Unit 6 - Inflammation

Question 1

Defintion:
adaptive response to injury, illness that brings plasma, dissolves substances, blood cells into interstitial tissues where damage occurred

Answer 1

inflammation

Question 2

Definition:

damaged cells, bacteria, exudate removed through phagocytosis

Answer 2

debridement

Question 3

Is pallor a sign of inflammation

Answer 3

No, redness is

Question 4

is pitting edema a sign of inflammation

Answer 4

No

Question 5

6 signs of inflammation

Answer 5

• redness
• swelling
• warmth
• pain
• heat
• impaired function

Question 6

4 S/S of systemic reaction

Answer 6

• fever
• increased pulse
• tachypnea
• leukocytosis (WBC > 12,000)

Question 7

5 S/S of local reaction

Answer 7

• erythema
• warmth
• pain
• edema
• functional impairment

Question 8

Describe the inflammatory process

Answer 8

• complex response of vascular tissues triggered by harmful stimuli

Question 9

Stage 1 of inflammation

Answer 9

vascular and cellular responses

Question 10

Stage 1 of inflammation:

• Blood vessels at site _____
• Inured tissues releases _____, _____, and _____
• Chemical mediators cause _____
• Vascular permeability _____
• Fluid, proteins, and leukocytes…
• Leukocytes -> …
• Leuko_____

Answer 10

• Blood vessels at site constrict
• Inured tissues releases histamines, kinines, and prostaglandins
• Chemical mediators cause hypermia
• Vascular permeability increases
• Fluid, proteins, and leukocytes leak into interstitial spaces causing edema and pain
• Leukocytes -> margination, emigration
• Leukocytosis

Question 11

In the presence of an attack such as an infection, _____ WBCs are released from the bone marrow, and as WBCs move out of the bone marrow into the blood, the bone marrow (increases/decreases) its production of additional leukocytes, leading to _____.

Answer 11

additional
increases
leukocytosis

Question 12

Instructing the client on the use of _____ razor and _____ toothbrush and assessing for bleeding and bruising would be appropriate actions for a client with decreased platelet levels, or thrombocytopenia.

Answer 12

electric

soft

Question 13

T/F: placing a patient in reverse isolation precautions would be appropriate for the client with neutropenia

Answer 13

T

Question 14

Defintion:

a decrease in the number of neutrophils

Answer 14

Neutropenia

Question 15

Stage 2 of inflammation:

Answer 15

exudate production

• serous
• purulent
• hemorrhagic

Question 16

Stage 3 of inflammation:

Answer 16

reparative phase

• regeneration
• fibrous tissue formation

Question 17

2 parts to fibrous tissue formation:

Answer 17

• granulation tissue

- cicatrix

Question 18

rapid release of inflammation mediators ->

Answer 18

anaphylaxis

Question 19

Histamine and heparin work together to…

Answer 19

increase blood flow to injured site

- H1 and H4 receptors involved in inflammatory response

Question 20

As a person grows older, there is an overall _____ in the speed and strength of the immune response

Answer 20

decrease = there is a decrease in the number of B cells in circulation

Question 21

Describe healthy inflammatory response

Answer 21

activation and recruitment of WBCs to the affected site

Question 22

Typical onset of rheumatoid arthritis

Answer 22

middle age with increased incidence among older adults

• also occurs in children and young adults

Question 23

_____ or _____ Americans have increased risk for gallstone

Answer 23

Native or Mexican Americans

Question 24

_____ _____ are more likely than caucasians to develop nephritis as a result of lupus

Answer 24

African Americans

Question 25

Restricting fluids could cause respiratory secretions to...

Answer 25

thicken and hinder the client's ability to maintain a clear airways = fluids should be encouraged

