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87 Cards in this Set

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Immune system provides protection, eliminates foreign substances, identifies
non self proteins and what?
Immune system provides protection, eliminates foreign substances, identifies
non self proteins and what?

- Immature cells
- removes foreign proteins and other Substances
What cells are responsible for phagocytosis?

what is phagocytosis?
What cells are responsible for phagocytosis?

- neutrophils
- macrophages

what is phagocytosis?
-scan and destroy
Where do non-specific and specific immune response begin?
where do non specific and specific immune response begin?

-Stem Cells located in Red Bone Marrow
What would you notice in a pts CBC that would indicate an overwhelming
infection?
What would you notice in a pts CBC that would indicate an overwhelming
infection?

-bands shifting to the left (this means they are immature b/c we used up all the mature ones.)
what WBC is the greatest number?
what WBC is the greatest number?
-neutrophils
What is histamine?
What is histamine?
- an allergy response
What is Basophils job?
What is Basophils job?

-releases Histamine (allergies)
what norm WBC level?
what norm WBC level?
5000-10,000
What is function of Leukocytes (WBC)?
What is function of Leukocytes (WBC)?

- destroy foreign cells (phagocytotic)
- lice the cell (kill)
- make antibodies
(produce specific antibody against the antigen)
- Leukocytes do not make cytokines
what is S/S of inflammation?
what is S/S of inflammation?

- redness
- warmth
- swelling
- pain
- decrease function
What do you try to prevent when pt.’s WBC is < 1000?
what do you try to prevent when pt.’s WBC is < 1000

- prevent infection because pt. has no immunity
What is the first line of defense against infection?
What is the first line of defense against infection?

- Intact skin is the best defense against microorganisms
What's the next step for B cells after encountering an antigen?
What's the next step for B cells after encountering an antigen?

-Make copy, send specific antibodies to T cells (so it can attack the specific antibodies after encountering antigen)
What does IgG (Immunoglobulin G) indicates when it is elevated?
What does IgG (Immunoglobulin G) indicates when it is elevated?

- pt. has Infection, Virus and/or Bacteria
What is IgG (Immunoglobulin G)?
IgG (Immunoglobulin G)

- is major antibody found in blood
- normal range: 620 – 1400 mg/dl
- fight infection
What is artificial immunity?
What is artificial immunity?

- Vaccinations / Immunizations (artificially introduced)
What does IgE (Immunoglobulin E) indicate?
What does IgE (Immunoglobulin E) indicate?

- an Allergic Response
(s/s sneezing, itching, running nose, redness, swelling, coughing, rhinitis)
What are the subset of T cells (T lymphocytes) for cell mediated immunity?
What are the subset of T cells (T lymphocytes) for cell mediated immunity?

- Helper Cells (CD4)
- Suppressor cells (CD8)
- Natural Killer Cells (cytotoxic T) NK cells
What does innate / natural immunity mean?
What does innate / natural immunity mean?

-body's first line of defense against the external environment
After having the flu, pt has what kind of immunity?
After having the flu, pt has what kind of immunity?

- Natural, Active Immunity
What is neutropenia?
what is neutropenia
- lack of neutrophils

FYI: neutropenia, a condition of an abnormally low number of neutrophils (white blood cells)
Is increased granulocyte, a desired to response to treatment of neutropenia?
Is increased granulocyte, a desired to response to treatment of neutropenia?

-YES, it shows that the treatment is working (you would be triggering more WBC's being made). Increase granulocytes will increase neutrophils
What does desensitization mean?
What does desensitization mean?

-lower or suppress immune response to an allergy (give in small amounts subQ daily and increase the dose slowly on a daily basis)
Would an increase in granulocytes be positive in a pt with neutropenia?
Would an increase in granulocytes be positive in a pt with neutropenia?

-yes
Why is an infection is a problem after splenectomy (remove the spleen)?
Why is an infection is a problem after splenectomy (remove the spleen)?

- Because you just lost part of the immune system
Why after weekly (or daily) desensitization treatment pt. have to wait for 20 minutes?
Why after weekly desensitization treatment pt. have to wait for 20 minutes?

- You want to make sure that pt. doesn’t have allergic reaction

- Have Epinephrine and Benedryl ready in case
Why do we need to decrease that allergy injection dose if the pt. missed the previous week?
Why do we need to decrease that allergy injection dose if the pt. missed the previous week?

- Because immunity has been decreased during the week that missed

- Consult doctor
What is Anaphylaxis?
What is Anaphylaxis?

- Anaphylaxis is a life-threatening type of allergic reaction
- Need immediate attention
What is your first intervention for pt. with Anaphylaxis?
What is your first intervention for pt. with Anaphylaxis?

- Establish airway
- Check ABC (airway, breathing, circulation)
-give epi & Benadrill
If pt is a healthy old adult and immune system is intact, should it function properly?
If pt is a healthy old adult and immune system is intact, should it function properly?

-YES. Immune system should function normally in older adults
What do you teach a pt. who has numerous allergies?
what do you teach a pt. who has numerous allergies?

- need to find out what he/she allergic to
- avoid the allergen
What does a positive scratch test indicate?
What does a positive scratch test indicate?

