The document discusses two scenarios related to cardiovascular health issues in teenagers. The first scenario describes a 16-year-old male who presents for a sports participation exam and is found to have a grade II/VI systolic murmur, but is cleared with no restrictions. The document notes that many heart issues have no symptoms and can be missed on exams. It prompts the reader to consider how they would diagnose and treat the patient, and how genetics, ethnicity, or behavior could impact the case. The second scenario describes a 6-year-old girl who died from anaphylactic shock after presenting with hives and shortness of breath at school, where she could not be treated. The document asks the reader to discuss the physiological

1. Discussion 1: Cardiovascular Alterations
At least once a year, the media report on a seemingly healthy
teenage athlete collapsing during a sports game and dying of
heart complications. These incidents continue to outline the
importance of physical exams and health screenings for
teenagers, especially those who play sports. During these health
screenings, examiners check for cardiovascular alterations such
as heart murmurs because they can be a sign of an underlying
heart disorder. Since many heart alterations rarely have
symptoms, they are easy to miss if health professionals are not
specifically looking for them. Once cardiovascular alterations
are identified in patients, it is important to refer them to
specialists who can further investigate the cause.
Consider the following scenario:
A 16-year-old male presents for a sports participation
examination. He has no significant medical history and no
family history suggestive of risk for premature cardiac death.
The patient is examined while sitting slightly recumbent on the
exam table and the advanced practice nurse appreciates a grade
II/VI systolic murmur heard loudest at the apex of the heart.
Other physical findings are within normal limits, the patient
denies any cardiovascular symptoms, and a neuromuscular
examination is within normal limits. He is cleared with no
activity restriction. Later in the season he collapses on the field
and dies.
To prepare:
·
Review the scenario provided, as well as Chapter 24 in the
Huether and McCance text. Consider how you would diagnose
and prescribe treatment for the patient.
·
Select one of the following patient factors: genetics, ethnicity,
or behavior. Reflect on how the factor you selected might

2. impact diagnosis and prescription of treatment for the patient in
the scenario.
QUESTIONS to be addressed in my assignment:
1.
A description of how you would diagnose and prescribe
treatment for the patient in the scenario.
2.
Then explain how the factor you selected might impact the
diagnosis and prescription of treatment for that patient.
3.
Summary with Conclusion
REMINDERS:
1)
2-3 pages (addressing the 3 questions above excluding the
title page and reference page).
2)
Kindly follow APA format for the citation and references!
References should be between the period of 2011 and 2016.
Please utilize the references at least three below as much as
possible and the rest from yours.
3)
Make headings for each question.
Discussion 2: Anaphylactic Shock
The treatment of anaphylactic shock varies depending on a
patient’s physiological response to the alteration. Immediate
medical intervention and emergency room visits are vital for
some patients, while others can be treated through basic

3. outpatient care.
Consider the January 2012 report of a 6-year-old girl who went
to her school nurse complaining of hives and shortness of
breath. Since the school did not have any medication under her
name to use for treatment and was not equipped to handle her
condition, she was sent to an emergency room where she was
pronounced dead. This situation has raised numerous questions
about the progression of allergic reactions, how to treat students
with severe allergies, how to treat students who develop allergic
reactions for the first time, and the availability of epinephrine
in schools. If you were the nurse at the girl’s school, how would
you have handled the situation? How do you know when it is
appropriate to treat patients yourself and when to refer them to
emergency care?
To prepare:
·
Review “Anaphylactic Shock” in Chapter 23 of the Huether and
McCance text, “Distributive Shock” in Chapter 10 of the
McPhee and Hammer text, and the Jacobsen and Gratton article
in the Learning Resources.
·
Identify the multisystem physiologic progression that occurs in
anaphylactic shock. Think about how these multisystem events
can occur in a very short period of time.
·
Consider when you should refer patients to emergency care
versus treating as an outpatient.
·
Select two patient factors different from the one you selected in
this week’s first Discussion: genetics, gender, ethnicity, age, or
behavior. Reflect on how the factors you selected might impact
the process of anaphylactic shock.

4. QUESTIONS to be addressed in my assignment:
1.
An explanation of the physiological progression that occurs in
anaphylactic shock.
2.
Describe the circumstances under which you would refer
patients for emergency care versus treating as an outpatient.
3.
Explain how the patient factors you selected might impact the
process of anaphylactic shock.
4.
Summary with Conclusion
REMINDERS:
1)
2-3 pages (addressing the 4 questions above excluding the
title page and reference page).
2)
Kindly follow APA format for the citation and references!
References should be between the period of 2011 and 2016.
Please utilize the references at least three below as much as
possible and the rest from yours.
3)
Make headings for each question.
RESOURCES:
Readings

5. ·
Huether, S. E., & McCance, K. L. (2012).
Understanding pathophysiology
(Laureate custom ed.). St. Louis, MO: Mosby.
o
Chapter 22, “Structure and Function of the Cardiovascular and
Lymphatic Systems”
This chapter examines the circulatory system, heart, systemic
circulation, and lymphatic system to establish a foundation for
normal cardiovascular function. It focuses on the structure and
function of various parts of the circulatory system to illustrate
normal blood flow.
o
Chapter 23, “Alterations of Cardiovascular Function”
This chapter presents the pathophysiology, clinical
manifestations, evaluation, and treatment of various
cardiovascular disorders. It focuses on diseases of the veins and
arteries, disorders of the heart wall, heart disease, and shock.
o
Chapter 24, “Alterations of Cardiovascular Function in
Children”
This chapter examines cardiovascular disorders that affect
children. It distinguishes congenital heart diseases from
acquired cardiovascular disorders.
·
McPhee, S. J., & Hammer, G. D. (2010).

6. Pathophysiology of disease: An introduction to clinical
medicine
(Laureate Education, Inc., custom ed.). New York, NY:
McGraw-Hill Medical.
o
Chapter 10, “Cardiovascular Disorders: Heart Disease”
This chapter begins by exploring the normal structure and
function of the heart. It then examines the etiology,
pathophysiology, and clinical manifestations of five heart
disorders: arrhythmias, congestive heart failure, valvular heart
disease, coronary artery disease, and pericardial disease.
·
Jacobsen, R. C., & Gratton, M. C. (2011). A case of
unrecognized prehospital anaphylactic shock.
Prehospital Emergency Care
,
15
(1), 61–66.
Retrieved from the Walden Library databases.
This article provides
information relating to the diagnosis and management of
anaphylactic shock. It also explores difficulties encountered
when diagnosing uncommon clinical presentations of
anaphylactic shock.
Optional Resources
·

7. American Heart Association. (2012). Retrieved from
http://www.heart.org/HEARTORG/
·
Million Hearts. (2012). Retrieved from
http://millionhearts.hhs.gov/index.html
·
National Heart, Lung, and Blood Institute. (2012). Retrieved
from
http://www.nhlbi.nih.gov/