Med/surg #1

Front 1

Can you have inflammation without infection?

Back 1

Yes, but you can't have infection without inflammation

Front 2

Inflammation

Back 2

sequential respone to cell injury, neutralizes and dilutes inflammatory agent, removes necrotic materials, establishes an enviroment suitable for healing and repair

Front 3

Local S and Sx of inflammation

Back 3

redness, heat, pain, swelling, loss of function

Front 4

Systemic response to inflammation

Back 4

Increased WBC count with a Shift to the left, malaise, nausea, and anorexia, increased pulse and respiratory rate, fever

Front 5

Nursing interventions for inflammation?

Back 5

Acute intervention for fever: antipyretics, RICE, Health Promotion, keep wound if present clean and bandaged.

Front 6

What is Viral Load?

Back 6

The amount of HIV in the blood plasma

Front 7

What is a shift to the left?

Back 7

Having high levels of immsyutr neutrophils called bands in an acute bacterial infection.

Front 8

Complement system major functions:

Back 8

enhanced phagocytosis, increased vascular permeabilty, chemotaxis, cellular lysis

Front 9

Early s and sx of HIV

Back 9

Generally asymptomatic
Fatigue, headache, low-grade fever, and night sweats, usually mistaken for the flu

Front 10

Transmission of HIV

Back 10

blood, semen, vaginal secretion, and breast milk (body fluids only)

Front 11

Normal CD4+ T Helper Cells Count

Back 11

800-1200

Front 12

Immune problems happen with CD4+ T Helper Cells Count

Back 12

below 500

Front 13

AIDS CD4+ T Helper Cells Count

Back 13

below 200

Front 14

Intermediate Chronic Clinical Manifestations of HIV

Back 14

CD4+ T Helper Cells Count of 200-500, viral load increases, HIV becomes for active

Front 15

Intermediate Chronic symptoms

Back 15

Thrush, Oral Hairy Leukoplakia, Shingles, Persistent vaginal candidal infections, Herpes, Bacterial infections, kaposi sarcoma

Front 16

Oral Hairy Leukoplakia

Back 16

is a part of the Intermediate Chronic Stage of HIV

Front 17

Kaposi Sarcoma

Back 17

Most common type of malignacy in HIV, most common in patients on immunosuppresant drugs, happens during the intermiediate chronic stage of HIV

Front 18

Late chronic or AIDS

Back 18

Innune system severly compromised,CD4+ T Helper Cells Count less than 200, rsik for oppertunistic disease, possible malignancies, wasting and dementia

Front 19

Common Oppertunisitic diseases

Back 19

Pheumocystis jiroveci pnemonia, Cryptococcal meningitis, Cytomegalovirus retinitis, Myobacterium avium complex, Kaposi Carcoma, Influenza

Front 20

Protease inhibitors

Back 20

Interfere with activity of enzyme protease in managment of HIV

Front 21

Fusion Inhibitors

Back 21

Interfere with HIV CD4 receptor site binding and entery into cells in managment of HIV

Front 22

Combination antiretroviral therapy

Back 22

Three or more drus from different groups are prescribed at full strength

Front 23

HIV Risk Factors

Back 23

Blood Transfusions before 1985, Sharded needles, sexual history, has any STDs

Front 24

Antietroviral Therapy/adherence

Back 24

Is complex, has interactions, does not work for everyone, is expensive, treament is recommened when immune suppression is great to prevent burnout

Front 25

Hemoglobin Lab Values

Back 25

Male: 13-18g/100mL
Female: 12-16 g/100mL

Front 26

Hematocrit

Back 26

Male: 45-52%
Female: 37-48%

Front 27

Leukocyte (WBC) Count

Back 27

4.3-10.8

Front 28

Erythrocyte (RBC) Count

Back 28

4.2-5.9

Front 29

Platelet Count

Back 29

150,000-350,000

Front 30

Thrombocytopenia

Back 30

Low Platelet count

Front 31

Hematopoiesis

Back 31

Blood Cell Production
occurs in bone marrow

Front 32

Plasma/Blood %

Back 32

Plasma 55%/Blood 45%

Front 33

Iron Deficiency Anemia Etiology

Back 33

Inadequate dietary intake, 5-10% of ingested iron is absorbed, Malabsorption, Blood loss, Hemolysis

Front 34

Iron Deficiency Anemia Signs and Symptoms

Back 34

Pallor, Glossitis (inflammation of the tounge), Cheilitis (Inflammation fo the lips)

Front 35

Pallor

Back 35

Low Hemaglobin, low blood flow to the skin

Front 36

Treatment of iron Deficiency Anemia

Back 36

Increase intake of iron with oj on an empty stomach, liquid iron through a straw d/t teeth staining, nutritional therapy, oral or parenteral iron supplements, transfusion of packed RBCs, black stools

Front 37

Parenteral Iron Supplements

Back 37

Can be used IM or IV, IM may stain skin, always change needle before giving to prevent stain,

Front 38

At Risk groop for Iron Deficiency Anemia

Back 38

Premenopausal women, pregnant, low socioeconimic backgrounds, older adults, and individuals experiencing blood loss

