Module 2: Caring for Patients with Inflammation & Infections

Question 1

inflammation

Answer 1

localized protection reaction of tissue injury, irritation or infection

Question 2

infection

Answer 2

growth of pathogenic microbes in the body, may or may not be contagious, caused by bacteria, virus, fungi, parasite

Question 3

UTI risk factors

Answer 3

inability to empty bladder, obstructed urinary flow, ↓ natural host defences, catheterization or cystoscopy, inflammation or abrasion of urethral mucosa, diabetes (r/t ↑ urinary glucose)

Question 4

UTS s/s

Answer 4

50% of pts are asymptomatic, dysuria, frequency, urgency, nocturia, incontinence, suprapubic or pelvic pain, hematuria or back pain, fever, older adult = fatigue + cognitive changes

Question 5

UTI pharmacological interventions

Answer 5

treat infection → antibiotics
pain management → analgesics

Question 6

UTI non-pharmacological interventions

Answer 6

↑ fluids and promote frequent urination, avoid irritants, hygiene, remove/replace foley, promote pt knowledge, monitor and manage potential complications

Question 7

c.diff risk factors

Answer 7

antibiotic therapy, GI tract surgery, IBD or colorectal cancer, weakened immune system, use of chemotherapy drugs

Question 8

c.diff s/s

Answer 8

watery diarrhea (15x/day), severe abdo pain, loss of appetite, fever, blood or pus in stool, weight loss

Question 9

c.diff pharmacological interventions

Answer 9

antibiotics → vancomycin, metronidazole
fecal transplants, probiotics, antiemetics

Question 10

c.diff non-pharmacological interventions

Answer 10

fluid PO/IV, isolation precautions, maintain nutrition, promote pt knowledge, monitor and manage potential complications

Question 11

pneumonia risk factors

Answer 11

conditions that produce mucous or obstruct/interfere with normal drainage, smoking, prolonged immobility with shallow breathing, depressed cough reflex, advanced age

Question 12

pneumonia s/s

Answer 12

vary with type of pneumonia, fever, chest pain, tachypnea, tachycardia, sputum, orthopnea

Question 13

pneumonia pharmacological interventions

Answer 13

administer appropriate antibiotics, viral = no antibiotics, antipyretic as needed, O2 if required

Question 14

pneumonia non-pharmacological interventions

Answer 14

improve airway patency, remove secretions, rest + conserve energy balance with mobilization, deep breathing and coughing, promote fluid intake, maintain nutrition, promote pt knowledge

Question 15

WBC & differential

Answer 15

elevated with inflammation and infection, trends in response to treatment, link to assessment

Question 16

c-reactive protein (CRP)

Answer 16

non-specific indicator of inflammation, monitor trends, detect and monitor inflammatory process

Question 17

procalcitonin

Answer 17

detects or rules out sepsis, mostly bacterial in origin

Question 18

mild elevation of procalcitonin

Answer 18

local infection, non-infectious systemic inflammation

Question 19

more elevation of procalcitonin

Answer 19

likely bacterial sepsis

Question 20

culture

Answer 20

propagation of microorganisms in a growth medium, any body tissue or fluid can be evaluated in laboratory by using culture techniques to detect and identify infectious processes

Question 21

sensitivity

Answer 21

determine the “sensitivity” of bacteria to an antibiotic and evaluates for resistance to antibiotics

Question 22

aspirin (ASA)

Answer 22

MOA: suppress inflammation, mild-mod pain, reduce fever, prevent MI and stroke
adverse effects: bleeding, renal impairment, gastric ulcer
considerations: higher doses = anti-inflammatory effect, avoid use in renal impairment, take with food, use in pregnant pts can increase risk of post-partum hemorrhage or prolong labour

Question 23

ibuprofen

Answer 23

MOA: suppress inflammation, mild-mod pain, reduce fever
adverse effects: gastric ulcer, bleeding, renal impairment, increase risk of thrombotic events
considerations: ↑ risk of MI/stroke, use lowest effective dose for shortest amount of time, potential for cross-sensitivity with ASA

Question 24

acetaminophen (tylenol)

Answer 24

classification: antipyretic, non-opioid analgesic
adverse effects: vary rate, safe at any age using correct dose
considerations: can cause hepatic necrosis, alcohol consumption, increase risk of bleeding if taking warfarin

Question 25

dexamethasone & prednisone

Answer 25

MOA: anti-inflammatory and immunosuppressive, higher doses for inflammatory disorders (rheumatoid arthritis, IBD, asthma)
adverse effects: increased risk of infection, hyperglycemia, osteoporosis, thinning of skin, fluid and electrolyte disturbance, anxiety, depression, mania

Question 26

vancoymcin

Answer 26

MOA: used for life-threatening infections
adverse effects: risk for nephrotoxicity, ototoxicity, rapid IV infusion can lead to histamine reaction, phlebitis
considerations: monitor trough levels, caution if pt has renal impairment, avoid nephrotoxic drugs (NSAIDs)

Question 27

metronidazole

Answer 27

MOA: protozoal infections and anaerobic bacterial infection, surgical prophylaxis for abdominal colorectal or gynecologic procedures
adverse effects: nausea, vomiting, headache, dry mouth, diarrhea, vertigo
considerations: avoid alcohol use, can produce dangerous reactions if taken with warfarin

Question 28

acyclovir (antiviral)

Answer 28

MOA: first choice for herpes simplex virus and varicella-zoster virus
adverse effects: serious side effects are uncommon
considerations: does not kill the virus, do not take if breastfeeding (transfers into breast milk)