Ch. 3 inflammation

Lymphocytes

-Love viruses -agranulocyte

Cellular stage of inflamm response

-WBC diapedisis -movement of WBCs into area (margination, emigration, chemotaxis, phagocytosis). -guided by cytokines, bacterial and cellular disease.

common manifestations of fever

-anorexia -myalgia -fatigue -increased respirations -elevated HR -dehydration -Chills due to release of pyrogen many of these due to the increase of metabolic rate, increased need for O2, and use of body proteins as energy source. -headache may be caused due to vasodialation of cerebral vessels

basophils

-increase w allergic reaction -contain granules -granulocytes --binding of IgE triggers release of histamine and vasoactive agents from the basophil granules.

Eosinophils

-increase w allergic reaction -contain granules which contain histamine -control release of specific chemical mediators -granulocyte

Vascular stage of inflamm response

-initial vasoconstriction followed rapidly by vasodialation (results in redness, warmth, heat, pain). -increased capillary permeability ( fluid moves into tissues) -exudate dilutes offending agent -results in 5 cardinal signs -WBC diapedesis - Characterized by increased Blood flow, vasodialation. -vasodialation one of the earliest manifestations of inflamm.

Chronic inflammation

-longer duration lasting days to years. -associated with proliferation of blood vessels (angiogenesis), tissue necrosis, and fibrosis (scarring). -a reoccurring or progressive acute inflammatory process or low-grade smoldering response that fails to evoke an acute response. -due to chronic irritant -body unable to remove source -non specific -granulomatous -Increases in macrophaes -may cause systemic signs (all over) -scar tissue -decrease in tissue function

Neutrophils

-most numerous leukocyte in circulating blood. -highly mobile, first to appear on site of acute inflam. -love bacteria -contain granules -granulocyte Mature neutrophil = SEG = Acute inflam. Immature neutrophil = BANDS = Chronic

Acute inflammation

-short duration -nonspecific / early response to injury -aimed primarily at removing the injurious agent and limiting tissue damage. -responds in minutes up to several days. -characterized by exudation of fluid and plasma proteins and emigration of leukocytes. -localized -increase in neutrophis -return to normal

Drug fever is a fever that can occur with the administration of a specific drug and then disappear when the drug is discontinued. Which of the following is a way that drugs can induce fever? (Select all that apply.)

Drugs can act as direct pyrogens. Drugs can induce an autoimmune response. Drugs can injure tissues directly.

Tumor necrosis factor-α and IL-1 are major cytokines that mediate inflammation. If the patient is developing a systemic response to an infection, the nurse will likely assess which of the following clinical manifestations? Select all that apply.

Elevated temperature. Tachycardia. Anorexia

Calor

Heat / increased Bp, exudation of fluid, release of inflamm. , chemical mediators.

Which statements are true regarding chronic inflammation? Select all that apply.

It is usually a result of persistent irritants. The inflammatory agent is usually resistant to phagocytosis. It involves the presence of mononuclear cells like lymphocytes.

A normal response to fever is an elevated heart rate. A client with a fever who is not exhibiting an elevated heart rate would indicate to the nurse that the cause of the fever might be which of the following?

Legionnaires disease

The nurse is assessing patients who are febrile. Which of the following patients is at greatest risk due to fever?

Older adult patient with heart failure Explanation: Patients with heart failure, other cardiac diseases, or pulmonary diseases are at greater risk when they have a fever due to the demand for oxygen that is placed on the body with a fever. Every elevated degree Celsius of temperature increases the basal metabolic rate by 7% and causes increased workload for the heart.

Opsonization

Opsonization is the coating of particles with proteins, lectins, and complement to make them more attractive for phagocytes to recognize them as a foreign pathogen. Immunization is the process of acquiring the ability to respond to an antigen after its administration by vaccine. Immunity is protection from disease and, more specifically, infectious disease. Memory response occurs on second or subsequent exposures to the antigen.

Dotor

Pain / stretching of pain receptors and nerves by inflamm. exudates, chemical mediators.

Functio Laesa

Pain, distribution of tissue structure, fibroplasia, and metaplasia.

In which of the following patients should the nurse anticipate the necessity of regulating body temperature through a heat-gain response? Select all that apply.

Patient in a huddle position Patient with hyperthyroidism

Blood =

RBCs, Platelets, wbcs made in bone marrow

Rubor

Redness/ increased BP

Cardinal signs of inflammation

Rubor (redness) Tumor (swelling) Calor (heat) Dolor (pain) Functio lasea (loss of function)

Tumor

Swelling / exudation of fluid

Purulent exudate contains what substances?

Tissue debris White blood cells by products

Select the most likely source of a fever in a 16-month-old female child.

UTI

Leukocytes

White Blood Cells -major cellular components of inflam. system. Include: neutrophils, eosinophils, basophils.

immune system

blood cells, not a body system

Interlukin I

causes fever/ chemical mediator

prostaglandin

chemical mediator causes fever

Bradykinin

chemical mediator, causes pain ( from an injured cell)

fibrinous exudates

contain large amounts of fibrogen and form a thick and sticky meshwork, much like fibers of a blood clot

purulent exudate

contains pus, degraded WBC, and proteins

leukopenia

decrease in WBC

membranous exudates

develop on mucous membrane surfaces and are composed of necrotic cells enmeshed in a fibropurlent exodate.

Pyrogens are substances that produce fever in the body. Substances such as bacterial products, bacterial toxins, or whole microorganisms enter the body and stimulate the host cells to produce certain mediators. What are these called?

endogenous pyrogens Explanation: Exogenous pyrogens, such as bacterial products, bacterial toxins, or whole microorganisms, induce host cells to produce fever-producing mediators called endogenous pyrogens. "Outer" and "set-point" pyrogens do not exist.

Tumor necrosis factor ( TNF) and Interlukin 1 ( IL-1) release causes what systemic responses?

fever, hypotension and increased heart rate, anorexia, release of neutrophils into circulation, and increased level of coricosteroid hormones.

leukotrienes

from injured cells, WBC diapedisis movement of WBCs to area. recruit their buddies to defend.

Granulomatous

lesion in distinctive form of chronic inflamm. - to mm lesion in which massing macrophages are modified and resemble endothelial cells. -may clump into mass -dense membrane of CT eventually encapsulates the lesion and isolates it.

Most febrile illnesses are due to common infections and are relatively easy to diagnose. In certain instances, however, it is difficult to establish the cause of a fever. In these instances, the elevation in temperature is referred to as a fever of unknown origin (FUO). What is a common cause of FUO?

malignancies

WBCs

neutrophils, basophils, eosiniphils, monocytes/macrophages.

hemorrhagic exudate

occurs when there is severe tissue injury that causes damage to blood vessels or where there is significant leakage of red blood cells from capillaries.

monocytes/macrophages

produce potent vasoactive mediators (prostaglandins, leukotrienes, PAF, inflamm. cytokines, promote regeneration of tissue. -phagocytosis -engulf larger and greater quantities of foreign materials leftover from neutrophils. -love fungi -agranulocyte

purpose of inflammation

protective response to injury. attempts to neutralize harmful agents and prepare for wound healing.

Metabolism changes when an individual has a fever. What are the primary sources of energy during a fever?

proteins and fats

Histamine

vasodialator (open up blood vessels, drop BP) Bronchioconstrictor (SOB). -cell-derived mediator. -derived from amino acids -act by producing changes in blood vessel tones

serous exudate

watery fluids low in protein content that result from plasma entering the inflammatory site.