401006 : Bio-science School of Nursing and Midwifery - Nursing Assessment

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Question: Nursing Assessment

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Solution:

Fever development and benefits (Total: 5 marks)

What is fever? Explain how Peter’s fever developed.

1. Fever is a state of a fluctuation in core body temperature beyond the normal range (36.5 – 37.5 0C). Although the upper threshold is debatable among practitioners, a body temperature beyond 37.5 0C will normally cause the patient to start noticing an unusually high temperature. It occurs naturally as an immune response to the presence of pathogens in the body (Craft et al. 2015).Peter developed the fever as a result of the presence of pyrogens in his blood.These pyrogens could have been exogenously secreted by infectious bacteria or endogenously by the body’s immune system. Pyrogens in the blood will normally stimulate interleukin-1 which will regulate immune response. IL-1 may trigger vasoconstriction to conserve body heat. Pyrogens raise the thermostatic threshold of the hypothalamus. Consequently, the hypothalamus triggers heat generating and heat-loss reduction events. This combination of events causes a net body temperature rise. Fever is known to be among the commonest medical signs, particularly among children(WHO, 2015).

SState, with explanation, two benefits of fever.

1. Fever fights off potential disease-causing microbes: Fever causes a fluctuation in body temperature beyond the normal range. Microbes in the body system that could potentially cause diseases find it more difficult to thrive in temperatures that are higher or lower than normal. It can boost the body’s immunity: Fever triggers the production of more white blood cells that help to fight infections.

    

Prescription, mode of action and effectiveness of phenoxymethylpenicillin. (Total: 10 marks)

Given that influenza is caused by a virus, why was Peter prescribed an antibiotic?

1. Phenoxymethylpenicillin is an antibiotic and antibiotics are known to lack the ability to kill viruses. However, since the fever itself is not a serious medical condition that needs treatment, the antibiotic was only given to inhibit complications. If the viral infection (influenza) stays for too long, bacteria may take advantage and attack the body and cause a secondary bacterial infection (Bullock & Manias, 2014). Bacterial pharyngitis causes inflammation of the throat. Vessels become more permeable and proteins sip out appearing as a white exudate. The antibiotic administered to Peter did not assist him to feel better or reduce the flu at all.

The doctor prescribed phenoxymethylpenicillin. Discuss the mode of action of phenoxymethylpenicillin.

1. Bacteria replicate by binary fission. A single-cell bacterium breaks a portion of its peptidoglycan cell wall and divides into two, generating an identical replica of the original cell. Antibiotics prevent peptidoglycan cross linksfrom forming in the cell walls. The ?-Lactam rings found in phenoxymethylpenicillin bind to DD-transpeptidase causing DD-transpeptidase to be unable to catalyze the formation of the cross links in the bacterial cells.In such a scenario, cell wall degradation occurs at higher rates than the cell wall production, which causes the cells to eventually die.

Explain why antibiotics are not effective against viruses.

1. The simplicity of viruses,in terms of gene composition and thus protein structure, makes them a difficult target. Since they can only thrive inside the host cell, they use the host cell to perform most of their functions. Therefore, attacking them in most cases would mean attacking the host cells. There is a difficult balance between targeting the viruses without damaging host cells (Marieb & Hoehn, 2016). Bacteria are able to be fought with relative ease because they reside as independent cells, therefore, they can be exclusively targeted.

    

Spreading of influenza and breaking its mode of transmission. (Total: 5 marks)

Describe two (2) possible ways that Peter could have contracted the influenza virus (modes of transmission).

1. Peter could have contracted the flu fromphysical contact with another infected person. For instance, if he was close enough to an infected person, he could have inhaled the viruses from the infected person’s cough or sneeze. Since flu may take up to a whole day before manifestation, Peter could have been unaware that the person was having the flu (Lee & Bishop, 2016). Peter could also have touched an infected surface or object, then touched his mouth, eyes or nose.

   3.2 Identify two (2) ways by which the modes of transmission could be broken

   Transmission is broken by avoiding intimate contact with infected person Also by avoiding entry of droplets, secretions and fomites from infected person into wounds

Physiological basis of the signs and symptoms (Total: 10 marks)

Describe the physiological basis of the first signs/symptoms of Peter’s throat. Relate your response to this case study.

Describe the physiological basis of the second signs/symptoms of Peter’s throat. Relate your response to this case study.

Describe the physiological basis of the third signs/symptoms of Peter’s throat. Relate your response to this case study.

• Replication of microorganisms (Total: 5 marks)

Compare and contrast the processes by which viruses and bacteria replicate

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