INFLAMMATION
It is a local tissue reaction due to injury or irritation or when the cells are damaged by any kind of agent.
Causes
1. Mechanical e.g. Trauma, pressure.
2. Thermal, e.g. Extrema base and acid
3. Chemical e.g. Strong acids and alkalis, irritating gases,
4. Biological e.g. Micro-organisms
5. Immunological e.g. Antigen-antibody and autoimmune reactions.
Pathophysiology
3 major physiologic responses occur.
1. Vascular response
2. Fluid exudation (oozing)
3. Cellular exudation.
Vascular response
Injury
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Release of chemical substances (histamine or kinins)
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Transitory vaso-constriction followed by vaso-dilatation of capillaries
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Increased permeability of capillary walls.
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Fluid and cellular exudation
Fluid exudation
From capillaries into interstitial spaces - during 1" 24 hrs.
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Initially fluid is serous but as capillary walls become more permeable, protein is lost
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Increases colloid osmotic pressure in Interstitial spaces
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More fluid exudation
Cellular exudation
WBC's migrate through the capillary wall into the affected tissue. Leucocytes respond within the first few hours. Neutrophils ingest bacteria and dead tissue, then they die releasing proteolytic enzymes.
Liquify the dead neutrophils, dead bacteria and other dead cells. Monocytes and lymphocytes appear later.
Leaked plasma fluid
Fibrinogen fibrin clot formation forms a wall around the injured area prevents spread of infection.
Signs and symptoms
Local Redness, heat, swelling, pain and impaired function. General Malaise, fever, anorexia, headache, lethargy, weakness.
Nursing Management
1. Prevention of further injury.
- Inflammatory agents should be removed or minimized.
- Thermal agents should be removed
- External chemical agents to be diluted and area to be irrigated with water or Normal saline
- Tissue or blood culture to be taken to identify micro-organisms.
- Position patient to eliminate pressure on the affected area. Proper alignment of the affected limb or joint is essential.
- Dressing should be applied to open regions protect from trauma, air borne contaminants and prevent spread of infections to others.
- Basic aseptic techniques frequent handwashing and careful disposal of contaminated dressings should be practiced
2. Promote healing and tissue repair
- Elevate the affected part encourages venous and lymphatic drainage, reduces swelling, lessens pain and increases flow of blood into the area.
- Application of heat or cold.
- Heat relaxes the muscle tissue and increases blood flow.
- Cold constriction of vessels decrease volume of exudates and degree of swelling
- When an open lesion is present exudates and necrotic tissue should be removed to promote healing
3. Conserve Energy
- The affected part should be placed at rest to decrease energy demands, to prevent further trauma and lessen the pain
4. Increased fluid intake
- Fluid intake is increased to promote dilution and elimination of toxic products.
- Calorie intake should be adequate to meet the energy demands and tissue breakdown
- Adequate protein and Vitamin C and facilitates healing.
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