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123 Cards in this Set
- Front
- Back
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What are some common causes of IgE-mediated anaphylaxis?
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foods
insect venoms latex medications immunotherapy (allergy shots) |
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What type of hypersensitivity reaction is allergic rhinitis or asthma?
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type I
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What type of hypersensitivity reaction is a hemolytic transfusion reaction?
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type II (cytotoxic/cytolytic)
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What type of hypersensitivity reaction is Goodpasture syndrome?
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type II (cytotoxic/cytolytic)
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What type of hypersensitivity reaction is lupus, RA, and type 1 diabetes?
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type III (immune-complex)
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What type of hypersensitivity reaction is contact dermatitis?
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type IV (delayed hypersensitivity)
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What type of hypersensitivity reaction is TB?
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type IV (delayed hypersensitivity)
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What type of hypersensitivity reaction is transplant rejection?
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type IV (delayed hypersensitivity)
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Benadryl, Claritin, and Zyrtec are examples of what type of drug used to treat allergic reactions?
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antihistamine
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Sudafed and Neo-Synephrine are examples of what type of drug used to treat allergic reactions?
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decongestant
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Flonase is an example of what type of drug used to treat allergic reactions?
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corticosteroid (nasal spray)
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Calamine lotion, coal tar solutions, and camphor are examples of what type of drug used to treat allergic reactions?
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antipruritic
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Cromolyn is an example of what type of drug used to treat allergic reactions?
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mast cell-stabilizing
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Singulair is an example of what type of drug used to treat allergic reactions?
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leukotriene receptor antagonist
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the recommended treatment for control of allergic symptoms when the allergen cannot be avoided and drug therapy is not effective
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immunotherapy
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What type of allergy cannot be safely treated with immunotherapy?
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food allergies
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Name some foods that cause an allergic reaction in people who are allergic to latex.
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bananas
avocados kiwi fruit tomatoes water chestnuts guava hazelnuts potatoes peaches grapes apricots |
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What is the greatest risk factor for developing a latex allergy?
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long-term multiple exposures to latex products
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What is the primary trigger of MCS (multiple chemical sensitivites)?
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odor
(gas exhaust, perfume, cigarette smoke, plastic, pesticides, etc.) |
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How is MCS (multiple chemical sensitivities) treated?
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by avoiding the chemicals that trigger the symptoms
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Certain HLA types are associated with what 3 autoimmune diseases?
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ankylosing spondylitis
lupus diabetes |
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Name some causes of secondary immunodeficiency disorders.
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Drugs (chemo, corticosteroids) - this is the MOST COMMON cause**
Age Malnutrition Diseases (AIDS, cirrhosis, diabetes, lupus, burns) Therapies (radiation, surgery) Stress |
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In most transplantation situations, the biggest concern is the host's rejection of the graft. However, in _____________, the graft rejects the host or recipient tissue.
How is this treated? |
graft-vs-host disease
usually, the organ must be removed. no meds can reverse this... |
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Transplant rejection can be prevented by closely matching _____, ______, and ______ between donor and recipient.
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ABO
Rh HLA |
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rejection that occurs minutes to hours after transplantation
no treatment for this but to remove the organ |
hyperacute rejection
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rejection that occurs days to months after transplantation
this is treated by changing the patient's immunosuppressive drug therapy |
acute rejection
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rejection that occurs months to years after transplantation and is irreversible
is typically a result of repeated bouts of acute rejection |
chronic rejection
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group of immunosupressive drugs that includes tacrolimus (Prograf) and cyclosporine (Sandimmune)
*most effective immunosuppressants available |
calcineurin inhibitors
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immunosupressive agent used in renal transplant recipients
*type of cytotoxic drug |
sirolimus (Rapamune)
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type of cytotoxic drug that has been shown to decrease the incidence of late graft loss
*AE = GI toxicities (N/V/D) |
mycophenolate mofetil (CellCept)
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immunosuppressive drug used to prevent and treat acute transplant rejection
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monoclonal antibodies (Muromonab-CD3)
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type of immunosupressive drug used to severely immunosupress a patient immediately after transplantation to prevent early rejection
also used to treat acute rejection |
polyclonal antibodies (Atgam)
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Phenergan, Thorazine, and Pepcid are examples of what type of drug used to treat N/V?
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antihistamine
*these drugs block acid secretion |
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Scopolamine is an example of what type of drug used to treat N/V?
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anticholinergic
*these drugs dry up secretions |
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Reglan is an example of what type of drug used to treat N/V?
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benzamide
*these drugs speed up gastric emptying |
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Prilosec is an example of what type of drug used to treat N/V?
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proton pump inhibitor
*these drugs block acid production |
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Tums and Rolaids are examples of what type of drug used to treat N/V?
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antacid
*these drugs neutralize stomach acid |
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What type of meal should a patient with N/V eat when tolerated?
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high carb, low fat
*fat slows peristalsis |
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What types of things are risk factors for or can contribute to a patient developing GERD?
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hiatal hernia
foods (caffeine, chocolate, fatty foods) alcohol smoking obesity |
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What are some possible complications of GERD?
