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Questions and Answers
What is the initial phase of the inflammatory response?
Which symptom is NOT typically associated with inflammation?
Which type of exudate is characterized by a high protein content and is often seen in inflammatory responses?
What is a key nursing action in managing a patient with fever related to infection?
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In the reparative phase of inflammation, which process primarily occurs?
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What differentiates acute inflammation from chronic inflammation?
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Which of the following agents is primarily responsible for causing vasodilation during the vascular response in inflammation?
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Which of the following is NOT a characteristic of the inflammatory response?
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What is the term for the removal and destruction of bacteria by phagocytic cells during the inflammatory response?
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Which type of exudate is characterized by the presence of dead neutrophils and digested bacteria?
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Which of the following is NOT a characteristic of acute inflammation?
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What is the expected temperature indicating systemic inflammation?
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During the reparative phase of inflammation, what type of tissue appears pink or red?
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Which assessment cue would NOT be classified as a localized sign of inflammation?
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What may result from the persistence of an injurious agent in the body?
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Which of the following components does NOT contribute to the accumulation of pain during inflammation?
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What is a key characteristic of the acute inflammatory response?
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Which of the following types of exudate indicates a strong inflammatory response and is typically associated with bacterial infections?
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What is the goal of nursing care when managing a patient with cellulitis?
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In the management of fever, which of the following medications is an antipyretic that inhibits prostaglandin synthesis?
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What distinguishes chronic inflammation from acute inflammation?
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What is one of the main complications of fever in older adults?
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Which of the following dietary components may help reduce inflammation?
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Which laboratory test is most commonly used to evaluate the presence of inflammation?
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What vital signs indicate a possible infection or inflammation in a patient?
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Which action is crucial for a nurse to teach a patient with a skin wound to minimize the risk of infection?
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Study Notes
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
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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.
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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.
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Description
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.
