Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med/Serg > Allergies/Transfusion/Anaphylaxis > Flashcards

Allergies/Transfusion/Anaphylaxis Flashcards

1
Q

What are the functions of immune response?

A

Defence

Homeostasis

Surveillance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different types of immunity?

A
  1. Natural or innate (born with it)
  2. Acquired
    - active *natural (infections)
    * artificial (immunizations)
    - passive (transfer of immunoglobulin across the placental membrane)
    * *passive immunity is short lived
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Central or primary lymphoid organs of immune system?

A
  • thymus

- bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Peripheral lymphoid organs?

A
  • lymph nodes
  • spleen
  • tonsils
  • associated tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which cells are involved with immune response?

A
  • Mononuclear phagocytes

- B and T lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 TYPES OF IMMUNITY?

A
  • humoral immunity
  • cell-mediated immunity
  • altered immune response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Humoral immunity?

A

antibodies (immunoglobulins) produced by plasma cells

produces: strong and longer lasting immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cell-meidated immunity?

A

immune response brought on by T cell antigen recognition

produces: sensitized T cells and lymphokines

Protection from:

  • viruses/some bacteria
  • fungal infections
  • transplant rejection
  • contact hypersensitivity reactions
  • tumor identity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Altered immune response (hypersensitivity)

A

heightened immune response against foreign antigen

produces: depends on allergen and immune response

heightened reaction to hum oral or cell mediated immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Altered immune response (hypersensitivity) risk factors?

A
  • family hx of allergies or asthma
  • have asthma or allergic condition
  • children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of hypersensitivity reactions?

A
  • anaphylactic (humoral immunity)
  • cytotoxic (humoral immunity)
  • immune complex (humoral immunity)
  • delayed (cell mediated immunity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anaphylactic (humoral immunity) examples?

A

anaphylactic and atopic reactions like: asthma, allergic rhinitis, urticaria, angioedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cytotoxic (humoral immunity) examples?

A
  • ABO incompatibility transfusion reaction

- RH incompatibility transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Immune complex (humoral immunity) examples?

A

reactions associated with autoimmune disorders like: lupus, rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Delayed (cell-mediated immunity) examples?

A

contact dermatitis hypersensitivity reactions to: bacterial, fungal, viral infections and transplant rejections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hypersensitivity reactions release histamine into the body which effects the other body systems in which ways?

A
  • Smooth muscle contraction of the airway and GI tract
  • Increased vascular permeability
  • Vasodilation
  • Increased secretion of mucous
  • Itching
  • Gastric acid secretions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Effects of anaphylactic reaction on neuro system?

A

headache, dizziness, parathesia, feeling of doom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Effects of anaphylactic reaction on intengumentary system?

A

pruritus, angioedema, erythema, urticaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Effects of anaphylactic reaction on respiratory system?

A

hoarseness, coughing, narrowing of airway, wheezing, stridor, dyspnea, tachycardia, respiratory arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Effects of anaphylactic reaction on cardiovascular system?

A

systemic vasodilation & vasopermeability, hypotension, tachycardia, cardiac arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Effects of anaphylactic reaction on gastrointestinal system?

A

cramping, abdo pain, nausea, bloating, vomiting, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Interventions for anaphylactic reaction?

A
  • recognize S&S
  • maintain airway
  • administer 02 prn
  • ask for help
  • take vitals, 02 sat and LOC
  • if reaction from insect bite, remove sting from skin
  • start IV stat
  • place pt in recumbent position and elevate legs
  • maintain BP
  • keep pt warm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

EPINEPHRINE (ADRENALIN) for anaphylaxis?

A

Drug classes: sympathomimetic drug, cardiac stimulant, vasopressor, bronchodilator, etc.

Therapeutic actions: vasoconstriction, bronchodilation, vasodilation

Adverse effects: fear, anxiety, tenseness, restlessness, headache, nausea, pallor

Nursing: Take vital signs prior and while tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Benadryl (diphenhydramine)

A

Drug classes: antihistamine, cough suppressant

Therapeutic actions: competitively blocks the effect of histamine, antipruritic and sedative effects

Adverse effects: drowsiness, sedation, dizziness, disturbed coordination

Nursing: Monitor patient’s response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cimetedine (Tagamet)

A

Drug classes: histamine2 antagonist

Therapeutic actions: inhibits the action of histamine

Adverse effects: dizziness, somnolence, headache, confusion, hallucinations, diarrhea

Nursing: Monitor side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

ON GOING MONITORING for allergic reaction?

