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NR 324 Adult Health I Exam 2 2024/2025.
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NR 324 Adult Health I Exam 2 2024/2025. 299 Questions and Correct Answes Complete With Solutions
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NR 324 Adult Health I Exam 2 2024/2025.Inflammatory response
sequential reaction to cell injury.
- Neutralizes and dilutes the inflammatory agent
- Removes necrotic materials
- Establishes an environment suitable for healing and repair
The mechanism of inflammation is basically the same regardless of the injury agent. The intensity of
the response-
Depends on the extent and severity of injury and on the reactive capacity of the injured person
The inflammatory response can be divided into four parts:
1. Vascular response
2. Cellular response
3. Formation of exudate
4. Healing
Vascular response
Results in vasodilation causing hypermedia (increased blood flow in the area) and increased capillary
permeability.
- These actions result in redness, heat, and swelling at the site
Cellular response
Neutrophils and monocytes move to the inner surface of the capillaries and then through the capillary
wall to the site of injury
Exudate consists of...
Fluid and leukocytes that move from the circulation to the site of injury
- The nature and quantity of exudate depend on the type and severity of the injury and the tissues
involved
Several chemical mediators aid the inflammatory process-
- The complement system is an enzyme cascade consisting of pathways to mediate inflammation and
destroy invading pathogens
— Major functions of the complement system are enhanced phagocytosis, increased vascular
permeability, chemotaxis, and cellular lysis
- PGs are generally considered proinflammatory and are potent vasodilators contributing to increased
blood flow and edema formation.
— PGs also perform a role in sensitizing pain receptors to stimuli that would normally be painless.
,The local response to inflammation includes-
Manifestations of redness, heat, pain, swelling, and loss of function.
Systemic manifestations of inflammation include-
An increased WBC count with a shift to the left, malaise, nausea and anorexia, increased pulse and
respiratory rate, and fever.
The basic types of inflammation are:
Acute
Subacute
Chronic
Acute inflammation
The healing occurs in 2-3 weeks and usually leaves no residual damage
Subacute inflammation
Has the features of the acute process but lasts longer
Chronic inflammation
Lasts for weeks, months, or even years
The best management of inflammation is-
prevention of infection, trauma, surgery, and contact with potentially harmful agents
The ability to recognize the clinical manifestations of inflammation is important so that appropriate
treatment can begin. Treatment may include-
- Fever management
- Rest
- Drug therapy
- Specific treatment of the injured site
—Immediate treatment may prevent the extension and complications of inflammation
Drug therapy to decrease the inflammatory response and lower the body temperature involves-
- The use of Aspirin, Acetaminophen, some NSAIDs, antihistamines, and corticosteroids
Healing Process- Healing includes 2 major components of:
Regeneration and repair
Regeneration
The replacement of lost cells and tissues with cells of the same type
Repair
,Occurs by primary, secondary, and tertiary intention
Primary intention
Takes place when wound margins are neatly approximated, such as with a surgical incision or a paper
cut.
—Three phases of the continuum for this process:
1. Initial
2. Granulation
3. Maturation
Secondary intention
Wounds occur from trauma, injury, and infection and have large amounts of exudate and wide, irregular
wound margins with extensive tissue loss
— These wounds may have edges that cannot be brought together
Tertiary intention
Occurs with delayed suturing of a wound in which 2 layers of granulation tissue are sutured together
Wounds are classified by:
Their cause (surgical or non surgical; acute or chronic) and depth of tissue affected (superficial, partial
thickness, or full thickness)
The purposes of wound management include:
- Cleaning a wound to remove any dirt and debris from the wound bed
- Treating infection to prepare the wound for healing
- Protecting a clean wound from trauma so that it can heal normally
Perform a thorough assessment of wounds on admission and on a regular basis
Observation and recording of wound characteristics are essential tasks
Nursing and inter professional care for the patient with a tissue injury is highly variable.
It depends on the causative agent, the degree of injury, and the patient's condition
The type of wound management and dressings needed depend on-
- Type
- Extent
- Characteristics of the wound
- Phase of healing
A variety of adjunctive therapies may be used to aid in wound healing:
- Negative-pressure wound therapy (vacuum-assisted wound closure)
- Hyperbaric O2 therapy
- Platelet-derived growth factor
, Negative-pressure wound therapy (vacuum-assisted wound closure)
Uses suction to remove drainage and speed wound healing
Hyperbaric O2 therapy
Accelerates granulation tissue formation and wound healing
Platelet-derived growth factor
Stimulates wound healing by promoting cell proliferation and migration
Special nutritional measures promote wound healing.
- High fluid intake is needed to replace fluid loss from perspiration and exudate formation
- Diet high in protein, carbs, and vitamins with moderate fat intake necessary to promote healing
It is important that the patient, the family, or both know-
How to care for the wound and perform dressing changes
Pressure injury definition
Localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a
medical or other device
Pressure injury occurs-
Because of intense and/or prolonged pressure or pressure in combination with shear.
- The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition,
perfusion, co-morbidities, and condition of the soft tissue
The clinical manifestations of pressure injuries depend on-
- The extent of the tissue that is involved
- The injury can present as intact skin or an open injury and may be painful
Assess patients for pressure injury risk initially on admission and at periodic intervals based on-
Patient's condition and care setting
Care of a patient with a pressure injury requires-
Local care of the wound
Support measures of the whole person, including adequate nutrition, pain Mgmt, control of other
medical conditions, and pressure relief
Local care of the pressure injury may involve:
- Debridement
- Wound cleaning
- Application of a dressing
- Relief of pressure
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