Which of the following assessment data indicate the presence of a loca

Which of the following assessment data indicate the presence of a local inflammatory process? (Select all that apply.)

1. Client reports being cold
2. Left elbow warm to the touch
3. Elevated white blood cell (WBC) count
4. Pitting edema of +2 around the right ankle
5. Client reports knee pain of 5 on a scale of 1 to10
6. Client observed grimacing while raising shoulder to brush hair

ANSWER

ANS: 2, 4, 5, 6
Signs of localized inflammation include swelling, redness, heat, pain or tenderness, and loss of function in the affected body part. When inflammation becomes systemic, other signs and symptoms develop, including fever, leukocytosis, malaise, anorexia, nausea, vomiting, lymph node enlargement, or organ failure.