140 Exam 1 Review Flashcards
1
Q
What to remember about inflammation
A
- remember that the inflammatory process is NON-specific
- steps of the inflammation are similar regardless of cause
- degree of response depends on severity and scope of injury
2
Q
acute vs chronic inflammation
A
- goal of acute: get rid of harmful stimuli and initiate repair
- examples: meningitis, appendicitis, anaphylaxis
- goal of chronic: NONE, agent persists and leads to permanent tissue injury
- DOES NOT serve a beneficial or protective function
examples: IBD, Rheumatoid arthritis
3
Q
can we have inflammation without in infection
A
YES
4
Q
can we have infection without inflammation
A
NO (generally)
5
Q
local vs. systemic inflammation: Cardinal signs of inflammation
A
Local: swelling, pain, redness, loss of function, and exudate
Systemic: Fever, increased WBC, increased plasma proteins, malaise, fatigue
6
Q
local symptoms of appendicitis
A
- RLQ pain
- rebound tenderness
- constipation/abdominal distension
7
Q
systemic symptoms of appendicitis
A
- low grade fever
- elevation in WBC
- anorexia/malaise
8
Q
What to remember about the immune response
A
- the steps of the immune response are going to start no matter what the cause (papercut, surgical incision, puncture wound, infection, etc)
- it is going to cause vasodilation and increased blood flow –> redness/heat
- increase vascular permeability —> swelling, pain, loss of function
- healing - exudates
9
Q
neutrophils
A
play an important role because they can perform phagocytosis- important in bacterial invasions
10
Q
lymphocytes
A
important in fighting viruses
11
Q
mast cells & basophils
A
release histamine- PRO-
12
Q
inflammatory hormones
A
increases vascular permeability
13
Q
age related differences for inflammation
A
- older adults and neonates may not mount the same response to inflammation
- older adults —> slower wound healing
- neonates —> decreased ability to respond (fever in kids is not good)
14
Q
CRP & ESR
A
- non specific inflammatory lab tests
- tell us inflammation is present but not the location or cause
15
Q
what is the best way to prevent inflammation
A
infection prevention and injury prevention
16
Q
inflammation intervention
A
- RICE (rest, ice, compression, elevation)- most effective right after an injury
- immobilization devices
- pharmacology:
- steroids
- NSAIDs
- monoclonal antibodies
- antipyretics
- analgesics
- antimicrobials
17
Q
what is meningitis
A
- inflammation of the meninges
- bacterial vs. viral: BACTERIAL is worse
- high risk groups- college students, members of the military, unvaccinated/immunocomprimised
18
Q
clinical manifestations of menigitis
A
- headache
- fever/chills
- nuchal rigidity/neck immobility
- Kernig/Brudzinski sign
- photophobia
19
Q
diagnostics for meningitis
A
- CT
- lumbar puncture
- blood cultures
20
Q
treatment for meningitis
A
- ABX, steroids?, hydration, monitor for complications —> ICP, change/decrease in mental status
- PREVENTION- vaccination/prophylactic treatment for close contacts
21
Q
Nursing priorities for meningitis
A
- ASSESS NEURO STATUS
- initiate infection precautions
- pain and fever management
- decrease stimuli
- encourage hydration and ambulation
22
Q
findings for appendicitis
A
- elevated WBC, CRP/ESR
- low grade fever
23
Q
what does it mean when the pain stops in appendicitis
A
- the appendix has burst
- client needs surgery
- antibiotics
- pain meds
- IV fluids
24
Q
if someone has appendicitis and has appendicitis do we give them a laxitive?
A
NOOOO
25
serotonin antagonists
- ondansetron
- monitor for prolonged QT syndrome (check with EKG)
- common side effect- DIZZINESS
26
dopamine antagonists
- metoclopramide
- intentional use: to treat nausea/vomiting
- can stimulate motility
- side effects: sedation, restlessness, and neuroleptic malignant syndrome, extrapyramidal reactions
27
bulk forming agents/fiber supplements
- psyllium
- fiber supplements
- drink 8 oz of fluid with med (can develop constipation)
28
laxatives
- bisacodyl
- stimulating intestinal motility, stimulating gut to go
- hold for diarrhea
- hold for someone with appendicitis or bowel obstruction
- hold for abdominal problems
29
stool softeners
- docusate sodium
- common stool softener- Colace
- make sure client drinks 8 oz water with med
- don’t give if client has diarrhea!
- Work by increasing absorption of water into stool, facilitating passage of stool
30
5- aminosalicylates
- sulfasalazine
- used to treat IBD
- make sure client is not allergic to SULFA
31
immunosuppresants
- azathioprine
- want to suppress the immune system
- used to treat IBS
- monitor for infection
- monitor for neutropenia and thrombocytopenia
- educate client that they have a higher risk for infection
32
Crohn's
- can occur anywhere in the GI tract
- RLQ abdominal pain
- characterized by skip lesions
- common complications: fistula, abscess
- "cobblestone" appearance
33
ulcerative colitis
- isolated to the colon and rectum
- ulceration is continuous
- LLQ abdominal pain
- bleeding often occurs
- common complications: toxic megacolon and need for blood transfusion
34
applies to both crohn's and UC
- chronic inflammatory condition
- stress management to reduce exacerbations
- elevated ESR and CRP
- requires nutrition and possibly TPN during exacerbation
- increased risk of colon cancer
35
nursing considerations IBD
- hydration
- vital signs
36
teaching to help decrease amount of stools
- stress reduction
- low fat/low fiber diets
37
What is TPN
- method of providing nutrients to the body via IV route
38
why is TPN given to someone experiencing an exacerbation of IBD
- bowel rest
- allows time for healing
39
Is TPN digested
- no, it is given intravenously
- needs to be given through CVADs
40
How can nurses prevent infect with TPN
- change tubing q24h
- ensure aseptic technique when attaching/changing dressing
- do not infuse anything else through that line
- monitor for signs of infection
41
what is important about monitoring blood sugar with TPN
- q4-6h in the first 24 hours
- start slow and slowly increase
- have dextrose 10% at the bedside if bag runs dry
42
B lymphocytes
- antibodies
- SPECIFIC
- remembers specific antigens/invaders
43
T lymphocytes
apoptosis
44
complement system
complements or builds upon the immune response (makes it stronger)
45
inflammation
neutrophils
46
active acquired
gettig sick/vaccines
47
passive acquired
introduction of antibodies- mom tobabcy or antibody infusions
48
what is important to remember about epinephrine
NEVER DELAY ADMINISTRATION
49
type 1 hypersensitivity
- anaphylaxis
- IgE
50
type 2 hypersensitivity
- tissue specific/cytotoxic
- blood transfusions
51
type 3 hypersensitivity
- immune complex
- RA
52
type 4 hypersensitivity
- cell mediated/delayed
- poison ivy/ PPD skin test
53
what to remember about prednisone
need to take it as prescribed!!!
54
what to remember about RA
- preventing exacerbation = slowing the progression
- there is no cure
55
live attenuated viruses
- contraindicated in anyone who is immunosuppressed
56
HIV
- Kaposi's sarcoma= opportunistic infection
- any signs of opportunistic infection/increase in viral load= need access to medications
57
best prevention of HIV for healthcare workers
do not recap needles
