Nursing Week 13: Inflammation and Infection

Week 13: Inflammation and Infection

• Infection: Invasion of body tissue by microorganisms, potentially causing disease or illness.
• Inflammation: Physiological response to reduce the effects of perceived harmful substances, a non-specific reaction.

Competencies

• Define patient-centered, evidence-based care using the nursing process.
• Discuss factors creating a culture of safety in caring for patients with common health alterations.
• Discuss health promotion, maintenance, illness & injury prevention, and healing facilitation.
• Discuss critical thinking use to prioritize patient care elements during nursing process implementation.
• Discuss critical thinking strategies used in making clinical judgments.
• Discuss roles of interprofessional collaborative practice members.

Inflammation Defense against Infection

• Adaptive response to illness or injury.
• Brings fluid (plasma), dissolved substances, and blood cells to interstitial tissue where invasion or damage occurred.
• First phase of the healing process.
• Non-specific.

Inflammation ≠ Infection

• Pain
• Swelling
• Redness
• Heat
• Impaired function

Inflammatory Response Stages

• Stage 1: Vascular and Cellular Response
  • Cell injury triggers release of histamines, prostaglandins, and kinins.
  • Blood vessels dilate, increasing blood supply to the site (hyperemia).
  • Vasoconstriction (transient) followed by vasodilation.
  • Histamine, prostaglandins, and kinins are released.
  • Redness appears.
  • Increased vascular permeability allows fluid, proteins, and leukocytes to leak into the interstitial space, causing edema.
  • Leukocytes accumulate at the site and initiate the clotting response.
  • Pain is from fluid accumulation and chemical release, causing swelling (edema).
  • Examples of injuries: sprains, minor burns, broken bones.
• Stage 2: Exudate Response
  • Exudate (fluid escaping blood vessels) contains tissue cells, phagocytic cells, and their byproducts.
  • Phagocytosis: removal/destruction of bacteria (ingestion).
  • Types of exudate: Serous, Purulent, Hemorrhagic.
• Stage 3: Reparative Phase
  • Replacement/repair of injured tissues.
  • Granulation tissue forms, which appears pink or red and is fragile.
  • Damaged cells are replaced one by one
  • If regeneration is not possible, repair occurs via fibrous tissue (scar).

Infection Diagnostics

• CBC: Complete Blood Count
• ESR: Erythrocyte Sedimentation Rate
• CRP: C-Reactive Protein

Nursing Care and Collaborative Management

• Health promotion/teaching
• Preventing injuries
• Providing proper nutrition (omega-3 fatty acids, probiotics, antioxidants, decreasing saturated fats, cholesterol, high glycemic index).
• Early recognition of inflammation.
• Prompt treatment.

Nursing Care Management (RICE)

• Rest: The injured area for 48 hours.
• Ice: Apply for 20 minutes at a time, 4-8 times per day.
• Compress: To reduce swelling.
• Elevate: Injured limb 6-10 inches above the heart.

Infection Concept

• Invasion of body tissue by microorganisms with the potential to cause illness or disease.

Susceptible Host factors

• Elderly
• Infants
• Immunocompromised
• ANYONE

Portal of Entry

• Mouth
• Nose
• Eyes
• Cuts in skin

Mode of Transmissions for Infections

• Direct contact
• Indirect contact
• Vectors

Portal of Exit

• Coughing/Sneezing
• Bodily Secretions
• Feces

Cellulitis

• Inflammation of subcutaneous tissues (often following a skin break).
• Deep inflammation of the subcutaneous tissue is from bacterial enzymes.
• Common organisms: Staphylococcus aureus, Streptococci
• Signs & Symptoms: Warm or hot to touch, Redness, Swollen, Fever/chills, Lethargy, Discomfort, Lymph node enlargement.

Assessment

• Recognize infection
• Document location, trace border.
• Assess for symptoms
• Vital signs
• Precipitating factors
• Monitor for sepsis, gangrene.

Planning

• Set goals (minimizing infection, managing pain)
• Education

Nursing Implementation

• Rest
• Encourage oral hydration
• Elevation
• Comfort measures (possible moist heat - need order)
• Hand hygiene; wound care; prevention, reporting, symptoms
• Medications (antibiotics).

Antibiotics (Collaborative Practice)

• Improvement should be seen within 3 days.
• Antibiotics should continue in most cases 5 to 14 days.
• Encourage oral hydration.
• Patients should complete the prescribed course of antibiotics unless an adverse response occurs.

Teaching

• Wash hands before touching the wound.
• Wash the wound daily with soap and water.
• Topical Antibiotics (may be ordered).
• Monitor for signs (infection, increased fever, pain, redness).
• Report if signs or symptoms worsen.

Differential Assessment

• Examine for signs and symptoms associated with inflammation & infection to differentiate various conditions.

Skin Assessment - Deeper Pigmentation

• Erythema: red hue, hyper or darker pigmentation, or darker blue hues.

Important Note

• Inflammation is always present with an infection, but infection is not always present with inflammation.

Fever (Pyrexia)

• Systemic response to infection, increase in body temperature.

Physiology of Fever

• Cellular metabolism increases
• Increases heat production
• Oxygen needs increase
• Cellular hypoxia (can cause angina, confusion)
• Energy stores become depleted (fatigue)
• Pulse and respirations increase; diaphoresis (sweating) occurs.
• Dehydration.

Fever Management

• Beneficial aspects include killing microorganisms and increased phagocytosis.
• Antipyretic drugs inhibit prostaglandin synthesis (e.g., salicylates, acetaminophen, NSAIDs).

Fever in the Older Adult

• Older adults are sensitive to temperature extremes.
• Deterioration in vasomotor control of vasoconstriction and vasodilation.
• Reduced subcutaneous tissue, sweat gland activity, and metabolism.
• Dehydration resulting from elevated temperature can be serious, potentially fatal.

Explore the critical concepts of inflammation and infection in nursing. This quiz covers the physiological responses to harmful substances and highlights the importance of evidence-based care while prioritizing patient needs. Gain insights into the roles of interprofessional collaboration and the nursing process in patient treatment.