NUST08011 Nursing Care And Decision Making

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Question:

(1) Dan is running a 5 mile run. In this worksheet, you will be asked for your thoughts on the homeostatic controls mechanisms.

During the run, Dan’s heart rate is 154bpm. His respiration rate is increased to 50 breaths per minute. And his temperature rises from 39?c to 39?c.

This is due to an increase in cellular metabolism and energy use.

Analyze each physiological reading and include a discussion on the normal homeostatic controls for each.

(2) Examine the impact of acute renal glomerulonephritis (AG) on the kidney structure and function and on the process and regulation.

(3) Third-degree Burns are full thickness burns that involve the entire thickness the skin.

Explain the consequences of this serious injury to the normal functioning of the skin and its structures.

The body’s effects on hypothermia and hyperthermia should be considered. It must also consider how the body regulates temperature to keep it within its normal range.

Answer:

The homeostatic regulation process involves the detection by cell receptors, followed by a message to the control center.

Waterhouse, 2013. After that, the control centre activates the effector cell to restore the normal state.

Three physiological changes were observed in Dan during a 5 mile road run. The heart rate increased to 154 beats per minute, which is higher than the normal 60-100 beats per hour. Running stimulates the adrenal gland and results in an increase in adrenaline hormones.

The nerve impulses were then sent to the nervous branch of sympathetic nerves, and then to other organs. As a result, Dan’s heart rate increases to meet the high oxygen and mineral requirements of his heart. This causes the blood to flow less efficiently to the skin and digestive system (Waterhouse 2013).

The second step is to increase the rate of respiration from the normal 12-20 minutes per minute to 50 in one minute.

This is followed by the sending of the message “medulla”, to increase the rate of respiration to increase oxygen and to release excess carbon dioxide.

Third, Dan’s body temperature rises from normal 37 degrees Celsius to 39 degrees Celsius. This is due to greater blood flow to the bones and skin cells.

After running five miles, the cells in the body use a control mechanism to bring back normal.

Dan ran faster because of the Adrenaline hormone. After it finishes, the hormone levels drop and impulses from sympathetic nerves die. The heart rate then drops to normal.

After activity has ceased, respiration rates decrease as oxygen is required to break down food and produce energy. Eventually, respiration rate recovers to normal.

Glomerulonephritis, also known as acute glomerular inflammation and cellular proliferation due the mechanism of immune system. This condition is usually short-term and only occurs in the glomerular region.

These conditions can be caused by an infection or non-steroidal medication intake.

A glomerulus can be described as a group of small blood vessels and nerve endings that is located in the end of a kidney tubule.

The basic cell that regulates water and ions balance in the body, the nephron (as we all know) is found in many kidneys.

Two parts make up the Nephron: the glomerulus with a cup-shaped structure known as “Bowmen’s cap” which holds many blood capillaries, and the renal tubule that receives fluid from the former.

Hyalinization is the process of eating self-immune cells. This indicates irreversible injury.

The kidney might grow to be about half its normalbean-shaped counterpart, which measures 11cm in length at the top of the posteriorlumbar. (Diadyk et. al. 2016, 2016).

These changes were caused by a large amount of protein in urine, called proteinuria, and blood, which was reduced in Glomerular Filtration rate (i.e. oligoanuria). RBC casts are also affected and contribute to the active urine sediment.

Glomerulus acts like a filter, helping to remove water and other ions from the blood into Bowmen’s capsule. In this way macromolecules are retained and blood is preserved.

It receives blood via the efferent vein. Once the levels are balanced, the nephron structures is complete.

A decreased GFR results in increased retention of nephron salts and water, which can lead to an expansion of intravascular vessels, high pressure, pH imbalance, and affect the volume urine produce. The hormone levels of ADH, swelling of extremities, and other factors may also influence the volume of the urine.

The glomerulus can’t maintain proper water and/or ion balance. This could be due to cell proliferation within the capillaries of the glomerulus.

Excess fluids and salts build up in the blood due to dysfunction of glomerulus.

ADH hormone is responsible for water balance. Also, the capillaries develop osmotic tension.

The osmotic tension decreases when the water level in cells is high. This causes the production of less ADH and leads to more water being excreted from the cells.

When there is less water, the osmoticpressure rises which causes an increase in ADH hormone. This decreases the water excretion rate from the capillaries.

