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Nursing PICOT Question
Nursing PICOT Question
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healthcare setting. Nurses and other healthcare professionals are tasked with identify relevant
nursing diagnoses by analyzing and clustering patient information based on the symptoms.
According to Turabian (2019), nursing diagnosis refers to a clinical judgment based on the
examining all the vulnerabilities to their health and developing an appropriate treatment strategy
to improve their health outcome in the healthcare setting. To identify a medical condition of a
patient, nurses prioritize their diagnosis procedures, examine the root problems of the condition,
and create an issue-based plan used to meet the health needs of a patient. This is the same
procedure applied in the case of Tom, a construction field worker who shows signs and
From the case study, it is clear that Tom's diagnosis is tetanus. I concluded this way
because the most prevalent symptoms of tetanus in adults are pain in the jaws and stiffness in the
body parts and soaring throats. Most importantly, Tom has a lockjaw, which is synonymous with
tetanus. According to Nakajima et al (2018), tetanus bacteria grows in puncture wounds on the
body which are caused by insect bites, nails, and blunt objects. Contaminated wounds are major
storage areas where tetanus bacteria grow and multiply. In this case, Tom forgot about the
wound that was caused by a large metal rod, which created a chance for the entry of tetanus
bacteria. When tetanus bacteria enter the body, they affect the working mechanism between the
muscles and the nerve system. When the tetanus bacteria come into contact with these body
parts, it leads to damage of the neuromuscular junction which amplifies the chemical signal that
causes tightening of muscles (Nakajima et al, 2018). This is what Weant et al (2021) call
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"muscle spasms" which lead to the inability to nurse the injury especially when sanitation of the
affected area is poor. The resultant effects of muscle spasms include irritability, restlessness, and
lockjaws. Restlessness is the most common symptom because many body muscles are affected
by the tetanus bacteria which affect the normal breathing system in human beings. For example,
Nakajima et al (2018) reveal that when important breathing muscles lose their power due to the
effect of tetanus bacteria, it becomes hard to breathe and in worse situations, it can lead to death.
All these symptoms are present in the case study. For example, Tom shows signs of restlessness,
stiffness in major parts of the body like the neck, and challenges in opening jaws due to the
From the examination of tetanus disease, the main vaccine for its treatment is tetanus
toxoid. This means that Tom was given tetanus toxin as an antitoxin. Tetanus Toxoid gives a
passive immunity because it contains previously performed antibodies, which means it is not a
primary anti-toxin that can warrantee it to give active immunity. According to Ticha et al
(2021), tetanus antitoxin is mixed with some quantity of TIGH to give a patient a low-level
passive immunity that is responsible for initiating active immunization. Besides, tetanus toxoid is
only applicable to people more than 7 years and above. The tetanus toxoid anti-toxicant is
injected subcutaneously or intramuscularly in the affected area because the tetanus bacteria
mostly affect the muscle system in the body. Again, there is sufficient evidence from the case
study that tetanus toxoid is the anti-toxin that was administered to Tom. For example, after
visiting the doctor, the affected part was thoroughly cleansed. Ticha et al (2021) reveal that
injecting the tetanus toxoid requires cleansing of the affected area using a relevant germicide.
Therefore, the aforementioned arguments explain why tetanus toxoid is the antitoxin that was
given to Tom.
