inflammation is non-specific, what causes it?
Injury causes inflammation
"Itis" = Inflammation & not infection
The steps are always the same no matter what the cause
What is the body's goal's when relating to inflammation?
Limit tissue damage
Remove injured cells
Repair the damage
Get started immediately
What causes acute inflammation?
Caused by a micro-organism, it's usually caused by a pus-producing bacteria such as STAPH AUERUS or STRETOCOCCUS
What else causes acute inflammation?
Methicillin resistant Staph A (MRSA)
vancomycin resistant enterococcus
What is chronic inflammation?
te cause is not destroyed or there are repetitive bouts
TB, syphilis, fungal, organisms, arthritis
What are the steps of inflammation? (6 steps)
Immdiate release of chemical mediators within seconds (histamine, bradykinin, prostaglandins)
Vessel dilation to increase capillary permeability & allow increased blood flow (esp w/histamine)
Fluid Exudate (protein, water, EBCs flow in)
Cellular exudate-EBCs (specifically neutrophils) arrive 1st, then monocytes & macrophages. They destroy foreign agents & forms waste.
Healing happens w/regeneration & scar tissue formation
What are the 5 signs of inflammation?
Loss of Function
What are some nursing interventions for inflammation?
Rest the inflammed part
Apply heat to affected part
Allow drainage of pus
Provide appropriate meds such as anti-inflammatory or antibiotics
What is immunology?
The study of the reaction of tissues of the immune system as they react to antigen stimulation
Hopefully recognizes self from non-self
What is the purpose of the immune system?
Exclude harmful agents from the body
Recognize harmful agents w/in the body
Respond to harmful agents and dispose of them
What organs are involved in immunity?
(The 1st line of defense)
Undifferentiated Stem Cells
(Start life in the bone marrow. They can migrate from the bone marrow)
P.S. - A stem cell can be considered a "starter cell" or "a baby-baby"
what are thee types of immunity?
What are some hints for B&T-Cells?
B-Cells: Lymphocytes manufactured in bone marrow
B-Cell: mature in bone marrow, spleen, tonsils
B-Cells beomce T-Cells if migrate & mature in thymus
Either B-Cells or T-Cells if migrate and mature in the nodes of the lymph system
What is humoral development (antibody-mediated immunity)?
B-Cells stay in bone marrow or go to spleen
Is the antigen-antibody response
Offers immediate protection
in the Humoral response what is IgM?
Can lyse cell walls & activate compliment system
Blood marker grouping
in the Humoral response what is IgG?
Protects against bacteria/virus
Can cross placenta
in the Humoral response what is IgE?
Responds to allergies & parasites
in the Humoral response what is IgA?
Protects mucous membranes
In all body fluids
in the Humoral response what is IgD?
Remains attached to B-Cells
Plays a key role in initiating early B-Cell response
When is Humoral immunity activated?
When bacteria invades
With mucosal tissue invaders like the cold virus and influenza
Plasma cells make the IgG
What is cell mediated development?
Undiff stem cells being in bone marrow and mature in the thymus
The thymus matures T-Cells that have specific functions, what are those T-cells?
How is cell-mediated immunity activated?
Chronic bacterial infection such as syphilis, TB
Viral infections such as measles, herpes, chicken pox
it also reacts to transplanted or transformed cells such as tissue transplants or transformed cells of cancer
What is a factor that facilitates T-Cell communication?
What is a substance that inhibits viral replication (Could be virus specific). Possible also hypes the macrophages up in order to make them more powerful?
What is the syste that makes antibodies stronger, cause chemotaxis & help cause lysis of bacterial cell membrane?
What is macrophage development?
Start as undiff stem cells in bone marrw
known as a monocyte when living in the blood
Phagocytize large particulate matter
It's role is to rid body of worn out cells & debris
What is granulocyte development (BEN)?
Start out as undiff stem cells in bone marrow AKA polymorphonuclear leukocytes AKA pollys
Can become neutrophils (phaocytic 1st responder, largest #, live 3-4 days in blod, 1-2 days in tissue, also use their eenzymes to destroy bacteria)
Neutrophils "sniff" their way to an injury. It's also called pulled in by "chemotaxis", particularly with a bacterial infection
Mature neutrophils are called segs
Can become eosinophils (fight mainly allergies & parasites)
Can become basophils (assist w/blood movement, ie. anticoagulant)
immature neutrophils are called bands or stabs
Can become mast cells
If the # of neutrophils is down, the risk of infection is UP
What is the medical term for allergic response?
What are some nursing assessments for hypersensitivity?
Occurs within 10-30 min of exposure
Watery, itchy eyes
What are some interventions for hypersensitivity?
Remove from source if possible
Pharmacology for hypersensitivity
What are some health promotions for hypersensitivity?
