NUR 111 Exam 4
Question 1.
Inflammation
ANSWER
Is a localized reaction intended to neutralize, control or eliminate an offending agent.
Question 2.
Inflammatory Re-sponse
ANSWER
Inflammation is a localized reaction intended to neutralize, control or eliminate an offending agent. Nonspecific response to injured or dead cells Eliminates
invading pathogens Allows for tissue repair Occurs in response to infection or injury Infection is one way to get inflammation but it is not the only way Can be
acute or chronic That offening agent may be the persons own body Not specific A protecting mechanism that responds to injured or dead cells Usually
occurs in healthy tissue adjacent to the dead cells
Question 3.
Stages of Inflammation
ANSWER
1st stage: Vascular response Blood vessel response 2nd stage: Cellular Response White blood cells Reparative phase They all happen very close together
Question 4.
Vascular Response
ANSWER
Usually localized to the area of injury but can be systemic Momentary vasoconstriction then lots of Vasodilation Increased permeability of vasculature Makes
it easier for blood and cells to pass through the blood vessel walls Increased concentration of blood Due to the vasoconstriction and permeability Clotting
Due to platelets rushing to the area that help clot off injury to stop the bleeding
Question 5.
Cellular Response
ANSWER
Leukocytes accumulate at site Due to increased permeability of the blood vessels Cytokines cause endothelial cells to bind to leukocytes Cytokines are
chemical messengers that tell the brain there is an injury Leukocytes travel through the capillary into tissue So you have white blood cells fighting infection in
the tissue Leukocytes engulf invading organisms
Question 6.
Exudate
ANSWER
You get exudate with inflammation If exudate starts containing bacteria and bacterial debris then it becomes puss and is a sign of a bacterial infection and
becomes part of your excaudate Moves into injured area after inflammatory event as part of the cellular response Carries Proteins Fluid Lymphocytes
Monocytes Macrophages Granulocytes
, Question 7.
Healthy exudate
ANSWER
The whole point of it if it is health is to: Eradicate pathogen Remove dead tissue debris Secrete cytokines Initiate healing
Question 8.
Reparative Phase
ANSWER
Glucose and oxygen travel to site needing repair Regeneration depends on the type of cells Regeneration Labile They multiply constantly So they are
relatively easy to regenerate Ex. Skin cells Permanent Does not regenerate Ex. Neurons Stable Regenerate sometimes if there is injury Takes longer
because they do not multiply constantly Ex. Kidney or liver cells Replacement Replacing the tissue that was damaged
Question 9.
Acute Inflammatory Response
ANSWER
Tissue injury/exposure and the release of chemical mediators Vasodilation and increased blood flow Swelling and retraction of activated endothelial cells
Increased vascular permeability and leakage of small plasma proteins "Walling off" Movement of immune response cells to the site of injury Exudate
formation Movement of glucose and oxygen to the site needing repair Release of chemical repair factors from activated endothelial cells
Question 10.
Chemical Mediators
ANSWER
Histamine and Kinins
Question 11.
Histamine
ANSWER
Pro-inflammatory Induces the vascular response Lives in mast cells so the mast cells release the histamines which causes vasodilation Stimulation results in
itching, pain, edema, vasodilation, and bronchoconstriction Anti-histamines are given to combat these symptoms Histamine is a big chemical mediator when
talking about inflammation
Question 12.
Kinins
ANSWER
Increase vascular permeability Attract neutrophils to the site
Question 13.
Five Signs of Inflammation
ANSWER
Heat Redness Swelling Pain Loss of function
, Question 14.
Systemic Response to Inflammation
ANSWER
Fever Leukocytosis Increased white blood cells Malaise General icky feeling Loss of appetite Aching Weakness
Question 15.
Acute Inflammation
ANSWER
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
Question 16.
Chronic Inflammation
ANSWER
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
Question 17.
Autoimmune issue
ANSWER
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
Question 18.
Risk factors affecting Chronic Inflammation
ANSWER
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
Question 19.
Nursing Assessment for Inflammation and Infection
ANSWER
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 re-sponse 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
Question 20.
Local Assessment Findings for Inflammation and Infections
ANSWER
Erythema (redness) Warmth Pain Edema (swelling) Functional Impairment Pruritis (itching rash) HIPER: Heat Induration (hardening) Pain Edema Redness
, Question 21.
Systemic Assessment Findings for Inflammation and Infections
ANSWER
Temp will increase Pulse will increase Respirations will increase WBC will increase Malaise/fatigue HIPER: Heat Induration (hardening) Pain Edema
Redness
Question 22.
Primary Nursing Inter-ventions with Inflammation and Infection
ANSWER
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
Question 23.
Are there any secondary screenings for the inflammatory process?
ANSWER
There are no secondary screenings for the inflammatory process
Question 24.
Collaborative Interventions for the Inflammatory Process
ANSWER
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
Question 25.
Infection Cycle
ANSWER
Infectious agent - Reservoir- Portal of exit- Mode of transmission- Portal of entry- Hostback to infectious agent and it just keeps going in a cycle. The nurse's
job is to break the cycle at some point
Question 26.
Infectious Agent
ANSWER
Bacteria Fungi Virus Parasite (protozoan)
Question 27.
Virulent
ANSWER
the ability of an organism to cause disease. How strong is it
Question 1.
