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chapter 1 Flashcards

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1
Q

what is immunity?

A

a state of responsiveness to foreign substances such as microorganisms and tumor proteins

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2
Q

what are immune defenses?

A

skin, cornea and mucous membranes protect against the invasion of microorganisms

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3
Q

what is active acquired immunity?

A

(antibodies made by own body)
Naturally: result from antibodies produced after a disease or illness
Artificially: through inoculation (eg, immunization)

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4
Q

what is passively acquired immunity?

A

(immunity obtained by others)
Naturally: though the transfer of immunoglobulins across the placenta from mother to fetus
Artificially: Antibodies obtained through injection of serum

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5
Q

what are hypersensitivity reactions?

A

undesirable responses produced by the normal immune system including allergies and autoimmune diseases
May be classified according to the source of the antigen, the time sequence (immediate or delayed), or the basic immunological mechanisms causing the injury

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6
Q

what should a nurse ask a pt about allergies?

A

1) do you have allergies?
2) family allergies
3) past and current allergies
- identify past and current allergens that may have triggered a reaction is essential for controlling or preventing allergic reactions

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7
Q

what is an atopic reaction?

A

meaning that a person has a tendency to become sensitive to environmental allergens
-20% of the population is atopic

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8
Q

what are some atopic disease that can result in?

A

allergic rhinitis, asthma, atopic dermatitis, urticarcia and angioedema

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9
Q

what is allergic rhinitis?

A
  • also known as hay fever
  • may be seasonal
  • substances such as pollens, dust, or moulds are the primary cause of allergic rhinitis
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10
Q

what are some symptoms of allergic rhinitis?

A

nasal discharge, sneezing, lacrimation (excessive tearing), pruritus around the eyes, nose, throat and mouth

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11
Q

what do many cases of asthma have?

A

an allergic component

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12
Q

what are some symptoms of asthma?

A

Dyspnea, wheezing, coughing, sensation of tightness in the chest and thick sputum

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13
Q

what happens in the body when someone has an asthma attack?

A

SRS-A and histamine produce bronchial smooth muscle constriction, excessive secretion of viscous mucus, and decreased lung compliance

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14
Q

what is dermatitis? what is it caused by?

A
  • a chronic inherited skin disorder
  • caused by several enviromental allergens
  • skin lesions are more generalized and involve vasodilation of blood vessles, which results in interstitial edema with vesicle formation
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15
Q

when does urticaria (hives) develop?

A

develops rapidly after exposure to an allergen and may last for minutes or hours

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16
Q

what is responsible for the pruritus associated with the lesions with hives?

A

histamine

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17
Q

what does H1 do?

A
  • vasodialates
  • mass cells (causes allergic reaction)
  • causes swelling in lips and eyes
  • causes pruritus
  • causes bronciocontriction
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18
Q

what does H2 do?

A

vasodialation

causes release of mass cells

19
Q

what does antihistamine do?

A

stops receptors

1) benadryl (H1 blocker) ~4 hour half life
2) ranidine (H2 blocker) ~ 2.5 hour half life

20
Q

what are some interventions a nurse can make for pt allergies?

A
  • help ot make lifestyle adjustments to minimize exposure to the offering allergens (ex, elimination diet)
  • enviromental control of allergens (ex, change of occuption, giving up a pet, sleeping in air conditioned room, covering bed sheets with hypoallergenic covers
21
Q

what teaching can a nurse do for knowledge deficit about allergies?

A
  • teach pt about ways to avoid exposure to allergens
  • teach pt how to use epipen
  • encourage use of medical alert bracelet
  • teach importance of informing health care providers of allergies
22
Q

what is anaphylaxis?

A
  • occurs suddenly after exposure to allergen
  • can be life threatening as a result of bronchial contriction and subsequent airway obstruction and vasular collapse (cadiac arrest occurs)
  • shock can occur rapidly and is manifested by rapid, weak pulse, hypotension, dialted pupils, dyspnea, and possible cyanosis
23
Q

what are some allergens that cause anaphylactic shock?

A
  • penicillins
  • insulins
  • chemotherapetic drugs
  • sulfonamides
  • blood products
  • contrast media for angiography
  • eggs, nuts, shellfish
  • insect venom
  • tentanus, diphtheria, rabies, and snake venom antitoxins
24
Q

what are some signs and symptoms of anaphylaxis

A

-swelling of conjuncitiva
- runny nose
-swelling lips, tongue and or throat
-fast or slow heart rate
-low blood pressure
-skin: hives, itchiness, and flushing
-pelvic pain
-CNS: lightheadedness, loss of consciouness, confusion, headache, anxiety
RESP: shortness of breath, wheezing or stridor, hoarseness, pain with swallowing, cough
GI: crampy abdominal, pain, diarrhea, vomiting,
-loss of bladder control

25
Q

What is angioedema?

