NUST08011 Nursing Care And Decision Making

Question:

(1)This worksheet will ask you to make comments on homeostatic control mechanisms that operate when Dan does a five-mile road run.

His heart rate rises to 154bpm, his respiration rate to 50 per minute, and his temperature to 39?c.

The increase in energy and cellular respiration is evident.

Analyze the changes in each of these physiological readings and discuss the normal homeostatic control mechanisms.

(2) Evaluate the effects of acute glomerulonephritis upon the structure and function the kidneys, and on the process osmoregulation.

(3) Third-degree burns involve full-thickness injuries that affect the entire thickness and depth of the skin.

Explain the impact of this severe injury on normal skin function and structures.

Examine the effects of hypothermia or hyperthermia on the body. Also, consider how the body works in order to maintain a comfortable body temperature.

Answer:

Homeostatic regulation occurs when there is increased activity. This involves the detection of cell receptors and a message being sent to the control centre.

Waterhouse, 2013, states that the control center activates effector cells in order to restore normal changes.

The first change Dan noticed was an increase in heart rate to 154bpm, compared to a normal heart beat of 60-100bpm. This is because running stimulates the adrenal glands and increases the amount of adrenaline hormones in the blood.

The impulses then went to the nervous system branch and to the sympathetic nerves. As a result, the heart beats faster to meet the high demand for oxygen and minerals from the skeletal muscles. This compromises blood flow to the digestive system and skin (Waterhouse, 2013).

The second is an increase in respiration rate, from 12-20 per minute to 50 per minute.

The message is sent to the center for respiration “medulla” which increases the respiration rate in order to increase oxygen, release excess carbon dioxide, and restore the normal oxygen level (Waterhouse 2013, 2013).

The body temperature of Dan rises from 37 to 39 degrees Celsius due to increased blood flow to the skin cells and skeletal muscles to meet high energy and oxygen needs.

After running 5 miles, the body’s control mechanism to return to normal occurs.

Dan was able to run faster thanks to the fight hormone, adrenaline hormone. When it is finished the hormone level drops and the impulses from the sympathetic nerve die. This causes the heart rate to drop to normal.

As it reduces oxygen requirements in food to make energy, the respiration rate drops. The respiration rate returns to normal.

Glomerulonephritis is a condition that causes inflammation in the glomerular area and cellular proliferation. It can also be called acute, which means it occurs for a short time.

This disease is often caused by infection or non-steroidal drugs intake.

A glomerulus, which is composed of many nerve endings and tiny blood vessels, is found in the end of a kidney tubule.

We know that the basic cell of the kidney, the nephron, is located in the end region of a tubule. It regulates the body’s water and ions balance.

The glomerulus, which is a cup-shaped structure called “Bowmen’s capsule”, contains the kidney. This holds blood capillaries and the fluid.

The process of eating self-immune cells, called hyalinization, can indicate irreversible injury.

The kidney can grow in size by about half compared to a normalbean-shaped kidney, which measures 11 cm at the top of the posterior lumbar (Diadyk and al., 2016).

Changes in kidney function included an increase in protein levels (called proteinuria) and blood in the urine (called hematuria), a reduction in Glomerular Filtration Ratio (i.e., Oligoanuria), RBC castings, and RBC contributing to active urine sediment.

Glomerulus is a filter that helps to remove water ions from blood and into Bowmen’s capsule. This allows macromolecules to be retained and blood to remain.

It receives blood from efferent arterial. The nephron structure, which is surrounded by blood vessels to allow for reabsorption and water resorption, is connected to Bowmen’s capsule.

A decrease in GFR can cause an increase in intravascular vessels volume, high blood pressure, pH imbalance, and a reduction or increase of urine production depending on the levels of ADH (anti-diuretic hormonal) and swelling of the extremities.

The glomerulus has a problem maintaining the correct water and ion balance. This is due to cell proliferation in the glomerulus. It could cause congestive heart disease, kidney failure, and even pulmonary oedema (Makhova, Vikhodseva, and Novicova (2016).

