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    《ISPN学习》总第506期
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    《ISPN学习》总第580期
    日期:2020-02-02 10:58:00    
     
    《ISPN学习》2020年01月06日总第580期
     
     
     
    想提高专业英语听力吗?想边练听力边增加护理专业知识吗?Listening -- Elementary》(专业英语听力 – 初级)可助你一臂之力。
     
     
    ISPN  Review  
     
    Inflammatory Response
          ---- Clinical Presentation 临床表现

    Activation of the inflammatory response produces a characteristic clinical picture. The Latin words calor, tumor, rubor, and dolor describe a typical inflammatory reaction. Calor, or heat, occurs because of the increased blood flow to the area. Tumor, or swelling, occurs because of the fluid that leaks into the tissues as a result of the change in capillary permeability. Rubor, or redness, is related again to the increase in blood flow caused by the vasodilation. Dolor, or pain, comes from the activation of pain fibers by histamine and the kinin system. These signs and symptoms occur any time a cell is injured (Figure 15.2). For example, if you scratch the top of your hand and wait for about a minute, the direct line of the scratch will be red (rubor) and raised (tumor). If you feel it gently, it will be warmer than the surrounding area (calor). You should also experience a burning sensation or discomfort at the site of the scratch (dolor). Invasion of the lungs by bacteria can produce pneumonia.
     
    激活炎症性应答就会造成一个很有特色的临床现象。拉丁词热、肿、红和痛便是对炎症应答的典型描述。Calor或heat,是因为该部位血流增加而出现的。Tumor或swelling,量力而为毛细管通透性变化导致液体渗入组织而出现的。Rubor或redness,再次与血管扩张引起的血流增加相关;dolor或pain,来自组胺和激肽系统激活疼痛纤维。一旦细胞受损,这些体征症状随时可能出现(图15-2)。例如,如果你抓挠手背,差不多1分钟左右,抓过的那条直线就会变红(rubor)、隆起(肿)。如果你轻轻摸它,就会感觉比周围热(calor)。你还会在抓挠部位体验到灼伤感(dolor),细胞侵入肺腑就可能造成肺炎。
     
    If the lungs could be examined closely, they would also show the signs and symptoms of inflammation. They would be red from increased blood flow; fluid would start to leak out of the capillaries (often this can be heard as rales); the patient would complain of chest discomfort; and the increased blood flow to the area of infection would make it appear hot or very active on a scan. No matter what the cause of the insult, the body’s local response is the same.
     
    如果肺可以近距离检查的话,他们也会显现炎症症状体征。会因为血流增加而发红;液体会开始渗出毛细管(通常,这一现象可以听出为湿罗音);患者会抱怨说胸部不舒服;感染部位血流增加会使该处在扫描时看上去很热或很活跃。不管侵入原因是什么,机体的局部反应是相同的。
     
    Once the inflammatory response is under way and neutrophils become active, engulfing and digesting injured cells or the invader, they release a chemical that is a natural pyrogen, or fever-causing substance. This pyrogen resets specific neurons in the hypothalamus to maintain a higher body temperature, seen clinically as a fever. The higher temperature acts as a catalyst to many of the body’s chemical reactions, making the inflammatory and immune responses more effective. Treating fevers remains a controversial subject because lowering a fever decreases the efficiency of the immune and inflammatory responses.
     
    一旦炎症应答进行,中性白细胞变得活跃,吞噬、消化受损细胞或入侵者,就会释放出一种化学物质,即天然致热原,或引起发热反应的物质。致热原重调下丘脑特定神经元,维持较高的体温,临床上就是发烧。高温是机体很多化学反应的催化剂,使炎症性和免疫应答更加有效。发烧的治疗仍有争议,因为降热也会降低免疫和炎症应答的功效。
     
    The leukotrienes (autocoids activated through the kinin system) affect the brain to induce slow-wave sleep, which is believed to be an important energy conservation measure for fighting the invader. They also cause myalgia and arthralgia (muscle and joint pain)—common signs and symptoms of various inflammatory diseases—which also cause reduced activity and save energy. All of these chemical responses make up the total clinical picture of an inflammatory reaction.
     
    白三烯(激肽系统激活的自泌物)影响大脑,引起慢波睡眠,这一过程被认为是战胜入侵者的一个重要能量守恒措施。白三烯还会引起肌痛和关节痛(肌肉和关节痛),--多种炎症性疾病的常见症状体征,这也会引起活性的降低和能量的保存。所有这些化学应答构成了炎症反应的总的临床现象。
     
     
    Vocabulary for Today   
     
    clinical picture -- 临床现象
    calor – n. 热
    rubor – n. 红
    dolor – n. 痛
    capillary permeability -- 毛细管通透性
    vasodilation – n. 血管扩张
    scratch – v. 抓挠
    neutrophils – n. 中性白细胞
    engulf – v. 吞噬
    pyrogen – n. 热原
    hypothalamus – n. 下丘脑
    catalyst – n. 催化剂
    slow-wave sleep -- 慢波睡眠
    myalgia – n. 肌痛
    arthralgia – n. 关节痛
     

    Video  
     
    Inflammatory Response 3/4
     
     
     
    Test  
     
    1. Which nursing action is most likely to detect early signs of infection in a patient who is taking immunosuppressive medications?
    A. Monitor white blood cell count.
    B. Check the skin for areas of redness.
    C. Check the temperature every 2 hours.
    D. Ask about fatigue or feelings of malaise.
    2. A patient is admitted to the hospital with a pressure ulcer on the left buttock. The base of the wound is yellow and involves subcutaneous tissue. The nurse classifies the pressure ulcer as stage
    A. I.
    B. II.
    C. III.
    D. IV.
     
     
     
    答案
    Key to Questions
     
    1. D. Ask about fatigue or feelings of malaise.
    2. C. III.

     





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