NUR 213 Inflammation
1. Exemplars
Answer
Acute Cholecystitis Nephritis
Chronic Diverticulitis Myocarditis Autoimmune
Inflammatory Bowel Diseases
2. Definition
Answer
Inflammation is an immunologic defense against tissue injury, infec- tion , or allergy.
It is a protective process initiated to minimize or remove the pathologic agent triggering the
inflammation and to promote healing
It is the body's physiologic response to injury Inflammation can occur without infection
Per Giddens , pg 216
3. Risk factors
Answer
All individuals are at risk
The very young that have an immature immune response The elderly, the immune system loses
it ability to respond Uninsured because they do not have early intervention Autoimmune
diseases
Allergies Genetics
Chronic diseases
Absence of good hand and personal hygiene Poor sanitation and nutrition
Environmental factors
4. Steps in acute inflammation
Answer
Tissue injury and the release of chemical media- tors
Vasodilation and increased blood flow
Swelling and retraction of activated endothelial cells
Increased vascular permeability and leakage of small plasma proteins "Walling off"
Movement of immune response cells to the site of injury (fluid and WBC) Exudate formation
Movement of glucose and oxygen to the site needing repair Release of chemical repair factors
from activated endothelial cells
5. Enzymes
Answer
Inflammation Cyclooxygenase (COX) enzyme
Converts arachidonic acid into prostaglandins
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,Has two enzyme forms
COX-1
protects stomach lining and regulates blood platelets COX-2
triggers inflammation and pain
6. Comkin diagnostics
Answer
Laboratory tests CBC
WBC with differential CRP
ESR
Serologic tests to detect specific antibodies or viruses Radiographic studies
MRI CAT
PET scans colonoscopy
7. Wbc
Answer
White Blood Cell
Total number (Thousands) / mm blood NL values
4,300 - 10,800/mm
Differential
proportion of each of the 5 types of WBC's in a sample of 100 WBC's
Neutrophils
50-70% -phagocytosis bands are immature neutrophils
0-3%
Eosinophils
0-4%- seen in allergic reactions Basophils
0-2% - assoc. with leukemia Lymphocytes
20-40% -assoc with viral infections Monocytes
4-8% assoc. with chronic inflammation
8. Memory help
Answer
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, Never- neutrophils Let-lymphocytes
Monkeys-monocytes Eat-eosinophils Bananas- basophils
9. CRP
Answer
This test is non-specific for evaluating inflammatory disease (course & severity).
During an inflammatory process, a specific abnormal protein (CRP) appears in the blood.
NL values
Answer
< 0.8 mg/dL
Can be detected within 18-24 hrs. after tissue damage
Increase with CAD,PVD, RA, acute MI,3rd trimester of pregnancy Decrease with steroids and
ASA
10. Erythrocyte sedimentation rate
Answer
Measures "speed" which RBC's settle in tube of anti-coagulated blood
expressed as mm/hr
NL values
Answer
men 1-13 mm/hr women 1-20 mm/hr
** after age 50 levels increase
Increased levels indicate inflammatory / pathologic condition-RA acute MI Decrease with CHF
Mono, degenerative arthritis & sickle cell
11. Cardinal signs of inflammation
Answer
Redness Swelling
heat Pain
Loss of function
12. Primary prevention
Answer
Primary Prevention
Answer
Hand hygiene
Designated safety equipment Food and safety standards
There are no routine screening procedures for inflammation which is secondary prevention
Collaborative interventions are directed at promoting repair and healing by RICE,
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