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Immunity refers to the ability of the body to protect itself from infectious and harmful
diseases (Flajnik, 2018). There are two major categories of immunity; adaptive and innate where
adaptive immunity is the third line of defense in the body while innate immunity is inherent since
the birth of a person (Flajnik, 2018). Active and passive immunity fall under adaptive immunity
because both of them are forms of acquired immunity that protects an individual from a
particular pathogen. Active immunity is a type of immunity where the body actively produces
antibodies and the development of memory cells to protect a person from an external or foreign
pathogen (Flajnik, 2018). On the other hand, passive immunity is a type of immunity that results
from the introduction of antibodies from an external source to protect an individual from a
particular pathogen (Flajnik, 2018). In its entirety, active immunity produces long-term
protection to an individual while passive immunity is short-term because it does not produce
memory cells. Active and passive immunity is categorized into two classifications; natural and
artificial immunity. Natural active immunity refers to the production of antibodies in response to
a particular pathogen (Flajnik, 2018). For example, a person infected with chickenpox will
produce antibodies that can protect an individual for a long time. Artificial active immunity
attenuated pathogen (Flajnik, 2018). For example, children are vaccinated against polio to create
antibodies that protect them from polio-related effects. On the other hand, natural passive
immunity refers to receiving antibodies from other people or organisms like in the case of a
mother passing antibodies to the baby through breastfeeding (Flajnik, 2018). Artificial passive
According to Kittai et al (2017), organs are rejected by the body because of the response
from the immune system to a foreign organ. The immune system is responsible for protecting the
body from external or foreign elements. The entry of a foreign organ into the body triggers the
immune system to destroy it because such an organ conflicts with the normal functioning of the
human body. According to Kittai et al (2017), the immune system is responsible for mediating
cells in the body which deny any form of interaction with foreign organs. The immune system
protects the body from the entry of harmful substances like cancer cells, poisons, germs, and
foreign organs. Foreign organs enter the body in form of antigens which trigger a negative
response from the immune system because they are automatically labeled "foreign" by the entire
body system Kittai et al (2017). Therefore, when people receive organs from other people
through transplant surgery, the immune system responds to it as foreign. The mismatch of organ
A graft refers to transplanting tissue or an organ from one person or animal to another in
a particular body part (Eljazwi, 2020). The main goal of grafting is to replace or repair an injured
or damaged tissue or organ of the body. Since transplantation involves transferring of an organ or
tissue without their initial circulatory system, they vary in the way they interact and connect with
other new tissues. This is why there are different types of grafts based on the source. For
example, allografts are grafts that are transplanted from a genetically distinct person to another
genetically distinct person because they belong to the same species group (Eljazwi, 2020). There
is another type of graft called isograft where transplant tissues or organs are removed from the
monozygotic twin and transferred to another monozygotic twin (Eljazwi, 2020). Autograft is a
type of graft where one part of an individual’s body is removed to treat a damaged part of the
same body, like a skin graft applied on a burnt body part of the patient (Eljazwi, 2020). Lastly,
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xenograft is a type of graft where a transplanted tissue or organ is removed from an animal to
Elsewhere, the chimeric immune system refers to the type of immune where immune
stem cells from the recipient are mixed with those of the donor (June & Sadelain, 2018). This
type of immune ensures that the immunity of stem cells of the recipient of an organ transplant
and that of the donor remains strong and also prevents the body from rejecting organs.
Lastly, there are various ways in which the virus spreads in the body. For example, when
the flu virus attacks cells, it attaches its DNA to that of the host, making it multiply in the
process. When multiplication ceases, the virus' DNA produces several viral proteins through
transcription, leading to a continuous flow of viral particles that affect other cells (June &
Sadelain, 2018). However, this spread is prevented to attack the normal cells through interferons
which are responsible for signaling neighboring cells of the impending viral attack.
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References
Immunology, 18(7), 438-453.
June, C. H., & Sadelain, M. (2018). Chimeric antigen receptor therapy. New England Journal of
Medicine, 379(1), 64-73.
Kittai, A. S., Oldham, H., Cetnar, J., & Taylor, M. (2017). Immune checkpoint inhibitors in
Nakajima, M., Aso, S., Matsui, H., Fushimi, K., & Yasunaga, H. (2018). Clinical features and
Ticha, O., Klemm, D., Moos, L., & Bekeredjian-Ding, I. (2021). A cell-based in vitro assay for
1-11.
Weant, K. A., Fields, B., Guerin, C. S., & Justice, S. B. (2021). Don't Be a Stiff: A Review
20.