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N232 > Midterm module 2 infection, inflammation (Pneumonia, UTI, Cdiff, Arthritis) > Flashcards

Midterm module 2 infection, inflammation (Pneumonia, UTI, Cdiff, Arthritis) Flashcards

1
Q

What is the normal range of WBC

A

4-10.5 x 10^9 /L

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2
Q

what does elevated WBC indicate

A

the inflammatory response & possible infection

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3
Q

what is the lifespan of a WBC `

A

13-20 days

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4
Q

how do we get rid of WBC

A

destroyed by lymphatic system - excreted in feces

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5
Q

What is the normal range for neutrophils

A

2-6 x 10^9 /L

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6
Q

what does elevated neutrophils mean

A

bacterial or pyrogenic infection

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7
Q

what does elevated basophils mean

A

parasitic infections & sme allergic disorders

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8
Q

what does elevated lymphocytes mean

A

viral infection

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9
Q

what does elevated monocyte mean

A

chronic infections (phagocytosis)

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10
Q

What is rheumatoid factor for

A

to diagnosis rheumatoid arthritis - likely diagnosis of RA

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11
Q

What is C reactive protein

A

-non specific indicator of inflammation

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12
Q

when would C reactive protein be elevated

A
  • A serious bacterial infection like sepsis
  • Pelvic inflammatory disease
  • inflammatory bowel disease
  • some forms of arthritis
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13
Q

what is procalcitonin for

A

to detect or rule out bacterial sepsis

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14
Q

when is procalcitonin elevated

A

High levels indicated high probability of bacterial sepsis.

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15
Q

what does culture mean

A

the propagation of microorganisms in a growth medium.

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16
Q

What is sensitivity

A

Sensitivity analysis is a test that determines the sensitive of a bacterial to an antibiotic & resistance

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17
Q

What is the normal value for Sodium

A

135-145 mmol/L

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18
Q

what are signs of hyponatremia

A

Weakness, confusion, ataxia, stupor & coma

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19
Q

what are the causes of hyponatremia

A

Diarrhea, vomiting, Ng tube, Diuretics, Chronic renal insufficiency

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20
Q

what are the signs of hypernatremia

A

Thirst, agitation, mania, convulsions, dry mucous membranes

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21
Q

what are the causes of hypernatremia

A

increased Na+ intake, excessive free body H20 Loss, cushing syndrome

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22
Q

What is the normal value for potassium

A

3.5-5.0 mmol / L

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23
Q

what are the signs of hypokalemia

A

decrease in contractility of smooth muscle, skeletal & cardiac muscles. Weakness, paralysis, hyporeflexia, ileus, cardiac dysrhythmias, shirts, flat T waves

24
Q

what are the causes of hypokalemia

A

GI losses, diarrhea, vomiting, diuretics, burns

25
Q

what are the signs of hyperkalemia

A

Irritatbility, n/v, diarrhea, intestinal colic

26
Q

what are the causes of hyperkalemia

A

excessive dietary intake, ARF/CRF (acute renal failure/ chronic renal failure), infection

27
Q

what drugs would you give for inflammation

A

NSAID (Ibuprofen & ASA)

28
Q

what drugs would you give for antipyretic

A

acetaminophen, ASA, Ibuprofen

29
Q

what drugs would you give for for infection (antiviral)

A

Acyclovir

30
Q

what drugs would you give for infection (bacterial)

A

Cefazolin or vancomycin

31
Q

what drugs would you give for infection (protozoal)

A

Metronidazole

32
Q

what is the worst thing that could happen with antibiotics?

A

allergic

33
Q

what is the connection between penicillin & cephalosporins

A

10% of patients allergic to penicillins will also be allergic to cephalosporins

34
Q

most common side effects of antibiotic therapy

A
  • Nausea
  • Vomiting
  • Diarrhea
  • Nephrotoxicity
  • Hepatic toxicty
35
Q

What are the lifespan considerations for antibiotics

A

Pediatric: Dosages are weight based
Elderly: lower doses because worse kidney & liver function
Pregnancy: potential harm

36
Q

what are the main antipyretics

A

Acetaminophen
asa
ibuprofen

37
Q

What is the most common antipyretic

A

Acetaminophen

38
Q

Why use ibuprofen instead of tylenol

A

tylenol is very hard on the liver

39
Q

What are the risk factors to inflammation

A
  • psychological stress
  • physical injury
  • exposure to irritants
  • infection
40
Q

what are the risk factors of arthritis

A

Sex, age, family history, smoking, environmental exposures, obesity

41
Q

what are signs & symptoms of arthritis

A

Pain & joint swelling & limited movement & stiffness & weakness & fatigue

42
Q

What are some non-pharmacological pain management options for arthritis

A
  • Maintain & improve functional status
  • increase & improve functional status
  • increase patients knowledge of disease process
  • promote self-management by patient compliance with the therapeutic regimen
43
Q

