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Nsg 1102 > Inflammation > Flashcards

Inflammation Flashcards

0
Q

Which statement comparing inflammation and infection is true?

A. Manifestations of infection always include fever and inflammation is not associated with fever.
B. Inflammation is stimulated through B lymphocyte activation and infection is stimulated through T lymphocyte activation.
C. Inflammation occurs in response to tissue injury or tissue invasion and infection is always a response to tissue invasion
D. The duration of inflammatory responses is always much longer than the duration of infectious responses

A

C. Inflammation occurs in response to tissue injury or tissue invasion and infection is always a response to tissue invasion

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1
Q

The client has a chronic disease in which the process of self tolerance is deficient. You should expect the client to demonstrate which alteration in immunologic function? The client:

A. Is more susceptible to infection
B. will not express a fever even when infection is present
C. Will not develop antibodies in response to a vaccination
D. Is at greater risk for tissue damage from autoimmune diseases

A

D. Is at greater risk for tissue damage from Autoimmune diseases

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2
Q

How are the actions of inflammation and the actions of cell-mediated immunity different?

A. Inflammation provides immediate but temporary protection against pathogenic microorganisms
B. Protection provided by inflammation can be transferred from one person to another
C. Cell mediated actions result in fever
D. Only T-lymphocyte can distinguish self from non-self

A

A. Inflammation provides immediate but temporary protection against pathogenic microorganisms.

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3
Q

Which of the following manifestations or processes of inflammation is caused by increased capillary permeability?

A. Increased production of leukocytes
B. warmth or fever
C. Phagocytosis
D. Swelling

A

D. Swelling

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4
Q

In reviewing a client’s lab report of WBC count with differential, all of the following results are listed. Which lab finding alerts you to the possibility of a acute bacterial infection

A. Number and percentage of macrophages are not listed
B. Total WBC count is 19000/mm3
C. Neutrophils outnumber the lymphocytes
D. Monocytes are 2% of the total count

A

B. Total WBC count is 19000/mm3

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6
Q

What is the purpose of complement activation and fixation?

A. Stimulating cell-mediated immune responses to recognize cancer cells
B. Allowing antibody-mediated processes to assist neutrophils and macrophages in phagocytosis of invading microorganisms
C. Protecting the body from the continuous overreactions of immune and inflammatory responses that lead to autoimmune disease
D. Assisting the immune system to recognize an invading microorganisms on second or later exposure so that après rapid response can be mounted

A

B. Allowing antibody-mediated processes to assist neutrophils and macrophages in phagocytosis of invading microorganisms.

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7
Q

How are antibody-mediated immunity and cell-mediated immunity different?

A. Cell-mediated functions provide immediate but temporary immunity and antibody-mediated immunity is longer lasting.
B. Cell-mediated immunity is most efficient at protection against viruses and pollens, whereas antibody-mediated immunity is most efficient at protection against cancer and large microorganisms.
C. Antibody-mediated immunity involves cell products (antibodies) that attack invaders and cell-mediated immunity requires direct cell-to-cell interactions to attack invaders.
D. Antibody-mediated immunity is an independent function and cell-mediated immunity requires the interaction of inflammation and antibody-mediated immune function to be fully active.

A

C. Antibody-mediated immunity involves cell products (antibodies) that attack invaders and cell-mediated immunity requires direct cell-to-cell interactions to attack invaders.

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8
Q

The client, who has many serious health problems, has just been exposed to hepatitis B. Because this client might not survive an infection at this time, he is given human gamma globulin with a high concentration of antihepatitis antibodies. What type of immunity will result from this intervention?

A. Natural acquired active immunity
B. Artificial acquired active immunity
C. Natural acquired passive immunity
D. Artificial acquired passive immunity

A

D. Artificial acquired passive immunity

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9
Q

Name the 3 different types of Inflammation and describe them
( Lewis 189-190)

A

Acute
Subacute
Chronic

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10
Q

What are the 4 stages of inflammatory Response?

A

Vascular Response

  • Cellular Response
  • Exudate Production
  • Healing
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11
Q

Explain what occurs in the Vascular Response stage?

A

Following injury:
Local arterioles briefly vasoconstriction until Histamines, Kinins & Prostaglandins are released which cause >vasodilation which result in increased blood flow and increased filtration pressure.
The inflammatory serous exudates will contain albumin and plasma proteins to help with capillary permeability which will cause redness, heat and swelling.
The plasma proteins fibrogen will help in clot formation. Clots can help trap bacteria and prevent the spread of bacteria. Platelets will release growth factors that will start the healing process.

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12
Q

The plasma proteins fibrogen will help

A

clot formation

Clots can help trap bacteria and prevent the spread of bacteria.

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13
Q

Describe exudates formation stage in Inflammation? How many types are there?

A
  • Serous- clear like plasma
  • Sanguineous- contains RBC’s
  • Serosanguineous- pinkish watery w/ RBC
  • Purulent- WBC’s and Bacteria

Exudate is an accumulation of dead cells, WBC’s, RBC’s and fluid.

