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NUR2790 Rasmussen Nursing III Exam 3-Questions with Correct Answers/ Verified/ Latest Update 2024/2025
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Inflammatory immune response -️️Purpose: -Control bleeding -Remove waste products limit infection -Promote healing Local vasodilation -Delivers increased blood flow to bring neutrophils, macrophages and clotting factors to damaged area --Edema, redness, heat and pain Serious injuries: s...

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  • August 11, 2024
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  • 2024/2025
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NUR2790 Rasmussen Nursing III Exam 3-Questions with Correct
Answers/ Verified/ Latest Update 2024/2025
Inflammatory immune response - ✔️✔️Purpose:

-Control bleeding

-Remove waste products limit infection

-Promote healing



Local vasodilation

-Delivers increased blood flow to bring neutrophils, macrophages and clotting factors to damaged
area

--Edema, redness, heat and pain



Serious injuries: sustained response can damage vessels in area of injury



Prolonged response cause increase in permeability of capillaries



Systemic Inflammatory Response Syndrome (SIRS) - ✔️✔️Uncontrolled inflammation in multiple
organs that are far from the area of insult



Overwhelming self-defense mechanism



Re-increased activation of the inflammatory cell, such as neutrophils macrophages lymphocytes and
damage to the vascular epithelium, deterioration in distribution of nutrient to the organs, ends with
MODS



Causes of SIRS - ✔️✔️Infection

Pancreatitis

Ischemia

Trauma

Hemorrhagic shock

Aspiration of gastric contents

Massive transfusions

,Host defense deficiencies



Why the onset of inflammation? - ✔️✔️Failure to control source of the inflammation or infection



Persistent hypoperfusion due to prolonged shock



Presence of necrotic tissue (e.g., abscess)



Altered cellular oxygenation consumption (hypermetabolism)



SIRS: What happens in the body? - ✔️✔️Intravascular inflammation and increase vascular
permeability



Hypoxia (from damaged blood vessels)



Anaerobic metabolism due to hypoxia, forming lactic acid (byproduct of glucose metabolism)



Muscle fatigue



Failure of sodium/potassium pump (due to metabolic acidosis)

-Allows sodium to enter cells as potassium leaves.

-Fluid follows sodium into cells causing swelling and release of intracellular enzymes. Cells can't
function anymore



Calcium also enters the cells and blocks phosphorus stopping ATP



Cell bursts and dies; releases potassium into bloodstream

-Hyperkalemia

-cardiac dysrhythmias

-muscle weakness

,SIRS: What happens in the body - Neuroendocrine response - ✔️✔️Release of catecholamine's

-increased heartrate, cardiac output, metabolism, glucose

-activation of platelets



Prolonged catecholamine release

-hyperglycemia; insulin resistance

-cardiac dysrhythmias



Release of ACTH and cortisol

-increase glucose levels

-vascular constriction



Release of mineral corticoids like aldosterone when fluids are lost due to fluid shifts to interstitial
spaces or hemorrhage



SIRS: What happens in the body - Renal response - ✔️✔️Hypovolemia leads to renin,
angiotensinogen, angiotensin 1 (vasopressor) to angiotensin II stimulation

-increase B/P

-aldosterone secretion

*kidney reabsorbs sodium (water follows)

*excretes potassium



Antidiuretic Hormone (ADH) secreted

-water absorption; decreased urinary output



SIRS criteria - ✔️✔️SIRS is defined as 2 or more of the following variables:



Fever of more than 38°C (100.4°F) or less than 36°C (96.8°F)



Heart rate of more than 90 beats per minute

, Respiratory rate of more than 20 breaths per minute or arterial carbon dioxide tension (PaCO 2) of
less than 32 mm Hg



Abnormal white blood cell count (>12,000/µL or < 4,000/µL or >10% immature [band] forms)



Treatment of SIRS - ✔️✔️Treat the cause!



Treat hypotension with fluids and vasopressors



Sepsis - ✔️✔️A systemic response to infection; involves SIRS, results in endothelial (lining of blood
vessels) dysfunction and altered circulation and coagulation



Most common cause is gram-negative bacteria



Microorganism's toxins secrete endotoxins that stimulate capillary permeability



Hypotension, hypo-perfusion of organs



Sometimes the source of infection is never found



Severe sepsis associated with organ dysfunction***



Hypotension = septic shock

-Systolic less than 90, or a reduction of more than 40 mm Hg from baseline in the absence of other
causes of hypotension.



98.6F = 37C; Know conversions**



Fever is a common symptom, though it may be absent in elderly or immunosuppressed patients.



The hypothalamus resets in sepsis, so that heat production and heat loss are balanced in favor of a
higher temperature.

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