What are the risk factors for UTI

A
  • Inability to empty the bladder completely
  • obstructed urinary flow
  • decreased natural host defences
  • catheterization or cystoscopy
  • Inflammation or abrasion of the urethral mucosa
  • diabetes related to increased urinary glucose so increased food for bacteria
44
Q

what are the signs & symptoms of UTI

A
  • 50% will have no symptoms
  • pain & burning during urination
  • Frequency
  • Urgency
  • Nocturia
  • Incontinence
  • Suprapubic or pelvic pain
  • Hematuria or back pain
  • fever
  • older adult: fatigue & cognitive changes
45
Q

What are pharmacological treatment for UTI’s

A
  • Treat the infection (administer antibiotics as prescribed)
  • Pain management (Antipyretic, anti-spasmodic agents, analgesic, heat to perineum)
46
Q

what are the non-pharmacological therapy options

A
  • Increased fluids PO or IV
  • Frequent urination (helps to flush bacteria from urinary tract
  • Avoid irritants (coffee, tea, spices, Cola, Alcohol)
  • Promote patient knowledge
  • Monitor & manage potential complications
47
Q

what are the risk factors for C-Diff

A

Antibiotic therapy

  • Surgery of the GI tract
  • Diseases of the colon such as inflammatory bowel disease or colorectal cancer
  • A weakened immune system
  • use of chemotherapy drug
48
Q

What are the signs & symptoms of C-Diff

A 
Watery diarrhea, up to 15 times a day 
severe abdominal pain 
loss of appetite 
fever
blood or pus in the stool 
weight loss
49
Q

What are the pharmacological therapy option for C-Diff

A
  • Antibiotic: Vancomycin, Metronidazole
  • Fecal transplants
  • Probiotics, Anti-medics
50
Q

what are the non-pharmacological therapy option for C-Diff

A 
Fluids PO and or IV 
Isolation precautions 
maintain nutrition 
promote patient knowledge 
monitor & manage potential complications
51
Q

What are the risk factors of pneumonia

A
  • Conditions that produce mucus or obstruct/interfere with normal drainage
  • smoking
  • prolonged immobility with shallow breathing
  • depressed cough reflex
  • advanced age ( depressed cough reflex, glottic reflexes, & nutritional depletion)
52
Q

What are the signs & symptoms of pneumonia

A
  • Vary with the type of pneumonia
  • fever (shaking & chills)
  • Chest pain
  • tachypenia
  • tachycardia
  • sputum (green, yellow or other)
  • orthopenia
  • many more…
53
Q

what is the pharmocological therapy of pneumonia

A

Admin the appropriate antibiotics & O2 if needed

54
Q

non-pharmacological therapy for pneumonia

A
  • Improving airway potency (remove secretions)
  • Rest & conserve energy balance with mobilixation
  • deep breathing & coughing
  • promote fluid intake
  • maintain nutrition
  • promote patient knowledge
  • monitor & manage potential complications
55
Q

What are the steps to the sepsis screener

A
  • Must be adult patient (16+)
    1) Does the patient have 2 or more systemic inflammatory response syndrome criteria
  • Temperature greater then 38C or less then 36
  • Heart rate greater than 90b/min
  • Altered mental status (GCS less than 15)
  • Respiratory rate greater than 20 per minute
    2) Do they have any of the following risk factors?
  • looks unwell, age greater than 65, recent surgery, immunocompromised so AIDS chemotherapy, neutropenia, transplant, steroids, or chronic illness)
56
Q

Steps of what you need to do if sepsis is occurring

A

1) Initiate initial management of adult patients with suspected sepsis clinical order set
2) If systolic BP is less than 90 or MAP less than 65
- contact physician
- administer normal saline IV bolus & repeat 2x to maintain MAP at 65 mmhm or greater
3) contact physician within 15 minutes of patient check in for ongoing investigation & fluid resuscitation strategy
4) Obtain lactate & cultures prior to administering antibiotics
- if lactate is greater than 4 mmol/L contact physician & repeat the lactate in 2 hours
5) Administer appropriate antibiotics within 60 minutes of check in for patients with
- Map less than 65 mm/Hg despite 2 laters or patients with lactate greater than 4mmol/L

N232 (10 decks)

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