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14
Q

Describe the Healing stage in Inflammation

A

Regeneration

Repair

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15
Q

is the replacement of lost cells and tissues with cells of same type.
Depend on: If cells are Liable or Stable
Liable cells regenerate very rapidly
Stable cells- can do so overtime gradually

A

Regeneration

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16
Q

is healing as a result of lost cells being replaced by connective tissue. Most common type of healing which results normally with a scar.

A

Repair

17
Q

Name some systemic signs of inflammation?

A 
Leukocytosis (Shift to left)
Epinephrine cytokines released 
Elevated TPR
Malaise
Anorexia
Nausea
Lymphadenopathy (Lymph node enlargement)
Elderly—confusion
18
Q

A 43 yr old insurance agent had an emergency appendectomy yesterday. The nursing history reveals that the patient 5’11”, 175 lbs. He has been taking corticosteroids for severe asthma. Laboratory findings showed RBC and platelet counts within normal limits. His vital signs on the morning of the first post-op day are; Temp 99.6, pulse 96, Resp 22, BP 140/88.

How does activation of the patient’s complement system affect the healing process?

a. Attracts foreign protein
b. Contains and barricades foreign protein
c. Mediates and amplifies the immune system
d. Releases chemical substances

A

c. Mediates and amplifies the immune system

RATIONALE:
Major functions of the complement system are enhanced phagocytosis, increased vascular permeability, chemotaxis, and cellular lysis. All of these activities are important mediators of the inflammatory response and healing (pg.188)

19
Q

The patient should experience which systemic response to inflammation?

a. Decreased sedimentation rate (ESR).
b. Leukocytosis
c. Leukopenia
d. Phagocytosis

A

RATIONALE:

Leukocytosis is the increased number of leukocytes in the blood.

20
Q

The release of cytokines is what causes leukocytosis

A

Causes leukocytosis

21
Q

Are soluble factors secreted by WBC’s and other types of cells that act as intracellular messengers. They are important in causing the systemic manifestation of inflammation as well as inducing the production of fever. (Pg.188-189)

A

Cytokines

22
Q

What Lab tests would the nurse check to verify that systemic response to inflammation has occurred or is occurring?

A 
CBC to show increase in WBC's, 
Differentials,
Increased ESR, 
Increased CRP, 
Increased Neutrophils and Left Shift.
23
Q

What lab test would the nurse check to verify that this response has occurred/is occurring?

A

WBC’s. Normal range 4,500- 11,000mm

24
Q

Soluble factors secreted by WBC’s and other types of cells that act as intracellular messengers. They are important in causing the systemic manifestation of inflammation as well as inducing the production of fever. (Pg.188-189)

A

Cytokines

25
Q

Which factor may delay the patient’s inflammatory response?

a. Use of corticosteroids
b. Age
c. Postoperative pain
d. Weight

A

A. Use of Corticosteroids

26
Q

How does use of corticosteroids affect inflammatory response?

A

Interfere with tissue granulation,
Induce immunosuppressive effects (decreased synthesis of lymphocytes),
Prevent liberation of lysosomes

27
Q

On assessment, why does incision appear “puffy” ?

A

Because the accumulation of exudate causes edema / swelling

28
Q

Why does incision appear pink?

A

Because of vasodilation increases blood flow to the area causing erythema

29
Q

What explanation should the nurse give the patient when he asks why his temperature is not “normal”?

A

Increased Temp was triggered by the release of cytokines.
CYTOKINES cause fever by initiating metabolic changes in the temperature regulating center.
Start of the body defense mechanism.
Beneficial aspects of fever include:
- Increased killing of microorganisms,
- Increased phagocytosis by neutrophils, and
- Increases proliferation of T cells.
Elevated body temperatures may also enhance the activity of interferon’s (the body’s natural virus- fighting substance).

30
Q

Independent nursing intervention to support the patient during the inflammatory process.

A

R.I.C.E- Rest, Ice, Compression, Elevation.

31
Q

Dependent intervention to support the patient during the inflammatory process.

A

Drug therapy- A physician may write an order for an NSAID, antipyretic, antihistamine or various other meds used to decrease inflammatory response and lower body temperature.
Vitamins A, B-complex, C and D help with inflammation and healing.

32
Q

ACUTE INFLAMMATION

A

Healing occurs in 2 to 3 weeks
Usually leaves no residual damage
Expect to see Redness, Swelling, Warmth Edema, Loss of Functioning (Pain)
Neutrophils are predominant cell type at site

33
Q

SUBACUTE INFLAMMATION

A

Lasts for weeks to months
Has features of acute but it last longer
May become chronic and gradually damage tissue

34
Q

CHRONIC INFLAMMATION

A

Lasts for weeks, months / years
Repeatedly injures tissue
Lymphocytes and Macrophages are predominant cell types present
E.g. Rheumatoid arthritis

35
Q

Stages of Inflammatory Response

A
  • Vascular Response
  • Cellular Response
  • Formation of exudate
  • Healing
36
Q

Vascular Response

A

After injury - arterioles undergo vasoconstriction
Histamine & other chemicals are released - vessels dilate
Increases blood flow - raises filtration pressure
Increase capillary permeability and local edema

37
Q

Cellular Response

A

Chemotaxis happens - neutrophils

Nsg 1102 (1 decks)

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