NUR 111 FINAL EXAM ACTUAL QUESTIONS AND ANSWERS
RATED A+
✔✔Kinins - ✔✔Increase vascular permeability
Attract neutrophils to the site
✔✔Five Signs of Inflammation - ✔✔Heat
Redness
Swelling
Pain
Loss of function
✔✔Systemic Response to Inflammation - ✔✔Fever
Leukocytosis
Increased white blood cells
Malaise
General icky feeling
Loss of appetite
Aching
Weakness
✔✔Acute Inflammation - ✔✔Immediate response
Short duration (8-10days)
5 cardinal signs
Heat
Redness
Edema
Pain
Loss of function
Ex: scrapes, sprains, etc.
Can lead to chronic inflammation
✔✔Chronic Inflammation - ✔✔Weeks to years
Does not serve beneficial function
May not have a trigger for inflammation
Macrophages and leucocytes continually invade the tissue which causes damage to the
tissue which causes more invading into the tissue it is a positive feedback loop
Scarring & permanent tissue damage may occur
Ex: Lupus, rheumatoid arthritis, autoimmune diseases
✔✔Autoimmune issue - ✔✔With autoimmune disease we do not know why it happens
but the body turns on itself and thinks that its own tissue is foreign and it attacks its own
tissue
✔✔Risk factors affecting Chronic Inflammation - ✔✔Very young
,Very old
Underinsured
Because they ignore their inflammation because they do not have insurance
Autoimmune disorders
Allergies
The more allergies you have the more likely you are to get more allergies
Exposure to pathogens
Compromised immunity
Chronic disease
Lack of proper sanitation
✔✔Nursing Assessment for Inflammation and Infection - ✔✔History:
Identify trigger of inflammation
If you can figure out what causes it you can help get it away from the patient
Treat the Symptoms
Diagnostic Tests:
WBC
White blood cell count
NV is 5-10
CRP
C-Reactive protein which is a protein that is released after an injury and if this is high it
indicates inflammation
ESR
Erythrocyte sedimentation rate which is part of you inflammation response so if this is
high it is a sign of an inflammatory process
If ESR is higher
MRI, PET, CT
To try and find the site of injury if none are visible
All these labs go up with inflammation
✔✔Local Assessment Findings for Inflammation and Infections - ✔✔Erythema (redness)
Warmth
Pain
Edema (swelling)
Functional Impairment
Pruritis (itching rash)
HIPER:
Heat
Induration (hardening)
Pain
Edema
Redness
✔✔Systemic Assessment Findings for Inflammation and Infections - ✔✔Temp will
increase
,Pulse will increase
Respirations will increase
WBC will increase
Malaise/fatigue
HIPER:
Heat
Induration (hardening)
Pain
Edema
Redness
✔✔Primary Nursing Interventions with Inflammation and Infection - ✔✔PREVENTION!
Don't let them fall
Wash your hands
Pull invading devices (foleys) as fast as you can
Keep the patient clean
Reduce risk for injury/infection
Maintaining good hygiene
Properly using safety equipment
Properly storing and preparing food
✔✔Are there any secondary screenings for the inflammatory process? - ✔✔There are
no secondary screenings for the inflammatory process
✔✔Collaborative Interventions for the Inflammatory Process - ✔✔Pharmacologic
therapies
Corticosteroids
Immunosuppressant that decreases the immunity resonse
NSAIDs
Salicylates
Asprin
Acetaminophen
Does not deal with inflammation as much as it treats the pain
Immobilization
Helps prevent further damage
RICE
Rest
Ice
Facilitates vasoconstriction
Compression
Facilitates vasoconstriction
Helps with edema
Elevation
Helps with edema
, ✔✔Infection Cycle - ✔✔Infectious agent - Reservoir- Portal of exit- Mode of
transmission- Portal of entry- Host- back to infectious agent and it just keeps going in a
cycle. The nurse's job is to break the cycle at some point
✔✔Infectious Agent - ✔✔Bacteria
Fungi
Virus
Parasite (protozoan)
✔✔Virulent - ✔✔the ability of an organism to cause disease.
How strong is it
✔✔Colonization - ✔✔is where the bacteria or virus is living in the patients body but it is
not hurting them
✔✔Infection - ✔✔is where the bacteria or virus is causing body damage and you will
have specific manifestations of the disease
✔✔Bacteria Infectious Agent - ✔✔Aerobic- require oxygen to survive
Anaerobic- can live without oxygen
✔✔Fungi Infectious Agent - ✔✔Can have this anywhere even the blood stream
✔✔Virus Infectious Agent - ✔✔Antibiotics do not work on virus's
✔✔Reservoir - ✔✔Where the bug likes to live
The natural habitat of the organism that promotes growth and multiplication
Humans
We are warm, moist and full of food
Ex. HIV
Animals
Ex. Rabies
Soil
Ex. Gangrene, tetanus
Food
Water
Ex. Legionnaires disease
Dairy
Ex. Listeria. Seen a lot in the Amish and with people who do not pasteurize their dairy
Inanimate objects
Ex. Flu, C. Diff
✔✔Portal of Exit - ✔✔They all want to take over the world and have to exit the host to
do that
The point of escape for the organism from the reservoir
RATED A+
✔✔Kinins - ✔✔Increase vascular permeability
Attract neutrophils to the site
✔✔Five Signs of Inflammation - ✔✔Heat
Redness
Swelling
Pain
Loss of function
✔✔Systemic Response to Inflammation - ✔✔Fever
Leukocytosis
Increased white blood cells
Malaise
General icky feeling
Loss of appetite
Aching
Weakness
✔✔Acute Inflammation - ✔✔Immediate response
Short duration (8-10days)
5 cardinal signs
Heat
Redness
Edema
Pain
Loss of function
Ex: scrapes, sprains, etc.
