NUR 232 Week 8 Student view

Week 8 Overview

  • Focus on Infection, Gas Exchange, and Perfusion

Infection

Infection Terminology

  • Acute: Resolves in days to weeks (e.g., strep throat, influenza).

  • Chronic: Lasts longer than 2 weeks; may be incurable.

  • Localized: Infection limited to a specific body area (e.g., wound infection).

  • Disseminated: Infection spreads from an initial site to other body tissues.

  • Systemic: Affects the whole body (e.g., sepsis).

  • Epidemic: Increased disease cases above normal levels.

  • Pandemic: Global epidemic of a disease.

Categorization

  • Most common infections categorized by causative agent:

    • Bacterial

    • Viral

    • Fungal

    • Parasitic/Protozoa

Pathogen Facts

  • Pathogens can be highly or weakly virulent:

    • Highly virulent: HIV, TB

    • Weakly virulent: HSV, Influenza

  • Some are communicable before or after symptoms appear.

  • Dormant pathogens can reactivate (e.g., varicella - chicken pox to shingles).

Risk Factors for Infection

  • Populations at Risk: Age, socioeconomic status, geographic location.

  • Individual Risk Factors: Immunodeficiency, chronic diseases, environmental conditions.

Assessment

History

  • Incidence of injury or known pathogen exposure.

  • Past treatments (e.g., cancer, immunosuppressants).

  • Symptoms and travel history.

Examination

  • Full assessment for infection signs.

Diagnostic Tests

  • CBC with differential, cultures (urine, sputum, throat, blood).

  • C-reactive protein and ESR tests.

  • Imaging (X-ray, CT, MRI).

Clinical Management

Primary Prevention

  • Infection control (hand hygiene, immunizations).

Secondary Prevention

  • Screening for STIs.

Collaborative Interventions

  • Clinical nursing skills, antimicrobials, nutrition, fluid management.

Specific Infections

Acute Infections: Examples

  • Strep Throat: Bacterial; treat with antibiotics (10 days).

  • Influenza: Viral; symptomatic treatment.

  • Otitis Media: Affects younger children; worsen by secondhand smoke; treated with antibiotics.

Strep Throat

Clinical Manifestations

  • Symptoms: Headache, fever, abdominal pain, tonsil inflammation.

Diagnostic Evaluation

  • Rapid antigen testing and throat culture.

Therapeutic Management

  • Antibiotics like penicillin; important to complete the course.

Nursing Care Management

  • Apply warm/cold compresses to the neck.

  • Recommend saline gargles and age-appropriate fluids.

  • Educate about antibiotic therapy compliance.

Influenza

Overview

  • Caused by orthomyxovirus (types A, B, C).

  • Spread through direct contact and respiratory droplets.

Clinical Manifestations

  • Symptoms: Fever, chills, cough, myalgia, fatigue.

Diagnostic Evaluation

  • Rapid detection testing of secretions.

Management

  • Symptomatic care, antiviral therapy, prevention via vaccination.

Otitis Media

Overview

  • Presence of infection in the middle ear with inflammation.

  • Etiology includes viral and bacterial causes.

Clinical Manifestations

  • Symptoms: Fever, earache, irritability, potential for hearing loss.

Diagnostic Evaluation

  • Visual inspection of the tympanic membrane.

Therapeutic Management

  • Use of antibiotics; careful use to prevent resistance.

Gas Exchange

Process of Gas Exchange

  • Involves oxygen intake and carbon dioxide removal via the respiratory system.

  • Key anatomical structures include the nose, trachea, bronchi, alveoli, and pulmonary capillaries.

Risk Factors for Impaired Gas Exchange

  • Age, smoking, chronic conditions (e.g., COPD, CF), and others including environmental factors.

Assessment

History & Examination

  • Past medical history, family history, social environment.

Diagnostic Testing

  • Includes arterial blood gases, imaging, and pulmonary function tests.

Collaborative Interventions

  • Pharmacotherapy (e.g., bronchodilators, mucolytics).

  • Nutritional therapy and oxygen therapy as needed.

Asthma

Overview

  • Chronic inflammatory disorder with reversible airway obstruction.

  • Characterized by wheezing, cough, and chest tightness.

Triggers

  • Allergens, exercise, cold air, smoking.

Diagnosis & Management

  • Includes pulmonary function tests and medications (e.g., bronchodilators, corticosteroids).

Cystic Fibrosis (CF)

Pathophysiology

  • Inherited disorder causing thick mucus production.

  • Affects exocrine glands and disrupts respiratory function.

Clinical Manifestations

  • Respiratory infections, malabsorption issues, and complications affecting multiple systems.

Diagnostic Evaluation

  • Sweat chloride test and other genetic tests.

Management

  • Airway clearance therapies, nutritional support, and management of pulmonary infections.

Perfusion

Central and Tissue Perfusion

  • Central perfusion influenced by cardiac output.

  • Tissue perfusion involves blood flow to target tissues; can be impaired by vascular issues.

Sickle Cell Anemia

Overview

  • Hereditary condition affecting hemoglobin.

Pathophysiology

  • Sickle cells obstruct blood flow leading to complications.

Diagnostic Evaluation

  • Universal screening at birth; hemoglobin electrophoresis.

Management of Sickle Cell Crisis

  • Focused interventions for pain, hydration, and preventing complications.