Question 26

``` Modifiable Risk Factors: Crohn Disease: - Diet _____ in refined sugars - _____ fiber intake - smoking _____ ```

Answer 26

Diet low in refined sugars - increased fiber intake - smoking cessation

Question 27

Modifiable Risk Factor for Gallstone formation: - _____ an appropriate weight - diet _____ in fiber and _____ in fat - _____ rapid weight loss

Answer 27

- maintain an appropriate weight - diet high in fiber and low in fat - avoid rapid weight loss

Question 28

What affect do NSAIDS have on kidneys

Answer 28

nephrotoxic

Question 29

T/F: keeping the client well hydrated will help prevent kidney damage

Answer 29

T

Question 30

taking medication with food will _____ GI irritation

Answer 30

decrease, however preventing kidney damage is more of a priority

Question 31

Taking a medication on an empty stomach will _____ GI irritation

Answer 31

increase

Question 32

Is constipation an issue with NSAIDS?

Answer 32

No

Question 33

_____ are important to meet the energy demands of healing, and _____ is needed for cell growth

Answer 33

Carbohydrates | Protein

Question 34

The vegan client needs to be taught to eat _____ that provide the essential _____ _____ that can be lacking in a vegan diet

Answer 34

proteins | amino acids

Question 35

_____ are needed in moderation for the development of cell membranes

Answer 35

Fats

Question 36

Vitamin _, _, _, and the _-_____ vitamins are necessary to promote healing

Answer 36

C K A B-complex

Question 37

What does ESR stand for

Answer 37

Erythrocyte Sedimentation rate

Question 38

Normal ESR for male

Answer 38

0-15 mm/h

Question 39

Normal ESR for female

Answer 39

0-20 mm/h

Question 40

What does CRP stand for

Answer 40

C-reactive protein

Question 41

Serum electrolyte levels (are, are not) used to determine the presence of a systemic infection

Answer 41

are not

Question 42

_____ is used to assess for the presence of bacteria or blood in the urine

Answer 42

urinalysis

Question 43

An elevated WBC and 15% bands are indicative of...

Answer 43

an infection

Question 44

Wound cultures are used to identify...

Answer 44

probably microorganisms

Question 45

Elderly clients are at risk for increased _____ with NSAID therapy

Answer 45

bleeding

Question 46

T/F: clients should report any abnormal bruising

Answer 46

T, could indicate bleeding

Question 47

Are mood changes a side effect of NSAID therapy

Answer 47

No

Question 48

should you avoid caffeine when using an NSAID

Answer 48

No, there is no reason for avoiding caffeine

Question 49

Describe chronic inflammation of the bowel

Answer 49

sporadic periods of active disease (flares)

Question 50

Describe Ulcerative Colitis

Answer 50

affects mucosa and submucosa of colon, rectum

Question 51

Describe Crohn disease

Answer 51

usually affects terminal ileum and ascending colon | - may affect any portion of the GI tract

Question 52

_____ and _____ stools are typical symptoms of ulcerative colitis.

Answer 52

Diarrhea and bloody stool

Question 53

Is appendicitis associated with bloody stools

Answer 53

No and it is not usually associated with diarrhea either

Question 54

the teen with Crohn disease might have _____ pain and _____, but stools usually do not have blood in them

Answer 54

abdominal pain and diarrhea

Question 55

_____ _____ is usually seen in premature infants and not generally in an adolescent client

Answer 55

necrotizing enterocolitis

Question 56

The client with irritable bowel syndrome is taught to maintain a _____-than-normal fluid intake to maintain hydration

Answer 56

higher

Question 57

Ulcerative colitis: | The client's dry patches could be due to...

Answer 57

fluid deficit, but would not require immediate notification

Question 58

Ulcerative Colitis: T/F Two liquid stools a day is not excessive, but the client needs to take in enough fluid to account for the stools as well as the normal fluid needs of the body

Answer 58

T

Question 59

Ulcerative Colitis: | Moisturizing the skin is a _____ action of the client, but it does not indicate...

Answer 59

- positive | - does not indicate appropriate understanding of the teaching that is appropriate for this diagnosis

Question 60

Ulcerative colitis usually begins at...and progresses...

Answer 60

begins at rectosigmoid area of anal canal and progresses proximally

Question 61

Describe diarrhea with ulcerative colitis

Answer 61

- stool contains blood, mucus | - 6-10 bloody stools per day if severe

Question 62

With both ulcerative colitis and Crohn disease, the client experiences periods of _____-_____ _____ with sporadic periods of _____ _____ (flares). However, each condition has differences in clinical characteristics. With UC, the client may have 5-30 diarrhea stools per day with blood and mucus. Pain associated with UC presents with cramping in the LLQ (left lower quadrant) which is relieved by _____. All other clinical manifestations are unique to _____ disease.

Answer 62

symptom-free remissions active disease defecation Crohn

Question 63

In children, bowel _____ is rare, but may be a consequence of noncompliance with the treatment, because the disease would continue to progress. Diarrhea, vomiting, and intestinal obstructions are common symptoms of Crohn and may occur even if the client is compliant with medical care.

Answer 63

perforation

Question 64

Children suffer from _____ disease more than _____ _____

Answer 64

Crohn disease | ulcerative colitis

Question 65

Tests to diagnose irritable bowel syndrome

Answer 65

- upper and lower barium studies | - colonoscopy

Question 66

What is an intravenous pyelogram used to diagnose

Answer 66

kidney disorders

Question 67

What is an upper endoscopy used to diagnose

Answer 67

disorders of the esophagus and stomach

Question 68

A client with an ileostomy has (no, full) control over bowel movements and must always wear a collection device. The drainage tends to be liquid, but becomes paste-like with the intake of certain foods.

Answer 68

no

Question 69

Stoma care is taught to the client after surgery, and the goal is...

Answer 69

for the stoma to be pink with intact skin

Question 70

It is not critical that the ostomy pouch be clean and dry, particularly if the client has had a stool. A normal temperature (would, would not) be a particular goal for a client 6 weeks postoperatively. Patient with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.

Answer 70

would not

Question 71

Where is an ileostomy done

Answer 71

in the ileum of the small intestine

Question 72

What is the purpose of a loop ileostomy

Answer 72

formed to eliminate feces, allow tissue healing

Question 73

Describe what happens with continent ileostomy

Answer 73

intra-abdominal reservoir constructed and nipple valve formed

Question 74

Prednisone, a corticosteroid, can cause gastric irritation. It should be administered (with, without) meals

Answer 74

With to reduce gastric irritation | *do not give on empty stomach

Question 75

T/F: antigens in diet may stimulate exacerbation

Answer 75

T