Inflammation
ANSWER
Is a localized reaction intended to neutralize, control or eliminate an offending agent.
Question 2.
Inflammatory Re-sponse
ANSWER
Inflammation is a localized reaction intended to neutralize, control or eliminate an offending agent. Nonspecific response to injured or dead cells Eliminates
invading pathogens Allows for tissue repair Occurs in response to infection or injury Infection is one way to get inflammation but it is not the only way Can be
acute or chronic That offening agent may be the persons own body Not specific A protecting mechanism that responds to injured or dead cells Usually
occurs in healthy tissue adjacent to the dead cells
Question 3.
Stages of Inflammation
ANSWER
1st stage: Vascular response Blood vessel response 2nd stage: Cellular Response White blood cells Reparative phase They all happen very close together
Question 4.
Vascular Response
ANSWER
Usually localized to the area of injury but can be systemic Momentary vasoconstriction then lots of Vasodilation Increased permeability of vasculature Makes
it easier for blood and cells to pass through the blood vessel walls Increased concentration of blood Due to the vasoconstriction and permeability Clotting
Due to platelets rushing to the area that help clot off injury to stop the bleeding
Question 5.
Cellular Response
ANSWER
Leukocytes accumulate at site Due to increased permeability of the blood vessels Cytokines cause endothelial cells to bind to leukocytes Cytokines are
chemical messengers that tell the brain there is an injury Leukocytes travel through the capillary into tissue So you have white blood cells fighting infection in
the tissue Leukocytes engulf invading organisms
Question 6.
Exudate
ANSWER
You get exudate with inflammation If exudate starts containing bacteria and bacterial debris then it becomes puss and is a sign of a bacterial infection and
becomes part of your excaudate Moves into injured area after inflammatory event as part of the cellular response Carries Proteins Fluid Lymphocytes
Monocytes Macrophages Granulocytes
, Question 7.
Healthy exudate
ANSWER
The whole point of it if it is health is to: Eradicate pathogen Remove dead tissue debris Secrete cytokines Initiate healing
Question 8.
Reparative Phase
ANSWER
Glucose and oxygen travel to site needing repair Regeneration depends on the type of cells Regeneration Labile They multiply constantly So they are
relatively easy to regenerate Ex. Skin cells Permanent Does not regenerate Ex. Neurons Stable Regenerate sometimes if there is injury Takes longer
because they do not multiply constantly Ex. Kidney or liver cells Replacement Replacing the tissue that was damaged
Question 9.
Acute Inflammatory Response
ANSWER
Tissue injury/exposure and the release of chemical mediators Vasodilation and increased blood flow Swelling and retraction of activated endothelial cells
Increased vascular permeability and leakage of small plasma proteins "Walling off" Movement of immune response cells to the site of injury Exudate
formation Movement of glucose and oxygen to the site needing repair Release of chemical repair factors from activated endothelial cells
Question 10.
Chemical Mediators
ANSWER
Histamine and Kinins
Question 11.
Histamine
ANSWER
Pro-inflammatory Induces the vascular response Lives in mast cells so the mast cells release the histamines which causes vasodilation Stimulation results in
itching, pain, edema, vasodilation, and bronchoconstriction Anti-histamines are given to combat these symptoms Histamine is a big chemical mediator when
talking about inflammation
Question 12.
Kinins
ANSWER
Increase vascular permeability Attract neutrophils to the site
Question 13.
Five Signs of Inflammation
ANSWER
Heat Redness Swelling Pain Loss of function
, Question 14.
Systemic Response to Inflammation
ANSWER
Fever Leukocytosis Increased white blood cells Malaise General icky feeling Loss of appetite Aching Weakness
Question 15.
Acute Inflammation
ANSWER
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
Question 16.
Chronic Inflammation
ANSWER
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
Question 17.
Autoimmune issue
ANSWER
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
Question 18.
Risk factors affecting Chronic Inflammation
ANSWER
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
Question 19.
Nursing Assessment for Inflammation and Infection
ANSWER
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 re-sponse 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
Question 20.
Local Assessment Findings for Inflammation and Infections
ANSWER
Erythema (redness) Warmth Pain Edema (swelling) Functional Impairment Pruritis (itching rash) HIPER: Heat Induration (hardening) Pain Edema Redness
, Question 21.
Systemic Assessment Findings for Inflammation and Infections
ANSWER
Temp will increase Pulse will increase Respirations will increase WBC will increase Malaise/fatigue HIPER: Heat Induration (hardening) Pain Edema
Redness
Question 22.
Primary Nursing Inter-ventions with Inflammation and Infection
ANSWER
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
Question 23.
Are there any secondary screenings for the inflammatory process?
ANSWER
There are no secondary screenings for the inflammatory process
Question 24.
Collaborative Interventions for the Inflammatory Process
ANSWER
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
Question 25.
Infection Cycle
ANSWER
Infectious agent - Reservoir- Portal of exit- Mode of transmission- Portal of entry- Hostback to infectious agent and it just keeps going in a cycle. The nurse's
job is to break the cycle at some point
Question 26.
Infectious Agent
ANSWER
Bacteria Fungi Virus Parasite (protozoan)
Question 27.
Virulent
ANSWER
the ability of an organism to cause disease. How strong is it
