Module 2- Inflammation and Infection Flashcards
(98 cards)
1
Q
what diagnostics would you want for inflammation?
A
- CRP
- rheumatoid factor
- WBC count
- differential
2
Q
what diagnostics would you want for infection?
A
- WBC count
- differential
- CRP
- procalcitonin
- identification of an organism
- gram stain (purple dye that appears in gram positive bacteria)
- C+S
3
Q
lifespan for WBC’s
A
13-20 days
4
Q
how are WBC’s destroyed and excreted?
A
destroyed by lymphatic system and excreted in feces
5
Q
what is rheumatoid factor?
A
- TO DIAGNOSE RHEUMATOID ARTHRITIS (RA)
* POSITIVE RESULTS = LIKELY DIAGNOSIS OF RA
6
Q
whats the normal range for basophils?
A
0.0-0.10 x10 9/L
7
Q
basophils
A
parasitic infections and some allergic disorders
8
Q
normal range for eosinophils
A
0.0-0.45 x10 9/L
9
Q
eosinophils
A
allergic disorders and parasitic infections
10
Q
what is the normal range for neutrophils?
A
2.00-6.00 x10 9/L
11
Q
neutrophils
A
bacterial or pyogenic infections
12
Q
normal range for lymphocytes?
A
1.00-4.00 x10 9/L
13
Q
lymphocytes
A
viral infections
14
Q
normal range for monocytes?
A
0.10-0.80 x10 9/L
15
Q
monocytes
A
chronic infections (phagocytosis)
16
Q
what is c-reactive protein?
A
non-specific indicator of inflammation
17
Q
what could cause someone to have high levels of CRP?
A
- serious bacterial infection (sepsis)
- pelvic inflammatory disease (PID)
- inflammatory bowel disease
- some forms of arthritis
18
Q
why is a procalcitonin test done?
A
detect or rule out bacterial sepsis
19
Q
normal range for procalcitonin? what could a high level mean?
A
0.0-0.25 u/L. Its a protein and means high probability of bacterial sepsis
20
Q
low levels of procalcitonin mean?
A
low risk of bacterial sepsis
21
Q
when would you want a test for procalcitonin and CRP?
A
monitor for increases or decreases in CRP and PCT to determine response to therapy or progression of inflammatory/infectious
22
Q
what is a culture?
A
growth of microorganisms in a growth medium. Any tissue or fluid can be evaluated
23
Q
what is a sensitivity test?
A
determines sensitivity of bacteria to an antibiotic and evaluates resistance to antibiotics
24
Q
what is hyponatremia?
A
low sodium concentration
25
symptoms of hyponatremia
weakness, confusion, ataxia, stupor, and coma
26
what could cause hyponatremia?
diarrhea, vomiting, NG tube O/P, diuretics, CRI (colour rendering index)
27
what is hypernatremia?
elevated sodium concentration
28
symptoms of hypernatremia
thirst, agitation, mania, convulsions, dry mucous membranes
29
what could cause hypernatremia?
increased Na intake (IV/PO), excessive free body water loss, cushing syndrome
30
what is hypokalemia?
lower than normal potassium levels (lower than 3.5mmol/L)
31
symptoms of hypokalemia
decrease contractility of smooth muscle, skeletal and cardiac muscles- weakness, paralysis, hyporeflexia, ileus, cardiac dysrhythmias, thirst, flat T waves
32
what could cause hypokalemia?
GI losses/disorders, diarrhea, vomiting, diuretics, burns
33
what is hyperkalemia?
higher than normal potassium levels (greater than 5.0mmol/L)
34
symptoms of hyperkalemia
irritability, N/V, diarrhea, intestinal colic
35
what could cause hyperkalemia?
excessive dietary intake, ARF/CRF, infection
36
what do you want to give with hyponatremia?
want to give sodium
37
what do you want to give with hypernatremia?
want to give free water
38
signs of localized infection
warmth, erythema at site
39
signs of systemic infection
inc. body temp, fatigue, malaise, low BP, high HR (cause body is compensating)
40
what is a sepsis screener?
