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Questions and Answers
What is responsible for redness and heat in the area during the inflammatory process?
Which white blood cells are the primary phagocytes that engulf organisms and foreign material during the inflammatory process?
What type of fluid, cells, and inflammatory byproducts compose the exudate released from the wound during the inflammatory process?
Which stage of the inflammatory process involves entry of leukocytes into the affected area?
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What is the primary cause of swelling, pain, and loss of function during inflammation?
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Which component of the inflammatory process is responsible for the engulfment of cell debris and foreign material?
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What determines the amount of exudate released from a wound during inflammation?
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Which stage of inflammation involves transport of leukocytes to the affected area?
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Study Notes
False Imprisonment
- Actual physical restraint is not necessary to be considered false imprisonment; simply telling a patient they will be tied to the bed if they try to leave can be considered false imprisonment.
Negligence
- Omission or commission of an act that departs from acceptable and reasonable standards
- Can take several forms:
- Malfeasance: committing an unlawful or improper act
- Misfeasance: performing an act improperly
- Nonfeasance: failure to take proper action
- Malpractice: failure to abide by the standards of one’s profession
- Criminal negligence: disregard to protecting the safety of another person
Slander
- The spoken form of defamation
- Actual damage must be proven, except when:
- Accusing someone of a crime
- Accusing someone of having a loathsome disease
- Making a statement that affects a person’s professional or business activity
- Calling a woman unchaste
Accountability
- Being held accountable or responsible for one’s own actions
- Maintaining competence
Fidelity
- Respecting our words and promises to our patients
- Keeping our promises
Diarrhea Management
- Oral rehydration therapy using fluid and electrolyte replacement and water for adults is cost-effective and replaces fluid loss without the challenges associated with intravenous fluid therapy
- Replace lost fluids and electrolytes with:
- Weak tea
- Water
- Bouillon
- Clear soup
- Gelatin
- Foods low in fiber include:
- Eggs
- Well-cooked meat, fish, and poultry
- Juices without pulp
- Refined bread and cereal products
- Well-cooked fruits and vegetables
- Probiotics can be used to prevent, limit, and control diarrhea
- Foods containing probiotics include:
- Cheese
- Yogurt
- Tempeh
- Miso
- Soymilk
- Some commercial dairy drinks
Fluid and Electrolyte Balance
- Alterations in fluid and electrolyte balance occur faster and more often in infants and children compared to adults
- Maintaining fluid balance is particularly important in older patients due to their increased risk for dehydration, fluid overload, and electrolyte imbalances
Fecal Impaction
- Signs of fecal impaction include:
- Unable to have BM
- Need to push harder only to have small amounts of dry and hard stool
- Fewer than normal number of BMs
- Pain in back and/or abdomen
- Urinating more or less than usual or unable to urinate
- Breathing problems
- Rapid heartbeat
- Dizziness
- Low BP
- Swollen abdomen
- Sudden explosive diarrhea
- Leaking stools
- Nausea
- Vomiting
- Being confused and losing sense of time and place with rapid heartbeat, seating, fever
Intake and Output
- Intake includes all fluids entering the client’s body
- Output includes all fluids that leave the client’s body
- Examples of intake and output include:
- Water
- Ice chips
- Juice
- Milk
- Coffee
- Ice cream
- Parental fluids
- Central lines
- Feeding tubes
- Blood transfusions
- Urine
- Perspiration
- Exhalation
- Diarrhea
- Vomiting
- Drainage from all tubes
- Bleeding
Incident Report
- Used to document the occurrence of anything out of the ordinary that results in or has the potential to result in harm to a patient, employee, or visitor
- Used for quality improvement and not for disciplinary action
- Filed and documented in a specific location
Ethical Dilemmas
- Nurse’s role:
- Encourage patients to express their desires
- Advise patients to express their desires in advance directives, wills, and other legally binding documents
- Advocate compliance with patients’ wishes
- Identify significant others who impact and are impacted
- Consider family members, friends, and caregivers who are involved with the patient and the situation
- Review the medical literature for discussions and case experiences
- Discuss issues with other health team members
- Form an ethics committee to study ethical problems within the specific care setting
Inflammatory Process
- Vascular and cellular stages are the main components of the inflammatory process
- Vascular stage:
- Small blood vessels constrict in the area
- Vasodilatation of arterioles and venules that supply the area
- Increased blood flow results in redness and heat in the area
- Histamine release leads to an increased permeability of vessels, allowing protein-rich fluid to pour into the area
- Swelling, pain, and loss of function can occur
- Cellular stage:
- White blood cells (leukocytes) move quickly into the area
- Neutrophils, the primary phagocytes, engulf the organism and consume cell debris and foreign material
- Exudate composed of fluid, cells, and inflammatory byproducts is released from the wound
- The exudate may be clear (serous), contain red blood cells (sanguinous), or contain pus (purulent)
Microorganism Transmission
- Involves the following stages:
- Escape from the host or reservoir of infection
- Transport to the new host
- Entry to the new host
- Escape from the new host
- Different pathogens have different modes of transmission
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Description
Test your knowledge on the signs of fecal impaction, including the inability to have a bowel movement, pushing hard with little stool, abdominal pain, and other related symptoms.
