Exam III - Final Flashcards
This is the initial response to injury that focuses on eradicating dead tissue and protecting against infection, an automatic response to tissue damage.
Acute inflammation
One of the components of the first (optimal) outcome to the inflammatory processes.
This is when damaged tissue is replaced by identical tissue. The pathogen is removed and tissues are allowed to heal
Restitution (example: sprained ankle)
One of the components of the first (optimal) outcome to the inflammatory processes.
The _____ outcome of the inflammatory process damaged cells are unable to be repaired and fibrous tissue replaces damaged tissue forming scar tissue
A. First outcome
B. Second outcome
C. Third outcome
D. Fourth outcome
B. Second outcome
The ____ outcome of the inflammatory process involves the development of chronic inflammation. Pathologic agents remain active and tissue destruction continues. The immune system tries to resolve and fibrous tissue continues to form instead of new tissue.
A. First outcome
B. Second outcome
C. Third outcome
D. Fourth outcome
C. Third outcome
High outcome of morbidity and mortality
The ____ outcome of the inflammatory process involves acute inflammation and restitution
A. First outcome
B. Second outcome
C. Third outcome
D. Fourth outcome
A. First outcome
The ____ outcome of the inflammatory process involves the death of tissue and death of host
A. First outcome
B. Second outcome
C. Third outcome
D. Fourth outcome
D. Fourth outcome
For the five classic signs of acute inflammation?
Redness, swelling, pain, heat, loss of function
This is an immediate, short lived response
Increased blood flow,
Increased vascular permeability,
Migration of Leukocytes from the blood to the tissues, and
Movement of proteins, fluids, lymphocytes, monocytes, macrophages, and granulocytes to remove tissue debris and pathologic organisms are all physiologic changes to _____ _____
Acute inflammation
_____ _____ continues for weeks to years and does not go away, however it can slow down or it can exacerbate. A granuloma is formed at the site of injury and an accumulation of macrophages, fibroblasts, and collagen form
Chronic inflammation
Examples are untreated tuberculosis, and inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.
What are the risk factors for inflammation?
Being very young: undeveloped immune system,
Being very old: weakened immune system,
Immune compromise: AIDS, chemo, radiation
What triggers inflammation?
Allergens,
Exposure to infectious agents,
Age (very young, very old),
Physiological ability to respond (immune compromise)
What determines the symptoms and duration of the inflammatory response?
Disease,
Patient condition,
Response to treatment
What are the classic findings with inflammation if internal damage is present?
Fever,
Increased WBC,
Slowing/absence of tissue or organ function
What laboratory tests are performed to determine inflammation/ infection?
WBC w/differential: increased indicates positive,
C-reactive protein (CRP): indicates presence of inflammation in cardiac patients,
ESR: increased shows inflammation
A positive Epstein-Barr test indicates the presence of ______
Mononucleosis
What are the primary preventions to reduce risk for inflammation?
Hand hygiene,
Keep wounds clean,
Ensure food/water safety,
Use safety equipment (helmet, knee pads, etc)
What are the primary nursing interventions for inflammation?
RICE for sprains (rest, ice, compression, elevation),
Immobilization (splint),
Pharmacological agents:
Steroid-reduces swelling, pain
NSAIDS-reduces pain, fever, inflammation
Antipyretics-reduces fever (get blood cultures for fever 103+)
Analgesics-reduces pain
Antimicrobials-for prophylaxis or for identified microorganisms
What types or research are found in primary literature?
Quantitative research,
Qualitative research,
Mixed design research
This type of research uses objective observation and validation, random controlled trials, double blind studies, cohort studies, case-controlled studies, case studies and longitudinal studies
Quantitative research
This type of research uses a person’s experiences, interviews, surveys, questionnaires, ethnography, phenomenology, grounded theory and case reports
Qualitative research
This type of research uses a combination of quantitative and qualitative research, using a wholistic approach
Mixed design research
What is a randomized control trial?
Uses test group and control group i.e. Drug trial
What is a cohort study?
Research following one group of people
What is a case controlled study?
A study of two groups with two different outcomes
What is a case study?