A 
Monitor vital signs
respiratory effort 
O2 sat
cardiac rhythm
 LOC
Anticipate intubation or tracheostomy if severe laryngeal edema
27
Q

Epipen?

A

Epinephrine (.3mg) to be injected by self or other in case of a severe allergic reaction. Used by or for a person that is well known to suffer from an anaphylactic allergy to a specific substance.

28
Q

FOLLOW UP for anaphylaxis?

A
  • Anaphylactic allergen is written in red on the chart of the patient
  • Patient should wear a medic-alert bracelet
  • Patient should carry an epipen at all times
  • Should be offered immunotherapy, especially if allergen is insect bites
29
Q

IMMUNOTHERAPY used when?

A

individuals with anaphylactic reaction to insect venom or when allergen can’t be avoided and drug therapy is not effective.

30
Q

Immunotherapy goal?

A
  • To keep high levels of “blocking” IgG levels

- To help individual develop allergen-specific T suppressor cells

31
Q

immunotherapy treatment?

A
  • sub-cutaneous injection twice or once a week
  • dose of allergen increasing gradually
  • takes about two years to reach the maximum therapeutic effect
  • could last up to 5 years or indefinitely with severe allergies or insect stings
32
Q

ATOPIC REACTIONS?

A 
ALLERGIC RHINITIS (HAY FEVER)
ASTHMA
ATOPIC DERMATITIS
URTICARIA (HIVES)
ANGIOEDEMA
33
Q

ALLERGIC RHINITIS (HAY FEVER)?

A
  • Most common type 1 hypersensitivity reaction.
    • Seasonal or year round (perennial allergic rhinitis)
    • Principal causes: pollen, dust, molds, animal dander, weeds and grass
34
Q

ALLERGIC RHINITIS (HAY FEVER)? S&S?

A 
Nasal discharge
Sneezing
Lacrimation
Mucosal swelling and airway obstruction
Pruritus around eyes, nose, throat and mouth
35
Q

ASTHMA?

A
  • bronchial smooth muscle constriction
  • excessive secretion of viscoid mucus
  • edema of mucus membranes of bronchi
  • decreased lung compliance
36
Q

ASTHMA S&S?

A 
Dyspnea
Wheezing
Coughing
Chest tightness
Thick sputum
37
Q

ATOPIC DERMATITIS characteristics?

A

CHARACTERISTIC:
exacerbation and remission

PRESENTATION:

  • skin lesions are generalized
  • involve vasodilation of blood vessels
  • vesicle formation
  • erythema, crust and cracks
38
Q

URTICARIA (HIVES)?

A 
PRESENTATION:
-transient wheals 
(pink, raised, edematous, pruritic areas)
-is localized
-develops shortly after exposure
-could last minutes or hours
39
Q

ANGIOEDEMA?

A

PRESENTATION:

  • lesions similar to urticaria but deeper in the skin, and mucosa layers
  • diffuse swelling; no welts; the outer skin appears normal or reddish
  • swelling starts in the face and then progresses to the airway and other parts of the body

AREAS INVOLVED:
Eyelids, lips, tongue, larynx, hand, feet and GI

SENSATION:
Burns, stings, slight itch and abdominal pain

REACTION:
Swelling might occur suddenly or over a few hours and could last for 24 hrs

40
Q

DELAYED 
HYPERSENSITIVITY
REACTIONS?

A

SAME AS CELL-MEDIATED IMMUNE RESPONSE
Tissue damage caused by T lymphocytes and macrophages. Reaction takes between 24-48hrs

Includes:

  • contact dermatitis
  • hypersensitivity reactions to bacterial, fungal and viral infections and transplant rejections
41
Q

CONTACT DERMATITIS?

