NURS 6501 Discussion: Alterations in Cellular Processes
Scenario: 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.
Strep throat may be associated with recurrent infections caused by viruses and bacteria. In this scenario the patient is negative for recurrent infection and negative for virus but positive for bacteria with the strep throat result. It is a painful condition that can be life threatening if not treated. Children with multiple strep infections in a year may have a genetic trait that makes it hard to fight the infection. In this case the patient is negative because of no past medical history. Race and gender do not predispose an individual to this infection. Other factors of getting strep throat are common with children in the ages of 5-15 years and is less frequent with children under the age of 5 years. Streptococcus infection is the definite cause of strep throat, a group A streptococcus also known as pyogenes, is a bacterium responsible for this infection. If untreated can lead to recurrent episodes
NURS 6501 Discussion Alterations in Cellular Processes
, and more serious condition like rheumatic fever {McCance, & Huether.2019}. Strep pyogenes commonly spread from person to person, via the salivary glands through droplets or nasal discharge. Incubation period of 2-5 days, average 3days from time of exposure to develop symptoms, can last 3-7 days with and without treatment {CDC.gov, nd.}.
Genetically researchers discover that children with recurrent strep throat have smaller germinal centers in their tonsils which recognize and fight the bacteria. Strep infection causes the body to release small antimicrobial peptides. These short chains of amino acids are lethal to bacteria in several ways like poking a hole on the bacteria
NURS 6501 Discussion Alterations in Cellular Processes
membranes which activate reinforcements in the form of infection-fighting cells called neutrophil. Testing of throat culture to confirm diagnosis. Symptoms of fever, sore throat with painful swallowing with redness and white patches at the back of the throat and swelling of lymph nodes on the sides of the neck. Cold symptoms are excluded in strep throat infection. Treatment is with antibiotics, educate patient to avoid exposing others by frequent handwashing, cover mouth and nose when coughing and sneezing. Cleaning surroundings and changing of toothbrushes and avoid kissing others. Clinically allergic disorder may accompany by airways inflammation like wheezing, an attack to the bronchial hyper-responsiveness, tachycardia, angioedema, tachypnea and hypotension.
There is a situation of anaphylaxis an allergic reaction. Hypersensitivity reaction are immune responses that are exaggerated or inappropriate against an antigen or collagen. They are classified in four forms. Type 1, 11, and 111 hypersensitivity reactions are known as immediate hypersensitivity reactions because it occurs within 24hours. The antibodies IgE, IgM, and IgG mediate them. Anaphylactic response is mediated by IgE antibodies that are produce by the immune system in response to environmental proteins also known as allergens such as dust, and mites {Vaillant & Zito, 2019}.
The process of this reaction is these antibodies IgE bind to mast cells and basophils that contain histamines granules that is released in reaction and causes inflamm
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