Teach the pt what the allergic trigger is and how to avoid it
Teach the patient to keep epi & benedryl on their person a all times and when to use it
What is infection?
The immune system is activated by pathogen
Remember that we always have inflammation with infection but it doesn't work the other way
Baby neutrophils are "bands"
Mature neutrophils are "segs"
A "shift to the left" is an increased # of babies
Antibiotics are used for infections, what do they do and what do they end with?
They interfere w/ micro-organism reproduction in different ways
End with "cidal" or "static"
What are some nursing interventions for antibiotics?
administer all of the meds at appropriate times to keep level in blood at proper therapeutic level
C&S before 1st dose
Some may take w/meals
S.E. Nausea & Diarrhea
Administer 1 hour before antacid or 2 hour after
Encourage fluids 2500-3000ml
If 2 AB are being administered for resistant strain observe for secondaary supra-infection
What are some Labs and Diagnostics for Infection?
CBC with differential
Norm: WBC's 5,000-10,000
BEN (All granular WBC's)
-Basophils cause vasodilation due to release of histamine & heparin, increase in anaphylaxis
-Eosinophils increase with allergies & parasites
-Neutrophils pulled in by chemotaxis & appear 1st with bacterial infections. Mature=segs, Babies=bands, "Shift to the left"=Infection
What is antimicrobial susceptibility & organism ID report?
Obtain before 1st dose of AB
Note the drug name w/ indicator in this infection:
R=Resistant to drug
S=Susceptible to drug
1+=Mild sensitivity to drug
3+=Best drug against bug
What are some nursing assessments for infection?
Assess immune function & infection
Age, gender, weight, surgeries & causes, current health status, VS, H&H, CBC w/Diff, nutritional status, lytes, UA, blood cultures, coag studies, hx of chronic disease or spleen/bone marrow disease, presence of invasive lines, current tx & meds (esp corticosteroids)
Wha are some nursing interventions for infection?
observe for S&S of infection
Meds as ordered
What are some health promotions for infection?
Proteins are the building block of repair, help with the immune response (because antibodies are proteins)
Vit-C produces collagen to help repair tissue
Zine & Multi-Vits improve immune function
Decreased serum protein limits nutrienttransport availability
What is Non-specific resistance?
the inborn power of the body to defend itsef against the invasion of infectious organisms
Is sometimes dependent on the environment
In general, implies resistance to all infections
What is species resistance?
Resistance possessed by one species of animals against certain diseasescommon to other species
Man does not contract many diseases common to lower species and many of the lower animals do not contract diseases of man
EX: Gonorrhea and Syphilis are diseases of man only
What is racal or group resistance?
Is the inherent resistance of certain races or groups of people to disease to which other races or groups are highly susceptible
When a disease organism is first introduced into a race or group of people, it is highly pathogenic or virulent
The longer a race has been exposed to a certain disease the less susceptible the race becomes
EX: Blacks are more susceptible to TB than whites
What is individual resistance?
Sometimes referred to as innate or genetic resistance
Environmental factors may also influence individual resistance
In some: The antibody or the inflammatory response may be inadequate
Ind resistance can vary rom one period of life of an in to another period.
-Conditions such as malnutrition, alcoholism, fatigue, exposure to cold and wet and the presence of some chronic disease and even psychosomatic factors (Stress) can lower the body's resistance to infection
What is the purpose of the body when relating to barriers to disease?
Protected by the unbroken skin
Secretions of the skin, including lysozyme have some bactericidal action
What protects the conjunctivae when relating to barriers to disease?
The cojuctivae are protected by the eyelids and by the continual washing action of tears which also contain bactericidal secretions
What protects the lungs when pertaining to barriers of disease?
The lungs are protected by the arrangement of bones in the nose which makes a devious passageway for air
Also protected by mucous membranes lining the respiratory tract which help trap dust and microorganisms
Organisms from the nose are expelled by sneezing and organisms from teh lungs are expelled by coughing
How are the genitalia protected when pertaining to barriers of the disease?
Protected by mucus and by acid secretions
What protects the gastrointestinal tract when pertaining to barriers to disease?
Protected to some extent by the acidity of gastricjuic and other secretions such as mucus and bile
What power does phagocystosis?
Power possessed by WBC's for engulfing foreign material including some bacteria
Neutrophils have the power of diapedesis (Leaving the circulatory system between the walls of capillaries and going out into the tissue)
Some lymphocytes and monocytes become localized in tissues
These cells phagocytize foreign partibles from the blood or lymph as it flows past them
These cells constitute the reticuloendothelium system of phagocytes and is one of the most important defense mechanisms of the body.
Lymphocytes, important in cellular immunity, are called T (Thymus) cells