A detailed analysis of members of groups making inferences
What is a longitudinal study?
A study done over time
_____ is the study of people and cultures
Ethnography
_____ is the study of experiences and consciousness from the first person point of view
Phenomenology
_____ _____ is the discovery of theory through the analysis of data
Grounded theory
This organization is responsible for the standards of medical care in diabetes
American Diabetic Association
This organization is responsible for lipid screening and cardiovascular health in childhood
American Academy of Pediatrics
This organization is responsible for setting guidelines for HPV vaccinations used to prevent cervical cancer
American Cancer Society
What types of research are found in secondary literature?
Evidence summaries,
Systematic reviews/Meta-analysis
This type of research summarizes evidence from multiple studies and draws a conclusion
Systemic reviews/Meta-analysis
This type of research is labor intensive
This type of research summarizes original research studies and is not done first hand
Evidence summaries
What are the attributes of evidence?
Replicability (can be repeated with same results),
Reliability (is tool used for measurement reliable),
Validity (did research answer the question being asked)
The US Preventative Services Task Force issues this grade when they strongly recommend with high certainty that the net benefit of the intervention is substantial?
A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement
A. Grade A
The US Preventative Services Task Force issues this grade when they recommends against with moderate to high certainty that the intervention has no net benefit or that the harms outweigh the benefits
A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement
D. Grade D
The US Preventative Services Task Force issues this grade when they believe the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence may be lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined?
A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement
E. Grade E or IStatement
The US Preventative Services Task Force issues this grade when there is a high certainty that the net benefit is moderate or there is a moderate certainty that the net benefit is moderate to substantial
A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement
B. Grade B
The US Preventative Services Task Force issues this grade when there may be considerations that support providing the intervention in an individual patient, but not for the general population. There is at least moderate certainty that the net benefit is small (neutral)?
A. Grade A B. Grade B C. Grade C D. Grade D E. Grade E or IStatement
C. Grade C
Whate does the initiative GRADE stand for?
Grading of Recommendations Assessment, Development, and Evaluation
What are the three barriers to implementing evidence-based nursing?
Lack of knowledge,
Overwhelming amounts of information,
Time constraints
What are the 5 steps to facilitate the use of evidence?
- Develop an answerable question
- Search the literature to uncover evidence to answer the question
- Evaluate the evidence found
- Apply the evidence to a practice situation
- Evaluate the outcome
Which type of cells are involved in the ingestion and phagocytosis of microorganisms and foreign protein?
A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes
A. Neutrophils
Which type of cells release histamine and heparin in areas of tissue damage and respond to allergens?
A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes
D. Basophils
Which type of cells release vasoactive amines during allergic reactions to limit inflammatory reaction?
A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes
C. Eosinophils
Which type of cells are involved in the recognition of foreign proteins and microorganisms, ingestion and phagocytosis?
A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes
B. Macrophages
Phagocytosis, repair, antigen presenting/processing and secretion of cytokines for immune system control
Which type of cells become sensitized to foreign cells and proteins?
A. Neutrophils B. Macrophages C. Eosinophils D. Basophils E. Lymphocytes
E. Lymphocytes
What is the classic sign of tuberculosis?
Night sweats
Also: fever, cough, fatigue, chest pain, hemoptysis, weight loss, loss of appetite
What is an unusual sign of acute pancreatitis?
Grey Turner’s Sign
Bruising of flanks
What is the hallmark sign of Crohn’s Disease?
Rectal bleeding
What happens when ammonia levels are increased in patients with cirrhosis of the liver?
Metabolic encephalopathy (profound confusion)
Which pharmacological agent reduces swelling/inflammation and pain?
A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials
A. Steroids
Which pharmacological agent reduces fever?
A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials
C. Antipyretics
Get blood cultures for fever >103
Which pharmacological agent reduces pain?
A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials
D. Analgesics
Which pharmacological agent reduces pain, fever, and inflammation?
A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials
B. NSAIDs
Which pharmacological agent is used as a prophylaxis or for identified microorganisms?
A. Steroids B. NSAIDS C. Antipyretics D. Analgesics E. Antimicrobials
E. Antimicrobials