Test 3 Flashcards
Infection
the invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication or antigen-antibody response
Otitis Media
an inflammatory disorder usually caused by an infection of the middle ear occurring as a result of a blocked Eustachian tube, which prevents normal discharge
- common complication of an acute respiratory infection
- 3 types: Acute otitis media (AOM), Otitis media with effusion (OME), and otitis externa (Swimmer’s ear)
acute otitis media (AOM)
is usually painful and often requires treatment with antibiotics. Symptoms include redness of the tympanic membrane, pus, and fever.
otitis media with effusion (OME)
is a buildup of fluid in the middle ear without symptoms of infection and is often caused by viral upper respiratory infections and allergies, generally resolving on its own.
otitis externa (swimmer’s ear)
an infection of the ear and outer ear canal. Usually treated with antibiotics
conjunctivitis
also known as “pink eye”; an inflammation of the conjunctiva.
usually caused by allergy, infection, or trauma
bacterial or viral conjunctivitis is extremely contagious
conjunctivitis assessment
- itching, burning, or scratchy eyelids
- redness
- edema
- discharge
who are more prone to otitis media and why?
infants and children, because they have Eustachian tubes that are shorter, wider, and straighter
otitis media assessment
- fever
- acute onset of ear pain
- crying irritability, lethargy
- loss of appetite
- rolling of head from side to side
- pulling on or rubbing the ear
- purulent ear drainagee may be present
- red, opaque bulging, immobile tympanic membrane on otoscopic examination
- signs of hearing loss (indicative of chronic OM)
Myringotomy
a surgical incision into the tympanic membrane to provide drainage of the purulent middle ear fluid, may be done by a laser assisted procedure
tympanoplasty tubes
small cylinder-shaped tubes inserted into the middle ear to allow continued drainage and to equalize pressure and allow ventilation of the middle ear
influenza
highly contagious acute viral respiratory infection
-may be caused by several viruses, usually known as types A, B, and C
Who is the the flu vaccine contraindicated in?
people with egg allergies
influenza assessment
- acute onset of fevered muscle aches
- headache
- fatigue
- sore throat, cough, rhinorrhea
Pneumonia
infection of the pulmonary tissue, including the interstitial spaces, the alveoli, and the bronchioles
- the edema associated with inflammation stiffens the lung, decreases lung compliance and vital capacity, and causes hypoxemia
- community or hospital acquired
- WBC and erythrocyte sedimentation rate are elevated
- sputum culture identifies organism
- x-ray shows lobar or segmental consolidations, pulmonary infiltrates, or pleural effusions
Pneumonia assessment
- chills
- elevated temperature
- pleuritic pain
- tachypnea
- rhonchi and wheezes
- use of accessory muscles for breathing
- mental status changes
- sputum production
Urinary tract infection (Cystitis)
an inflammation of the bladder from an infection, obstruction or the urethra, or other irritants
- more common in women because the urethra is shorter and located close to the rectum
- sexually active and pregnant women are most vulnerable
most common causative organisms of UTI
- Escherichia coli
2. species of Enterobacter, Pseudomonas, and Serratia
UTI/Cystitis assessment
- Frequency and urgency
- burning on urination
- voiding in small amounts
- inability to void
- incomplete emptying of the bladder
- lower abdominal discomfort or bad discomfort, bladder spasms
- cloudy, dark, foul-smelling urine
- hematuria
- malaise, chills, fever
- WBC greater than 11,000mm3 on urinalysis
UTI client education
- avoid alcohol
- take medication as prescribed
- take entire course of antibiotics
Normal Values: Hemoglobin (hgb)
M: 14-18
F: 12-16
Normal Values: Hematocrit (hct)
M: 42-52
F: 37-47
Normal Values: Red Blood Cells (RBC)
M: 4.7-6.1
F: 4.2-5.4
Normal Values: White Blood Cells (WBC)
5,000-10,000
Normal Values: Prothrombin time (Pt)
11-12.5
Normal Values: Partial Prothrombin time (Ptt)
60-70
Normal Values: Albumin
3.5-5g/dL
Normal Values: Calcium
8.5-10.5 mEq/L
Normal Values: Chloride
95-105 mEq/L
Normal Values: Glucose
70-110 mg/dL
Normal Values: Iron
M: 80-180
F: 60-160
Normal Values: Potassium
3.5-5
Normal Values: Protein
6.4-8.3
Normal Values: Sodium
135-145
Normal Values: Magnesium
1.5-2.5
Normal Values: pH
7.35-7.45
Normal Values: pCO2
35-45
Normal Values: pO2
80-100
Normal Values: HCO3
22-26
Normal Values: O2sat
95-100%
Normal Values: Phosphate
2.5-4.5
Normal Values: Specific Gravity
1.010-1.025
Normal Values: AST
0-35
Normal Values: ALT
