MIDTERM Flashcards
what is the chain of infection?
remember in order
- infectious agent ; disease causing microorganisms bacteria, viruses, protozoa, fungi, parasites
- reservoir; where pathogens live and thrive
- portal of exit; how pathogens leave reservoir
- mode of transmission; how pathogens travel to host
- portal of entry; how pathogens enter host (bodily openings)
- susceptible host; someone who can get sick easily
what is the first line of defense in a infection and inflammatory process? give examples
skin and mucus membranes; skin the largest organ that stops pathogens from entering body, snot or ear wax trapping pathogens from entering further
what is the second line of defense in the inflammatory and infections process?
inflammatory response after pathogens enter body; warmth, redness, and swelling of the site appear to indicate a infection
immunocompromised patients are…
more prone to getting sick because of their decreased immunity
are at increase risk for
- bacterial
- fungal
- viral infection
- parasitic infection
organs of the immune system
- leukocytes
- thymus and bone marrow
- lymph nodes
- spleen
- liver
leukocytes
white blood cells
neutrophils, monocytes, macrophages are what type of WBC
phagocytes “eating cells”…eat bad things
thymus gland
located in mediastinum (between lungs) makes t cells (remembering cells, they remember how unwanted cells look and kill them)
bone marrow
found inside certain bones “birthplace” of blood, WBC, RBC, platelets
lymph nodes
filter bad substances that go through the lymphatic fluid; also have lymphocytes to help fight infections and diseased
spleen
stores RBC’s and activates lymphocytes
liver
clears pathogens from body
Why is it beneficial for nurses to use maslow’s hierarchy of needs when planning care?
help prioritize patients needs
Innate immunity (natural/nonspecific immunity)
present at birth like first line of defense baby’s nose hairs not letting anything enter, the HCL acid in baby’s stomach; also nonspecific so they wide range of cells
acquired immunity (specific immunity)
developed after direct contact with a antigen through illness or vaccination; that’s why there specific because they remember what “covid” cells look like fighting them before it impacts the body
what are the 3 chemical mediators
these substances are released during a injury or infection
- prostaglandins
- histamine
- leukotrienes
prostaglandins
promote inflammation by increasing blood flow
histamine
released by basophils during an allergic reaction widens blood vessels (vasodilation)which leads to redness and warmth of area, and vasodilation causes vessels to start leaking causing edema (vascular permeability)
leukotrienes
narrow airways causing it harder to breath like allergic reactions or asthma, also has vascular permeability which causes edema (swelling)
cytokines & eicosanoids
cause blood and blood vessels to change directing blood to site of injury/infection
cortisol
hormone produced by adrenal cortex that’s anti-inflammatory
kinin system
produces bradykinin that controls the contraction and dilation of blood vessels
S&S of inflammation
local; localized to injured area like swelling, redness, pain, and heat which could lead to the loss of function like spraining your ankle
systemic; related to whole self causing fever, headaches, chills, sweating, muscle aches like covid you get chills, fevers ect. its not possible to get a fever on just your thumb
one-celled microorganisms
portozoa
wound healing
tissue regeneration starts at the beginning of inflammation process speed of healing depends on
- type of tissue injured
- how bad the wound is
- if there’s infection
- and if the host is healthy
elderly, immunocompromised and diabetes patients all have poor healing
medical vs surgical asepsis
medical asepsis is the “clean technique” it limits the spread of microorganisms most effective method is hand washing
surgical asepsis is the “surgical technique” eliminated all microorganisms and their spores
standard precaution
donning PPE for blood and bodily fluid regardless of their isolation status
hypersensitivity
mild reaction (ex jasmeen and her hives)
allergy
3 stages mild, moderate, and severe localized symptoms
anaphylaxis
severe life threatening allergic response to certain item that require EpiPen or penicillin (gurman and his but load of allergies that make his eyes swell up)
homeostasis
absence of disease; returning body to normal stable set
dimensions of a healthy person
- physical
- cognitive
- affective
- behavioral
- social
maslows hierarchy of needs
bottom
- physiological needs;
- safety;
- love and belonging;
- esteem;
- self-actualization
top
alarm
fight or flight response adrenaline boosts
resistance
shock of stress is gone and body starts to repair itself like returning your fast HR to normal
exhaustion
chronic stress that drains the physical, emotional, and mental
adaption to stress
distress; bad stress results from overwhelming, harmful, or threatening situations like money problems or natural disaster
eustress; good stress; experienced from positive event like getting a premotion or having a kid
illness as a stressor
stressor; can be positive or negative just needs to activate a stress response
external environment; stresses that start outside of the individual like work related stress, school stress, car crashes
internal stressors; stressors that start within, like negative self talk, health issues, putting pressure on yourself to do good.
