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N232 > Module 2- Inflammation and Infection > Flashcards

Module 2- Inflammation and Infection Flashcards

1
Q

what diagnostics would you want for inflammation?

A
  • CRP
  • rheumatoid factor
  • WBC count
  • differential
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2
Q

what diagnostics would you want for infection?

A
  • WBC count
  • differential
  • CRP
  • procalcitonin
  • identification of an organism
  • gram stain (purple dye that appears in gram positive bacteria)
  • C+S
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3
Q

lifespan for WBC’s

A

13-20 days

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4
Q

how are WBC’s destroyed and excreted?

A

destroyed by lymphatic system and excreted in feces

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5
Q

what is rheumatoid factor?

A
  • TO DIAGNOSE RHEUMATOID ARTHRITIS (RA)

* POSITIVE RESULTS = LIKELY DIAGNOSIS OF RA

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6
Q

whats the normal range for basophils?

A

0.0-0.10 x10 9/L

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7
Q

basophils

A

parasitic infections and some allergic disorders

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8
Q

normal range for eosinophils

A

0.0-0.45 x10 9/L

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9
Q

eosinophils

A

allergic disorders and parasitic infections

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10
Q

what is the normal range for neutrophils?

A

2.00-6.00 x10 9/L

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11
Q

neutrophils

A

bacterial or pyogenic infections

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12
Q

normal range for lymphocytes?

A

1.00-4.00 x10 9/L

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13
Q

lymphocytes

A

viral infections

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14
Q

normal range for monocytes?

A

0.10-0.80 x10 9/L

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15
Q

monocytes

A

chronic infections (phagocytosis)

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16
Q

what is c-reactive protein?

A

non-specific indicator of inflammation

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17
Q

what could cause someone to have high levels of CRP?

A
  • serious bacterial infection (sepsis)
  • pelvic inflammatory disease (PID)
  • inflammatory bowel disease
  • some forms of arthritis
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18
Q

why is a procalcitonin test done?

A

detect or rule out bacterial sepsis

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19
Q

normal range for procalcitonin? what could a high level mean?

A

0.0-0.25 u/L. Its a protein and means high probability of bacterial sepsis

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20
Q

low levels of procalcitonin mean?

A

low risk of bacterial sepsis

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21
Q

when would you want a test for procalcitonin and CRP?

A

monitor for increases or decreases in CRP and PCT to determine response to therapy or progression of inflammatory/infectious

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22
Q

what is a culture?

A

growth of microorganisms in a growth medium. Any tissue or fluid can be evaluated

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23
Q

what is a sensitivity test?

A

determines sensitivity of bacteria to an antibiotic and evaluates resistance to antibiotics

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24
Q

what is hyponatremia?

A

low sodium concentration

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25
Q

symptoms of hyponatremia

A

weakness, confusion, ataxia, stupor, and coma

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26
Q

what could cause hyponatremia?

A

diarrhea, vomiting, NG tube O/P, diuretics, CRI (colour rendering index)

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27
Q

what is hypernatremia?

A

elevated sodium concentration

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28
Q

symptoms of hypernatremia

A

thirst, agitation, mania, convulsions, dry mucous membranes

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29
Q

what could cause hypernatremia?

A

increased Na intake (IV/PO), excessive free body water loss, cushing syndrome

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30
Q

what is hypokalemia?

A

lower than normal potassium levels (lower than 3.5mmol/L)

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31
Q

symptoms of hypokalemia

A

decrease contractility of smooth muscle, skeletal and cardiac muscles- weakness, paralysis, hyporeflexia, ileus, cardiac dysrhythmias, thirst, flat T waves

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32
Q

what could cause hypokalemia?

A

GI losses/disorders, diarrhea, vomiting, diuretics, burns

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33
Q

what is hyperkalemia?

A

higher than normal potassium levels (greater than 5.0mmol/L)

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34
Q

symptoms of hyperkalemia

A

irritability, N/V, diarrhea, intestinal colic

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35
Q

what could cause hyperkalemia?

A

excessive dietary intake, ARF/CRF, infection

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36
Q

what do you want to give with hyponatremia?

A

want to give sodium

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37
Q

what do you want to give with hypernatremia?

A

want to give free water

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38
Q

signs of localized infection

A

warmth, erythema at site

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39
Q

signs of systemic infection

A

inc. body temp, fatigue, malaise, low BP, high HR (cause body is compensating)

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40
Q

what is a sepsis screener?

A

2 or more inflammatory receptors

41
Q

if patient is septic, will they look well/pink?