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erosive esophagitis
Barrett's esophagus (precancerous lesions) |
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What are some things you should teach your patient with GERD to do?
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Stop drinking alcohol.
Stop smoking. Eat a high-carb, low-fat diet. Avoid lying down right after eating. Treat with PPIs, H2 antagonists, and antacids. |
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If lifestyle modification cannot control the patient's GERD, what surgery can be done?
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Nissen fundoplication - part of the fundus of the stomach is wrapped around the lower portion of the esophagus to reinforce and repair it
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inflammation of the gastric mucosa that occurs as a result of a breakdown in the normal gastric mucosal barrier
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gastritis
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What are some risk factors for developing gastritis?
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drugs (NSAIDs, aspirin)
diet (alcohol, spicy foods) H. pylori smoking |
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What would you as the nurse do to treat a patient with acute gastritis?
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Eliminate the cause.
Treat N/V symptoms with antiemetics. Maintain NPO status and advance diet slowly. Give IVF to prevent dehydration. Assess emesis for s/s of bleeding. |
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With what GI disorder may a patient need to receive vitamin B12 injections?
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gastritis
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Are antibiotics used to treat diarrhea?
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RARELY! Using them could cause a c-diff infection!
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What two electrolytes can get out of balance in a patient with diarrhea?
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K+
Mg++ |
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Chronic diarrhea causes what acid-base imbalance?
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metabolic acidosis
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Lomotil, Immodium, and Pepto-Bismol are three drugs that are used to treat _________.
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diarrhea
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What are two important things you as the nurse can do for someone with fecal incontinence?
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Implement a bowel training program.
Maintain skin integrity, especially in the bedridden and older adult patient. |
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Name some common causes of constipation.
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narcotics
low fiber diet sedentary lifestyle dehydration depression stress |
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What should the nurse teach her patient with constipation?
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Increase dietary fiber.
Drink enough fluids. Exercise regularly. Establish a regular time to defecate. |
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Who is responsible for removing an impaction?
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the RN!!
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What are the clinical manifestations of appendicitis?
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rebound tenderness
RLQ pain anorexia N/V |
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Palpation of the left lower quadrant which causes pain to be felt in the right lower quadrant is known as ___________ and is found in what GI disorder?
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Rovsing's sign
appendicitis |
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What diagnostic studies are done in a patient with appendicitis?
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CBC - to determine if WBC is elevated
CT scan or ultrasound - to see if appendix is enlarged |
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What are the complications associated with appendicitis if it is not treated?
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rupture and peritonitis
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What are the s/s of peritonitis?
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tachycardia
tachypnea pallor abdominal distention/pain restlessness fever/chills |
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Should you put heat or ice on an inflammed appendix?
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ice
**NEVER USE HEAT - may cause appendix to rupture |
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What can cause a nonmechanical intestinal obstruction?
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anesthesia
head injury |
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Prior to an intestinal obstruction, you will hear __________. After the obstruction, you will hear ______________.
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hyperactive bowel sounds
NOTHING |
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What are the clinical manifestations of intestinal obstruction?
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N/V
abdominal pain/ distention inability to pass flatus hypoactive/absent bowel sounds |
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Why is an NG tube used in a patient with intestinal obstruction?
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to decompress (suction) the stomach since nothing is getting through
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What are the clinical manifestations of diverticulitis?
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** Most have no symptoms!
Can cause: abdominal pain over involved area of colon change in bowel habits possible fever or elevated WBC (esp. in elderly) |
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What should the nurse do for a patient with diverticulitis?
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**To prevent it in the first place, teach pt. to eat more fiber and less red meat/fat and to exercise more.
During acute phase: Keep patient NPO and encourage bedrest. Monitor WBC. Monitor for peritonitis. Once patient is no longer NPO, give them a high-fiber diet with NO NUTS! |
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What are some possible complications of diverticular disease?
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peritonitis
bowel obstruction bleeding |
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What are the clinical manifestations of hemorrhoids?
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bleeding
pruritus prolapse pain |
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Should a patient with hemorrhoids use doughnut pillows to sit on?
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NO!
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What should the nurse teach a patient with hemorrhoids?
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Use stool softeners to prevent constipation.
Avoid prolonged standing or sitting. Use sitz baths to reduce discomfort and swelling. |
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yellowish discoloration of body tissues that results from an alteration in normal bilirubin metabolism or flow of bile into the hepatic or biliary duct systems
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jaundice
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What is the route of transmission for hepatitis A?
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fecal-oral
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What is the route of transmission for hepatitis B?
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blood/body fluids
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What is the route of transmission for hepatitis C?
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blood/body fluids
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What is the route of transmission for hepatitis D?
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blood/body fluids
*can only cause infection when hep B is present |
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hepatitis without jaundice
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anicteric jaundice
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hepatitis with jaundice
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icteric jaundice
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severe impairment or necrosis of liver cells caused by acute viral hepatitis
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fulminant hepatitis
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What should the nurse do for a patient with acute viral hepatitis?
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Encourage the patient to rest.
