NR 324 Adult Health I Exam 2 2024/2025.

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 Maintaining adequate nutrition is an important: - Nursing responsibility and involves the identification and correction of malnutrition states Pressure injuries affect : - The quality of life of patients and their caregivers - It is important that the nurse support the caregiver through the added responsibility of pressure injury treatment Genetics definition The study of genes and their role in inheritance - Genetics determine the way that certain traits or conditions are passed down from one generation to another Genomics definition The study of all a person's genes (the genome), including interactions of these genes with each other and with the person's environment Genomics includes the study of- Complex diseases (i.e., heart disease, diabetes mellitus, cancer), because these diseases are typically caused by a combination of genetic and environmental factors rather than by a single gene Mutation definition Any change in the usual DNA sequence - A genetic mutation is like a spelling error in a gene's sequence Gene mutations occur in 2 ways: - Inherited from a parent (Germline mutation) - Acquired (Somatic mutation) during a person's lifetime Germline mutation definition Passed from parent to child Acquired (somatic) mutation definition Occur in the DNA of a cell at some time during a person's life -An acquired mutation is passed on to all cells that develop from that single cell Genetic disorders can be categorized into- - Autosomal dominant - Autosomal recessive - Sex-linked (X-linked) recessive Autosomal dominant disorder definition Caused by a mutation of a single gene pair (heterozygous) on a chromosome Autosomal recessive disorder definition Caused by a mutation in 2 gene pairs (homozygous) on a chromosome X-linked recessive disorder definition Caused by a mutation on the X chromosome Genetic disorders can be: - inherited (person born with altered genetic code) - acquired (e.g., replication errors, damage to DNA from toxins) Genetic disorders can be caused by: - Mutation in a single gene - Mutations in multiple genes(Multifactorial inheritance disorder), which are often related to environmental factors - Damage to chromosomes (changes in the number or structure of entire chromosomes) Genetic testing includes: - Any procedure done to analyze chromosomes or genes that can determine if a mutation or predisposition to a condition exists Genetic testing may lead to- Ethical and social issues People making decisions about genetic testing should be aware of all the safeguards that have been developed to maintain- Confidentiality and actions they need to take to assure information remains confidential Genetic testing may uncover information that may affect a family member who was- Not tested The results of genetic tests are not always straightforward, which often makes them- challenging to interpret and explain A positive test result means- That the lab found a change in a particular gene, chromosome, or protein that was being tested. A positive test result may: - Confirm a diagnosis (e.g., Huntington's disease) - Indicate that a person is a carrier of a particular genetic mutation (e.g., cystic fibrosis) - Identify an increased risk of developing a disease (e.g., breast cancer) - Suggest a need for further testing - A positive result of a predictive or presymptomatic genetic test usually cannot establish the absolute risk of developing a disorder or predict the course or severity of a condition