-an allergy. The pt is allergic to the substance
What group of people are at risk for latex allergy beside nurses?
What group of people are at risk for latex allergy beside nurses?

- Mechanics
- Food servers
- Hair Dressers
- anyone who wears gloves regularly
Which fruits should you avoid if you're allergic to latex?
Which fruits should you avoid if you're allergic to latex?

-Kiwi
-Banana
What kind of condoms do u have a pt who is allergic to latex use?
What kind of condoms do u have a pt who is allergic to latex use? \

-Latex-Free condoms
Pt. is exposed to poison ivy on the left leg, what is the S/S would you try to control so pt. doesn’t get secondary infection?
Pt. is exposed to poison ivy on the left leg, what is the S/S would you try to control so pt. doesn’t get secondary infection

- Itching & Scratching
- Do not scratch

-wash off & wash hands, pat dry, apply barrier, no heat, apply cold

(the pt will b at risk for an infection if there is no barrier protecting the open scratches)
What is Urticaria?
What is Urticaria?

- Hives (skin welts, raised red itchy bumps, wheels)
- allergic reaction to ABX (antibiotics)
What is Angioedema?
What is Angioedema?

- Severe allergic reaction.
- needs immediate urgent attention

(FYI: Angioedema refers to swelling that occurs in the tissue just below the surface of the skin, most often around the lips and eyes.)
What are the physical s/s of Anaphylaxis?
What are the physical s/s of Anaphylaxis?

- Angioedema (swelling beneath the skin) à emergency
- Increase Heart Rate
- Weak & Rapid Thready Pulse
- Hypotension
- System collapsed

(also possible answers: Urticaria & Pruritus)

(FYI: Anaphylaxis is a life-threatening type of allergic reaction)
What is excessive response to the presence of an allergen?
what is excessive response to the presence of allergen?

- Hypersensitivity or an Allergy
What is the normal Pulse oximetry range?

What are other names for Pulse oximetry?
What is the normal Pulse oximetry range?

- saturation (SaO2) 95-100%

What are other names for Pulse oximetry?

- Pulse Ox
- SaO2
- SpO2 and
- Oximetry range
Is angioedema urgent?
Is angioedema urgent?

-yes. it can cause death
What is Pulse oximetry used for measuring?
What is Pulse oximetry used for measuring?

Pulse oximetry is used to measure the O2 in the pt's body tissue

(FYI:Pulse oximetry provides estimates of arterial oxyhemoglobin saturation (SaO2) of a patient's hemoglobin.)
Is wheezing a symptom of anaphylaxis?
Is wheezing a symptom of anaphylaxis?

-Yes, it is an emergency situation.

If pt is blue that means that there is no O2 in the persons system.

*FYI: wheezing is bad, but it depends on the pt's situation.

What does the pt look like at the time of the situation?

- BLUE
What does diminished breath sounds mean for a pt with an asthma attack?
What does diminished breath sounds mean for a pt with an asthma attack?

-airway is obstructed and getting worse, respiratory failure
(no breathing =no o2)
What does the position of the pt have to do with breath sounds?
What does the position of the pt have to do with breath sounds?

- To listen to it pt. need to be in a sitting up position (high Fowler, semi fowler…)
What is your intervention when pt. has transfusion reaction?
What is your intervention when pt. has transfusion reaction?

- Stop the transfusion immediately
- Start IV with normal saline
- Collect urine sample
- Send everything to the lab
What Is Autologous Blood?
What Is Autologous Blood?

- The patient's own blood.
Can pt. with A negative blood donate to A positive pt.?
Why or why not?
Can pt. with A negative blood donate to A positive pt.?
- NO

Why not?
- Because it is different type it will cause hemolytic reaction
What is a hemolytic transfusion reaction?
What is a hemolytic transfusion reaction?

- blood types don't match and the blood cells destroy one another
What blood type is the universal donor?
What blood type is the universal donor?
- O neg
What foods should an immunosuppressant pt. avoid?

what is ok to eat?
What foods should an immunosuppressant pt. avoid?

- Avoid fresh, uncooked, raw foods
- fresh, uncooked, raw, unprotected foods

what is ok to eat?
- ok to eat banana's and fruits with skin that need peeling.
What blood type is the universal recipient?
What blood type is the universal recipient?
- AB+
What is the primary nursing responsibility for a pt. who is immune suppressed?
What is the primary nursing responsibility for a pt. who is immune suppressed?

- Reverse isolation
- Protection pt. from infection (us) and us from the pt.
What has autoimmune been linked to?
What has autoimmune been linked to?

- excessive ingestion of fats in the diet
What does Autoimmune diseases attack?
What does Autoimmune diseases attack?

- your connective tissue / collagen
Definition of autoimmune disorder?
Definition of autoimmune disorder?

- When the immune system mistakenly attacks and destroy healthy body tissues
What cell should be suppressed to prevent transplant rejection?
What cell should be suppressed to prevent transplant rejection?

- The Natural Killer T Cell
What are the immunosuppressant drugs?
What are the immunosuppressant drugs?