Promote nutrition. Treat N/V and pain. Teach patient to avoid alcohol and liver toxic meds. |
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What is the goal of treatment for chronic hepatitis?
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Decrease viral load and give meds that interfere with viral replication.
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What drugs are used to treat acute viral hepatitis?
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there aren't any!!
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How can hepatitis be prevented?
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handwashing
personal hygiene environmental sanitation screening of food handlers active immunizations to ppl over age 2 |
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What causes postnecrotic cirrhosis?
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hepatitis
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What causes biliary cirrhosis?
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chronic biliary obstruction and infection
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What causes cardiac cirrhosis?
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longstanding right heart failure
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What are some EARLY clinical manifestations of cirrhosis?
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anorexia
dyspepsia flatulence N/V/D/C |
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What are some LATE clinical manifestations of cirrhosis?
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jaundice
skin lesions (spider angiomas) hematologic problems (thrombocytopenia, leukopenia, anemia) endocrine problems peripheral neuropathy |
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What are some complications of cirrhosis?
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portal hypertension
esophageal and gastric varices peripheral edema ascites hepatic encephalopathy hepatorenal syndrome |
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How is ascites treated?
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Limit patient's sodium intake.
Paracentesis - manually drain fluid out of abdomen |
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What is the goal in treating hepatic encephalopathy?
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reduce ammonia (using Lactulose)
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What are the clinical manifestations of cholecystitis?
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RUQ pain (may radiate to right scapula and shoulder)
fever jaundice N/V |
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What are the clinical manifestations of acute pancreatitis?
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midepigastric pain that may radiate to the back
N/V dehydration abdominal distention |
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What are the clinical manifestations of peptic ulcer disease (PUD)?
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burning epigastric pain
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What are the risk factors for developing peptic ulcer disease (PUD)?
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H. pylori
caffeine coffee aspirin smoking alcohol |
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How long should you keep a patient NPO after an endoscopy?
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until his gag reflex returns
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For gastric lavage, should you use normal saline that is room-temp or refrigerated?
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room-temp!
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Why should you keep the vent lumen of the NG tube positioned above midline?
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to prevent gravity drainage of gastric contents through the port
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What drug therapy is used to treat peptic ulcer disease (H. pylori)?
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two antibiotics and a PPI
*H2 antagonists are used to promote ulcer healing after triple therapy is finished |
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What are some potential complications of peptic ulcer disease?
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GI bleeding - b/c region is very vascular
perforation gastric outlet obstruction - ulcers can cause swelling and obstruct pyloric sphincter dumping syndrome after GI surgery |
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What should you teach your patient to do in order to prevent dumping syndrome after GI surgery?
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Lie down after meals to prevent rapid stomach emptying.
Limit fluid intake with meals. |
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What is the drug of choice to treat pain caused by acute pancreatitis?
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morphine
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Why is dehydration associated with acute pancreatitis?
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nausea/vomiting
pancreatic inflammation and "third spacing" |
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What are some risk factors for developing acute pancreatitis?
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alcohol abuse
cholelithiasis age over 55 yrs obesity |
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What blood work and tests are diagnostic for acute pancreatitis?
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elevated serum amylase and possibly lipase
CT scan - to look at size of pancreas and identify any necrosis |
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bluish color around bellybutton
*this is associated with what GI disease? |
Cullen's sign
acute pancreatitis |
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blue/red or green/brown flanks
*this is associated with what GI disease? |
Turner's sign
acute pancreatitis |
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How should you position a patient with acute pancreatitis to promote comfort?
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side lying with hips and knees flexed
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Effective treatment for acute pancreatitis should lead to:
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decreased abdominal distention
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What are some clinical manifestations of early alcohol withdrawal?
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agitation
anxiety tremors irritability diaphoresis |
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How is alcohol withdrawal treated?
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Ativan
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What are the clinical manifestations of delirium tremors (most severe form of alcohol withdrawal)?
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high BP
confusion hallucinations delusions seizures fever tremors diaphoresis |
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What type of long-term diet should a patient recovering from acute pancreatitis eat?
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high carbs
*Avoid spicy foods, caffeine, and alcohol |
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What are the clinical manifestations of colon cancer?
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change in bowel habits
blood in stool abdominal distention/pain |
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What are some risk factors for developing colon cancer?
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age > 50 yrs
high fat diet family hx obesity sedentary lifestyle hx of ulcerative colitis hx of polyps |
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Why are prophylactic antibiotics taken before a colonoscopy?
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to decrease bacteria in intestine and to decrease risk of post op wound infection
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What position should you place a patient in after colon resection?
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Fowler's
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superficial separation of wound edges
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dehiscence
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What may precede wound evisceration?
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excessive drainage from incision
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What should you do if wound evisceration occurs?
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cover the wound with sterile towels moistened with sterile saline
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If this is elevated, it may indicate that colon cancer is coming back.
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CEA
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What color should an ostomy stoma be?
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pink
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What should you wash a stoma with?
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mild soap
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How often should a colostomy pouch be changed?
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every 5 days and as needed
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