Doctors can indicate third-degree burns when the body has been burnt 50%.

Basaran and colleagues (2008) state that the skin is composed of multiple layers of cells, tissues, and cells.

It also includes the epidermis, which is the outermost layer. This layer contains many layers, including Stratum Corneum (a layer made up of keratin protein), Stratum Lucidum (a layer with transparent cells), Stratum Granulosum(a layer composed of granular cell), Stratum Spinosum and Stratum Germanitivum (the deepest layer).

Each layer serves a different purpose and is a part of the body.

These layers are most often destroyed by third-degree burns.

Third-degree burns cause the destruction of the epidermis, up dermis, and subcutaneous layers of the skin.

It covers cuts to hands, feet and genitals.

It can also burn the muscles, tendons and bones beneath it (L et. al., 2016).

As the nerves involved in the burns have been destroyed, the sensation at the burned area is negligible.

The burned area appears white and the skin becomes disfigured. Tissue scarring also occurs (Watkins 2013, 2013).

The pain of burning can cause the victim to become pale, anxious, confused, and scared.

It can lead to a rapid decline in blood pressure, which may cause pallor and cold extremities.

Fluid loss from the blood circulation is also possible. Not just fluid loss in the cells that have been destroyed, but also the liquid substance that leaks from the damaged area secondary to loss of skin protective covering.

It also results in a disruption in the levels potassium and sodium salts, which can further cause changes in the osmotic equilibrium of the body fluids.

The skin that has been burned does not have the ability to protect against infection, heat regulations, make vitamin D, secrete and eliminate melanin, fight off infections, or resist heat.

Third-degree skin burns can have such severe effects that they affect the skin’s ability regulate its homeostatic temperatures.

Environment factors, such as heat and cold, can have a significant impact on the cardiovascular organs.

The cardiac organs are able to double their output if the body temperature rises from around 36.5 degrees to 39 degrees Celsius (called hyperthermia).

In such a situation, the skin thermal receptors, nerves, and brain send impulses to regulate temperature in the brain. This further activates the reaction to heat release.

Vasodilation, which is the radiation of heat, causes heat loss in the body. Skin vasodilation leads to sweating.

These risk factors include diabetes, age, and other health issues.

Heat stress resistance decreases with age and diabetes.

Hypothermia occurs when the internal body temperature drops to 37 degrees Celsius. In response to this, the thermal receptors send impulses back to the brain. Blood vessel constriction and skin constriction occur to conserve heat and reduce heat loss.

Here, the respiratory rate drops and cardiac output decreases (Doshi, Giudici (2015)

References

Basaran K.; Bicer A.; Beskardes Y.; Ermis I.

Is it a third-degree burn or a fried eggs?

Diadyk O.; Nekrasova L.; Taran O.; Siroshtanova I.; Kominko L. (2016).

Acute Glomerulonephritis (Case Report): Clinical and Pathologic Characteristics

Doshi, H. and Giudici M. (2015).

The EKG in hyperthermia and hypothermia.

Journal of Electrocardiology, 48(2) pp.203-209.

Kidney Structure and Function.

Microscopy and Microanalysis. 15(S2): pp.74-75.

Glomerulonephritis with Neulasta

The Pharmaceutical Journal.

L, B., C, I., BH, K, D, T. (2016).

Third degree skin injuries due to a MRI Conditional Electrocardiographic Monitoring System.

Journal of Radiology and Imaging, 1(4) pp. 29-32.

E. Makhova and G. Vikhodseva (2016).

Evaluation Of Disorders Of Hemostasis and Functional State Of Kidneys And Renal Hemodynamics Among Children With Nephrotic syndrome Of Acute Glomerulonephritis.

V Mire Nauchnykh Otkrytiy (0(2)), P.40.

Hemostatic System and its Regulation for Disorders of Renal Function.

Ponticelli C. and Glassock R.

Primary glomerulonephritis.

Oxford University Press.

Acute Poststreptococcal Glumerulonephritis, The Most Common Type of Acute Glomerulonephritis.

Pediatrics in Review, 36(1) pp.3-13.

Homeostatic control mechanisms.

Part 1: Skin rashes. Taking a dermatological history.

Practice Nursing, 24(1). pp. 30-33.

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