- Methotrexate (rjei,atrex)
- Cyclosporine (neural sandimmune)
- Azathioprine (Imuran)
- Prograf (tacrolimus)
What nursing intervention for pt. with immune disorder?
What nursing intervention for pt. with immune disorder?

- Protect pt. from infection (because pt. is lacking of immunity)
What do you do prior to an organ donation?
What do you do prior to an organ donation?

- Cross check blood and tissue types to prevent rejection
What is possible cause for urticaria on pt.’s palm and sole shortly after bone marrow transplant?
What is possible cause for urticaria on pt.’s palm and sole shortly after bone marrow transplant?

- GVHD (Graft Versus Host Disease)
- Complication of transplantation
What are s/s of B12 deficiency?
What are s/s of B12 deficiency?

- Sore red beefy tongue
- Paresthesia (numb and tingling of hands and feet)
- Fatigue
- Anorexia
- Weight loss
- Pallor (pale)
What substances influences B12 deficiency?
What substances influences B12 deficiency?

- Lack of secretion of Intrinsic Factor from the parietal cell
(pernicious anemia)
What kinds of disorders cause B12 deficiency?
What kinds of disorders cause B12 deficiency?

- Anorexia
- Crohns disease
- Gastric surgery (lack of parietal cells)
- Ulcerative colitis
What are the s/s of Ulcerated Colitis?
What are the s/s of Ulcerated Colitis?

- Weight loss
- Diarrhea (15–20X a day)
- Abd distension
- Bloody Diarrhea
- Occult Blood (hidden blood)
What does occult mean?
What does occult mean?

-hidden blood in stool, check in IBS and ulcerative cholitis
Would you check for occult in pt. with ulcerative colitis or IBS (irritable bowel syndrome)?
Would you check for occult in pt. with ulcerative colitis or IBS (irritable bowel syndrome)
- YES
Why do pt's with crohn’s disease need parental vitamin injections?
Why do pt's with crohn’s disease need parental vitamin injections?

- Because pt. has intestine absorption problem. can't absorb orally
How do you know the treatment is working for crohn’s disease pt.?
How do you know the treatment is working for crohn’s disease pt.

- Pt. gaining weight (pt. is absorbing nutrient)
When checking bowel sound what you do first?
When checking bowel sound what you do first?

- Inspection because if you start palpation everything inside will start aggravating
What is primary goal of care for crohn’s pt.?
What is primary goal of care for crohn’s pt.?

- Monitor fluid and electrolytes
- Monitor skin break down (peritoneal + anal areas)
When would pt. with RA (Rheumatoid arthritis) complain the most about pain and stiffness?
When would pt. with RA (Rheumatoid Arthritis) complain the most about pain and stiffness?

- In the morning (because it is immobile at night)
What are the classic S/S of RA?
What are the classic S/S of RA?

- Joint pain,
- joint swelling,
- joint stiffness BILATERALLY
What lab do you expect to see elevated in the RA pt.?
What lab do you expect to see elevated in the RA pt.?

- Elevated ESR (erythrocyte sedimentation rate) indicates inflammation
What is the first symptom of RA
What is the first symptom of RA
- Inflammation and Join pain (synovial tissue)
What is the classic s/s of SLE (Systemic Lupus Erythematosus)?

what are the other s/s?
What is the classic s/s of SLE (Systemic Lupus Erythematosus)?
- Butterfly rash on the face

What other signs?
- fever
- weight loss
- fatigue
- proteinuria (profusely)
what is proteinuria?
what is proteinuria?

- an excess serum protein in urine

(FYI: the presence of excessive protein (chiefly albumin but also globulin) in the urine; usually a symptom of kidney disorder)
what do we find in urine of a pt. with SLE?
what do we find in urine of a pt. with SLE

- proteinuria
what test confirms SLE?
what test confirm SLE
- anti-deoxyribonucleic acid (ANTI-DNA)
- positive anti-nuclear antibody (ANA)
why pt. with SLE need to monitor body temperature
why pt. with SLE need to monitor body temperature?

- because if temperature is elevated it may indicates exacerbation (SLE is getting worse)
is SLE genetic problem? most with male or female?
is SLE genetic problem?

- YES
- female
What is Goodpasture's Syndrome?
What is Goodpasture's Syndrome?

- It is autoimmune disorder
- Attack kidney (glomerulus membrane) and lungs
- Against neutrophils

(FYI: Goodpasture's Syndrome is a rare disease in which the kidneys are attacked by the body's own immune system, also known as anti - GBM disease)
What are the s/s of Goodpasture's Syndrome?
What are the s/s of Goodpasture's Syndrome?

- SOB
- Hemoptotis (cough up blood)
- Decrease ursine output
- Generalized edema
- Weight gain
- Hypertension
- tachycardia
What is the cause of death in Goodpasture's Syndrome?
What is the cause of death in Goodpasture's Syndrome?

- Kidney failure
What kind of treatment do we offer to Goodpasture's Syndrome pt.?
What kind of treatment do we offer to Goodpasture's Syndrome pt.?

- PLASMAPHERESIS (remove antibody from the blood plasma)
RH- can't get RH+
RH- can't get RH+ (need rhagam injections)
but
RH+ can get RH-