INFLAMMATION

NCMB 312 LEC

By: Dr. P.A. Maroma
Learning Objectives:

 At the end of the session, the students are

expected to be able to:
 Enumerate the purposes of inflammation;
 Understand its causes and pathophysiology;

 Analyze its signs and symptoms;

 Utilize the nursing process as a framework in the

care of clients with inflammation.
Define Inflammation:
 “-itis”
 A nonspecific response
 Defensive response to injury; compensatory
 A biochemical & cellular processes which occur in
highly vascularized tissue
Purposes:
 To localize the injurious agent; prevents further
spread of the injury.
 To destroy the injurious agent.
 To promote healing.
 To stimulate immune response.
Etiology/Causes (Inflammants):

 Physical trauma
 Ex. Stabbing, Gunshot wound, vehicular
accidents
 Chemical agents
 ↑ Hydrochloric acid inside the body
 Alcohol (ex. Toxic hepatitis & pancreatitis)

 Uric acid – end product of protein catabolism;

can lead to gouty arthritis
 Microorganisms
Etiology/Causes (Inflammants):

 Autoimmune
 Acute glomerulonephritis → can lead to chronic
glomerulonephritis
 RHD
 Systemic Lupus Erythematosus(SLE)
 Idiopathic – unknown cause
 Allergy
 Allergic rhinitis
 Nutrient Deprivation
 Heat
 Burn injury
Types of Inflammation:
 Course
 Acute
◼ Ex. Burn Injury
 Chronic
◼ Autoimmune

 Infectious/ Non-infectious
 Infectious
– caused by microorganisms
 Non-infectious – any cause except microorganisms
Pathophysiology
CardinalSigns:
 Redness (Rubor)
 Heat (Calor)
 Swelling (Tumor)
 Pain (Dolor)
 Limited/Loss of function (Functio Laesa)
 ** Pleural effusion – pleural cavity (between
parietal pleura and visceral pleura) fills with fluid
Stages of inflammation:
 Vascular response w/ Fluid exudation
 Cellular response
 Tissue repair
Types of Exudates
1. Catarrhal/Mucoid exudate – thin, watery with mucus;
heals rapidly
• Typical of allergy
2. Serous – thin, clear, watery; can be light yellow in
color
3. Sanguineous – pinkish to red
• ↑RBC
• Ex. Hemothorax
4. Sero-sanguineous – small amount of RBC
5. Purulent – thick, foul-smelling
• Contains dead cell & organisms
• Yellow, green
• Ex. Abscess
Cellular Response
** Normal amount of WBC: 5,000-10,000
** ↑ WBC = leukocytosis
1. Neutrophils
 Most numerous WBC
 First to go at the site of injury
2. Monocytes
 Chronic inflammation
3. Lymphocytes
 Responsible for the production of antibodies
4. Eosinophils
Cellular Response
** lymphadenopathy – “kulani”; palpable lymph
nodes
1. Margination – WBC form their line along
peripheral walls of the blood vessel
2. Emigration – WBC shifted out of blood vessels
3. Chemotaxis – WBCs are attracted at the injured
cells
4. Phagocytosis – WBC kills the involved
microorganisms; results to dead WBC and
microorganisms
Tissue Repair
 Regeneration
 Damaged cells are replaced by cells identical in
structure & function
 Scar Tissue Formation
 Ex. Fulminant Hepatitis leading to Liver Cirrhosis
Systemic Manifestations:
 Fever
 Chills
 Anorexia
 Lymphadenopathy
 Nausea and Vomiting
 Sepsis
 Leukocytosis
 Fatigue
 Body malaise
Diagnostic Test

 X-rays
 CT Scan

 MRI

 Blood Tests

 Urine Tests
 Goals of Care Interventions

 ↓ Fever  TSB
 ↑ Oral Fluid Intake
(OFI)
 Monitor vitas signs
(especially Temp.)
 Cold environment and
proper ventilation
 Goals of Care Interventions
 Proper positioning
 (Ex. Head trauma → 30-45° head elevation – promotes venous return
without increased ICP)

 Reduce  Hot and Cold application – apply for 15-20 minutes, about 3x a day.
24-48 hours
swelling and
HOT APPLICATION:
edema  Vasodilation

 Relieve pain 
 ↑ blood flow
Causes muscle relaxation
 ↑ cellular metabolism
COLD APPLICATION:
 Vasoconstriction
 ↓ blood flow
 Numbs nerve endings
 ↓ cellular metabolism
 Ex. Appendicitis (HEAT IS CONTRAINDICATED IN THIS CASE!!)
 Ex. Thyroid Surgery – apply ice collar (1/3 to 1half full of ice)
 Medical
 NSAIDs
 Ibuprofen-Motrin
 Naprosyn-Naproxen
 Goals of Care Interventions

 Bed rest
 Diet (High protein)
 Ex. Burn (↑ Carbs, ↑protein)
 Promote healing  Hepa (↑Carbs, ↑ Protein, ↓ Fat)
 Gastritis (Bland diet – no acid, no
spices, caffeine)
 Surgical intervention
1. Debridement
2. Thoracentesis
3. Pericardiocentesis
4. Paracentesis – removal of fluid
in abdomen
5. Disarticulation – cutting through
a joint
6. Amputation – cutting through a
bone
7. Incision & drainage
 SUMMARY
 Thank you for listening.