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69:262 Medical Nursing > Test 1 > Flashcards

Test 1 Flashcards

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1
Q

Chronic inflammatory disorder of the airways
Causes airway hyper-responsiveness leading to sneezing, breathlessness, chest tightness, and cough.

A

Asthma

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2
Q

Major precipitating factor of an acute asthma attack:
↑ inflammation hyper-responsiveness of the tracheo-bronchial system
Can last 2–8 weeks
vaccines are recommended for children 6 months and older and adults with asthma

A

Influenza

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3
Q

Allergens
Exercise
Respiratory infections
Nose and sinus problems
Drugs and food additives
GERD (Gastro-esophageal reflux disease)
Air Pollutants
Emotional Stress

are all examples of

A

Asthma triggers

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4
Q

Unpredictable and variable
Expiration may be prolonged
Wheezing is unreliable to gauge severity
Cough variant asthma
Cough may be non productive
Difficulty w airmovement

A

Clinical manifestations of Asthma

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5
Q

Cough is the only symptom.
Bronchospasm is not severe enough to cause airflow obstruction

A

Cough variant asthma

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6
Q

Particularly at night or early morning
Could be abrupt or gradual
Could last minutes to hours

A

Coughing w asthma

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7
Q

Inspiration – expiration ratio of 1:2 to 1:3 or 1:4
Bronchospasm, edema, and mucus in bronchioles narrow the airways
Air takes longer to move out

A

Prolonged expiration (asthma)

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8
Q

An ___________ attack usually reveals signs of hypoxemia:
Restlessness
↑ anxiety
Inappropriate behaviour

A

acute athma

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9
Q

↑ pulse and blood pressure
Pulsus paradoxus (drop in systolic BP during inspiratory cycle >10 mm Hg)
Respiratory rate > 30 breaths/minute

A

Signs of hypoxemia (asthma)

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10
Q

Life threatening asthma: Clinical manifestations are similar to those of non-severe asthma but are more ________ and _________.

A

Serious; prolonged

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11
Q

May include pneumothorax, pneumomediastinum, acute cor pulmonale with right ventricular failure, and severe respiratory muscle fatigue that leads to

A

respiratory arrest

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12
Q

Restlessness
↑ anxiety
Inappropriate behaviour
↑ pulse and blood pressure
Pulsus paradoxus
Respiratory rate > 30 breaths/minute

A

signs of hypoxemia

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13
Q

Detailed history and physical exam
Symptoms – because wheezing and cough are seen with a variety of disorders, this complicates the diagnosis
Pulmonary function tests – variable airflow obstruction
Peak flow monitoring
CXR
ABGs
Oximetry
Allergy testing
Blood levels of eosinophils
Sputum culture and sensitivity

A

Diagnostic studies in asthma

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14
Q

Stimulates sympathetic nervous system
Effects on respiratory tract
Carbon monoxide
Passive smoking (secondhand smoke)

A

Effects of nicotine

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15
Q

Increases HR
Causes peripheral vasoconstriction
Increases BP and cardiac workload
Compounds problems in CAD

A

Nicotine: Stimulates sympathetic nervous system

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16
Q

Increased production of mucus
Hyperplasia of goblet cells
Lost or decreased ciliary activity

A

Nicotine: Effects on respiratory tract

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17
Q

↓ O2 carrying capacity
↑ Heart rate
Impaired psychomotor performance and judgement

Nicotine can have these effects because of ________:

A

Carbon monoxide

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18
Q

↓ Pulmonary function
↑ Risk of lung cancer
↑ Rates of mortality from ischemic heart disease

A

Nicotine: Passive smoking COPD (second-hand smoke)

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19
Q

COPD can develop with intense or prolonged exposure to:
dusts, vapours, irritants, or fumes.
high levels of air pollution.

These are examples of ______ chemicals

A

Occupational chemicals and dust COPD (risk factors)

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20
Q

Recurring infections impair normal defense mechanisms.
Risk factor for COPD
Intensify pathological destruction of lung tissue
HIV infection
TB is a risk factor

A

Infection COPD (risk factors)

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21
Q

α-Antitrypsin (AAT) deficiency
Genetic risk factor for COPD
Severe AAT deficiency occurs in 1 in 5000–1 in 5500 of Canadian and North American population

A

Herdity COPD (risk factors)

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22
Q

Some degree of the same symptoms of emphysema is common because of physiological changes of aging lung tissue.

A

Aging COPD (risk factors)

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23
Q

Develops slowly
Diagnosis is considered with
cough.
sputum production.
dyspnea.
Underweight w/ adequate calories
Anorexia
Chronic fatigue
Polycythemia & cyanosis

A

COPD Clinical Manifestations

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24
Q

Prolonged expiratory phase
Wheezes
Decreased breath sounds
↑ Anterior–posterior diameter

A

Physical examination findings (COPD)

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25
Q

COPD long term ______ therapy improves:
prognosis.
mental acuity.
exercise tolerance.
sleep

A

oxygen

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26
Q

An autosomal recessive, multisystem disease characterized by altered function of the exocrine glands of the lungs, pancreas, and sweat glands
Abnormally thick, abundant secretions from mucous glands lead to a chronic, diffuse, obstructive pulmonary disorder in almost all clients.

A

Cystic fibrosis

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27
Q

Exocrine pancreatic insufficiency
Sweat glands excrete increased amounts of sodium and chloride.
Mutations on chromosome 7 - alters transport of sodium & chloride in the sweat

A

Cystic fibrosis

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28
Q

Chronic fatal respiratory disease
The most common genetic disease among White people in Canada

A

cystic fibrosis

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29
Q

Etiology and pathophysiology
Obstruction of ducts of the exocrine system is caused by thick, viscous secretions – these adhere to lumen of the ducts which eventually undergo fibrosis
URTI may present and include chronic sinusitis, and nasal polyposis
Thick secretions obstruct bronchioles, leading to air trapping and hyperinflation.

A

cystic fibrosis

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30
Q

pseudomonas aeruginosa

A

Most common organisms cultured in Cystic fibrosis

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31
Q

Progressive loss of lung tissue from inflammation and scarring which results in chronic hypoxia that leads to pulmonary hypertension and cor pulmonale.

A

cystic fibrosis

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32
Q

Blebs and large cysts in lungs are severe manifestations of _______ in CF

A

destruction

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33
Q

Nursing diagnoses
Ineffective airway clearance
Ineffective breathing pattern
Impaired gas exchange
Imbalanced nutrition: less than body requirements
Ineffective coping

A

Cystic fibrosis

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34
Q

Past definitions of COPD included the terms chronic bronchitis and _______

A

emphysema

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35
Q

a progressive lung disease caused by over-inflation of the alveoli (air sacs in the lungs)

A

emphysema

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36
Q

an umbrella term used to describe a group of lung conditions (emphysema is one of them)

A

COPD (Chronic Obstructive Pulmonary Disease)

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37
Q

Received blood transfusion or clotting factors before 1985?
Shared needles, syringes, or other injection equipment with another person?
Had a sexual experience with your penis, vagina, rectum, or mouth in contact with these areas of another person?
Had a sexually transmitted infection (STI)?

A

Questions to ask someone at high risk for HIV

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38
Q

↓ Autoantibodies
↓ Cell-mediated immunity
↓ Delayed hypersensitivity response
↓ Expression of IL-2 receptors
↓ IL-1 and IL-2 synthesis
↓ Primary and secondary antibody
responses
↓ Proliferative response of T and B
cells
Thymic involution

A

Effects of Aging on the Immune System

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39
Q

________ are lined with smooth muscle that controls the amount of air entering the lungs.

A

Bronchioles

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40
Q

Dilation and constriction of the airways are controlled by the ___________ nervous system

A

autonomic

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41
Q

produce a fine mist to be inhaled by mask or a handheld device.

A

Nebulizers

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42
Q

inhaler that delivers a fine powder

A

Dry powder inhaler (DPI)

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43
Q

use of a propellant to deliver a measured dose of drugs to the lungs during a breath.

A

Metered dose inhalers (MDI)

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44
Q

______ and ______ are medications that dilate bronchi

A

Beta-adrenergicagonists; anticholinergics

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45
Q

drugs of choice in the treatment of acute bronchoconstriction

A

Beta-adrenergic agonists

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46
Q

Used to prevent and treat wheezing, difficulty breathing, chest tightness caused by lung diseases such as asthma, and COPD

A

Beta-adrenergic agonists

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47
Q

Respiratory drug:
Ultra short acting
Immediate effect but lasts only 2-3 hours

(Isuprel)

A

Isoproterenol

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48
Q

Anticholinergic (muscarinic antagonist), causes bronchodilation by blocking cholinergic receptors in bronchial smooth muscle.

A

Atrovent (ipotropium)

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49
Q

Inhaled ________ used for the long term prevention of long term management.

A

Glucocorticoids

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50
Q

Inhaled
Beclomethasone
Pulmicorte
Flovent

Orally
Methylprednisolone
Prednisone

A

Glucocorticoids

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51
Q

For asthma or as a nasal spray for allergic rhinitis.
Reduces inflammation – not a bronchodilator.
Minimal systemic absorption of inhaled medication
Half life of 1.5 hours
Local effects may include voice hoarseness
A large percentage of long term beclomethasone users will develop candidiasis.

A

Beclomethasone (QVAR)

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52
Q

Inhibit the release of histamine from mast cells
Prophylactic use for asthma – ineffective for bronchospasm.
Maximum effect may take several weeks so must be taken on a regular daily basis.

A

Mast cell stabilizers

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53
Q

Newer drugs approved in the 1990s
They modify the action of leuotrienes, so they reduce inflammation and ease bronchoconstriction.
Asthma prophylaxis by reducing inflammatory component of asthma.
Leukotrines are mediators of the immune response that promote airway edema, inflammation, and bronchoconstriction.
Singular and Accolate – taken orally

A

Leukotriene Modifiers

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54
Q

______ for relieving cough due to colds:
They dampen the cough reflex when treating coughs related to allergies or colds.
Good for dry hacking non productive coughs.
We don’t want to suppress the cough in emphysema and bronchitis.

Can be classified as Opioids or Non Opioids.
Opioids can cause significant respiratory depression.
Opioids can be combines with other agents such as antihistamines, decongestants and non opioids antitussives in cold and flu symptoms.
Codeine or Hydrocodone

A

Antitussives

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55
Q

Most common non opioids is ___________.
In a variety of cold and flu preparations.
Available in a variety of formulations.
It acts in the medulla.
Non drowsy and non dependent.
Rapidly absorbed in the GI tract.
Onset with in 15 to 30 minutes – half life is unknown.
Crosses the blood-brain barrier.
Metabolites are excreted in urine.

A

(Non Opioid antitussive) Dextromethorphan

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56
Q

_______ - Benylyn, Balminil
Expectorants increase bronchial secretions by reducing the thickness, or viscosity of bronchial secretion – this increases mucus flow which makes it easier to cough up.

A

Guaifenesin – Benylyn, Balminil

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57
Q

Includes asthma, chronic bronchitis and emphysema.
A progressive disease with the terminal stage being emphysema (from years of chronic inflammation) – no cure!

The goals of treatment are to treat infections, control cough and relieve bronchospasms

Pharmacotherapy includes, bronchodilators, and sometimes mucolytics, expectorants, antibiotics and oxygen.

Opioids are avoided because of the risk of respiratory depression.

A

COPD

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58
Q

Involves two main processes. Ventilation moves air into and out of the lungs and perfusion allows for gas exchange across the capillaries.

A

Physiology of respiration

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59
Q

Pharmacotherapy focuses either on the bronchial constriction and or the inflammation component of _____

A

Asthma

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60
Q

a rapidly acting bronchodilator and is the first line medication in rescue inhalers that reverses airway narrowing in acute asthma attacks
Beta2-adrenergic agonist that causes dilation of the bronchioles.

MDI, 1-2 inhalations tid-qid/day (max 8 inhalations/day)
Can be given every 30 – 60 minutes until relief is obtained.
Nebulizer solution, 2.5mg tid-qid PRN

A

Salbutamol

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61
Q

Acts by selectively binding to beta2 - adrenergic receptors in bronchial muscle to cause bronchodilations.
When taken 30 to 60 minutes prior to physical activity – helps to prevent exercise induced bronchospasm.
Asthma maintenace therapy drug because of long effect
Takes 15 to 25 minute to act so not good for acute symptoms.
Half life of 3 – 4 hours

A

Salmeterol (Serevent)

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62
Q

Loosen mucus

A

Mucolytics

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63
Q

Produce thinner mucus

A

Expectorants

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64
Q

Suppress inflammation

A

Glucocorticoids

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65
Q

Inhibit histamine release

A

Mast cell stabilizers

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66
Q

Suppress cough

A

Antitussives

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67
Q

Side effects – irritability, nervousness, tachycardia, insomnia and anxiety are common side effects of __________ bronchodilators that result from sympathetic nervous system stimulation.

A

Beta-adrenergic agonists

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68
Q

An older alternative to beta agonist for the treatment of asthma

A

Methylxanthines and anticholinergics

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69
Q

are older established drugs (Aminophylline, theophyline).
Side effects include nausea and vomiting, and CNS stimulation and dysrythmias.

A

methylxanthines

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70
Q

One _________ (Atrovent) has widespread use.

A

anticholinergic

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71
Q

help to loosen thick bronchial secretions by breaking down the chemical structure of mucus molecules - cause thick secretions to become thinner.

(Acetylcysteine – Mucomyst)

A

Mucolytics

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72
Q

relax bronchial smooth muscles resulting in lower airway resistance
easier breathing for patients.
Inhaled produce little systemic toxicity because only small amounts of the drugs are absorbed.

A

Beta-adrenergic agonists

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73
Q

Respiratory drug:
Medication acts quickly but last 5-6 hours

(Alupent, Orciprenaline)

A

Metaproterenol

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74
Q

Respiratory drug:
Medication acts quickly but last 5-6 hours

(Bricanyl)

A

Terbutaline

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75
Q

Respiratory drug:
Medication acts quickly but last 5-6 hours

MAXAIR

A

pirbuterol

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76
Q

Respiratory drug:
Med acts intermediate (not instant relief)
8 hours

A

Salbutamol (Ventolin)

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77
Q

Respiratory drug:
Lasts Up to 12 hours

A

Salmeterol

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78
Q

Given via inhalation with effects peaking in 1 – 2 hours and continue up to 6 hours.
Half life of 2 hours.
Less effective then the beta2 agonist –or glucocorticoids for an additive effect.
Sometimes used for nasal congenstion and chronic bronchitis.

A

Atrovent (ipotropium)

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79
Q

Oral ________ may be used to the short term management of acute asthma.

A

glucocorticoids

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80
Q

Inhaled___________ are first line therapy for asthma – they suppress airway inflammation without major side effects and help to prevent acute asthma attacks. (Evidence-based therapy for asthma)

A

glucocorticoids

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81
Q

the first mast cell stabilizer discovered. It is a safe alternative to glucocorticoids.
has a short half life of 80 minutes so must be inhaled 4 – 6 times aday.

A

Cromolyn

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82
Q

The 3 most widely used are:
beta-2 agonists – like salbutamol, salmeterol, formoterol and vilanterol.
anticholinergics – like ipratropium, tiotropium, aclidinium and glycopyrronium.

A

Types of bronchodilators

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83
Q

Genetic locks that keep cells functioning normally
Mutations that alter their expression can activate them to function as oncogenes

A

Proto-oncogenes

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84
Q

Regulate normal cellular processes such as promoting growth

A

Proto-oncogenes

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85
Q

Suppress growth of tumors

A

Tumour suppressor genes

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86
Q

Function to regulate cell growth
Suppress growth of tumours
Are rendered inactive by mutations
Result in loss of suppression of tumour growth

A

Tumour suppressor genes

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87
Q

Well differentiated
Usually encapsulated
Expansive mode of growth
Characteristics similar to parent cell
Metastasis is absent.
Rarely recur

A

Benign

88
Q

Usually undifferentiated
Able to metastasize
Infiltrative and expansive growth
Frequent recurrence
Moderate to marked vascularity
Rarely encapsulated
Becomes less like parent cell

A

Malignant

89
Q

Once ________, mutation is irreversible.
Not all mutated cells form a tumour.
Mutated cells become tumours only when they establish the ability to self-replicate and grow.

A

initiated

90
Q

_____ may be
Chemical
Radiation
Viral

A

Carcinogens

91
Q

Carcinogen effects in the stage of initiation are usually ________ and additive.

A

irreversible

92
Q

Initiation
Promotion
Progression

A

Cancer development

93
Q

Anatomical
Histological
Extent

are ways that ______ can be classified

A

Tumours

94
Q

carcinomas
sarcomas
lymphomas

A

Anatomical classification

95
Q

Grade 1
Grade 2
Grade 3
Grade 4

A

Histological classification

96
Q

Stage 0
Stage 1
Stage 2
Stage 3
Stage 4

A

Extent classification

97
Q

grading and severity

A

Histological analysis

98
Q

Extent of disease (cancer)

A

staging

99
Q

Change in bowel or bladder habits.
A sore that does not heal.
Unusual bleeding or discharge.
Thickening or lump in breast or elsewhere.
Indigestion or difficulty in swallowing.
Obvious change in wart or mole.
Nagging cough or hoarseness.

A

CAUTION - 7 Warning Signs of Cancer

100
Q

Superior Vena Cava syndrome
Spinal Cord Compression
Third Space Syndrome
Intestinal Obstruction

A

Obstructive oncological emergency

101
Q

SIADH
Hypercalcemia
Tumor Lysis Syndrome
Septic Shock
Disseminated Intravascular Coagulation

A

Metabolic oncological emergency

102
Q

Cardiac Tamponade
Carotid Artery Rupture

A

Infiltrative oncological emergency

103
Q

Common fears experienced by the patient with ________ include disfigurement, dependency, unrelieved pain, financial depletion, abandonment, and death.

A

cancer

104
Q

CD4+ counts of 800–to 1,200 cells/μL are generally considered _________.

A

normal

105
Q

Main goals for ____ drug therapy:
Decrease viral load
Maintain/raise CD4+ counts
Delay related symptoms and opportunistic infections
Prevent transmission

A

HIV

106
Q

Nebulizers
Dry powder inhaler (DPI)
Metered dose inhaler (MDI)

A

Devices for Delivering Drugs via Inhalation

107
Q

presence of two or more chronic illness that are not directly related to each other in a person at the same time.

A

Comorbidity

108
Q

simultaneous occurrence of several chronic medical conditions in the same person, may or may not be related to each other.

A

Multimorbidity

109
Q

Dose of one analgesic equivalent in pain-relieving effects compared with another analgesic

A

Equianalgesic dose

110
Q

Fast-acting drugs for breakthrough
Long-acting drugs for constant pain

A

Scheduling analgesics

111
Q

Dose adjustment based on assessment of the analgesic effect versus adverse effects
Use the smallest dose to provide effective pain control with fewest adverse effects

A

Titration

112
Q

Transduction
Transmission
Perception
Modulation

A

Pain process

113
Q

noxious stimuli cause cell damage with the release of sensitizing chemicals (prostaglandins, bradykinin, serotonin, substance P, histamine) - these substances activate nociceptors and lead to generation of action potential

A

Transduction

114
Q

action potential continues from: site of injury to spinal cord, spinal cord to brain stem and thalamus, thalamus to cortex for processing.

A

Transmission

115
Q

conscious experience of pain

A

Perception

116
Q

neurons originating in the brain stem descend to the spinal cord and release substances (e.g. endogenous opioids) that inhibit nociceptive impulses

A

Modulation

117
Q

Cardio
Respiratory
Sensory
Urinary system
Gastric Intestinal
Musculoskeletal system
Skin

Are all systems impacted when someone is at the _______

A

end of life

118
Q

Gradual decrease in urinary output
Incontinent of urine
Unable to urinate

A

Physical manifestations of end of life (urinary system)

119
Q

______ is a normal reaction to loss
Anger, guilt, anxiety, sadness, depression, despair, or a combination of these
Disruption in sleep, changes in appetite, physical symptoms, and illness

A

Grief

120
Q

takes place before the actual death

A

Anticipatory grief

121
Q

BE SENSITIVE
NO REPEATED UNNECESSARY ASSESSMENTS
PAIN AND RESPIRATORY STATUS

A

End of life

122
Q

Can occur with difficulty breathing or diaphoresis at end of life

A

Anxiety

123
Q

Jerking or twitching
Can occur with high dose of opioids

A

MYOCLONUS

124
Q

At end of life
Related to dry skin, nutritional deficits, anemia, friction, immobility, shearing forces, incontinence
Skin becomes mottled, cool cyanotic as circulation decreases.

A

SKIN BREAKDOWN

125
Q

an increase and growth of muscle cells

A

Hypertrophy

126
Q

increased cell production in a normal tissue or organ

A

Hyperplasia

127
Q

(of body tissue or an organ) waste away, especially as a result of the degeneration of cells, or become vestigial during evolution.