Front 39

Pernicious Anemia
Cobalamin Deficiency B12 Etiology

Back 39

GI surgery, Chronic diseases of the GI tract, Long-term users of H2-histamine receptor blockers (ranidatine), alchoholism, Absence of Intrinsic Factor

Front 40

Pernicious Anemia
Cobalamin Deficiency Clinical Manifestations

Back 40

Sore (beefy) tounge, anorexia, nausea, vomitting, abdominal pain, neuromuscular manifestations- weakness, Paresthesia of the feet and hands, Ataxia (diff. walking), impaired thought process, parasthesis f the feet and hands

Front 41

Intrinsic Factor

Back 41

Protein secreted by the parietal cells of the gastric mucosa. It is required for cobalamin absorption in the small intestine

Front 42

Pernicious Anemia
Cobalamin Deficiency Causes

Back 42

Pernicious Anemia, Gastrectomy, Nutritional deficiencies, chronic alcoholism, hereditary enzymatic defects

Front 43

Pernicious Anemia
Cobalamin Deficiency B12 Treatment

Back 43

Parenteral or intranasal administration of cobalamin, increase in dietary cobalamin does not correct the anemia, still needs adequate dietary intake

Front 44

Pernicious Anemia
Cobalamin Deficiency B12 Managment

Back 44

Ensure no injuries r/t pt's diminished sensation to heat and pain, frequently evaluate patient for gastric carcinoma,

Front 45

Anemia of Chronic Disease

Back 45

Underproducation of RBC's, mild shortening of RBC servival

Front 46

Anemia of Chronic Disease Causes

Back 46

End-stage renal disease: primary factor decreased erythropoietin, chronic liver disease, chronic inflammation, malignant tumors, chronic endocrine diseases

Front 47

Anemia of Chronic Disease findings and treatment

Back 47

Increased Serum Ferritin and iron stores. Normal folate and cobalamin levels, treating underlying cause is best, rarely blood transfusions, erythropoietin therapy

Front 48

Aplastic Anemia Etiology

Back 48

Pancytopenia= decrease in all blood cell types
Low incidence Affecting 2 of every 1 million people
Congential:Chromasomal alterations or Acquired: results from exposer to ionizing, radiation, chemical agents, viral and bacterial infections

Front 49

Aplastic Anemia Manifestations

Back 49

abrupt or gradual development, symptoms caused by suppression of any or all bone marrow elements, Fatigue, dyspnea, Cardiovascular and cerebral response, neutropenia

Front 50

Aplastic Anemia Managment adn complications

Back 50

Must monitor for fever!
Preventing complications from infection and hemorrhage, untreated prognosis is poor (70% Fatal)

Front 51

Aplastic Anemia Treatment

Back 51

Hematopoietic stem cell transplantation (HSCT)
Immunosuppressive therapy

Front 52

Hemolytic Anemia

Back 52

Destruction or hemolysis of RBC's at a rate that exceeds production, extrinsic (aquired) more common then instrinsic

Front 53

Hemolytic Anemia manifestations

Back 53

Jaundice, dystroyed RBC's cause increased bilirubin, enlarged spleen and liver, Tubular necrosis ( hemoglobin molecules can obstruct renal tubulars)

Front 54

3 extrinsic categories

Back 54

1 physical factors
2 immune reactions
3 infectious agents and toxins

Front 55

Who is considered at risk fr HIV?

Back 55

The CDC recommends testing for everyone between the ages of 13-64

Front 56

Considerations for diabetic patients and those taking immunosuppressives..

Back 56

at risk for infection

Front 57

A patient has a postive EIA test, what is the next step?

Back 57

Repeat the EIA and confirm the diagnosis with a western blot

Front 58

Complications of anemia

Back 58

if heart is overworked thying to get oxygen to the blood this can lead to heart failure, and heart magaely

Front 59

Anemia where this is no cell production and they are more at risk for infection

Back 59

Aplastic Anemia

Front 60

Acquired hemolytic anemia

Back 60

Physical factors: extreme force on cells
Immune reactions: antigen-antibody reactions destroy RBC's, isoimmune reactions, autoimmune reactions

Front 61

Lymphomas

Back 61

malignant neoplasms originating in the bone marrow and lymphatic stuctures resulting in proliferation of lymphocytes

Front 62

5th most common type of cancer

Back 62

Lymphomas

Front 63

Reed-Sternberg Cells

Back 63

abnormal, giant, multi-nucteated cells located in lymph nodes, found in Hodgkins Lymphomas

Front 64

Megaloblastic Anemia

Back 64

Folic ascid deficient, similar manifestations to B-12 deficient anemia

Front 65

Hodgkin's Lymphoma S and Sx

Back 65

, weight loss, fatigue, weakness, fever chills tachycardia, night sweats,

Front 66

Hodgkins Lymphoma Clinical manifestations

Back 66

Reed-Sternberg Cells present in biopsy of lymph, 2 centameters or larger lymph nodes in cervical, axillary or inguinal lymph nodes