A

When skin is exposed to a certain substance that becomes antigenic
over a period of 7-14 days (the memory cells from the antigen)

On subsequent exposures to the substance, a sensitized person develops eczematous skin lesions within 48 hrs.

PRESENTATION:

  • skin appears erythematous and edematous
  • papules, vesicles and bullae
  • may burn, itch or sting
  • is localized and restricted to the area exposed to allergen

CAUSES: metal compounds, rubber compounds, poison ivy, poison oak and sumac, cosmetics, some dyes

42
Q

PREVENTION TO LATEX ALLERGY?

A

-Use non-latex gloves if not in contact with infectious material
-Use powder-free gloves
-Do not use oil-based hand cream or lotions when wearing gloves
-Wash hands with soap after removing gloves
medic-alert bracelet and Epipen if severe allergy

43
Q

MICROBIAL HYPERSENSITIVITY REACTIONS?

A

TUBERCULOSIS IS AN EXAMPLE

PPD skin test will read positive after 48-72hrs. after injection because the initial cell-mediated reaction, memory cells remain

44
Q

MULTIPLE 
CHEMICAL SENSITIVITIES 
(IDIOPATHIC ENVIRONMENTAL INTOLERANCES)?

A
  • Linked to various chemicals and food in the environment
  • Subjective symptoms related to multiple body systems: fatigue, headache, nausea, pain, dizziness, mouth irritation, disorientation and cough.
  • Primarily in women
  • Odour is principle trigger
45
Q

TRANSPLANT REJECTIONS reactions?

A

Hyperacute
Acute
Chronic
IMMUNOSUPPRESSIVE THERAPY FOR LIFE

46
Q

ALLERGIC RECTIONS- NURSING INTERVENTIONS?

A 
HEALTH HISTORY
Family allergies
Past and present allergies
Clinical manifestations and course of allergic reactions
Social and environmental factors

PHYSICAL EXAMINATION

SUBJECTIVE DATA:
FUNCTIONNAL HEALTH PATTERNS
-health perception and health management
-nutrition; elimination
-activity and exercises
-cognitive and perceptual (ex itching)
-role and relationship (ex home-work)
OBJECTIVE DATA:
RASHES
EYES-EARS AND THROAT
RESPIRATORY
POSSIBLE FINDINGS (blood test, skin tests)
47
Q

DIAGNOSTIC STUDIES?

A

CBC with differential
-with immunodeficieny lymph count will be lower than 1200 µ, eosinophil count is higher than normal
Immunoglobulins

  • Sputum, nasal and bronchial cultures
  • Pulmonary functions for asthma
  • Skin testing
  • Alpha-1 Antitrypsin
48
Q

CHRONIC ALLERGIES?

A

CHARACTERISTIC:
Remission and exacerbation of symptoms

TREATMENT:
Allergen recognition and control
-decrease exposure to offending allergen
-treat the symptoms
-talk to patient of having a safer environment
-teach patient relaxing techniques and stress management

49
Q

ANTIHISTAMINES (Benadryl)?

A
  • For treatment of allergic rhinitis and urticaria

- Best results if taken as soon as allergy signs and symptoms appear

50
Q

SYMPATHOMIMETIC AND DECONGESTANT DRUGS?

A
  • Epinephrine or adrenaline

- Sudafed (orally or nasally; used for allergic rhinitis and could last hours.)

51
Q

CORTICOSTEROIDS?

A
  • nasal spray for rhinitis (Nasonex)

- oral cortisone to relieve severe discomfort of allergies

52
Q

TOPICAL ANTIPRURITIC?

A
  • Calamine lotion
  • benadryl ointment
  • coal tar solution (ex Tegrin shampoo)
  • camphor
53
Q

CYTOTOXIC REACTIONS?

A

Involves the direct binding of antibodies to an antigen on the cell surface
Antigen-antibody will create a reaction that will destroy cellular tissue by: -cytolysis
-phagocytosis

Target cells frequently destroyed are: erythrocytes, platelets and leucocytes
Antigen involved are ABO, Rh and drugs

54
Q

HEMOLITIC TRANSFUSION REACTION?