A

Atrophy

128
Q

a process whereby one type of mature tissue is replaced by another type of mature tissue not indigenous to that organ or tissue

A

Metaplasia

129
Q

the abnormal development of cells within tissues or organs

A

Dysplasia

130
Q

Lack of cellular differentiation is considered a hallmark of cancer

A

Anaplasia

131
Q

______ can cause cell damage from irreversible damage or altered function – without cell destruction.

A

injury

132
Q

If the stimulus causing the damage is removed then altered function can be _________.

A

reversible

133
Q

Hypoxia/ischemic injury
Heat and cold
Radiation
Electrothermal injury
Mechanical trauma
Chemical injury
Microbial injury
Immunological
Neoplastic growth
Normal substances

A

Causes of lethal cell injury

134
Q

type of lethal cell injury
substances are released that injure or damage (antigen/antibody responses, inflammation)

A

Immunological

135
Q

Type of lethal cell injury
cell destruction from the introduction of lethal toxins.

A

Bacterial

136
Q

Type of lethal cell injury
viruses which can take over cell metabolism.

A

Microbial injury

137
Q

This type of lethal cell injury can lead to cell death from altered cell metabolism.

A

Chemical Injury

138
Q

Physical Injury which can damage cell and lead to cell ______

A

death

139
Q

Apoptosis – the end of normal cell life.
Necrosis – everything else that causes an inflammatory response from the release of intracellular contents.

A

Two types of cell death

140
Q

the end of normal cell life.

A

Apoptosis

141
Q

Can occur from trauma, infection, ischemia, exposure etc.
Death of tissue

A

Necrosis

142
Q

Programmed cell death

A

Apoptosis

143
Q

Not normal in developed tissues; serious when many cells involved

A

Necrosis

144
Q

Another form of necrosis is ____ which is necrosis of an appendage.

A

gangrene

145
Q

There can be ___ or ___ gangrene.

A

dry; wet

146
Q

____ action usually contributes to wet gangrene
dry gangrene can occur related to ____ diseases and the degenerative changes.

A

Bacterial; chronic

147
Q

Is odorous and soft. When caused by trauma such as a crush injury or burn there is a sudden change in blood flow which can be fatal.

A

Wet gangrene

148
Q

REMEMBER THAT ANY ODOR IS INDICATIVE OF ______ INFECTION.

A

BACTERIAL

149
Q

The ________ cell action refers to the ability to protect itself.
protect by ingesting harmful foreign particles, bacteria and dead or dying cells.

A

phagocytic

150
Q

monocytes, macrophages, neutrophils, tissue dendritic cells and mast cells.

A

The main types of phagocytes

151
Q

______ from cell injury has either a:
Vascular response
Cellular response
Formation of exudate
Healing

A

Inflammation

152
Q

______ of the inflammation depends on:
The extent or severity of the injury
The reactive capacity of the injured person

A

Intensity

153
Q

Vascular response leads to vasoconstriction of the small arterioles.
↓
Injury site is sealed by platelets to form a fibrin platelet clot which then releases pro inflammatory mediators like histamine that causes dilation.
↓
With dilation there is increased blood flow to the area – hyperemia.
↓
Hyperemia causes increased capillary permeability causing fluid movement from
the capillaries into the tissue spaces – serous fluid.
↓
Serous fluid – inflammatory exudate which causes more pressure changes and more fluid to pull from blood vessels which is seen as edema.
↓
Serous fluid contains plasma fibrinogen that changes to fibrin that strengthens the blood clot that was originally formed by the platelets.
↓
The clot helps minimize blood loss and trap bacteria to help from spreading.
↓
WBC’s migrate to the site of inflammation – chemotaxis

A

Healing process

154
Q

arrive to the site of inflammation in about 6 – 12 hours
*Short life span of 24 – 48 hours
*Bone marrow reproduces more
*Immature cells can be released to try and keep up with the demand - neutrophil bands)

A

Neutrophils

155
Q

arrive 3 – 7 days after the onset of inflammation
*become macrophages when they enter the site
*They clean the area of debris before healing can occur.
*Long lifespan
*If the macrophages can not eat all the debris then they accumulate and encapsulate it by collagen leading to the formation of a granuloma. – we see this with TB

A

Monocytes

156
Q

arrive later with their role being immunity.

