A nurse works with clinic patients who have chronic
neurological diseases. Which goal is the priority for all
patients with chronic neurological
... [Show More] disease?
a. bowel and bladder control
b. independent functional ability
c. adequate nutritional status
d. maintenance of skin integrity -
....ANSWER...Answer: B
What is the body's second line of defense? -
....ANSWER...Inflammatory response, pyrogens,
interferons, and complement proteins
________________________ always causes an
inflammation response - ....ANSWER...Infection
What are the functions of the inflammatory response? -
....ANSWER...Neutralize and dilute an inflammatory
agent
Remove necrotic materials - phagocytosis
Establish an environment suitable for healing and repair
What are the local responses to inflammation? -
....ANSWER...Redness
Heat
Pain
Swelling
Loss of function
What are the systemic effects of inflammation? -
....ANSWER...Increased WBC count with a shift to the
left
increased neutrophil production particularly with
infection
"bands" (immature cells) and "segs" (mature cells)
Increased pulse and respiration
Nausea and anorexia
Fever
What cellular mediators trigger local reactions? -
....ANSWER...Histamine (stimulates vasodilation)
Prostaglandins
Which type of meningitis is more severe? -
....ANSWER...bacterial meningitis
It is a medical emergency. If untreated, mortality rate is
near 100%
What causes bacterial meningitis? - ....ANSWER...S.
pneumoniae or Neisseria meningitidis
What causes viral meningitis? -
....ANSWER...enterovirus, arbovirus, HIV, or herpes
simplex (HSV)
What causes encephalitis? - ....ANSWER...Epidemic
Viruses transmitted by ticks & mosquitoes (i.e. West
Nile)
Non-epidemic
Measles, mumps or chickenpox
HSV
Protozoa
What are prostaglandins? - ....ANSWER...Proteins that
circulate in an inactive state
Activated by antibodies or infectious organisms.
Also active in autoimmune diseases
Considered to be pro-inflammatory
Potent vasodilators
Sensitize pain receptors
Stimulate hypothalamic temperature regulating area
leading to fever
What is the complement system? -
....ANSWER...Works in tandem with inflammatory
process
Group of inactive proteins in circulation that, when
activated, stimulate the release of other chemical
mediators, promote inflammation, chemotaxis, and
phagocytosis.
Major mediator of the inflammatory response through
an enzyme cascade (C1 - C9)
Enhanced phagocytosis
Increased vascular permeability
Chemotaxis
Movement of cells in response to chemical signals.
Cellular lysis
What is peritonitis? - ....ANSWER...Results from
localized or generalized inflammatory process of
peritoneum
ruptured ulcer or appendix
contamination from fistulas
traumatic injury
Inflammatory process leads to massive fluid shifts and
adhesions
What is the most common symptom of peritonitis? -
....ANSWER...Pain
Assessment of pain, including location, very important
in determining cause
Other symptoms vary based on severity and acuteness
of situation
What are the diagnostic tests for peritonitis? -
....ANSWER...CBC
peritoneal aspiration
abdominal X-ray, ultrasound or CT scan
What _____________ circulate to hypothalamic
temperature-regulating center & promote synthesis of
PGE2? - ....ANSWER...cytokines
RATIONALE: PGE2 increases thermostatic set point
ANS causes heat conservation & generation so core
temp increases to new set point
How does a fever help the body fight infection? -
....ANSWER...Creates unfavorable environment for
bacteria
Increases metabolism which accelerates phagocytosis
Severe fever (>105 degrees) is life threatening
Destroys enzymes needed for biochemical reactions
What is a sign of infection in an immunosuppressed
patient? - ....ANSWER...Will present with "just not
feeling well."
What does RICE stand for? - ....ANSWER...RICE: to
treat inflammation associated with soft-tissue injury
Rest
Ice
Compression - observe circulation & sensation distal to
compression
Elevation
What are the drug classes used to treat chronic
inflammation? - ....ANSWER...Immunomodulators
Immunosuppressants
Corticosteroids
What does the complement system do? -
....ANSWER...Causes cell death by rupturing of cell
membrane (cellular lysis)
Also activated in autoimmune diseases
Damages healthy tissue in combination with
inflammatory process.
What is hypovolemic shock? - ....ANSWER...Loss of
intravascular fluid
Absolute hypovolemia
-External fluid loss
Relative hypovolemia
-Third-spacing - fluid moves into extravascular space
Symptoms reflect affected organs
Hypotension and tachycardia
Cool, clammy and pale skin - tissue perfusion
Low output - renal perfusion
Change in mental status - cerebral perfusion
What is septic shock? - ....ANSWER...Systemic
inflammatory response to infection
Hypotension despite fluid resuscitation
Pathophysiology
Vasodilation
Maldistribution of blood flow
Myocardial depression
Symptoms
Fever, hypotension, tachycardia, tachypnea
What is appendicitis? - ....ANSWER...Infection and
inflammation of the appendix
Typically begins with periumbilical pain, followed by
anorexia, nausea, and vomiting
Pain persistent and continuous
shifting to lower right quadrant
localizing at McBurney's point (halfway between
umbilicus and right iliac crest)
The following information was included in the change
of shift report on a patient who is prescribed aspirin for
its anticoagulant effects. Which patient symptom would
be the first priority for the nurse to report to the
attending physician?
two liquid stools in past 24 hours
nauseous symptoms
heartburn when recumbent
dark tarry stools - ....ANSWER...Dark tarry stools
suggest slow upper GI bleeding which would be the
priority symptom to report to the physician.
The patient has an order for administration of a
glucocorticoid. The nurse would question this order if
the patient also has which condition?
rheumatoid arthritis
systemic fungal infections
asthma
systemic lupus erythematosus -
....ANSWER...Systemic fungal infection
The nurse should question administration of a
glucocorticoid to a patient with any type of infection,
because the drug suppresses immune responses that
would normally allow the body to fight infection.
Glucocorticoids are absolutely contraindicated for
patients with systemic fungal infections. The use of
glucocorticoids in a patient with asthma, systemic lupus
erythematosus or RA is expected, because these are
autoimmune, inflammatory disorders that would
respond to glucocorticoid intervention.
The nurse is preparing to administer an initial dose of
aspirin and obtains a brief health history. Based on an
understanding of the therapeutic effects of this drug, the
nurse would anticipate the patient to have which
medical diagnosis?
arthritis
asthma
chronic renal disease
ulcerative colitis - ....ANSWER...arthritis
The nurse should anticipate that the initial dose of
aspirin will begin to reduce inflammation; therefore, the
nurse would expect the patient to be experiencing an
inflammatory disorder, such as arthritis. Aspirin would
be inappropriate for patients with ulcerative colitis,
because these patients are already at risk for bleeding,
and the use of aspirin could potentiate further bleeding.
Aspirin can exacerbate asthma and should not be used
with these patients. Aspirin can impair renal function; it
is not given to treat renal disease.
The nurse is administering high-dose intravenous
methylprednisolone to a patient who is experiencing an
acute relapse of multiple sclerosis. Which chronic
condition, if present, could be negatively affected by
this treatment?
Inflammatory bowel disease
Diabetes mellitus
Rheumatoid arthritis
Asthma - ....ANSWER...Diabetes mellitus [Show Less]