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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
what are the signs of hyperkalemia
Irritatbility, n/v, diarrhea, intestinal colic
26
what are the causes of hyperkalemia
excessive dietary intake, ARF/CRF (acute renal failure/ chronic renal failure), infection
27
what drugs would you give for inflammation
NSAID (Ibuprofen & ASA)
28
what drugs would you give for antipyretic
acetaminophen, ASA, Ibuprofen
29
what drugs would you give for for infection (antiviral)
Acyclovir
30
what drugs would you give for infection (bacterial)
Cefazolin or vancomycin
31
what drugs would you give for infection (protozoal)
Metronidazole
32
what is the worst thing that could happen with antibiotics?
allergic
33
what is the connection between penicillin & cephalosporins
10% of patients allergic to penicillins will also be allergic to cephalosporins
34
most common side effects of antibiotic therapy
- Nausea - Vomiting - Diarrhea - Nephrotoxicity - Hepatic toxicty
35
What are the lifespan considerations for antibiotics
Pediatric: Dosages are weight based Elderly: lower doses because worse kidney & liver function Pregnancy: potential harm
36
what are the main antipyretics
Acetaminophen asa ibuprofen
37
What is the most common antipyretic
Acetaminophen
38
Why use ibuprofen instead of tylenol
tylenol is very hard on the liver
39
What are the risk factors to inflammation
- psychological stress - physical injury - exposure to irritants - infection
40
what are the risk factors of arthritis
Sex, age, family history, smoking, environmental exposures, obesity
41
what are signs & symptoms of arthritis
Pain & joint swelling & limited movement & stiffness & weakness & fatigue
42
What are some non-pharmacological pain management options for arthritis
- 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
What are the risk factors for UTI
- 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
what are the signs & symptoms of UTI
- 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
What are pharmacological treatment for UTI's
- Treat the infection (administer antibiotics as prescribed) - Pain management (Antipyretic, anti-spasmodic agents, analgesic, heat to perineum)
46
what are the non-pharmacological therapy options
- 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
what are the risk factors for C-Diff
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
What are the signs & symptoms of C-Diff
``` Watery diarrhea, up to 15 times a day severe abdominal pain loss of appetite fever blood or pus in the stool weight loss ```
49
What are the pharmacological therapy option for C-Diff
- Antibiotic: Vancomycin, Metronidazole - Fecal transplants - Probiotics, Anti-medics
50
what are the non-pharmacological therapy option for C-Diff
``` Fluids PO and or IV Isolation precautions maintain nutrition promote patient knowledge monitor & manage potential complications ```
51
What are the risk factors of pneumonia
- 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
What are the signs & symptoms of pneumonia
- Vary with the type of pneumonia - fever (shaking & chills) - Chest pain - tachypenia - tachycardia - sputum (green, yellow or other) - orthopenia - many more...
53
what is the pharmocological therapy of pneumonia
Admin the appropriate antibiotics & O2 if needed
54
non-pharmacological therapy for pneumonia
- 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
What are the steps to the sepsis screener
- 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
Steps of what you need to do if sepsis is occurring
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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