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NUR 213 Inflammation
- Exemplars
Answer Acute Cholecystitis Nephritis Chronic Diverticulitis Myocarditis Autoimmune Inflammatory Bowel Diseases
- Definition
Answer Inflammation is an immunologic defense against tissue injury, infec- tion , or allergy.It is a protective process initiated to minimize or remove the pathologic agent triggering the inflammation and to promote healing It is the body's physiologic response to injury Inflammation can occur without infection Per Giddens , pg 216
- Risk factors
Answer All individuals are at risk The very young that have an immature immune response The elderly, the immune system loses it ability to respond Uninsured because they do not have early intervention Autoimmune diseases Allergies Genetics Chronic diseases Absence of good hand and personal hygiene Poor sanitation and nutrition Environmental factors
- Steps in acute inflammation
Answer Tissue injury and the release of chemical media- tors Vasodilation and increased blood flow Swelling and retraction of activated endothelial cells Increased vascular permeability and leakage of small plasma proteins "Walling off" Movement of immune response cells to the site of injury (fluid and WBC) Exudate formation Movement of glucose and oxygen to the site needing repair Release of chemical repair factors from activated endothelial cells
- Enzymes
Answer Inflammation Cyclooxygenase (COX) enzyme Converts arachidonic acid into prostaglandins
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Has two enzyme forms
COX-1
protects stomach lining and regulates blood platelets COX-2
triggers inflammation and pain
- Comkin diagnostics
Answer Laboratory tests CBC WBC with differential CRP ESR Serologic tests to detect specific antibodies or viruses Radiographic studies
MRI CAT
PET scans colonoscopy
- Wbc
Answer White Blood Cell Total number (Thousands) / mm blood NL values 4,300 - 10,800/mm Differential
proportion of each of the 5 types of WBC's in a sample of 100 WBC's
Neutrophils
50-70% -phagocytosis bands are immature neutrophils
0-3% Eosinophils
0-4%- seen in allergic reactions Basophils
0-2% - assoc. with leukemia Lymphocytes
20-40% -assoc with viral infections Monocytes
4-8% assoc. with chronic inflammation
- Memory help
Answer 2 / 3
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Never- neutrophils Let-lymphocytes Monkeys-monocytes Eat-eosinophils Bananas- basophils
9. CRP
Answer This test is non-specific for evaluating inflammatory disease (course & severity).During an inflammatory process, a specific abnormal protein (CRP) appears in the blood.NL values
Answer < 0.8 mg/dL Can be detected within 18-24 hrs. after tissue damage Increase with CAD,PVD, RA, acute MI,3rd trimester of pregnancy Decrease with steroids and ASA
- Erythrocyte sedimentation rate
Answer Measures "speed" which RBC's settle in tube of anti-coagulated blood
expressed as mm/hr NL values
Answer men 1-13 mm/hr women 1-20 mm/hr ** after age 50 levels increase Increased levels indicate inflammatory / pathologic condition-RA acute MI Decrease with CHF Mono, degenerative arthritis & sickle cell
- Cardinal signs of inflammation
Answer Redness Swelling heat Pain Loss of function
- Primary prevention
Answer Primary Prevention
Answer
Hand hygiene Designated safety equipment Food and safety standards There are no routine screening procedures for inflammation which is secondary prevention Collaborative interventions are directed at promoting repair and healing by RICE,
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