A

Blood group antigens (A & B) are found only on RBCs membranes
ABO INCOMPATIBILITY

55
Q

ACUTE HEMOLYTIC REACTiON?

tx = shock treatment

S&S? Chills, fever, low back pain, flushing, tachycardia, tachypnea, hypotension, vascular collapse, hemoglobinu-ria due to hemolysis of RBCs

A

Antibodies on the recipient’s serum react with antigens on the donor’s RBCs.
Results in agglutination of cells which can obstruct capillaries and block blood flow
Hemolysis of the RBCs releases free hemoglobin into the plasma

The hemoglobin is filtered by the kidney and may be found in urine and may obstruct the renal tubules

The clinical reactions may be mild or severe
Usually develop within the first 15 minutes of transfusion

56
Q

ACUTE TRANSFUSION REACTIONS

- FEBRILE, NON-HEMOLYTIC REACTION

A

Most common
-due to the sensitization of the patient to the WBCs of the donor (leucocytes)

  • S&S: sudden chills and fever (+1C), flushing, anxiety, muscle pain and vomiting
  • Management: Stop transfusion, call md and give antipyretics
57
Q

ACUTE TRANSFUSION REACTIONS

-ALLERGIC REACTIONS

A
  • Due to patients sensitivity to plasma proteins of the donors blood.
  • Most common with patients who have hx of allergies
  • S&S: mild-flushing, itching, hives
  • Management: stop transfusion. If mild symptoms, give patient antihistamine (as ordered) and restart transfusion slowly. If severe, discontinue.
58
Q

ACUTE TRANSFUSION REACTIONS

-CIRCULATORY OVERLOAD

A

-In patients with cardiac or renal insufficiency

-S&S: cough, dyspnea, pulmonary congestion,
hypertension, tachycardia, distended neck veins

-Management: stop infusion, place patient upright with feet in dependant position, give diuretics and O2 as ordered

59
Q

ACUTE TRANSFUSION REACTIONS

-Sepsis

A
  • Due to blood products becoming infected from improper handling and storage
  • S&S: rapid onset of chills, high fever, vomiting, diarrhea, marked hypotension or shock
  • Management: stop transfusion, obtain blood cultures and send bag with remaining blood and all tubing back to blood bank
60
Q

DELAYED TRANSFUSION REACTIONS?

A
  • Can occur 2-14 days after the administration of blood
  • Include delayed hemolytic transfusion reactions (fever, mild jaundice, decreased hematocrit)
  • No acute treatment is required but must be taken into consideration for further transfusions- notify MD
61
Q

ADMINISTRATING BLOOD PRODUCTS?

A
  • Use an 18 gage needle preferably
  • Maximum infusing time for blood product is 4 hours
  • Has to be administered within 30 min. after the product gets to the unit
  • Must be given in conjunction with Normal Saline only with a Y connection
  • Do not use the transfusion line to administer medications
  • Use an IV line specific for blood products (has a filter integrated)
62
Q

STEPS WHEN ADMINISTERING BLOOD PRODUCTS?

A

-When the blood product is delivered to the unit, two nurses must make positive identification of the blood donor AND the recipient
-Inspect blood or blood component (visually)
-Nurse must verify patient understanding of procedure and S&S to report as well has obtaining a signed consent
Nurse take VS before transfusion and reports abnormalities (esp. hyperthermia)
-Nurse remains at the patient’s bedside for the first 15 min. or 50ml of the transfusion for safety measure (transfusion reaction) rate 2ml/min.
-After 15 min. or 50ml of blood infusion, VS are taken again and rate of infusion is governed by the clinical condition of the patient and the product being infused

63
Q

IMMEDIATE ACTIONS TO TAKE IF REACTION OCCURS-transfusion

A

-Stop transfusion
-Keep main IV line open with Normal Saline (different line than blood set)
-Take vital signs and monitor urine output
-Notify blood band and MD immediately- anticipate possible orders
-Check concordance of information on label, voucher and patient`s ID band
-If transfusion is discontinued, send blood bag with tubing, blood specimen and reaction report to the blood bank
Send blood for C&S in the presence of fever, chills, dyspnea or hypotension
-Inform blood bank if symptoms persist or worsen
-Document the reaction in patient’s chart in RED

Med/Serg (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions