Case Study – Allergies leading to Anaphylaxis

Case Study – Allergies leading to Anaphylaxis

Objectives

1. Explain the risk factors, symptoms, etiology, progression, diagnosis, treatment and prognosis. 2. Demonstrate the ability to access and critically evaluate information from a wide variety of sources (such as Library databases and internet sources). Read the case presentation and answer the questions that follow. The Case Study Rubric will be used to assess your work. The Case Study rubric lists the criteria for each question (required resources, word counts and citation requirements). Case Presentation Ashlee, a 20 year old female, has a known allergy to peanuts. She was having dinner at a Thai restaurant with friends when she began to experience dyspnea, which progressed to wheezing within a few minutes. Her friends called 911 when she started to slur her speech. Ashlee’s friends tell the emergency response personnel that she has a peanut allergy, but she didn’t have an epinephrine pen with her. On arrival, emergency personnel note diffuse urticaria on Ashlee’s arms and legs. Examination reveals angioedema of throat and tongue and pulmonary edema. Her BP is 88/50 mmHg; HR 140 bpm. An endotracheal tube is placed to create a patent airway, and 0.3 mg of epinephrine is administered intramuscularly into Ashlee’s thigh. After the epinephrine is administered, Ashlee’s symptoms begin to clear. When the ambulance arrives at the hospital, her breathing is improved and she no longer requires the endotracheal tube. Her pulse has lowered to 100 bpm and her blood pressure has stabilized due to the administration of epinephrine, so intravenous fluids are not necessary. Ashlee remains under observation for several hours. It is assumed that there was cross contamination at the restaurant because several Thai dishes contain peanuts. Despite Ashlee knowing about her peanut allergy, she was not prepared. She will need patient education before she is released from the hospital to prevent another anaphylactic reaction. In addition, a there can be a secondary phase after an asymptomatic period of 1-8 hours. She should remain within ready access of emergency care for the next 48 hours. Questions 1. Define the bold words. 2. Describe how the immune cells of the body lead to the signs and symptoms of an systemic allergic reaction (anaphylaxis). 3. We often hear people talk about having allergies like “hay fever “ There are others who are highly allergic to bee stings, which could ultimately lead to death. Differentiate anaphylactic shock from seasonal allergies comparing the etiology, signs and symptoms, diagnosis and treatment. 4. Explain to Ashlee in terms she can understand how the epinephrine pen reverses the reactions of anaphylaxis. Investigate and explain “allergy shots” to Ashlee. 5. Explain the prognosis of anaphylactic shock to Ashlee if she does not receive treatment during another systemic allergic reaction. Explain preventative measures that Ashlee can take as her next reaction could be more severe. Case Study – Leukemia Objectives 1. Explain the risk factors, symptoms, etiology, progression, diagnosis, treatment and prognosis. 2. Demonstrate the ability to access and critically evaluate information from a wide variety of sources (such as Library databases and internet sources). Read the case presentation and answer the questions that follow. The Case Study Rubric will be used to assess your work. The Case Study rubric lists the criteria for each question (required resources, word counts and citation requirements). Case Presentation Dawson, an energetic boy, 8 years of age, had shown less enthusiasm for his normal activities for a few days. He told his mother he felt tired and has nausea. His mother took his temperature and found that he had a low-grade fever (100.2 degrees F). She figured he had a virus, but after a week of him not feeling better she took him to the pediatrician. On examination the pediatrician noted that he appeared pale and had cervical lymphadenopathy. He prescribed a 10 day course of antibiotic. Dawson still did not feel better and continued to have a low-grade fever. When Dawson returned for a follow up appointment, his doctor noted ecchymoses of the skin and slight splenomegaly, which were not present at his first appointment. The pediatrician ordered a complete blood count (CBC), chest x-ray and computerized tomography (CT) of his abdomen. The blood tests indicated anemia, lymphoblasts; the chest xray was normal, and the CT confirmed splenomegaly. The pediatrician talked with Mr and Mrs. Jones privately and carefully explained that Dawson should have a bone marrow aspirate and that he was referring Dawson to a pediatric cancer center. Blood smear with lymphoblasts. [Digital image]. (n.d.). Retrieved from https://library.med.utah.edu/WebPath/HEMEHTML/HEME018.html Questions 1. Define the bold terms. 2. The exact cause of leukemia is not known. Scientists have learned how certain changes in the DNA inside normal bone marrow cells can cause them to become leukemia cells. Investigate and describe what these changes are in the DNA. 3. Dawson has lymphadenopathy which is a sign, but not a disease. Lymphadenopathy can occur with infection, but it can also occur in leukemia, like this patient’s case leukemia or in lymphoma. There are several types of leukemias and lymphomas. Differentiate acute lymphocytic leukemia (ALL) from Hodgkin’s lymphoma, comparing the etiology, signs and symptoms, diagnosis and treatment. 4. Dawson’s parents need to be educated on treatment for acute lymphocytic leukemia using terms that they can understand. At minimum this should include drug treatments, surgeries, and any at home-care. 5. Discuss the prognosis of ALL with Dawson’s parents.

  Excellent Good Fair Poor
Main Posting 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

 

Supported by at least three current, credible sources.

 

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

 

At least 75% of post has exceptional depth and breadth.

 

Supported by at least three credible sources.

 

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

 

One or two criteria are not addressed or are superficially addressed.

 

Is somewhat lacking reflection and critical analysis and synthesis.

 

Somewhat represents knowledge gained from the course readings for the module.

 

Post is cited with two credible sources.

 

Written somewhat concisely; may contain more than two spelling or grammatical errors.

 

Contains some APA formatting errors.

0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

 

Lacks depth or superficially addresses criteria.

 

Lacks reflection and critical analysis and synthesis.

 

Does not represent knowledge gained from the course readings for the module.

 

Contains only one or no credible sources.

 

Not written clearly or concisely.

 

Contains more than two spelling or grammatical errors.

 

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness 10 (10%) – 10 (10%)

Posts main post by day 3.

0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%)

Does not post by day 3.

First Response 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

 

Responds fully to questions posed by faculty.

 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

 

Demonstrates synthesis and understanding of learning objectives.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are fully answered, if posed.

 

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are answered, if posed.

 

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

 

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

 

Responses posted in the discussion may lack effective professional communication.

 

Responses to faculty questions are somewhat answered, if posed.

 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

 

Responses posted in the discussion lack effective professional communication.

 

Responses to faculty questions are missing.

 

No credible sources are cited.

Second Response 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

 

Responds fully to questions posed by faculty.

 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

 

Demonstrates synthesis and understanding of learning objectives.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are fully answered, if posed.

 

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are answered, if posed.

 

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

 

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

 

Responses posted in the discussion may lack effective professional communication.

 

Responses to faculty questions are somewhat answered, if posed.

 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

 

Responses posted in the discussion lack effective professional communication.

 

Responses to faculty questions are missing.

 

No credible sources are cited.

Participation 5 (5%) – 5 (5%)

Meets requirements for participation by posting on three different days.

0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%)

Does not meet requirements for participation by posting on 3 different days.

Total Points: 100