4-36
Normal Values: Creatinine
M: 0.6-1.2
F: 0.5-1.1
Normal Values: Digoxin
0.8-2.0
Normal Values: BUN
10-20
Normal Values: Platelet
150,000-400,000
Normal Values: LDL
<130
Normal Values: HDL
M: >45
F: >55
Normal Values: Triglycerides
M: 40-160
F: 35-135
Normal Values: TSH
2-10
Normal Values: T3
70-205
Normal Values: T4
M: 4-12
F: 5-12
Normal Values: Ammonia
15-45
Cellulitis Pathophysiology
occurs when an entry point through normal skin barriers allows bacteria to enter and release their toxins in the subcutaneous tissues
Cellulitis Nursing Management
Elevate the affected area 3-6 inches above heart level and apply warm, moist packs to the site every 2-4 hours
Influenza And B
cause epidemics
Influenza C
responsible for mild upper respiratory infections in children and adults
Influenza secondary complications
typically include sinusitis, otitis media, bronchitis, and bacterial pneumonia
Influenza Treatment
Rest, keeping warm, and drinking large amounts of fluids
- analgesics and cough medicines
- antivirals (Zanamivir and oseltamivir)
Influenza Vaccine
new vaccine created each year, (two type A and one type B)
- administered in autumn
- contraindicated in anaphylactic hypersensitivity to eggs
Pneumonia Pathophysiology
arises from normal flora present in patients whose resistance has been altered or from aspiration of the flora present in the oropharynx; pts often have underlying disease that impairs host defenses
- may also result from blood borne organisms
- affects both ventilation and diffusion
Community acquired pneumonia (CAP)
pneumonia occurring in the community OR 48 hours of hospital admission in its who do not meet criteria for HCAP
Health care-associated pneumonia (HCAP)
pneumonia occurring in a nonhospitalized pt with extensive health care contact with one or more of the following:
- hospitalizationfor 2 or more days in an acute care facility w/in 90 days of infection
- residence in a nursing home or long-term care facility
- antibiotic therapy, chemotherapy, or wound care w/in 30 days of infection
- hemodialysis treatment at a hospital or clinic
- home infusion therapy or home wound care
- family member w/ infection due to multi drug-resistant bacteria
Hospital-acquired pneumonia (HAP)
Pneumonia occurring 48 hours or more after hospital admission that did not appear to be incubating at the time of admission
Ventilator-acquired pneumonia (VAP)
a type of HAP that develops 48 hours or more after endotracheal tube intubation
Risk Factors for pneumonia
- debilitated by accumulated lung secretions (asthma, COPD, sickle cell anemia)
- cigarette smokers
- immobile
- immunosuppressed
- experiencing a depressed gag/cough reflex
- sedated
- experiencing neuromuscular disorders
- nasogastric/orogastric intubation
- hospitalized client
aspiration pneumonia
pulmonary consequences resulting from entry of endogenous or exogenous substances into the lower airway
Medical management for pneumonia
antibiotics (broad spectrum initially
- hydration
- antipyretics
- antitussives
- antihistamines
- rest
- O2
Glycosaminoglycan (GAG)
a hydrophilic protein, normally exerts a non adherent protective effect against various bacteria. The GAG molecule attracts water molecules, forming a water barrier that serves as a defensive layer between the bladder and the urine.
urethrovesical reflux
backward flow of urine from the urethra into the bladder
routes of infection: UTI
- transurethral route (ascending infection) most common
- through the bloodstream (hematogenous spread)
- by means of fistula from the intestine (direct extension)
medical management of UTI
- anti-infective
- bactericidal
- cephalosporin
- fluoroguinolone
- penicillin
- trimethoprim
- urinary analgesic agent
pyelonephritis
a bacterial infection of the renal pelvis, tubules, and interstitial tissue of one or both kidneys. Causes involve either the upward spread of bacteria from the bladder or spread from systemic sources reaching the kidney via the bloodstream
acute pyelonephritis
usually leads to enlargement of the kidneys with interstitial infiltrations of inflammatory cells atrophy and destruction of tubules and the glomeruli may result
chronic pyelonephritis
is a cause of chronic kidney disease that can result in the end of renal replacement therapies such as transplantation or dialysis
clinical manifestations of acute pyelonephritis
- chills, fever, malaise
- leukocytosis
- bacteriuria and pyuria
- low back pain, flank pain
- nausea/vomiting
- headache
clinical manifestations of chronic pyelonephritis
usually has no symptoms of infection
noticeable symptoms include: fatigue, headache, poor appetite, polyuria, excessive thirst, and weightloss