behavioral responses; can change overtime but its how one reacts to the stress the can avoid it, loss sleep from it, get angry, be emotional cry or laugh about the stress
coping strategies
- talking to others
- journaling
- crying
- walking
can be adaptive or maladaptive
adaptive are the healthy way of coping problem solving, exercising, reaching out for help.
maladaptive are the unhealthy ways like denial, substance abuse, playing the “sick role”, and avoiding your problem entirely
defense mechanisms
- blaming others for the problems you may have lead on for this long
- projecting spazzing out at others
- isolation taking yourself out of social gatherings
- denial and not believing what has happen is true
- suppressing your feelings
stress
a stimulus, process, response or state
it can lead to confusion or uncertainty
stressor
a event that stimulates (activates) the stress response
adaption
changes over time after experiencing stressful experiences your body just adapts
types of stress
- distress damaging stress
- eustress good stress that protects health
- chronic stress long term stress can last days, mouths, or years (more than 3 months)
- acute stress short term stress that cold last minutes or days (lasts less than 3 months)
- trauma can turn into PTSD, after experiencing a traumatic event you feel fear, helpless, hyperarousal(heightened alertness), irritated, angry
- PTSD flashbacks, horror, helplessness, sleep disturbance
increased risk of stresses
stress messes w/ immune system so you can have
mental health issues
autoimmune illnesses like insulin resistance
stress-related disorders
- acute stress disorder; being exposed to one or more traumatic event lasts at least 3 days - 1 month
- PTSD same symptoms as acute stress but more continuous
6 concepts about pain
- pain is a personal experience that’s influenced by physical health, emotional, and social factors (support group)
- pain is more than neurological it’s expressed through emotion
- understanding of pain can change over time
- how culture effects pain
- pain can be life changing either motivate you to become healthier or have a negative impact on your life
- there’s many ways to express pain
3 physiology of pain
nociceptive pain; physical pain like hammering your hand or burning your leg; tissue damage pain
neuropathic pain; burning, shooting, tingling, and electric shock caused by damage or dysfunction of the nervous system
nociceptors; pain detectors, they sense harmful stimuli and trigger pain
4 specific processes of nociceptive pain
- transduction; through chemical, thermal, and mechanical stimuli the body sends nociceptors to notice the pain. Substance p, serotonin, and prostaglandins are neurotransmitters that communicate that the body is under going pain
- transmission; sends the message to the brain of the painful stimuli through afferent (sends signals towards the brain) sensory never fibers so the brain can react to the stimuli
- perception; awareness of pain, feeling the burning sensation of the hot stove
- modulation reacting to the perception, taking you hand away from the hot stove
gate control theory of pain
open gate = signals being transmitted to the brain to be perceived as pain
closed gate= pain signal are restricted from going further so person feels less or no pain
there’s physical, emotional, and cognitive factors ex being worried or constantly thinking about your pain could open the gates leading you to feel more pain
acute pain
shot term pain lasts less than 3 months
persistent postoperative pain (PPP)
pain that goes beyond 2-3 months after a surgical procedure like a C sections or hip replacement…if you have pre-existing pain that was there before the surgery it’ll stay after the surgery as well
chronic pain
long term pain that lasts longer than 3 months could come in patterns or last longer than 12 hours a day
pain by inferred pathological process
- nociceptive pain; tissue damage
- visceral pain; meaning internal organ pain like uterus pain during mensuration, heart pain during myocardial infraction
- somatic pain; meaning musculoskeletal pain like hip hurting
