Pages 186-191: Med Surg Flashcards Preview

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Flashcards in Pages 186-191: Med Surg Deck (38):
1

why is the inflammatory response necessary?

neutralizes and dilutes the inflammatory agent, removes necrotic materials, and establishes an environment suitable for healing and repair

2

inflammation and infection

inflammation is always present with infection, but infection is not always present with inflammation (can be caused purely by heat, radiation, trauma, chemicals, rather than just infection)

3

vascular response step one

after cell injury, artioles briefly vasoconstrict

4

vascular response step two

histamine is released, vessels dialate, which causes hyperemia (increased blood flow to injured site)

5

vascular response step three

increased capillary permeability causes fluid to move from capillaries to tissue

6

vascular response step four

exudate is initially composed of serous fluid and plasma proteins, which exert oncotic pressure and further draw fluid from blood vessels causing edema

7

vascular response step five

when protein fibronogen leaves the blood, fibrin is activated, which strengthens clots

8

why are clots important to tissue?

traps bacteria, prevents their spread, framework of healing process

9

chemotaxis

directional migreation of WBCs to site of injury

10

cellular response via neutrophils

arrive to injury site within 6-12 hours and phagocytize bacteria; only live 24-48 hours

11

what do dead neutrophils produce?

pus

12

bands

immature neutrophils released due to bone marrow relasing more neutrophils into circulation and infection getting worse

13

shift to the left

when band neutrophils are increasing due to acute bacterial infections or progressive infections in general

14

cellular response via monocytes

arrive 3-7 days after onset of inflammation and transform into macrophages, which clean the area before healing can occur; long life span

15

multinucleated giant cell

particles are too large for a single macrophage and they accumulate, then encapsulate in collagen, causing formation of granuloma (small area of inflammation)

16

prostaglandins

produced from arachidonic acid and cause vasodilation (producing increased blood flow and edema PROINFLAMMATORY); can also act as pyrogen

17

complement system

enzyme cascade c1-c9 mediate inflammation and destroy invading pathogens through phagocytosis, increased vascular permeability, chemotaxis, and cellular lysis

18

c8 & c9

final components of complement system that pierce the cell and lyse

19

thromboxane

causes brief vasoconstriction and skin pallor at the injury site and promotes clot formation- short half life and gives way to prostaglandins and histamines vasodilation

20

leukotrienes

slow reacting anaphylaxis, which constricts smooth muscule of bronchi and stimulates chemotaxis

21

local response

redness, heat, pain, swelling, loss of fx

22

systemic response

increased WBC with shift to left, malaise, nausea, increased pulse and respirations, fever

23

systemic response possibly caused by

complement activation and cytokines

24

fever

onset is due to cytokines, hypothalamus stimulates ANS to promote shivering, and epinephrine released from the adrenal medulla increases the metabolic rate

25

benefits of fever

increased killing of microorganisms, increased phagocytosis from neutrophils, increased proliferation of T cells

26

acute inflammation

healing occurs in 2-3 weeks usually with no damage, neutrophils are predominant

27

subacute inflammation

same as acute, but inflammation lasts longer

28

chronic inflammation

may last for years, injurious agent persists or repeats injury to site, lymphocytes and macrophages dominant

29

when should fever be treated rapidly?

if 104+ or immunosuppressed patient

30

Aspirin

Salicylates lower the temperature, interfere with prostaglandins, and reduce capillary permeability; selectively depress CNS

31

Tylenol

acetominophen lower the temperature

32

NSAIDs

ibuprofen, motrin, advil inhibit synthesis of prostaglandins and reduce fever

33

corticosteroids

interfere with granulation tissue and induce immunosuppressive effects and reduce fever

34

Rest (RICE)

repair process is facilitated by allowing fibrin and collagen to form across the wound edges with little disruption

35

Ice (RICE)

ice used initially and heat used later around 24-48 hours

36

Compression (RICE)

counters the vasodilation effects and development of edema, asses distal pules and capillary refill before and after devices are placed

37

Immobilization

promotes healing by decreasing metabolic needs of the tissues

38

Elevation (RICE)

elevate above the level of the heart to reduce edema by increasing venous and lymphatic return; contraindicated in patients with reduced arterial circulation