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NUR 140- marie > 140 Exam 1 Review > Flashcards

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
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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
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3
Q

can we have inflammation without in infection

A

YES

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4
Q

can we have infection without inflammation

A

NO (generally)

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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

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6
Q

local symptoms of appendicitis

A
  • RLQ pain
  • rebound tenderness
  • constipation/abdominal distension
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7
Q

systemic symptoms of appendicitis

A
  • low grade fever
  • elevation in WBC
  • anorexia/malaise
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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
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9
Q

neutrophils

A

play an important role because they can perform phagocytosis- important in bacterial invasions

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10
Q

lymphocytes

A

important in fighting viruses

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11
Q

mast cells & basophils

A

release histamine- PRO-

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12
Q

inflammatory hormones

A

increases vascular permeability

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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)
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14
Q

CRP & ESR

A
  • non specific inflammatory lab tests
  • tell us inflammation is present but not the location or cause
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15
Q

what is the best way to prevent inflammation

A

infection prevention and injury prevention

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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
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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
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18
Q

clinical manifestations of menigitis

A
  • headache
  • fever/chills
  • nuchal rigidity/neck immobility
  • Kernig/Brudzinski sign
  • photophobia
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19
Q

diagnostics for meningitis

A
  • CT
  • lumbar puncture
  • blood cultures
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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
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21
Q

Nursing priorities for meningitis

A
  • ASSESS NEURO STATUS
  • initiate infection precautions
  • pain and fever management
  • decrease stimuli
  • encourage hydration and ambulation
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22
Q

findings for appendicitis

A
  • elevated WBC, CRP/ESR
  • low grade fever
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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
Q

serotonin antagonists

A
  • ondansetron
  • monitor for prolonged QT syndrome (check with EKG)
  • common side effect- DIZZINESS
26
Q

dopamine antagonists

A
  • metoclopramide
  • intentional use: to treat nausea/vomiting
  • can stimulate motility
  • side effects: sedation, restlessness, and neuroleptic malignant syndrome, extrapyramidal reactions
27
Q

bulk forming agents/fiber supplements

A
  • psyllium
  • fiber supplements
  • drink 8 oz of fluid with med (can develop constipation)
28
Q

laxatives

A
  • bisacodyl
  • stimulating intestinal motility, stimulating gut to go
  • hold for diarrhea
  • hold for someone with appendicitis or bowel obstruction
  • hold for abdominal problems
29
Q

stool softeners

A
  • 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
Q

5- aminosalicylates

A
  • sulfasalazine
  • used to treat IBD
  • make sure client is not allergic to SULFA
31
Q

immunosuppresants

A
  • 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
Q

Crohn’s

A
  • can occur anywhere in the GI tract
  • RLQ abdominal pain
  • characterized by skip lesions
  • common complications: fistula, abscess
  • “cobblestone” appearance
33
Q

ulcerative colitis

A
  • 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
Q

applies to both crohn’s and UC

A
  • 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
Q

nursing considerations IBD

A
  • hydration
  • vital signs
36
Q

teaching to help decrease amount of stools

A
  • stress reduction
  • low fat/low fiber diets
37
Q

What is TPN

A
  • method of providing nutrients to the body via IV route
38
Q

why is TPN given to someone experiencing an exacerbation of IBD

A
  • bowel rest
  • allows time for healing
39
Q

Is TPN digested

A
  • no, it is given intravenously
  • needs to be given through CVADs
40
Q

How can nurses prevent infect with TPN

A
  • change tubing q24h
  • ensure aseptic technique when attaching/changing dressing
  • do not infuse anything else through that line
  • monitor for signs of infection
41
Q

what is important about monitoring blood sugar with TPN

A
  • q4-6h in the first 24 hours
  • start slow and slowly increase
  • have dextrose 10% at the bedside if bag runs dry
42
Q

B lymphocytes

A
  • antibodies
  • SPECIFIC
  • remembers specific antigens/invaders
43
Q

T lymphocytes

A

apoptosis

44
Q

complement system

A

complements or builds upon the immune response (makes it stronger)

45
Q

inflammation

A

neutrophils

46
Q

active acquired

A

gettig sick/vaccines

47
Q

passive acquired

A

introduction of antibodies- mom tobabcy or antibody infusions

48
Q

what is important to remember about epinephrine

A

NEVER DELAY ADMINISTRATION

49
Q

type 1 hypersensitivity

A
  • anaphylaxis
  • IgE
50
Q

type 2 hypersensitivity

A
  • tissue specific/cytotoxic
  • blood transfusions
51
Q

type 3 hypersensitivity

A
  • immune complex
  • RA
52
Q

type 4 hypersensitivity

A
  • cell mediated/delayed
  • poison ivy/ PPD skin test
53
Q

what to remember about prednisone

A

need to take it as prescribed!!!

54
Q

what to remember about RA

A
  • preventing exacerbation = slowing the progression
  • there is no cure
55
Q

live attenuated viruses

A
  • contraindicated in anyone who is immunosuppressed
56
Q

HIV

A
  • Kaposi’s sarcoma= opportunistic infection
  • any signs of opportunistic infection/increase in viral load= need access to medications
57
Q

best prevention of HIV for healthcare workers

A

do not recap needles

NUR 140- marie (7 decks)

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