-mixed pain both acute and chronic
breakthrough pain
intense sharp or sudden pain like pulling a muscle
analgesics
medications that relieve pain like Advil, Tylenol ect
incident pain
pain that happens after a incident like getting knocked in the head or getting into a crash; has a specific and clear cause
self-reported pain is the
single most reliable indicator of pain
nonpharmacological pain relief
relieving your pain without medications by music, nature, acupuncture, distractions, guided medications, relaxing
- analgesics; which are pain relivers
- patient controlled analgesic (PCA); patient controls how much they need or get, instant relief, usually through pump or IV
- local analgesic; which is a anesthetic which numbs the area, and only gives medication to the site
- topical analgesic and anesthetic applied to the skin or mucus membranes analgesic only provides pain relief, while anesthetic provides numbing of the area
- sucrose; for infants; sugar mixed with water for infants to give them a pain relief for minor procedures
- local and regional anaesthetics and analgesics; local just a small area that gets numbed for a procedure, regional would be the whole limb get numbed this is because the procedure could take longer as well
these are all medications for what style of pain
- acute (short term)
- chronic (long term)
- persistent postoperative pain (PPP)
acute pain management
palliative care
end of life care; managing pain to live patients life fully
7 warning signs
caution up
C; change in bowel movements or bladder
A; a sore that doesn’t heal
U; unusual bleeding or discharge
T; thickening lump in breasts or anywhere else
I; indigestion or difficulty swallowing
O; obvious changes in warts and moles
N; nagging cough or hoarseness (cough so much start sounding all raspy)
U; unexplained weight loss
P; pernicious anemia
how are immunocompromised patients and terminal cancer patients related
radiation and chemotherapy causes weaker immune system making cancer patients easily sick and immunocompromised
ADPIE
A; assessment
D; diagnosis
P; planning
I; implementation
E; evaluate
subjective data; through patients statements only stuff they can feel like their pain or headache
O,P,Q,R,S,T,U,V, pain assessment
objective data; what nurse can gather through her 5 senses, through observations
dermis
after the epidermis includes hair follicles, thick layer, collagen, blood flow
epidermis
top layer of skin
functions of the skin
- losing nerve endings
- in T1D patients losing sensation in your feet
- protection
- temperature regulation
- secretion of sebum to keep skin oily
- vitamin D synthesis, when in the sun
- blood reservoir; skins ability to store and regulate blood flow
age related changes are
wrinkling
sweat glands decreased
production of sebum decreases
dryness is common
skin pales and looks flat
nails; flatten, yellow
pruritus
itching
Tx; corticosteroids, antihistamines
atopic dermis
3 stages
acute; red, and crusty rash
subacute; redness and scaling plaques
chronic; dry, thick scales
contact deratitis
coming in contact with a substance that causes an allergic response
Tx or nursing care; hand washing
seborrheic dermatitis
affects scalp= dandruff
Tx; medicated shampoos, topical ointments
psoriasis
scaley lesions this has no cure
Tx; is to deal with symptoms not for the cure; corticosteroids
ringworm
type of fungal infection
herpes simplex
cold sore that can be located on lips, cheeks, ears, and genitals
herpes zoster
known as shingles causes intense itching and pain effects half side of face or back, is transmittable
necrotizing meaning
healthy tissues dying
5 different types of burns
- thermal
- chemical
- electrical
- radiation
- inhalation
presbyopia
normal age-related change; bc of the poor accommodation caused by loss of elasticity
Tx: corrective lens
cloudiness of vision, common with aging and can occur with diabetes
S&S: cloudy vision, and seeing floaters and spots in vision
Tx: lens replacement
nursing care: patch is worn, monitor eye for drainage, and give medications as ordered
is what eye related issue?
