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Respond to at least two of your colleagues who selected at least one different factor than you in one of the following ways:

Share insights on how the factor your colleague selected impacts the pathophysiology of anaphylactic shock.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

                                                        Main Post

 Anaphylactic shock is a widespread hypersensitivity reaction called anaphylaxis (Huether & McCance, 2017).  Anaphylactic shock causes an accelerated allergic reaction that releases large amounts of histamine, which therefore results in vasodilation (Huether & McCance, 2017).  When a sensitized individual is exposed to an allergen it results in an anaphylactic shock which the physiologic alteration is similar to a neurogenic shock (Huether & McCance, 2017).  The physiologic alteration would include vasodilation and relative hypovolemia which then leads to a decreased tissue perfusion and impaired cellular metabolism (Huether & McCance, 2017).  The entire body is affected rapidly when it goes into an anaphylactic shock.

            According to Pistener & Mattey (2017), Anaphylaxis is a life-threatening emergency and in the school setting, school nurses prepare plans to prevent an emergency, educating staff and students on life-threatening allergies. An anaphylactic shock is defined as a sudden onset of one or more allergic reaction symptom lasting less than twenty-four hours; such as wheezing, rash, hives, itching, shortness of breath, angioedema, stridor, nausea, vomiting, dizziness, anxiety or diarrhea (Jacobsen & Gratton, 2011).  If I was the nurse practitioner in the school and the child came in complaining of one or more of the anaphylactic shock’s symptoms, I would first check my anaphylactic shock emergency plan and see if the child is carrying his Epinephrine pen or if the school has it. If the child has the Epinephrine pen or the school has it, I would administer the medication rapidly in order to avoid death. If the child and the school does not have the epinephrine pen, I would call 911 and report my findings and refer the patient to emergency care.  If the child came in complaining of a rash or hives that he/or she has had for a couple days, I would treat them in an outpatient setting and call their parents.

            Genetics is one of the factors I selected for anaphylactic shock due to genetically predisposed individuals, allergens such as shellfish, peanuts, latex, medications, and insect venoms initiate a humoral immune response (type I hypersensitivity reaction) that result in a mass production of immunoglobulin E (IgE) antibodies (Huether & McCance, 2017). The mast cells are de-granulated due to the allergen binding to IgE; thus, a mast cells release vasoactive and inflammatory cytokines in large quantities (Huether & McCance, 2017). The end product is the immune and inflammatory response is triggered causing vasodilation, increased vascular permeability, peripheral pooling, tissue edema, and constriction of extravascular smooth muscle which causes laryngospasm and bronchospasm as well as abdominal cramping (Huether & McCance, 2017).  Lastly, the immune system of a person with an allergy will perceive the allergen as a dangerous body. This would then create an antibody to fight off the foreign body.  This is when the process of an allergic reaction begins (Jacob, 2018).

Behavior is the second factor that impacts anaphylactic shock.  There are times when the patient is not aware of an exposure to allergen. The patient would then have an anaphylactic shock very rapidly which can result into a life-threatening situation. Patients with allergens causing anaphylaxis needs to be educated in carrying an epinephrine pen at all times.  Eating out in restaurants where they cook foods in close proximity, the patients needs to be educated in alarming the waiter that they have a food allergen.

References

Huether, S. E., & McCance, K.L. (2017). Understanding pathophysiology (6th ed.). St. Louis, 

MO: Mosby.

