Online Custom «Inflammation, Inflammatory Response and Fever» Essay Sample
Body temperature is regulated and maintained within the normal range by hypothalamus. The hypothalamus acts as the body thermostat that ensures that the body temperature remains within 96.7-99.4F. However, during bacterial infection, the exogenous pyrogen substance induces an increase in the set period of normal temperature in the hypothalamus. A trigger of fever is pyrogen, which, when released into the circulation system, triggers the release of prostaglandin E2 (PGE2) which causes a higher set temperature in the hypothalamus as the new normal. It is followed by vasoconstriction and shivering as a mechanism that the body attempts to raise the temperature to a high set point, thus causing fever. The bacterial cell wall structure called Lipopolyssacharide (LPS) as the exogenous pyrogen in bacterial infection triggers fever trough activation of prostaglandin E2 release that triggers an increase in body temperature (Serhan et al., 2010).
Localized inflammation has four cardinal signs which include fever, heat, swelling and erythematic. In an attempt to limit the area of injury, swelling occurs. It is a physiologic response that traps neutrophils, cytokines and pyrogen in the area of injury; this occurs spontaneously in order to localize infection or acute injury (Sussman, 2002). Erythematic response occurs as a result of vasodilation and influx of blood to the point of entry of the pathogen or an injury site. The spontaneous increase in blood to the site of disease is to transport Leucocytes that often rise to more than 20,000 cells/ microlitre. The increased vascular flow into the site exacerbates swelling and the presence of bacterial exogenic toxins alters temperature regulation mechanism in the hypothalamus, triggering the prostaglandins and subsequent fever ensues.
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There is no doubt that the pathologic condition is affecting the five year old case study; empirically, this is a classical bacterial infection. In the health center set up a broad spectrum antibiotic will be ideal, as more investigation is carried out. It, therefore requires critical analysis of the nurse having in mind the limited resources in terms of laboratory and microscopic equipment needed to diagnose such a disease.
In the case of the tympanic involvement in the case study provided, the mechanism of the erythematous membrane is the increase in blood flow and vasodilatation of the micro vessels. The combination of fever, fatigue, loss of appetite and fluid accumulation describes a classical example of inner ear disease. The nurse in caring for a child should be able to use appropriate antibiotic therapy to clear the disease and most importantly combine with Non-Steroidal Anti-inflammatory Drug (NSAID) that reverses inflammatory response.
When an ear infection occurs, the purulent discharge released contains the bacterial products, tissue debris and dead leukocyte. As the body tries to clear the infectious agent, the spontaneous release of neutrophils is activated and released to the site of infection. The case of pediatric ear disease is a good example of this mechanism, underlying fluid discharge and the erythematic response.
In the event of a complete blood count tests, certain indicators will confirm a bacterial infection. In any bacterial infection, the Neutrophils are high, thus distinguishing it from viral disease (Semple, 2005). Bacterial inflammatory reaction activates Acute-phase proteins release into the blood stream in response to cytokines produced during inflammation such as Interleukin-1 (IL-1) and IL-6 and Tumor Necrosing Factor (TNF), the combination of these specialized proteins makes blood viscosity rise, thus explains the high Erythrocyte Sedimentation Rate (ESR) during bacterial infection (Freehan, 2006). There is also leukocytosis, where specific macrophages and mediators released into circulation. In acute cases, the bone marrow is activated abnormally high, leading to a release of Premature Europhiles (PMN) or even immature neutrophils. When a blood sample is taken, there will be a high number of circulating neutrophils, most of which are immature or band form.
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According to Sussman (2002), inflammation is the body mechanism that aid in minimizing the area of injury, removes the pathogen, causing the disease together with the damaged tissue. However, when the inciting bacterial agent enters the blood stream it causes a cascade of response that causes Systemic Inflammatory disorder called Systemic Inflammatory Disorder. The classical symptoms of systemic response include fever and joint pains, also called arthralgia, anorexia. The pediatric case has alarming fever of 102 F, following infection of tympanic membrane infection. It is critical for the primary nurse to ensure meticulous two hourly temperature chart and administer antipyretics to reverse the fever.
Hypothalamus-Pituitary Axis (HPA) is the key mediator of system manifestation that results from the inflammatory response. When inflammation occurs, there is the release of anti-inflammatory corticoids from the adrenal cortex, in cases of impaired adrenal cortex function the severity of the inflammatory response (Cavaillon & Andre, 2009). In the febrile state, the immune system is activated in an attempt to clear the pathogen, the nurse should, therefore, promote adequate nutrition and hydration status of the child in order to enrich the body with sufficient nutrients. The high nutrient intake allows the body to match the high metabolic rate during febrile state and the high immune system.
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Wong et al (2011) argues that sit is important to treat ear infections promptly and adequately in order to prevent the infection from progressing to the inner ear and finally causing otitis media. Otitis is a severe infection that causes destruction of auditory structures and mastoid bone impairing hearing. When fever remains undesirably high for a long time, the nurse should ensure more active treatment is initiated to reverse the disease from getting systemic. In the case of the pediatric, the frequent ear infections have been attributed to the increased number of otitis media, as the ultimate complication. It is, therefore, crucial for the nurse to encourage the mother to actively to monitor any changes in the child habit and report to the hospital even after the discharge; this is because of the frequent cases of recurrence of inflammatory response and fever among children.
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