A nurse is working in a community health center and is caring for a 5-year-old c
ID: 121784 • Letter: A
Question
A nurse is working in a community health center and is caring for a 5-year-old child who was diagnosed as having a right ear infection. When collecting the nursing history, the mother states the child has had a fever to 102 degree F for 2 days, has been irritable, and complained of feeling tired. The child has been drinking fluids well but not eating. The physician describes the tympanic membrane as erythematous, bulging with fluid levels, and dull. The nurse collects the following vital signs: T. 102 R, P. 110, and R. 18. Fever is often considered to be associated with a bacterial infection. How does the body regulate temperature? Why is fever often associated with bacterial infections? Which of the clinical manifestations given are associated with a localized inflammatory response? What physiological factors are responsible for the development of these manifestations? If the physician ordered a complete blood count, what would you expect to see if there is a bacterial infection? Which of the above manifestations are related to a systemic response to the infection?Explanation / Answer
1. ANS: An ear infection occurs when a bacterial or viral infection affects the middle ear. the sections of your ear just behind the eardrum. Ear infections can be painful because of inflammation and fluid build-up in the middle ear. Having a fever is a clear sign that something is going on inside your body. But both bacteria and viruses can cause fevers and there's no specific difference between a fever caused by bacteria and one caused by viruses.
When you're infected, your immune system recognises it as a foreign invader (pyrogens in fever). Then the hypothalamus detects the pyrogens, it resets the thermostat to a higher temperature and tells the body to start processes that generate and retain more heat. The result is a fever.
Body temperature regulation:
The temperature of the body is regulated by neural feedback mechanisms which operate primarily through the hypothalmus. The hypothalmus contains temperature sensors. Under control of these, sweating begins at a skin temperature of 37°C and increases rapidly as the skin temperature rises above this value. The heat production of the body under these conditions remains almost constant as the skin temperature rises.
If the skin temperature drops below 37°C a variety of responses are initiated to conserve the heat in the body and to increase heat production. These include
1. Vasoconstriction to decrease the flow of heat to the skin.
2. Secretion of norepinephrine, epinephrine, and thyroxine to increase heat production
3. Shivering to increase heat production in the muscles.
2. ANS: Ear infections can be chronic or acute. Acute ear infections are painful but short in duration. Chronic ear infections either do not clear up,
Acute inflammation is the early response of a tissue to injury. the first line of defense against injury and is characterized by changes in the microcirculation, exudation of fluid and emigration of leukocytes from blood vessels to the area of injury. It occur before the immune response becomes established, and it is aimed primarily at removing the injurious agent.
When acute inflammation is unable to clear an infectious pathogen, chronic inflammation may occur.
The cells mononuclear cells (monocytes, macrophages, lymphocytes, plasma cells), fibroblasts are involved in this. and it leads to necrosis and fibrosis (simultaneous destruction and formation of new tissue).
The physiological factor lymph nodes behind the ear is responsible for this manifestation. Lymph nodes are major sites of B and T lymphocytes, and other white blood cells. Lymph nodes are important for the proper functioning of the immune system, acting as filters for foreign particles.
3. ANS: A complete blood count or CBC is an easy and very common test that screens for certain disorders that can affect your health. It determines if there are any increases or decreases in your blood cell counts. Normal values vary depending on your age and your gender. It can help diagnose a broad range of conditions and infections
The presence of an elevated white blood cell (WBC) count with elevated band forms has dogmatically been thought of as a marker for bacterial infection. So the CBC can help detect serious bacterial infections in pediatric patients with fever.
Please Remind this: Answering to many questions is against to CHEGG rules. So i am answering 1,2 and 3.
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