A

Lymphocytes

157
Q

– selective role in inflammation
-Released with allergic reactions
-Release chemicals that control the effects of histamine and serotonin

A

Eosinophils and basophils

158
Q

Redness
Heat
Pain
Swelling

A

manifestations of inflammation

159
Q

hyperaemia from vasodilation

A

Redness

160
Q

increased metabolism at inflammatory site

A

Heat

161
Q

change in pH; nerve stimulation by chemicals (e.g. histamine, prostaglandins); pressure from fluid exudate

A

Pain

162
Q

fluid shift to interstitial space: fluid exudates accumulate

A

Swelling

163
Q

a build-up of mucus in your nose and sinuses and phlegm in your throat.

A

Catarrh

164
Q

______ exudate is a specialized type of inflammatory fluid that the body releases in response to tissue injury or inflammation

A

fibrinous

165
Q

Redness, heat, swelling pain
Prodrome, chill, flush, defervescence

are things that happen when you have a _______

A

Fever

166
Q

_______ – healing is done in 2 – 3 weeks with no residual damage
Subacute – Same as acute but lasts longer.
Chronic – injury persists and lasts weeks to years

A

Acute

167
Q

Cytokines cause metabolic changes within the hypothalamus that is manifested as a _____.
Prostaglandin E2 (PGE2) increases temperature
Shivering, increased muscle tone, decreased perspiration from ANS increases temp.
Epinephrine increases the metabolic rate.

A

fever

168
Q

-Increases phagocytosis by neutrophils
-Increase killing of microorganisms
-Increased proliferation of t cells
-Increases interferon activity ( body’s natural virus fighting substance)

A

Benefit of a fever

169
Q

Prodrome
Chill
Flush
Defervescence

A

Stages of fever response

170
Q

mild headache, fatigue, malaise, muscle aches

A

prodrome

171
Q

“goose bumps” feel cold to increase the temperature

A

chill

172
Q

vasodilation or a feeling of warmth

A

flush

173
Q

sweating and a decrease in body temperature

A

defervescence

174
Q

FINAL PHASE OF INFLAMMATION IS ________ WHICH CONSISTS OF
1.Regeneration
2.Repair – Healing

A

HEALING

175
Q

replacement of lost cells and tissue
depends on the cell type

A

Regeneration

176
Q
  1. __________ Healing
    Most common type of healing is when connective tissue replaces lost cells resulting in scar formation
A

Repair

177
Q

A.PRIMARY
B. SECONDARY
C. TERTIARY

A

Types of wound healing

178
Q

Margins like a paper cut
Margins can be approximated

A

A.PRIMARY

179
Q

Margins cannot be approximated
Larger scar
Seen with chronic wounds, venous ulcers, trauma

A

B. SECONDARY

180
Q

Delayed Primary
Wound need to stay open in order to heal.
May require surgical closure.

A

C. TERTIARY

181
Q

Cause (surgical/nonsurgical)
Underlying pathology
Duration (acute or chronic)
Level of contamination
Depth of tissue (superficial; partial thickness; full thickness)

A

Wound classification

182
Q

All of these things cause _______:
Nutrition (Deficiencies in Vit C, protein and Zinc)
Poor circulation
Smoking
Corticosteroids meds
Infection
Anemia
Obesity
Diabetes mellitus
Poor general health
Mechanical friction on wound
Cold tem
Excessive moisture

A

Delay of healing

183
Q
  • people at risk include people with malabsorption problems, have deficient intake, high energy demands
  • Any with a 30% weight loss in the preceding 6 months is at risk
  • Anyone with 10% weight loss in the preceding 2 months
A

NUTRITIONAL RISK

184
Q
  • Adhesions
  • Contractures
  • Dehiscence and evisceration
  • Excess granulation tissue
  • Fistula formation
  • Infection
  • Hemorrhage
  • Formation of hypertrophic scars and keloids
  • Collaborative care
  • Drug therapy
  • Nutritional therapy
A

Complications of healing

185
Q

Initially cold for vasoconstriction
to decrease swelling, pain and congestion
After 24 – 48 hours heat to increase circulation to remove debris.
Compression Counters vasodilation and the development of edema after an injury
Support

A

Ice and heat

186
Q

Decreases tissue metabolic need

A

Immobilization

187
Q

Increases venous and lymphatic return
decreases edema
Reduces pain from engorgement.

