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Abstract
This article provides a review of the pathophysiological responses of the body to an insult. Once the initial insult has occurred, common pathways are Identifiable: the inflammatory immune response (UR), the neuroendocrine system is stimulated, and endothelial damage initiates the clotting cascade, all of which play an Important role in maintaining haemodynamic normality and promote healing. However, after an injury/insult patients are exposed to treatments, invasive procedures and may develop complications which can stimulate further these physiological processes. This can lead to alterations in oxygen supply and demand, metabolism and to the distribution of circulating volume. In some situations this can lead to overstimulation of the processes which, instead of promoting healing, cause damage. Why this downward progression and overstimulation occurs In some patients, despite optimum efforts at treatment, are not fully understood, but can lead to serious organ damage and even death days or weeks after the insult.
Physiological changes after an insult are common, and an understanding of the underlying physiological principles of the changes that occur during such insults is important. The insult in this instance can be identified as anything that triggers the inflammatory immune response (IIR) such as trauma, surgery/anaesthesia, burns, circulatory disorders/myocardial infarction (MI), renal/liver disease, pancreatitis, gastrointestinal disorders (ulcers, hernia, irritable bowel syndrome, inflammatory bowel disease, ulcerative colitis), shock, cardiac arrest, infection, deep vein thrombosis and pulmonary embolism.
However, patients suffering such an insult are not only exposed to their primary injury, but also to other factors, such as stress, blood transfusions, surgery, and nil by mouth, which can seriously affect their recovery and have serious consequences (Huddleston, 1992).
The nurse caring for these patients needs to understand that there is no specific nursing care or treatment for the physiological responses that occur to injury/insult, as these are essentially there to protect the individual. The nurse has to be aware that the interventions prescribed relate to ensuring effective oxygen supply to meet demand, maintaining adequate nutrients for metabolic requirements and fluid replacement to sustain a depleted circulating volume.
Knowledge regarding these changes, and the practical application of this knowledge to specific treatments being prescribed is essential in order to avoid death not only from the immediate effects of the injury, but also from later multiple...