2 or more inflammatory receptors
41
if patient is septic, will they look well/pink?
no!
42
what temp is considered febrile?
greater than 38.5 deg. cel
43
are older or younger people more susceptible to fever?
younger. older people don't tend to show high fever (even if bacteria is present), they will show signs of confusion etc instead
44
what drugs are anti-inflammatories
NSAIDS- aspirin and ibuprofen
45
what drugs are antipyretics
acetaminophen, ibuprofen, ASA
46
what is the classification for infection
antimicrobials (anti-virals, anti-bacterials, anti-protozoals)
47
what drug is an antiviral?
Acyclovir
48
what drug is an antibacterial (antibiotics)?
cefazolin, vancomycin
49
what drug is very nephrotoxic?
vancomycin
50
what drug is an anti-protozoal?
metronidazole
51
what do you need to know about antibacterial drugs?
- know pre/post assessments
- is it a safe dose
- what organ is this going to affect (liver/kidney toxicity)
- antibiotics affect the GUT, GI upset
- assess to see if antibiotic is working or not (WBC count)
52
what is the worst thing that could happen with a drug?
allergic rxn, could lead to anaphylaxis, lead to death
53
common side effects with antibiotic therapy?
N+V, diarrhea, nephrotoxicity, hepatic toxicity
54
lifespan considerations regarding antibiotics?
pediatric: doses are weight based
elderly: lower dosages
pregnancy: potential harm for fetus/mother
diabetics: inc. risk for infection
55
what drugs could you give for fever
acetaminophen, ASA, ibuprofen
56
why is ASA not a good medication to treat fever?
- b/c it can thin blood (be careful for excess bleeding)
| - reyes syndrome in kids (can cause swelling in live and brain)
57
what is infection?
- when body doesnt get rid of bacteria and will turn into infection (WBC's will tell you)
- colonization (presence of bacteria on body surface w/o causing disease in person
58
most common anti-pyretic and why?
acetaminophen (tylenol) and because it comes in all forms
59
why would you choose ibuprofen over tylenol?
because it decreases fever and helps with inflammation
60
why is it bad to give ibuprofen if pt has renal impairment?
because ibuprofen blocks PG which may lead to decreased blood flow to the kidneys
61
list risk factors for inflammation
psychological stress, physical injury, exposure to irritants, infection
62
what are S+S of infection?
- inc WBC
- inflammation
- fever
- malaise
- dec. BP and inc. HR
- cloudy urine
- inc. RR, dec. O2
- neutrophils (CRP)
- cough
- sputum
- crackles
- pain with inspiration
63
risk factors for arthritis?
- sex
- age
- family history
- environmental exposures
- obesity
- smoking
64
S+S for arthritis?
- pain
- joint swelling
- limited movement
- stiffness
- weakness
- fatigue
- inc. fluid in joints
65
pharmacological therapy for arthritis
manage the symptoms, dec. inflammation, modify the disease
66
non pharmacological pain mgmt
- maintain and improve functional status
- inc. patients knowledge of disease process
- promote self management by patient compliance with the therapeutic regimen
67
risk factors for UTI
- inability to empty bladder completely
- obstructed urinary flow
- dec. natural host defences
- catheterization or cystoscopy
- inflm or abrasion of urethral mucosa
- diabetes d/t inc. urinary glucose (bacteria love sugar)
68
S+S of UTI
- 50% of patients have no symptoms (if colonized, wont show S+S until UTI is really bad)
- pain and burning during urination
- frequency, urgency, nocturia
- incontinence
- supra pubic/pelvic pain
- hematuria/back pain and fever
69
pharmacological therapy for UTI
- treat infection (administer antibiotics as prescribed)
| - pain management (anti-spasmodic agents, analgesics, heat to perineum)
70
non pharmacological therapy for UTI
- inc. fluids PO and or IV, frequent urination (helps to flush bacteria)
- avoid irritants (coffee, tea, spices, cola, alcohol
- good hygiene, remove/replace foley (BID pericare)
- promote patient knowledge
- monitor and manage potential complications
71
risk factors for C-diff
- antibiotic therapy
- surgery of GI tract
- diseases of the colon (ex. inflammatory bowel disease, colorectal cancer)
- weakened immune system
- use of chemotherapy drug
72
S+S for C-diff
- watery diarrhea, up to 15x/day
- severe abdominal pain
- loss of appetite
- fever
- blood/pus in stool
- weight loss
73
pharmacological therapy for C-diff
- antibiotics: vancomycin, metronidazole
- fecal transplant
- probiotics (try to re-balance), antiemetics (for nausea and vomiting)
74
what diagnostics would you get for c-diff?