A

Elevation

188
Q
  • Surgical
  • when large amounts of nonviable tissue and sepsis is present.
  • Mechanical –
  • wet to dry dressing (debris sticks to the dressing and then removed)
  • Wound irrigation
  • ultrasonic
  • Autolytic
  • Hydrogels – promote softening
  • Enzymatic
  • Proteolytic enzymes applied to necrotic tissue – Santyl collagenase
  • Biosurgical
  • Medical grade maggots to digest dead tissue.
A

Cleaning and debriding
Types of debridement

189
Q
  • Depend on the extent of the tissue involved.
  • Staged according to the deepest level of tissue damage
  • ______________ (NPUAP) guidelines

Pressure injuries
A good indicator of quality care

A

National Pressure Ulcer Advisory Panel

190
Q

Invasion of body by _____ virus
↓
Enters a cell and starts to duplicate
↓
The antigens on the surface are recognized by a macrophage - it eats the virus and now the virus antigen is displayed on it surface.
↓
The antigen is recognized by the T helper
cells and now they bind to the macrophage causing cytokines to be released.
↓
T helper cells and T cytotoxic cells multiply.
and B cells multiply and produce antibodies
↓
T cytotoxic cells and natural killer cells
destroy infected body cells
↓
The virus is marked by binded antibodies
for macrophage destruction

A

HIV

191
Q

*CD4+ counts of _____ to _______ cells/μL are generally considered normal.

A

800–to 1 200

192
Q

*Main goals
*Decrease viral load
*Maintain/raise CD4+ counts
*Delay HIV-related symptoms and opportunistic infections
*Prevent transmission

A

HIV Drug therapy

193
Q

Skin and connective tissue and smooth muscle ______

A

regenerate

194
Q

Cardiac muscle and severely damaged skeletal muscle is replaced with ___________

A

connective tissue

195
Q

________ do not replicate or replace themselves they are replaced with scar tissue

A

Neurons

196
Q

A delay in healing may be caused by deficiencies in _____, _____, & ______

A

Vit C, protein, & Zinc

197
Q

(smoking) nicotine is a _________ and results in delayed wound healing

A

vasoconstrictor

198
Q

__________ meds – impairs phagocytosis

A

Corticosteroids

199
Q

________ – decreased oxygen - longer time requires for epithelization of the skins, maybe altered immune responses and slowed collagen synthesis, or impaired circulation and results in delayed wound healing

A

Anemia

200
Q

________ – adipose tissue has less blood supply and results in delayed wound healing

A

Obesity

201
Q

____________ – hyperglycemia causes impaired phagocytosis – also there is reduced oxygen and nutrients as a result of vascular disease and results in delayed wound healing

A

Diabetes mellitus

202
Q

Poor general health results in poor ______

A

wound healing

203
Q

Mechanical friction on wound – destroys ___________ and results in delayed wound healing

A

granulation

204
Q

Cold tem – decreases __________ activity and results in delayed wound healing

A

cellular

205
Q

_____________ – causes hyper granulations and results in delayed wound healing

A

Excessive moisture

206
Q

can destroy a parasite’s cell surface because they contain highly caustic chemicals

A

Eosinophils

207
Q

contain histamine and heparin that are released during inflammation

A

Basophils

208
Q

________ – increased inflammation and further destruction and results in delayed wound healing

A

Infection

209
Q

Repair of cellular damage,
Redistribution of cells in the cell cycle
Repopulation with normal cells
Reoxygenation of hypoxic tumor area.

A

The 4 Rs

210
Q

Albuterol
Ventolin
Proventil
Levalbuterol

Are all ______ acting bronchodilators

A

Short acting

211
Q

Salmeterol
Formoterol
Aclidinium
Tiotropium

Are all ______ acting bronchodilators

A

Long acting

212
Q

Low PaO2 is an indicator of this condition

A

hypoxaemia

213
Q

High PaCO2 is an indicator of this condition

A

inadequate alveolar ventilation

214
Q

Impairs heart & lungs -> impacting circulation -> retention of fluid
Pulmonary hypotension

A

COPD

215
Q

CHR

A

Chest X Ray

216
Q

air can’t come out of the lungs indicates an ________ problem

A

Obstructive

69:262 Medical Nursing (10 decks)

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