A

no!

42
Q

what temp is considered febrile?

A

greater than 38.5 deg. cel

43
Q

are older or younger people more susceptible to fever?

A

younger. older people don’t tend to show high fever (even if bacteria is present), they will show signs of confusion etc instead

44
Q

what drugs are anti-inflammatories

A

NSAIDS- aspirin and ibuprofen

45
Q

what drugs are antipyretics

A

acetaminophen, ibuprofen, ASA

46
Q

what is the classification for infection

A

antimicrobials (anti-virals, anti-bacterials, anti-protozoals)

47
Q

what drug is an antiviral?

A

Acyclovir

48
Q

what drug is an antibacterial (antibiotics)?

A

cefazolin, vancomycin

49
Q

what drug is very nephrotoxic?

A

vancomycin

50
Q

what drug is an anti-protozoal?

A

metronidazole

51
Q

what do you need to know about antibacterial drugs?

A
  • know pre/post assessments
  • is it a safe dose
  • what organ is this going to affect (liver/kidney toxicity)
  • antibiotics affect the GUT, GI upset
  • assess to see if antibiotic is working or not (WBC count)
52
Q

what is the worst thing that could happen with a drug?

A

allergic rxn, could lead to anaphylaxis, lead to death

53
Q

common side effects with antibiotic therapy?

A

N+V, diarrhea, nephrotoxicity, hepatic toxicity

54
Q

lifespan considerations regarding antibiotics?

A

pediatric: doses are weight based
elderly: lower dosages
pregnancy: potential harm for fetus/mother
diabetics: inc. risk for infection

55
Q

what drugs could you give for fever

A

acetaminophen, ASA, ibuprofen

56
Q

why is ASA not a good medication to treat fever?

A
  • b/c it can thin blood (be careful for excess bleeding)

- reyes syndrome in kids (can cause swelling in live and brain)

57
Q

what is infection?

A
  • when body doesnt get rid of bacteria and will turn into infection (WBC’s will tell you)
  • colonization (presence of bacteria on body surface w/o causing disease in person
58
Q

most common anti-pyretic and why?

A

acetaminophen (tylenol) and because it comes in all forms

59
Q

why would you choose ibuprofen over tylenol?

A

because it decreases fever and helps with inflammation

60
Q

why is it bad to give ibuprofen if pt has renal impairment?

A

because ibuprofen blocks PG which may lead to decreased blood flow to the kidneys

61
Q

list risk factors for inflammation

A

psychological stress, physical injury, exposure to irritants, infection

62
Q

what are S+S of infection?

A
  • inc WBC
  • inflammation
  • fever
  • malaise
  • dec. BP and inc. HR
  • cloudy urine
  • inc. RR, dec. O2
  • neutrophils (CRP)
  • cough
  • sputum
  • crackles
  • pain with inspiration
63
Q

risk factors for arthritis?

A
  • sex
  • age
  • family history
  • environmental exposures
  • obesity
  • smoking
64
Q

S+S for arthritis?

A
  • pain
  • joint swelling
  • limited movement
  • stiffness
  • weakness
  • fatigue
  • inc. fluid in joints
65
Q

pharmacological therapy for arthritis

A

manage the symptoms, dec. inflammation, modify the disease

66
Q

non pharmacological pain mgmt

A
  • maintain and improve functional status
  • inc. patients knowledge of disease process
  • promote self management by patient compliance with the therapeutic regimen
67
Q

risk factors for UTI

A
  • inability to empty bladder completely
  • obstructed urinary flow
  • dec. natural host defences
  • catheterization or cystoscopy
  • inflm or abrasion of urethral mucosa
  • diabetes d/t inc. urinary glucose (bacteria love sugar)
68
Q

S+S of UTI

A
  • 50% of patients have no symptoms (if colonized, wont show S+S until UTI is really bad)
  • pain and burning during urination
  • frequency, urgency, nocturia
  • incontinence
  • supra pubic/pelvic pain
  • hematuria/back pain and fever
69
Q

pharmacological therapy for UTI

A
  • treat infection (administer antibiotics as prescribed)

- pain management (anti-spasmodic agents, analgesics, heat to perineum)

70
Q

non pharmacological therapy for UTI

A
  • inc. fluids PO and or IV, frequent urination (helps to flush bacteria)
  • avoid irritants (coffee, tea, spices, cola, alcohol
  • good hygiene, remove/replace foley (BID pericare)
  • promote patient knowledge
  • monitor and manage potential complications
71
Q

risk factors for C-diff

A
  • antibiotic therapy
  • surgery of GI tract
  • diseases of the colon (ex. inflammatory bowel disease, colorectal cancer)
  • weakened immune system
  • use of chemotherapy drug
72
Q

S+S for C-diff

A
  • watery diarrhea, up to 15x/day
  • severe abdominal pain
  • loss of appetite
  • fever
  • blood/pus in stool
  • weight loss
73
Q

pharmacological therapy for C-diff

A
  • antibiotics: vancomycin, metronidazole
  • fecal transplant
  • probiotics (try to re-balance), antiemetics (for nausea and vomiting)
74
Q

what diagnostics would you get for c-diff?