Exceedive fluids and salts build up in the blood due to dysfunction of the glomerulus (Ponticelli & Glassock, 2009).

ADH hormone and capillary osmotic pressure development are key factors in water balance.

Osmotic pressure drops when cells have high water levels. This decreases ADH production and causes cells to lose more water.

The opposite happens when water levels are low. This causes the osmotic tension to rise, which leads to an increase in ADH hormone and a decrease in water excretion from capillaries.

Doctors will indicate third-degree burns if the body has been burned 50 percent.

Basaran et. al. (2008). The skin is made up of many layers of cells and tissues.

The epidermis, the outer layer, is thin and contains layers like Stratum Corneum, Stratum Lucidum, Stratum Granulosum (a granular cell layer), Stratum Spinosum and Stratum Germanitivum.

Each layer is responsible for a specific function and occurs in the body.

The majority of these layers are destroyed in third-degree burns.

Third-degree burns result in the destruction or the epidermis and up dermis of skin.

It covers burns to the hands, feet, groin and genital areas.

It can also cause injury to the bones, muscles, tendons, or underlying muscles. (L et al. (2016)

Because the nerves that were present at the site of the burn are destroyed, the sensation is minimal.

The area that has been burned appears white, the skin becomes disfigured and tissues are scarred (Watkins, 2013).

Due to the burning pain, the victim may feel anxious, confused, and pale. They may also become unconscious.

The rapid drop in blood pressure can cause cold extremities, pallor and eventual collapse.

Fluid loss from blood circulation also occurs. This is not only the fluid loss in cells that are destroyed but also the liquid substance that leaks from damaged tissues secondary to loss of skin protective covering.

The body’s osmotic balance is also affected by the changes in sodium and potassium levels.

Burnt skin is unable to fight infection, protect from heat regulation, produce vitamin D, secretion and elimination, or even form melanin. (L et al. 2016, 2016).

Third-degree burns to the skin can cause severe damage, affecting the skin’s ability to regulate its own homeostatic temperature.

The cardiovascular organs are affected by environmental factors like heat and cold.

A rise in body temperature (called hyperthermia), from 36.5 to 39 degrees Celsius leads to a doubling of cardiac organ output.

The skin thermal receptors and nerves transmit impulses to the brain to regulate the temperature. This activates the reflex to release heat.

Vasodilation is a process by which heat is lost to radiation. This leads to sweating.

Risk factors such as diabetes and age, for example, can lead to a decrease in resistance to heat stress.

The resistance to heat stress is decreased by age and diabetes.

Hypothermia is when the internal temperature drops from 37 to 34 degrees Celsius. The thermal receptors send impulses to brain to cause blood vessel constriction. This causes heat loss and heat conservation.

However, here the cardiac output and respiratory rate decrease (Doshi & Giudici 2015).

Refer to

Basaran K., Bicer A., Beskardes Y., and Ermis I.

A fried egg or third-degree burn?

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

Acute Glomerulonephritis – Clinical and Pathologic Features (Case report).

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

The EKG in hypothermia or hyperthermia.

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

Kidney Function and Structure.

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

Glomerulonephritis and Neulasta

The Pharmaceutical Journal.

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

Third-degree skin burns due to a MRI conditional electronic cardioographic monitoring system.

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

E. Makhova, G. Vikhodseva and L. Novicova (2016).

Evaluation Of Disorders of Hemostasis, Functional Status Of The Kidneys and Renal Hemodynamics in Children with Nephrotic Syndrome of Acute Glomerulonephritis.

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

(2016).

Ponticelli, C., and Glassock R. (2009).

Primary glomerulonephritis.

Oxford University Press.

Acute Poststreptococcal Glimmerulonephritis is the Most Common Acute Glomerulonephritis.

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

Homeostatic control mechanisms.

Part 1: Skin rashes. Skin structure and dermatological history.

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

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