Can lead to chronic inflammation
✔✔Chronic Inflammation - ✔✔Weeks to years
Does not serve beneficial function
May not have a trigger for inflammation
Macrophages and leucocytes continually invade the tissue which causes damage to the
tissue which causes more invading into the tissue it is a positive feedback loop
Scarring & permanent tissue damage may occur
Ex: Lupus, rheumatoid arthritis, autoimmune diseases
✔✔Autoimmune issue - ✔✔With autoimmune disease we do not know why it happens
but the body turns on itself and thinks that its own tissue is foreign and it attacks its own
tissue
✔✔Risk factors affecting Chronic Inflammation - ✔✔Very young
,Very old
Underinsured
Because they ignore their inflammation because they do not have insurance
Autoimmune disorders
Allergies
The more allergies you have the more likely you are to get more allergies
Exposure to pathogens
Compromised immunity
Chronic disease
Lack of proper sanitation
✔✔Nursing Assessment for Inflammation and Infection - ✔✔History:
Identify trigger of inflammation
If you can figure out what causes it you can help get it away from the patient
Treat the Symptoms
Diagnostic Tests:
WBC
White blood cell count
NV is 5-10
CRP
C-Reactive protein which is a protein that is released after an injury and if this is high it
indicates inflammation
ESR
Erythrocyte sedimentation rate which is part of you inflammation response so if this is
high it is a sign of an inflammatory process
If ESR is higher
MRI, PET, CT
To try and find the site of injury if none are visible
All these labs go up with inflammation
✔✔Local Assessment Findings for Inflammation and Infections - ✔✔Erythema (redness)
Warmth
Pain
Edema (swelling)
Functional Impairment
Pruritis (itching rash)
HIPER:
Heat
Induration (hardening)
Pain
Edema
Redness
✔✔Systemic Assessment Findings for Inflammation and Infections - ✔✔Temp will
increase
,Pulse will increase
Respirations will increase
WBC will increase
Malaise/fatigue
HIPER:
Heat
Induration (hardening)
Pain
Edema
Redness
✔✔Primary Nursing Interventions with Inflammation and Infection - ✔✔PREVENTION!
Don't let them fall
Wash your hands
Pull invading devices (foleys) as fast as you can
Keep the patient clean
Reduce risk for injury/infection
Maintaining good hygiene
Properly using safety equipment
Properly storing and preparing food
✔✔Are there any secondary screenings for the inflammatory process? - ✔✔There are
no secondary screenings for the inflammatory process
✔✔Collaborative Interventions for the Inflammatory Process - ✔✔Pharmacologic
therapies
Corticosteroids
Immunosuppressant that decreases the immunity resonse
NSAIDs
Salicylates
Asprin
Acetaminophen
Does not deal with inflammation as much as it treats the pain
Immobilization
Helps prevent further damage
RICE
Rest
Ice
Facilitates vasoconstriction
Compression
Facilitates vasoconstriction
Helps with edema
Elevation
Helps with edema
, ✔✔Infection Cycle - ✔✔Infectious agent - Reservoir- Portal of exit- Mode of
transmission- Portal of entry- Host- back to infectious agent and it just keeps going in a
cycle. The nurse's job is to break the cycle at some point
✔✔Infectious Agent - ✔✔Bacteria
Fungi
Virus
Parasite (protozoan)
✔✔Virulent - ✔✔the ability of an organism to cause disease.
How strong is it
✔✔Colonization - ✔✔is where the bacteria or virus is living in the patients body but it is
not hurting them
✔✔Infection - ✔✔is where the bacteria or virus is causing body damage and you will
have specific manifestations of the disease
✔✔Bacteria Infectious Agent - ✔✔Aerobic- require oxygen to survive
Anaerobic- can live without oxygen
✔✔Fungi Infectious Agent - ✔✔Can have this anywhere even the blood stream
✔✔Virus Infectious Agent - ✔✔Antibiotics do not work on virus's
✔✔Reservoir - ✔✔Where the bug likes to live
The natural habitat of the organism that promotes growth and multiplication
Humans
We are warm, moist and full of food
Ex. HIV
Animals
Ex. Rabies
Soil
Ex. Gangrene, tetanus
Food
Water
Ex. Legionnaires disease
Dairy
Ex. Listeria. Seen a lot in the Amish and with people who do not pasteurize their dairy
Inanimate objects
Ex. Flu, C. Diff
✔✔Portal of Exit - ✔✔They all want to take over the world and have to exit the host to
do that
The point of escape for the organism from the reservoir