A
  • C+S of stool
  • electrolyte levels
  • WBC (neutrophils)
75
Q

non-pharmacological therapy for c-diff

A
  • fluids PO and/or IV
  • isolation precautions
  • maintain nutrition
  • promote pt knowledge
  • monitor and manage potential complications
76
Q

risk factors for pneumonia

A
  • conditions that produce mucous or obstruct/interfere w/ normal drainage
  • smoking
  • prolonged immobility with shallow breathing
  • dec. cough reflex
  • advanced age (depressed cough reflex, glottic reflexes, and nutritional depletion
77
Q

S+S of pneumonia

A

vary with type of pneumonia

  • fever (shaking and chills)
  • chest pain
  • tachycardia
  • tachypnea
  • sputum (green or yellow)
  • orthopnea
78
Q

pharmacological therapy of pneumonia

A

-admin of appropriate antibiotics (vancomycin, cefazolin) and antipyretic as needed, O2 if required

79
Q

non-pharmacological therapy of pneumonia

A
  • improving airway patency (removing secretions)
  • rest and conserve energy balance with mobilization
  • deep breathing and coughing
  • promote fluid intake
  • maintain nutrition
  • promote patient knowledge
  • monitor and manage potential complications
80
Q

main symptoms of infectious pneumonia

A
  • high fever
  • chills
  • clamminess, blueness
  • headaches
  • loss of appetite
  • mood swings
  • low bp, high HR
  • pain in joints, fatigue, aches
  • nausea
  • vomiting
  • SOB
  • cough with sputum
81
Q

how to break the chain of infection

A
  • hand hygiene
  • don’t use anything from floor
  • different cloth for bed bath/pericare
  • dirty linens away from body
82
Q

what are the major types of pneumonia?

A
  • community-acquired pneumonia (CAP),
  • hospital-acquired pneumonia (HAP),
  • pneumonia in the immunocompromised host,
  • aspiration pneumonia
83
Q

community acquired pneumonia

A

occurs in community setting or within first 48hrs of hospitalization

84
Q

s. pneumoniae (pneumococcus)

A

most common community acquired pneumonia (CAP) in people less than 60years old with no comorbidity and those greater than 60 with comorbidity

85
Q

where does S. pneumoniae naturally reside?

A

upper resp tract

86
Q

what CAP affects those with comorbid illnesses (COPD, alcoholism, diabetes etc)?

A

H. influenzae

87
Q

hospital acquired pneumonia (aka nosocomial pneumonia)

A

occurs 48hrs after admission to hospital

88
Q

most lethal nosocomial infection is?

A

Hospital-acquired pneumonia (nosocomial pneumonia)

89
Q

pneumonia in the immunocompromised host

A

occurs with use of corticosteroids or other immunoexpressive agents, chemo, nutritional depletion,, AIDS, genetic immune disorders, long-term advanced life-support technology

90
Q

diagnosis of pneumonia is made by?

A
  1. history of resp. tract infection
  2. physical exam
  3. chest xray studies
  4. blood culture
  5. sputum exam
91
Q

what is a key treatment measure when community acquired pneumonia (CAP) is strongly suspected?

A

prompt admin (within 4-8hrs) of antibiotics in patients

92
Q

mortality rate is greater in what age group?

A

greater in older pt’s, more difficult to treat

93
Q

aspiration pneumonia

A

entry of endogenous or exogenous substances into lower airway

94
Q

most common type of aspiration pneumonia

A

bacterial infection (normally resides in the upper airway)

95
Q

patho of pneumonia

A

arises from normally present flora in patient whose resistance has been altered or it results from aspiration of flora present in oro-pharynx

96
Q

define colonization

A

microorganisms present without host interference or interaction

97
Q

define infection

A

host interaction with organism

98
Q

define infectious disease

A

infected host displays a decline in wellness due to infection

N232 (9 decks)

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