corticosteroid for allergic rhinitis is Fluticasone, and an example of an antihistamine (for respiratory illnesses) is cetirizine (Seidman et al., 2015). Other medications, such as decongestants, can be used besides the medications to clear the exudate, as these medications stop the inflammatory effects. The first-line intervention in managing the conditions is allergen avoidance due to the recurrence of the allergy. According to Keith et al. (2018), allergen avoidance is the most important management intervention for all allergens. However, for this client, there are various factors to consider, such as compliance

2. Describe the mechanism of action for each of the medication classes identified above:

Cetirizine is a highly selective peripheral histamine HI-receptor antagonist with high action. The inhibition of these receptors reverses the inflammatory responses and is thus effective in smooth muscle immune and vascular endothelial cells and the GI system (Naqvi & Gerriettes et al., 2021). Cetirizine does not cross the blood-brain barrier; hence no sedation effects like those in other antihistamines. In addition, the medication reduces neutrophils and basophils migration and vascular permeability, and fluid escape from the cells. The mechanism and onset of action make it a vital drug for acute allergic symptoms relief.

Fluticasone’s mechanism of action is poorly understood. However, the drug is an anti-inflammatory agent that stimulates glucocorticoid receptors in the body hence the potency in inflammation. The medication inhibits multiple immune system cells, such as mast cells, basophils, and eosinophils which play a significant role in allergic rhinitis, as seen earlier (Seidman et al., 2015). Intranasal corticosteroids are the mainstay treatment for chronic allergies.

3. Identify two treatment options that are NOT recommended (I.e., recommended against):

Antibiotics and antiviral agents are not recommended for all allergic or type hypersensitivity reactions. Tramper‐Stranders et al. (2021) note that antimicrobials negatively affect allergic diseases and could lead to severe diseases due to their mechanism of action, such as suppressing the immune system. They do not reduce the infection and can have side effects on the normal flora, worsening some allergic reactions. Infections may follow open wounds from allergic reactions, but these antimicrobials should not be prescribed to patients.

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References

Dispenza, M. C. (2019, November). Classification of hypersensitivity reactions. In Allergy & Asthma Proceedings (Vol. 40, No. 6). https://doi.org/10.3390/jcm8071062

Naqvi, A., & Gerriets, V. (2021). Cetirizine. In StatPearls [Internet]. StatPearls Publishing.

Seidman, M. D., Gurgel, R. K., Lin, S. Y., Schwartz, S. R., Baroody, F. M., Bonner, J. R., … & Nnacheta, L. C. (2015). Clinical practice guideline: allergic rhinitis. Otolaryngology–Head and Neck Surgery, 152(1_suppl), S1-S43. https://doi.org/10.1177/0194599814561600

Tramper‐Stranders, G., Ambrożej, D., Arcolaci, A., Atanaskovic‐Markovic, M., Boccabella, C., Bonini, M., Karavelia, A., Mingomataj, A., Mahony, L. O., Sokolowska, M., Untersmayr, E., & EAACI Task Force on Conscious and Rational use of Antibiotics in Allergic Diseases. (2021). Dangerous liaisons: Bacteria, antimicrobial therapies, and allergic diseases. Allergy, 76(11), 3276-3291. https://doi.org/10.1111/all.15046

Purpose
The purpose of this assignment is to apply hypersensitivity pathophysiological concepts to explain assessment findings of a patient with Allergic Rhinitis. Students will examine all aspects of the patient\’s assessment including: Chief Complaint (CC), History of Present Illness (HPI), Past Medical History (PMH), Family History (FH), Social History (SH), Review of Systems (ROS), and Medications and then answer the questions that follow on the provided Comprehensive Case Study template.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
1. Analyze the case to arrive at the type of hypersensitivity reaction that the patient is exhibiting. (CO1)
2. Explain the pathophysiology of the identified hypersensitivity reaction. (CO1)
3. Identify all subjective and objective information provided in the case. (CO3)
4. Explain, using pathophysiology, the rationale for each subjective and objective finding. (CO1, CO3)
5. Identify two types of medications that are strongly recommended for the treatment of allergic rhinitis according to the clinical practice guidelines on the management of allergic rhinitis. (CO2, CO5)
6. Explain the mechanism of action of the two medication classifications and include how the symptoms of allergic rhinitis are alleviated when taken. (CO2, CO5)