cataract
main cause of blindness, there’s optic nerve changes and pressure to back of the eye; two types of glaucoma open-angle glaucoma and angle-closed glaucoma
Tx: medications that reduce aqueous production and surgery
nursing care: pt. safety, and optometrist checkups
is what eye related issue?
glaucoma
idiopathic pain
is a chronic pain (lasts longer than 3 months) doesn’t have a specific and clear cause
separation of pigmented layer and sensory layer of eye that allows fluid to enter and separate the layers
S&S: flashing lights and floaters
Tx: surgery to seal tear
nursing care: bedrest with head elevated
is what eye related issue?
retinal detachment
usually occurs within kids and happens with colds with fluid building up in middle ear
S&S: headache, swelling behind ear, soreness
Tx and nursing care: oral antibiotics and topical ear drops
what ear disorder is this?
acute otitis media
irregularities in cornea or lens
Tx: corrective lens
is what eye related disorder?
astigmatism
nearsightedness
Tx: eye drops or eye surgery
what eye issue is this?
myopia
farsightedness
Tx: eye drops or eye surgery
what eye related disorder is this?
hyperopia
known as swimmer’s ear because protective layer of cerumen gets washed
S&S: pain that increases when pinna is pulled, dizziness
Tx: antifungal medication, topical antibiotics, and corticosteroids for non-fungal cause
nursing care: room temperature ear drops to prevent dizziness, ear plugs when swimming
what ear related disorder is this?
external otitis “swimmers ear”
the hardening of the middle ear bone
S&S: hearing loss with no infection
Tx: stapedectomy and prosthesis is inserted
nursing care: pain management, follow wound care for ear
what ear related issue is this
otosclerosis
hearing loss associated with aging
S&S: hearing well in quiet area but poorly in noisy places
Tx: hearing aids
nursing care: adaption with supportive devices, hearing aids
what ear related issue is this?
presbycusis
immunity
enables body to fight off invaders once their in the body
inflammation
the redness and swelling of the area
cutting your leg on a rusty can opener leads to what type of infection
- localized
- systemic/generalized
localized
Which of the following best describes the process of transduction in pain pathways?
a) The body interprets the pain signal in the brain.
b) The pain signal is sent from the spinal cord to the brain.
c) Painful stimuli are converted into electrical signals by nociceptors.
d) Pain signals are amplified or dampened by neurotransmitters.
c
You are assessing an athlete post fall with an
injured leg. In your nursing role identify the symptom the
athlete would be exhibiting?
A. An increased appetite
B. An increased heart rate
C. A decrease in perspiration
D. A decreased respiratory rate
b
As a nurse at work, identify an effective coping
method when dealing with stress:
A. Having a glass of wine
B. Going to sleep for 8 hours
C. Journaling the experience
D. Forgetting about the day
c
A nurse assesses that smoking, drinking alcohol, and exercising compulsively may occur as responses to a stressful situation. What type of response should this be considered?
a. external
b. withdrawal
c. denial
d. Internal
d, person is smoking drinking only as a coping mechanism towards his problems
using ADPIE answer this
A home health nurse is assisting a patient who is chronically ill with congestive heart failure to reorder time. What is the best intervention to assist this patient?
a. Encouraging the patient to get up earlier or to go to sleep later
b. Developing a daily schedule that allows time for activities, as well as for medical regimens
c. Giving up time-consuming activities such as watching television or answering e-mail messages
d. Encouraging the patient to complete only one task a day
b
What is an example of a positive stressor?
a. wedding planning
b. loss of a job
c. paying income tax
d. single motherhood
A
A nurse is teaching guided imagery to a prenatal class. Which of the following is an example of guided imagery?
a. singing
b. back massage
c. sensory peaceful words
d. listening to music
c