Jacob, L. M. (2018). Anaphylaxis. Salem Press Encyclopedia of Health. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=ers&AN=87325288&site=eds-live&scope=site

Jacobsen, R. C., & Gratton, M. C. (2011). A case of unrecognized prehospital anaphylactic 

shock. Prehospital Emergency Care, 15(1), 61-66. Retrieved from http://m.paems.org/pdfs/online-ce/A-case-of-unrecognized-prehospital-anaphylactic-shock.pdf

Pistiner, M., & Mattey, B. (2017). A Universal Anaphylaxis Emergency Care Plan: Introducing the New Allergy and Anaphylaxis Care Plan From the American Academy of Pediatrics. NASN School Nurse (Print), 32(5), 283–286. https://doi-org.ezp.waldenulibrary.org/10.1177/1942602X17713759

Overview
 

So far, we have looked at the Hero’s journey by examining its parts. While this approach is helpful in understanding how to examine the myth, it is important to look at whole texts to see what and how the process we have examined this semester creates meaning. To do this, we will examine The Epic of Gilgamesh. Gilgamesh is one of my favorite characters and this is one of my favorite stories. If we had more time, we could delve into the many mysteries that surround this nearly 5,000 year old story. But for now, we will explore it as exemplifying the Hero’s journey.
 

As I said, the Hero’s Journey is about more than its parts. Campbell writes that “the quest and the return are two halves of the same circle. They comprise the empowerment process or journey of beginning that joins the participants with the ideal realm of their deities.”
 

Seperation→Initiation→Return are parts of the process of transformation. So, we can begin with the idea that the heroic journey is a symbol of our own transformation. Further, Campbell argues that the hero is a model of behavior and the heroic act is one of transformation. In this perspective, the journey or trip is a manifestation of his or her own nature. The adventure is the experience of life that leads to a change in consciousness.
 

Simply put, the hero is a symbol of our vitality. The influence of a vital person is to vitalize us. As we read mythological narratives, we come into contact with those symbols that evoke our vital character. We get to know ourselves as we go along. We have to pay attention and choose symbols and situations that reveal the best in ourselves—not the worst.
 

This is why heroes often begin as negative characters. Certainly, at the start of the epic, Gilgamesh is a bad character. Yet, through a series of tragedies and loss, he discovers not his “true self” (we are who we are) as much as a positive outlet for his energies. Often, what causes us to “mess up” is not channeling our strength in the right direction or not using them at all. In the end, what makes Gilgamesh a great king are the same attributes that made him a horrible human being. But, once channeled in the right direction, he becomes a transformative figure.
 

The hero, as symbol, and the journey, as symbol, leads to a reversal of existence. What we thought was strength is a weakness. What we thought was our weakness is our strength. We look to those symbols that raise our consciousness by changing the field of our perception. These symbols and these narratives infuse all life with the significance of existing .Once we have completed our own quest, either in reality, through the stories, or both, we can have that feeling of sanctity always. We have transformed our life.
 

Readings

· The Epic of Gilgamesh 

Assignments

· Paper 2: Gilgamesh and the Hero’s Journey (Due no later than 12:00PM on Wednesday of Week 7)

Paper 2: Gilgamesh and the Hero’s Journey

Important Information to Remember:

· Due Date: This paper must be submitted no later than 12:00PM on Wednesday of Week 7.

· Due to time constraints, I will be unable to offer extensions or grade papers received after this date. Any paper received after Noon will receive a “Thanks for Sharing” and a zero.

· This counts as your final exam. 

The hero’s journey can be summed up with “Separation-Initiation-Return.” Explain each of these steps in detail using Gilgamesh to illustrate your explanation. After you have answered the question above, where do you see these characters and themes played out in popular culture? Be specific as you apply the stages of the hero’s journey to the film or TV show. Finally, discuss how both Gilgamesh and your contemporary hero vitalize the individual. Play mythographer and explore your own culture. Be specific by making use of clear examples from Gilgamesh and your pop-culture text. (quotes).
 

Reminder and Suggestions:
This paper is meant to give you the opportunity to illustrate your understanding of the material we have covered this semester
 

Guidelines:

· Your paper will need to be typed in a 12 point font and double spaced. Your paper should be at least 3 pages long.

Remember, the idea of this paper is to test your ability to be both a sponge and a fountain. After you get past the sponge stuff, really dig deep to make some connections that are meaningful to you.