Week 1 Case Study template
Pathophysiology & Clinical Findings of the Disease
1. Identify the correct hypersensitivity reaction:

2. Explain the pathophysiology associated with the chosen hypersensitivity reaction:

3. Identify at least three subjective findings from the case:

4. Identify at least three objective findings from the case:

Management of the Disease
*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

1. Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each:

2. Describe the mechanism of action for each of the medication classes identified above:

3. Identify two treatment options that are NOT recommended (I.e., recommended against):

References

[Must be on a separate page and in APA format]

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Requirements:
Content Criteria:
1. Read the case study listed below.
2. Refer to the rubric for grading requirements.
3. Utilizing the Week 1 Case Study Template Links to an external site., provide your responses to the case study questions listed below.
4. You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
5. You must use the Clinical Practice Guideline (CPG) for the management of allergic rhinitis to answer the treatment recommendation questions. The guideline can be found at the following web address: https://journals.sagepub.com/doi/10.1177/0194599814561600 Links to an external site. .You may also use a medication administration reference such as Epocrates to provide medication names.
6. Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.
Case Study Scenario
A 35-year-old woman presents to the primary care office with a history of nasal congestion that has worsened over time and recurrent sinus infections. She considered herself healthy until about 12 months ago when she began experiencing rhinorrhea, sneezing, and nasal stuffiness that \”seems to never go away\”. She noticed that her rhinorrhea greatly improved when she attended her family reunion on a two-week Caribbean cruise but returned after being home a few days. She lives with her husband and 5- year-old child. They have two household pets: a dog that has lived with them for the last 4 years and a cat who joined the family 1 year ago. Upon exam, the NP observed eyelid redness and swelling, conjunctival swelling and erythema, allergic shiners (lower lid venous swelling), Allergic crease (lateral crease on the nose) and inflamed nares.
Case Study Questions
Pathophysiology & Clinical Findings of the Disease
1. Identify the correct hypersensitivity reaction.
2. Explain the pathophysiology associated with the chosen hypersensitivity reaction.
3. Identify at least three subjective findings from the case.
4. Identify at least three objective findings from the case.
Management of the Disease
*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.
1. Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each.
2. Describe the mechanism of action for each of the medication classes identified above.
3. Identify two treatment options that are NOT recommended (I.e., recommended against).
4. NR507 Week 1 Case Study
NR507 Week 1 Case Study
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Pathophysiology & Clinical Findings of the Disease
The student:

– Identifies the correct hypersensitivity reaction.

 

 

– Explains the pathophysiology associated with the chosen hypersensitivity reaction.

– Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).

– Identifies at least three subjective findings from the case.

– Identifies at least three objective findings from the case.

(5 Required Elements) 45 pts
All 5 required elements are present 41 pts
1 required element is missing. 37 pts
2 required elements are missing 23 pts
3-4 required elements are missing. 0 pts
All 5 required elements are missing.
45 pts
This criterion is linked to a Learning Outcome Management of the Disease
The student:

– Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.

– Identifies two strongly recommended medication classes for the treatment of the condition and provides an example (drug name) for each.

– Describes the mechanism of action for each of the medications identified.

– Identifies two treatment options that are NOT recommended (I.e., recommended against). 45 pts
All 4 elements are present 41 pts
1 required element is missing 37 pts
2 required elements are missing 23 pts
3 required elements are missing 0 pts
All 4 required elements are missing
45 pts
This criterion is linked to a Learning Outcome Organization, spelling, grammar & APA format
The student:

– Uses the week 1 case study template for case study responses.

– Provides correct in-text citations for responses which match the reference page.

– Has minimal spelling, grammar & APA format errors. 10 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 0-2 errors in spelling, grammar or APA format. 9 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 3-5 errors in spelling, grammar or APA format. 8 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 6-8 errors in spelling, grammar or APA format. 5 pts
Case study template is not used for responses OR In-text citations are incorrect or do not match the reference page AND There are 0-5 errors in spelling, grammar or APA format. 0 pts
Case study template is not used for responses AND/OR In-text citations are incorrect or do not match the reference page AND There are 6 or more errors in spelling, grammar or APA format.
10 pts
This criterion is linked to a Learning Outcome Late penalty deductions
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy. 0 pts
Manual Deductions 0 pts
Manual Deductions
0 pts
Total Points: 100