Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). In your reply posts, include how the information you learned from your peer’s post will help you to provide care to a patient as a Nurse Practitioner.
Note: The expectation is not that you “agree” or “disagree” with your peers but that you develop a conversation with information that is validated via citations to encourage learning and to bring your own perspective to the conversation.
Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the other one is the reply to my other peer Post #2.
TURNITIN ASSIGNMENT (FREE OF PLAGIARISM)
POST # 1 – ALCINA
What is the purpose of a booster vaccination? Give an example and how an allergic reaction might occur in this situation.
In essence, vaccines are composed of dead or inactivated parts of bacteria or viruses in order to expose the immune system to the antigen so immunity can be developed (VanMeter et al., 2018). However, Chung indicates that vaccines contain other ingredients other than antigens for immunity, they also contain conjugating agents, stabilizers, preservatives, eggs, yeast and gelatin which can cause potential allergic reactions and mild reactions are becoming more common due to those ingredients (2014).
VanMeter and colleagues indicate that signs and symptoms of an allergic reaction do not take place after the first exposure to an allergen. At the first exposure the immune system forms antibodies and sensitizes the mast cells. Mast cells are responsible for producing the inflammatory response and releasing histamines (2018).
VanMeter et al. point out that the purpose of a vaccine booster is to remind the immune system of the antigen in order to produce the specific antibodies to fight the antigen. Once another vaccine is given it triggers the immune system to recall that specific antigen and the antibodies that target that antigen are released (2018).
One example of an allergic reaction triggered by a vaccine is the tuberculin or Mantoux skin test in which the body creates an inflammatory response at the injection site on the skin indicating previous exposure to the antigen. BCG is a vaccine produced from the bacillus Calmette-Guerin given in some countries against tuberculosis (VanMeter et al., 2018). The inflammatory response is generated by the immune system to alert the system where the allergen is and to remove it. Signs of allergic reaction to the Mantoux test are redness, swelling and pain in the area of the injection site (VanMeter et al., 2018).
McNeil et al. specify that it is advisable to be cautious when giving booster vaccinations. The DTAP (diphtheria, tetanus, and acellular pertussis) vaccine contains milk proteins used as stabilizers and may create anaphylactic reactions to booster vaccines for children with cow milk allergies (2018).
As a nurse practitioner it would be advisable to ask the patient about their allergies and vaccination history, reviewing the ingredients contained in vaccines and being aware of signs and symptoms of allergic reactions.
Chung E. H. (2014). Vaccine allergies. Clinical and experimental vaccine research, 3(1), 50–57.
McNeil, M. M., & DeStefano, F. (2018). Vaccine-associated hypersensitivity. The Journal of allergy and clinical immunology, 141(2), 463–472.
VanMeter, K.C., & Hubert, R.J. (2018). Gould’s pathophysiology for the health professions. Elsevier Saunders.
POST # 2 – KEARA
Topic: Explain why immediate neutralization or removal of a chemical spilled on the hand minimizes burn injury and how chemicals splashed in a person’s eye may be treated differently?
Burns can be due to more than just thermal burns that often occur from a fire. Hubert and VanMeter (2018) discuss other types of burns such as electrical or chemical burns that cause tissue destruction and inflammation to occur. The inflammatory process from a burn is acute but initiates the release of chemical mediators such as histamines, serotonin, prostaglandins to the site. Vasodilation occurs and capillaries become more permeable, allowing leukocytes to move into the site of injury. If any debris is present, phagocytes are released (Hubert & VanMeter, 2018). Often when this happens, Friedstat (2017) explains that when chemical burns occur, wound infections, cellulitis, and sepsis can happen if the burn is not neutralized as quickly as possible. This makes quick treatment especially important to catch before the burn enters deeper tissue and be re-characterized as a partial thickness burn or full thickness burn (Friedstat, Brown, & Levi, 2017).
When a burn occurs from a chemical spill, removal of the substance is needed immediately to reduce the effect of the burn and make it more difficult for the chemical to penetrate deeper into the tissue. In addition, removing any clothing or jewelry is important. Friedstat (2017) explains that removal of the chemical is the most important step in neutralizing chemical burn injuries. Next, gentle irrigation with water or saline to remove any remaining chemicals is important because if irritation is too pressurized, the chemicals can infiltrate deeper into the tissue (Friedstat, Brown, & Levi, 2017).
Chemicals splashed in a person’s eye are treated a little differently than surface of skin chemical burns, but have similar steps to follow. Bore (2018) lists the steps of chemical eye splash as first instilling anesthetic eyedrops and irrigate the eye for at least 30 minutes. In certain circumstances, implementing eye drops to neutralize pH of the eye can reduce effect of the chemical burn. For instance, Moghadam (2020) studies the effects of AV gel eye drops for alkali burned cornea and it showed that the defective area was reduced.
Checking labs on a patient with a burn is important because if a burn does not heal and foreign products enter the site, infection can occur. Checking labs that indicate infection such as CBC, white count, CRP, and lactate are useful in assessing infection and potential progression to sepsis. For patients that I may encounter with chemical burns, thorough assessment of the site is important especially if it is a fresh wound and monitoring the progress to ensure the area heals properly. Educating on future accidents and what to do if one occurs is equally as important. In addition, educating patients on signs and symptoms to look out for as the wound heals. Overall, removing the chemical is the best step in treating chemical burns on the skin.
Bore, M. (2018). Emergency management: chemical burns. Community Eye Health Journal, 31(103), 72.
Friedstat, J., Brown, D. A., & Levi, B. (2017). Chemical, electrical, and radiation injuries. Clinics in plastic surgery, 44(3), 657–669.
Hubert, R. J. & VanMeter, K. C. (2018). Gould’s pathophysiology for the health professions. St. Louis, MO: Elsevier Saunders.
Moghadam, M. R., Jafarinasab, M.-R., Yousefi, Z., Moghaddam, A. S., Memarzadeh, H., & Kanavi, M. R. (2020). Aloe vera gel-derived eye drops for alkaline corneal injury in a rabbit model. Journal of Ophthalmic & Vision Research, 15(1), 7–16.