Patho-PrepU: Ch. 3 Inflammation and Tissue Repair

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The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be:

"Children can be affected with almost all of the rheumatic diseases that occur in adults."

The nurse is providing discharge instructions for a postoperative client. The nurse determines the teaching is effective when the client verbalizes which statement about wound healing?

"I will regain almost full-tensile strength of an unwounded skin at the end of 3 months."

The nurse is caring for a client with chronic sinusitis. Which risk factors identified in the client's medical history are associated with this condition? (Select all that apply.)

- Asthma - Nasal polyps - Aspirin sensitivity

A client is being seen in the dermatology clinic for a follow-up appointment for a second-degree full-thickness burn. What are characteristics of second-degree burns? Select all that apply.

- Painful - Blistered - Mottled, pink red

The nurse is caring for a client who has suffered a burn injury to the anterior and posterior of the right arm, groin, and anterior right lower leg. According to the rule of nines, what is the estimated extend of the client's burn injury?

19%

A client has experienced an acute inflammatory response with an elevation of white blood cells. The nurse is reviewing the client's most recent lab results to determine if the counts have returned to a normal range. Select the result that suggests the client is now within normal range.

4000 to 10,000 cells/μL

A 79-year-old woman reports a recent onset of "nearly constant heartburn." During the assessment interview, she states that she has "lots of aches and pains." She states that she is not on any prescription medications but often takes aspirin for pain. The nurse should suspect what diagnosis?

Acute gastritis

Which digestive enzyme breaks down carbohydrates during acute pancreatitis?

Amylase

Which condition is an example of wound healing by secondary intention?

An infected burn of the arm

The nurse is caring for a client with chronic pancreatitis who reports abdominal pain. Which location will the client's pain radiate?

Back

A nurse is caring for a client admitted for a systemic infection. The client has leukocytosis. What other laboratory value does the nurse anticipate the health care provider to order?

C-reactive protein (CRP)

Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description?

Cobblestone

A client underwent an open cholecystectomy 2 days ago, and the incision is now in the proliferative phase of healing. What is the dominant cellular process that characterizes this phase of the client's healing?

Collagen secretion by fibroblasts

A nurse reading a sigmoidoscopy report notes that a client was found to have skip lesions. The nurse interprets this as an indication of:

Crohn disease

A young client presents reporting diarrhea, fecal urgency, and weight loss. The stool is light-colored and malodorous, and it tends to float and be difficult to flush. The client has also noted tender, red bumps on the shins and reports pain and stiffness in the elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in the stool. Which diagnosis would his care team first suspect?

Crohn disease

When assessing a client's incision, the nurse notes that the edges of the once approximated incision has begun to pull apart. The nurse documents that the client's incision has:

Dehisced

The nurse is teaching her client with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component?

Fat

Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:

Fistula formation

A client fell off his motorcycle, receiving several large abrasion-related surface wounds. What physiologic phenomenon will the client first experience?

Healing by secondary intention

What pathophysiological process does alcohol trigger as it relates to acute pancreatitis?

Increased permeability of ductules

Crohn disease is treated by several measures. Treatment with sulfasalazine will focus on which aspect of this disease?

Inflammatory suppression

The nurse is caring for a client with newly diagnosed systemic lupus erythematosus (SLE). Which over-the-counter medication does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse caring for a postoperative client documents that the surgical incision is healing by:

Primary intention

The nurse is assessing the wound of a postoperative client. The client has a 6-inch abdominal wound that is well approximated and closed with surgical suture. The wound does not display any redness or drainage. The nurse would document the healing process as:

Primary intention

The nurse would identify the presence of granulation tissue at a wound site by which characteristic?

Red, moist tissue

A client in the acute stage of inflammation will experience vasodilation of the arterioles and congestion in the capillary beds. The nurse would assess the client's skin for:

Redness

A nurse is assessing a client for the classic signs of acute inflammation. The nurse would assess the client for:

Rubor, swelling, and pain

A client has a burn that involves the entire epidermis and various degrees of the dermis. It is painful, moist, and blistered. The nurse recognizes the burn as:

Second-degree partial thickness

When caring for a client with a wound that is healing by primary intention, the nurse recognizes which characterization best describes this type of wound?

Surgical incision

While explaining wound healing to an older adult client with a diabetic ulcer on the foot, which statement best explains the early process of how the body restores structural integrity?

The basement membrane must be restored before epithelial cells can form a covering over the wound.

Why is H. pylori infection so difficult to treat?

The infection is deep in the stomach mucosa.

The nurse is assessing a client with diabetes and notes an area on the client's right foot as inflamed, necrotic, and eroded. The client states he accidentally slammed his foot in a door 2 weeks ago. The nurse would document this finding as a(n):

Ulceration

The nurse is caring for an obese client who has had abdominal surgery. The medical record states the wound has developed a dehiscence. Which finding does the nurse anticipate observing when changing the dressing?

Wound edges are 1.5 inches apart.

The nurse is assessing a client for acute inflammation of a wound. Which symptom does the nurse attribute to the acute inflammatory response?

edema

Inflammation can be either local or systemic. What are the most prominent systemic manifestations of inflammation?

fever, leukocytosis or leukopenia, and the acute phase response

A client is experiencing the early stages of an inflammatory process and develops leukocytosis. The nurse recognizes this as a/an:

increase in circulating neutrophils.

The nurse is caring for a client with an accumulation of 2.5 cm of darkened tissue scar over the area of a 3-mm injury. How does the nurse correctly document this finding in the medical record?

keloid

After many years of cigarette smoking, a client is admitted to have a "mass" removed from the lung. When explaining the surgery and recovery, the physician notes that the client is likely to have a good amount of fibrosis develop at the surgical area. After the physician leaves the room, the client asks the nurse what was meant by "fibrosis" in the lung. The nurse bases the response on the fact that tissue repair can:

result in replacement tissue in the form of connective (fibrous) tissue, which leads to scar formation or fibrosis of the lung.


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