PathoPharm: Exam #4 - Inflammation

what are natural barriers of protections?

physical, mechanical, biochemical barriers that are in place at birth

natural barriers are the __________ line of defense

first

what is the second line of defense?

inflammation

what are physical barriers?

- epithelial cells

- membranous sheets lining GI, GU, & respiratory tract

true or false: skin has a low pH 3-5

true

what are biochemical barriers?

- mucous, perspiration, saliva, tears, ear wax

- sebaceous glands

what is the inflammatory response?

nonspecific defense reaction to tissue damage caused by injury or infection

what is a normal microbiome?

natural bacteria throughout our body that protect us (skin)

what are the benefits of the inflammatory response?

limits amount of tissue damage

what are local inflammatory manifestations?

- heat/redness

- swelling

- pain

- exudate

what are the different kinds of exudate?

- serous = watery

- serosanguinous = thick/clotted

- purulent = pus

true or false: purulent drainage is a healthy sign

false (infection)

what are systemic inflammatory manifestations?

- acute phase response

- leukocytosis (high WBCs)

- fever

- sepsis (systemic infection)

what is septic shock?

sepsis paired with a low BP affecting hemodynamics

what are the cardinal signs of acute inflammation?

redness, swelling, heat, pain, & loss of function

step 1 of inflammation

vasodilation causes slower blood velocity & increases blood flow to site

step 2 of inflammation

capillary permeability results in leakage of plasma from vessel causing edema

step 3 of inflammation

as plasma moves outward, blood becomes viscous

step 4 of inflammation

increased blood flow & concentration of RBCs cause warmth & erythema

step 5 of inflammation

leukocytes adhere to vessel walls

how long does chronic inflammation last?

longer than two weeks

true or false: chronic inflammation may be associated with acute inflammation that did not resolve

true

what is chronic inflammation characterized by?

lymphocytes & macrophages

what are the actions of NSAIDs?

- inhibit biosynthesis of prostaglandins

- analgesic effect

- antipyretic effect

- inhibit platelet aggregation

- mimic effects of corticosteroids

- inhibit COX enzyme

what does a COX enzyme do?

converts arachidonic acid into prostaglandins

what are the two COX enzyme forms?

COX-1

COX-2

what is the function of COX-1?

protects stomach lining & regulates blood platelets

what is the function of COX-2?

triggers inflammation & pain

what are the nursing considerations when administering NSAIDs to a client?

- increase fluids to prevent nephrotoxicity

- food may be taken to reduce GI upset

- avoid citrus, spicy, coffee

- monitor for bruising & bleeding

true or false: patients can take antacids for GI upset BUT it has to be taken 2 hours before or after NSAID use

true

true or false: it is ok to take NSAIDs and eat herbs such as ginkgo, garlic, & ginger

false (bleeding may incerase)

what should female clients take into considerations when taking NSAIDs?

avoid 1 to 2 days before menses to prevent excessive bleeding

which enzymes do first generation NSAIDs inhibit?

COX-1 & COX-2

which enzymes do second generation NSAIDs inhibit?

COX-2

what are examples of first generation NSAIDs?

- aspirin, ibuprofen, naproxen, indomethacin

- diclofenac, ketorolac

- meloxicam, piroxicam

what are examples of second generation NSAIDs?

celecoxib

what are examples of corticosteroids (glucocorticoids) ?

- prednisone

- dexamethasone

- methylprednisolone

what is the action of corticosteroids?

control inflammation by suppressing or preventing many of the component of the inflammatory process at the injured site

what are the nursing considerations for corticosteroids?

- can cause GI upset, irritability, & hyperglycemia

- need to wean off slowly

what are the phases in wound healing?

- regeneration

- resolution

- repair

- scar tissue

regeneration

replacement of destroyed tissue by healthy tissue

resolution

inflammation subsides & tissue returns to normal state

repair

damage tissue replaces with scar tissue

scar tissue

fibrous connective tissue that binds damaged tissue

what is primary intention (wounds) ?

- small, clean wound

- regeneration & full resolution

- fill in, heal, shrink

what is secondary intention (wounds)?

- great loss of tissue with contamination

- repair/scar tissue

what is dehiscence? what would the nurse do?

- sutured wound popping back open

- occurs within 5-12 days after suturing

- keep it open & heal it heal from the bottom up

what is evisceration?

internal organs coming through the wound opening