A
  • swollen lips, eyes, cheeks
  • small airway
  • caused by A.C.E inhibitor
26
Q

what are some interventions for anaphylaxis?

A
  • ensure pt airway
  • remove insect stringer if it is present
  • administer epinephrine
  • administer high flow O2 via non-rebreather mask
  • keep pt warm (prevents shock)
  • administed diphenhydramine (benadryl) IM or IV
  • Administer H2 blockers
  • Maintain pt blood pressure with fluids, volume expanders or vaspressors
  • give fluids
27
Q

what can a nurse do when a pt is having ineffective airway clearance?

A

assess for airway patenct- may need to intubation or tracheostomy

  • adminster o2 via non rebreather mask
  • encourage slow deep breaths
  • monitor resp assessment, blood pressure, heart rate, o2 saturation, and resp rate
28
Q

what can slow progression of HIV?

A

combination antiretroviral drug therapy (ART)

29
Q

mental health conditions have been shown to increase the risk of getting what?

A

HIV (from impulsive behaviours, substance abusee, bad judgement)
(estimate that between 5% and 23% of ppl with chronic mental illness have HIV

30
Q

how can mentally ill people + HIV negitvely affect thier health?

A
  • affects ability to find and be retained in care

- decreases their ability to remain adherent once they start HIV treatment (3 pills a dat)

31
Q

how is HIV transmitted?

A

only under specific conditions that allow contact with infected body fluids, including:
blood (can be from sharing injection equipment)
semen
vaginal secretions
breast milk
(HIV infected ppl can transmit HIV to others within a few days of becoming infected)

32
Q

what is the most common ways that HIV is transmited?

A

Sexual contact

33
Q

how can HIV be transmitted during pregnancy?

A

perinatal tranmisttion can happen at time of delivery or after birth through breastfeeding

34
Q

what is the pathophysiology of HIV?

A

HIV is an RNA virus

  • RNA viris replicate in a backwards manner going from RNA to DNA
  • immune dysfunction in HIV is caused by damage and destruction to CD4 T cells
35
Q

how many CD4 T cells does a normal adult have per microliter of blood?

A

800 to 1200

36
Q

what is the acute infection of HIV?

A
  • development of HIV-specific antibodies is accompanied by flulike symptoms
  • occur 1-3 weeks after the initial infection and last for 1-2 weeks
  • during this time, a high level of HIV in blood is noted and CD4 T cells counts fall temporarilty but quickly retunr to baseline
37
Q

what is the chronic infection of HIV?

A
  • median interval between untreated HIV infection and a diagnosis on AIDS in about 10 years
  • During this time, CD4 T cells remain above 500 per microliter (200 to 400 is when person gets really sick)
  • referred to as asymptomatic disease but fatigue, headache, low grade fever, night sweats, and lymphadenopathy often occur
38
Q

what is AIDS?

A

the medial interval between untreated HIV infection and a diagnosis of AIDS is about 10 years
-diagnosis of Aids is characterized by numerous infections, variety of malignancies, wasting, and dementia can result from HIV related immune impairment

39
Q

what screening is there for HIV?

A
  • Screening of HIV specific antibodies is the most useful to detect HIV but there is a delay of 2 months after infection before the antibodies can be detected
  • new “rapid” HIV-anitbody tests can provide rapid results
  • determined by a decrease in CD4 T cells
  • also by decreases WBC count, especially neutrophils, low platelet.
40
Q

How does Antiretroviral therapy work?

A

supresses HIV replication and limits the potential for resistance which is a major factor limiting treatment effect

  • drugs that inhibit the ability of HIV to make a DNA copy early replication
  • drugs that inhibits the abiltiy for the virus to reproducein the late stages of replication
  • drugs that precents entry of HIV into cell
  • over the counter drugs and herbal therapies can have lethal interactions with ART
41
Q

what is included in a nursing assessment with a pt who is not known to have HIV?

A

-focus of behaviours that could put person at risk for HIV
-Have you ever had a blood transfusion or used clotting factors? if so, what is before 1985?
- Have you ever shared needles, syringes, or other injecting equipment with another person?
-Have you ever had sexual experiance?
-Have you ever had an STI?
(a positive response to any of these questions requires an in depth exploration of the issue specific to the identified risk

42
Q

what are the goals of therapy for a pt with HIV?

A
  • keep viral load low as possible, maintain a functioning immune system, improve pt quaility of life, reduce potential transmission of the virus, reduce HIV related disease, disability, and death
43
Q

what nursing managment is there for diarrhea?

A
  • helping pt collect specimens
  • recommending dietary changes
  • encouraging fluid and electrolyte replacement
  • instruct the pt about skin care and maintaining skin breakdown around perianal area

nurse 251 (14 decks)

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