TLO 1.3b Inflammatory Flashcards
S/S of inflammation
LOCAL
Local: pain erythema edema heat change in function
S/S of inflammation
SYSTEMIC
Systemic: fever malaise N/V leukocytosis *fever kills microorganisms, increases phagocytosis
Four types of wound healing
Inflammatory Phase
Proliferative Phases
Granulation Tissue
Maturation Phase
Wound healing
INFLAMMATORY PHASE
Cleansing phase
Last 1-5 days
Hemostasis: bruising
Inflammation: form scab as protective barrier
Wound healing
PROLIFERATIVE PHASE
Granulation phase
Occurs 3-22 days
Cell develop to fill wound causing formation of granulation tissue
Wound healing
GRANULATION TISSUE
Beefy red
Bleeds readily and is easily damaged
Wound healing
MATURATION PHASE
Epithelialization phase
Final phase
Begins 2nd or 3rd week continues until wound is healed
Collagen in wound bed from proliferative phase broken down to form scar tissue
Factors that inhibit wound healing
Nutritional deficiencies (vit c, protein, zinc) Impaired O2 Radiation Medication Inadequate blood supply Corticosteroids Infection Smoking Advanced age Obesity Diabetes Anemia
Types of wound healing: 3 types
Primary intention
Secondary intention
Tertiary intention
Types of wound healing
PRIMARY INTENTION
Little scaring
Wound involves minimal or no tissue loss
Edges are well approximated
Example: clean surgical incision
types of wound healing
SECONDARY INTENTION
Wound has extensive tissue loss that prevent edges from approximating
Wound should not be closed (infection)
Heals inner layer to surface with granulation tissue
Heals slower
prone to infection
types of wound healing TERTIARY INTENTION (3RD)
Delayed primary closure
Initially allowed to heal by 2nd intention
Wound is closed when no s/s of infection
Require strict aseptic technique
Wound drainage: 4
Serous: clear, straw color
Purulent: green
Serosanguineous: pink
Sanguineous: red, active bleeding
Wound complications
Hemorrhage Hematoma Infection Dehiscence Evisceration Fistula
Erythrocytes (RBC)
- components
- values
- levels
Transport O2/CO2
Formed in red bone marrow
women 4-5 million
men 4.5-6 million
Decreased: blood loss, anemia, leukemia, over hydration, pregnant, chronic renal failure
Increased: dehydration, high altitude, cardiovascular disease, polycythemia vera
Plasma
90% water Dissolved elements: albumin globulin fibrinogen/prothrombin RBC WBC Platelets
Leukocytes (WBC)
- purpose
- value
- levels
Presence of infection
Diagnose health problem
Adult 4,500-10,000
Leukopenia (low, <4000): lupus, RA, ETOH, viral infection, aplastic/pernicious anemia
Leukocytosis (high, >10,000): acute infection, trauma, tissue necrosis, inflammation, hemorrhage
What is WBC w/ differential?
Composed of 5 types of WBC’s
Value reported in %
More specific info r/t infection/disease process
What are the 5 different types of WBC and values?
Neutrophils: 50-70% Lymphocytes: 25-35% Monocytes: 4-6% Eosinophils: 1-3% Basophils: 0.4-1%
Platelets (thrombocytes)
- levels
- value
150,000-400,000 normal value
Aids in blood clotting by vasoconstriction and initiate clot formation
Thrombocytosis (increased): infection, acute blood loss, splenectomy
Thrombocytopenia (low): ITP, cancer, liver/kidney disease, lupus
Erythrocyte Sedimentation Rate (ESR)
- levels
- value
Measures rate that RBC settle out of unclotted blood.
Women: 20 mm/hr
Men: 15 mm/hr
Low levels: HR, sickle cell, mono, arthritis
High levels: RA, acute MI, surgery, burns, cancer
Wound culture procedure
Aseptic technique:
- Cleanse/irrigate wound
- Collect specimen from granulating tissue
- Label and send to lab immediately
* *Must be done prior to pt receiving antibiotics
Wound Cleansing
Use syringe with 19g angiocath Promotes healthy healing Use normal saline Follow doctors orders PPE Clean technique
Dressing changes- 2 types
Dry dressing change: No tough method
Wet to dry moist dressing: used to debride wound, inner gauze moist, loosely pack, apply secondary dressing
4 Types of drains
Penrose- flexible tubing
Jackson Pratt (JP)- bulb suction
Hemovac- disc shaped
Wound vac
