Homeostasis and communication

primary intention

wound margins well approximated, most rapid healing

secondary intention

larger wound, requires granulation tissue to fill gap

tertiary intention

wound suturing is delayed due to infection, more scaring, longer healing

proinflammatory hormones

when tissue is injured these increase blood flow to the injured area

increased blood flow

results in both redness and heat

swelling

the result of a combination of increased blood flow and extravasation of WBCs, fluids and other substances out of the vascular system into the injured area

exudate

material consists of serum, fibrin and WBCs that pass out of the blood vessels into an area of inflammation

extravasation

leaking of substances out of their containing structure. In inflammation, vascular permeability is increased, and water, salts, and small plasma proteins escape into the tissues.

Diapedesis

WBCs migrate out of the blood vessels into the tissues

Hyperemia

an increase in blood or blood flow to an area of the body

laboratory tests for inflammation

CBC, WBC, CRP, ESR

Rise in CRP

any rise in CRP (c reactive protein) will tell us there is inflammation. a protein made by the liver when inflammation is present

test to tell if infection is present

CBC: evaluates RBCs, WBCs and PLTs levels

hemoglobin

oxygen carrying pigment of the RBC

hematocrit

measures the volume of cells in whole blood

dehydration

increased hematocrit

neutrophils & bands

will be present when inflammation is occurring (bacterial infection)

Leukopenia

decrease in the number of WBC (happens during some diseases)

Leukocytosis

increase in the number of WBC (infection)

apoptosis

turns irregular cells into fragments for destruction

cell differentiation

embryonic -> somatic

neoplasm

an error in cellular replication occurs and can result in uncontrolled growth

neoplasia

errors of replication which have not been corrected

malignant

cancerous. multiple errors in cellular replication occurs over time

phytochemicals

plant based foods. antimicrobial, antioxidant, anti- inflammatory, and immune boosting properties

sarcopenia

degeneration of muscle

Anasarca

widespread swelling of the skin due to protein deficiency

hypoalbuminemia

low serum albumin (type of protein made in liver) less than 3.5g/dL. Causes low oncotic pressure, high hydrostatic pressure, and movement of fluid into tissues (edema)

Phenylketonuria (PKU)

an amino acid disorder- cannot metabolize amino acid phenylalanine

Fluid requirements for adult

30-30ml/kg/day or 2500 ml/day

Most clinically significant electrolytes

Na, K, Cl, Ca, Mg, P

sodium or chloride

any change in these can cause confusion in the older adult

potassium

too much or too little can lead to cardiac arrest

polyuria

excessive urination

diaphoresis

excessive sweating

oliguria

diminished urination

anuria

no urine output

dysuria

pain with urination

stress incontinence

loss of urine with increased abdominal pressure

overflow incontinence

partial retention of urine behind an obstruction

functional incontinence

inability to get to the toilet in time

urinary retention

external sphincter does not open for release of urine or blockage of urethra, leads to bladder distention

cystocele

part of the bladder wall bulges into the vagina

rectocele

part of the wall of the rectum bulges into the vagina

straight catheterization

short term catheter

indwelling foley catheter

long term catheter

Ileal Conduit

incontinent diversion to skin; type of urostomy

ileostomy

bowl ostomy at the end of the small intestine: liquid stool, watch for skin breakdown

colostomy

bowl ostomy in large intestine

loop colostomy

done in emergency

double barrel colostomy

2 distinct stomas

FICA tool for spiritual assessment

Faith, Importance/Influence, Community, Address

TRUST Domains for spiritual exploration

Traditions, Reconciliation, Understandings, Searching's, Teachers

Allostasis

the physiological process through which the brain tries to find a new homeostasis

informatics

information science and computer science