Name: ____________________________________

NURSING MANAGEMENT: INFLAMMATION AND INFECTION

I. For each of the following types of tissues or organs, identify the specific phagocytic cells of the
mononuclear phagocyte system that are present, and whether the cells are fixed or free.
a. Liver
b. Lung
c. Central nervous system
d. Blood
e.Connective tissue
f. Bone
g.Lymph nodes

II. A patient with inflammatory disease has the following symptoms. Identify the primary chemical mediators
involved in producing the symptom and the physiologic change that causes the symptoms.

Chemical mediators Physiologic change

a. Fever:
b. Redness:
c. Edema:
d. Leukocytosis:

III. True or False. If the statement is false, correct the bold word(s) to make it true.

_______ a. Nonsteroidal anti-inflammatory drugs used for inflammation inhibit the release of leukotrienes
from cells.
_______ b. The primary effect of most leukotrienes is formation of the slow-reacting substance of
anaphylaxis (SRS-A) that causes bronchial constriction.
_______ c. Prostaglandins are responsible for the constitutional symptoms of inflammation such as
malaise, fatigue, and anorexia.
_______ d. Complement factors C3a, C5a, and C4a bind to receptors on basophils, causing histamine
release and anaphylactoid reactions.
_______ e. Interleukin-1 (IL-1) and tumor necrosis factor (TNF) are cytokines that are released from
bacterial cells during phagocytosis.

IV. Match the characteristics and management techniques of wounds with their types (answers may be
used more than once).

________ a. Serosanguineous drainage 1. Closed wound

________ b. Adherent gray necrotic tissue 2. Red wound

________ c. Spray films 3. Yellow wound

________ d. Creamy ivory to yellow-green exudate 4. Black wound

________ e. Debridement of eschar necessary

________ f. Dry sterile dressing

________ g. Soft necrotic slough

________ h. Clean, moist granulating tissue

CASE STUDY:
INFLAMMATION
Patient Profile:
Kate G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She had been
applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has
developed chilling.
Subjective Data
• Complains of pain and heaviness in her leg
• States she cannot bear weight on her leg and has been in bed for 3 days
• Lives alone and has not had anyone to help her with meals
Objective Data
Physical examination:
• Yellow-red, 2 cm round, 1 cm deep, open wound above the medial malleolus with moderate amount of
thick yellow drainage
• Left leg red from knee to ankle
• Calf measurement on left 3” larger than right
• Temperature: 102° F (38.9° C)
• Height: 5’4” (160 cm); weight: 184lb (83.7 kg)
Laboratory:
• WBC: 18,300/µl; 80% neutrophils, 12% bands
• Wound culture: Staphylococcus aureus
Critical Thinking Questions

1. What clinical manifestations of inflammation are present in Kate?

2. What type of exudate is draining from the open wound?

3. What is the significance of Kate’s WBC count and differential?

4. What factors are present in this situation that could delay wound healing?

5. The physician orders aspirin to be given prn for a temperature above 102° F (38.9° C). How does the
aspirin act to interfere with the fever mechanism? Why is the aspirin to be given only if the
temperature is above 102° F? To prevent cycling of chills and diaphoresis, how should the nurse
administer the aspirin?

6. What type of wound dressing would promote healing of the open wound?

7. What precautions to prevent infection transmission are required in the care of Kate’s wound?

8. Based on the assessment data provided, write one or more nursing diagnoses. Are there any
collaborative problems?

Source:
Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., & Harding, M.M. (2017). Medical-Surgical
Nursing: Assessment and Management of Clinical Problems (10th ed.). St. Louis: Elsevier.