Question

2. A nurse is working in a community health center and is caring for a 5-year- child who was diagnosed as having a right ear infection. When collecting the nursing history, the mother states the child has had a fever to 1020F for 2 day has been irritable, and complained of feeling tired. The child has been drinking fluids well but not eating. The physician describes the tympanic membrane as erythematous, bulging with fluid levels, and dull. The nurse collects the followin vital signs: T. 102 R, P. 110, and R. 18. Fever is often considered to be associated with a bacterial infection. How does the body regulate temperature? Why is fever often associated with bacterial infections? Which of the clinical manifestations given are associated with a localized inflammatory response? What physiological factors are responsible for the development of these manifestations? If the physician ordered a complete blood count, what would you expect to see if there is a bacterial infection? Which of the above manifestations are related to a systemic response to the infection? 3. A nurse is working on a general medical surgical unit. Her assigned client is a 77-year-old who has a stage II decubitus ulcer on her coccyx. The nurse is discussing strategies to prevent skin breakdown and the wound healing process with a client. What is the difference between first-intention and second-intention healing? What are some factors that can cause delayed wound healing? What are some age-related differences in the elderly with regards to wound healing?

Answer 1

2. The body regulates the temperature in the following ways :-

- Hypothalamic nucleus normally controls homeostasis

- Normal temp maintained because of hypothalamic thermoregulatory center balances heat production (muscle/liver) with heat dissipation (skin/lungs)

- Heat is byproduct of obligatory energy use/metabolism

- If cold, will shiver to produce heat and vasoconstrict peripheral vessels to conserve heat

# Bacteria are tiny single-celled organisms, they are among the most microorganisms which causes infection and the main sign of infection is fever . That's why fever is often associated with bacterial infection .

# The clinical manifestation associated with a localized inflammatory response are :-

- erythematous tympanic membrane

- temperature of 102°F

# The physiological factors which are responsible for the development of these manifestation are :-

- fever

- unhealthy lifestyles

- infection

# In the complete blood count report ,we could see raised number of WBC as a sign of bacterial infection

3. A) The difference between Primary intention and secondary intention healing is :-

Primary healing - wound healing with skin edges that are approximated, risk of infection is low, healing occurs quickly with minimal scar formation as long as infection and secondary breakdown is prevented (similar to a surgical wound

Secondary Intention

This type of healing is in wounds with extensive tissue loss/infection & wounds in which the edges cannot be approximated (closed).

Would is left open and granulation tissue gradually fills in the deficit. Susceptible to infection. Wet to dry dressings. Ex: Pressure Ulcer

B) Factors that delay healing are age, chronic disease, perfusion, medications, smoking, nutrition/hydration, stress, infection, functional status.

# Factors elderly are likely to have that affect healing are inadequate nutrition, poor hydration, compromised immune, circulatory, and respiratory systems,altered elimination control, hypokinesia, altered mental status.