- C+S of stool
- electrolyte levels
- WBC (neutrophils)
75
non-pharmacological therapy for c-diff
- fluids PO and/or IV
- isolation precautions
- maintain nutrition
- promote pt knowledge
- monitor and manage potential complications
76
risk factors for pneumonia
- conditions that produce mucous or obstruct/interfere w/ normal drainage
- smoking
- prolonged immobility with shallow breathing
- dec. cough reflex
- advanced age (depressed cough reflex, glottic reflexes, and nutritional depletion
77
S+S of pneumonia
vary with type of pneumonia
- fever (shaking and chills)
- chest pain
- tachycardia
- tachypnea
- sputum (green or yellow)
- orthopnea
78
pharmacological therapy of pneumonia
-admin of appropriate antibiotics (vancomycin, cefazolin) and antipyretic as needed, O2 if required
79
non-pharmacological therapy of pneumonia
- improving airway patency (removing secretions)
- rest and conserve energy balance with mobilization
- deep breathing and coughing
- promote fluid intake
- maintain nutrition
- promote patient knowledge
- monitor and manage potential complications
80
main symptoms of infectious pneumonia
- high fever
- chills
- clamminess, blueness
- headaches
- loss of appetite
- mood swings
- low bp, high HR
- pain in joints, fatigue, aches
- nausea
- vomiting
- SOB
- cough with sputum
81
how to break the chain of infection
- hand hygiene
- don't use anything from floor
- different cloth for bed bath/pericare
- dirty linens away from body
82
what are the major types of pneumonia?
- community-acquired pneumonia (CAP),
- hospital-acquired pneumonia (HAP),
- pneumonia in the immunocompromised host,
- aspiration pneumonia
83
community acquired pneumonia
occurs in community setting or within first 48hrs of hospitalization
84
s. pneumoniae (pneumococcus)
most common community acquired pneumonia (CAP) in people less than 60years old with no comorbidity and those greater than 60 with comorbidity
85
where does S. pneumoniae naturally reside?
upper resp tract
86
what CAP affects those with comorbid illnesses (COPD, alcoholism, diabetes etc)?
H. influenzae
87
hospital acquired pneumonia (aka nosocomial pneumonia)
occurs 48hrs after admission to hospital
88
most lethal nosocomial infection is?
Hospital-acquired pneumonia (nosocomial pneumonia)
89
pneumonia in the immunocompromised host
occurs with use of corticosteroids or other immunoexpressive agents, chemo, nutritional depletion,, AIDS, genetic immune disorders, long-term advanced life-support technology
90
diagnosis of pneumonia is made by?
1. history of resp. tract infection
2. physical exam
3. chest xray studies
4. blood culture
5. sputum exam
91
what is a key treatment measure when community acquired pneumonia (CAP) is strongly suspected?
prompt admin (within 4-8hrs) of antibiotics in patients
92
mortality rate is greater in what age group?
greater in older pt's, more difficult to treat
93
aspiration pneumonia
entry of endogenous or exogenous substances into lower airway
94
most common type of aspiration pneumonia
bacterial infection (normally resides in the upper airway)
95
patho of pneumonia
arises from normally present flora in patient whose resistance has been altered or it results from aspiration of flora present in oro-pharynx
96
define colonization
microorganisms present without host interference or interaction
97
define infection
host interaction with organism
98
define infectious disease
infected host displays a decline in wellness due to infection
