Exam 1 Flashcards
Self markers on the surface of all cells
Human Leukocyte Antigens
For a person to be considered immunocompetent, which three processes must be intact and functioning?
- Inflammation
- Cell-mediated immunity
- Antibody mediated (humoral) immunity
“natural immunity,” cannot be developed or transferred from one person to another, not an adaptive response to exposure
Innate-native immunity
Recruitment and emigration of WBCs
Chemotaxis
Destroys bacteria and cellular debris
Monocytes
Weak phagocytic action; releases vasoactive amines during allergic reactions
Eosinophil
Releases histamine and heparin in areas of tissue damage
Basophil
Nonspecific recognition of foreign proteins and microorganisms; ingestion and phagocytosis
Macrophage
Nonspecific ingestion and phagocytosis of microorganisms and foreign protein
Neutrophil
Becomes sensitized to foreign cells and proteins
B-Lymphocyte
Secretes immunoglobulins (antibodies) in response to the presence of a specific antigen
Plasma Cell
Remains sensitized to a specific antigen and can secrete increased amounts of immunoglobulins specific to the antigen on re-exposure
Memory B Cell
Enhances immune activity through secretion of various factors, cytokines, and lymphokines
Helper/Inducer T-cell
Selectively attacks and destroys non-self cells, including virally infected cells, grafts, and transplanted organs
Cytotoxic/cytolytic T-cell
Nonselectively attacks non-self cells, especially body cells that have undergone mutation and become malignant; also attacks grafts and transplanted organs
Natural Killer Cell
Make up between 55% and 70% of the normal total WBC count
Mature Neutrophils
WBCs that increase during an infection
Banded Neutrophils
Increase during an allergic reaction
Eosinophils
Vascular stage of inflammation
Momentary vasoconstriction followed by vasodilatation and capillary leakage
Major cells of the vascular stage
Macrophages
Provide protection after invaders, especially bacteria, enter the body
Neutrophils
Mature neutrophils
Segmented
Immature neutrophils
Band
An increase in the band cells (immature neutrophils) in the white blood cell differential count; an early indication of infection
Left Shift or Bandemia
Difference in macrophages and neutrophils
Macrophages have a longer life span, neutrophils arrive at infection site earlier, macrophage can present the antigenic fragments to t cells with MHC (Major Histocompatibility Complex) after engulfing the bacterial cells
Which cells cause the manifestations of inflammation?
Basophils
Very active against infestations of parasitic larvae and also limits inflammatory reactions
Eosinophils
Resultant formation of pus, necrotic tissue and increased edema
Cellular stage
Major cells of cellular stage, arrive first to engulf
Neutrophils
Latex allergies go along with what?
Tomatoes/bananas
Iodine allergies go along with what?
Shellfish
New blood vessel growth
Angiogenesis
When does stage 3 begin?
At the time of injury
Immunity w/out antibodies but with recognition of antigen by T cells and their destruction of cells or on the secretion by T cells that enhance the ability of phagocytes to eliminate the antigen, also involves macrophages
Cell-mediated (adaptive)
B cells produce circulating antibodies in response to the presence of a foreign substance and recognize the substance upon renewed exposure
Antibody-mediated
May be transferred to other people, “active immunity,” must bind to an antigen
Antibodies
Clumping of antigen/antibody complexes
Agglutination
Overall function of T8
To suppress the immune response
T4
Helper cells
Ratio of T4 and T8
Should be twice as many T4s
Protein hormones and thus are messengers telling cells in the immune response how and when to act
Cytokines
Include interleukins, interferons, colony stimulating factors, and tumor necrosis factor (TNF)
Cytokines
- Cytokines produced by macrophages
- Cytokines produced by T cells
- Monokines
- Lymphokines
Rejection that occurs immediately when the host has preformed antibodies to the organ
Hyperacute
Occurs within the first few months owing to vaculitis→hypoperfusion and T and NK cell activity
Acute
The donated organ is scarred and becomes non-functional
Chronic
Refers to the ability to cause disease
Pathogenicity
Addresses how frequently the organism causes disease, and refers to the severity of the disease.
Virulence
Immunity resulting from the injection of antibodies or sensitized lymphocytes from another organism or, in infants, from the transfer of antibodies through the placenta
Passive immunity
Influenza, Mycobacterium tuberculosis, and Streptococcus pneumoniae can enter how?
Respiratory Tract
Salmonella enteritiditis, Salmonella typhi, Shigella, millions of other food borne illnesses enter how?
GI Tract
Most enter via percutaneous means or broken skin. Trepoonema Pallidum enters through intact skin
Skin/mucous membranes
Requires negative pressure room and N95 or higher fitted mask (N95 means 95% of air is filtered)
Airborne (TB, chickenpox)
Do not stay suspended in air, coughs/sneezes
Droplets (Flu)
Endogenous
From the pt
Exogenous
From outside the pt
CDC recommends what for infection control?
1/100 beds and surveillance
Involves musculoskeletal system
Rheumatic Dz
Crepitus
Pieces of bones/joints that got loose. Grating upon movement
Why is smoking bad for OA?
Limits oxygen flow to your cartilage
What is the most important aspect of infection control?
Hand hygiene pre and post donning and removing gloves
Placing multiple patients with the same organism in rooms together
Cohorting, used a lot with MDROs (multi drug resistant organisms)
Airborne Precautions
- Monitored negative airflow rooms required to prevent spread of microbes
- HEPA air filter
- N95 mask
- Limit pt movement
- Pt wears N95 mask if traveling around hospital
- For TB, measles, chickenpox
Droplet Precautions
- Private room preferred
- Protect from droplets that may travel 3 feet but are not suspended for long periods
- Wear a mask when within 3 fee of the patient
- Transport with mask
- For influenza, mumps, pertussis, meningitis
Contact Precautions
- For known or suspected infections transmitted by direct contact or contact with items in environment
- For MRSA, VRE, pediculosis (lice), scabies, RSV, C. diff
- Private room preferred
- Wear gloves when entering room
- Wear gown if body fluids are involved
- Travel only when necessary
- Have dedicated equipment
Standard Precautions
- Respiratory hygiene/cough etiquette (RH/CE)
- Patient, staff, and visitor education
- Posted signs
- Hand hygiene
- Cover nose/mouth with tissue and quickly dispose tissue
- Cough into shirt sleeve rather than covering with hand
- Safe injection practices
- Single use sterile needle
MRSA
- Rx: Vancomycin, Linezolid
- Health teaching: best way to decrease incidence
- Contact precautions
- Risk Factors: Older adults, Immunocompromised, Invasive lines, ICU patients
Community-associated MRSA
- Healthy non-hospitalized people infected
- Health teaching best way to decrease incidence
- Perform frequent hand hygiene, including use of hand sanitizers
- Avoid close contact with people with infectious wounds
- Avoid large crowds
- Avoid contaminated surfaces
Vancomycin-resistant Enterococcus (VRE) Risk group
Abdominal surgery, long hospital stays, enteral feedings, severely ill, immunocompromised
Grows in the gut and is needed for digestion, lives for several days on objects making it easy to spread from toilet seats, door handles
Enteroccous
Complex group of microbes, “slimy,” very hard to treat
Biofilms/Glycocalyx
Frequent catheter changes are recommended for long term use what for short-term use? (3weeks)
Silver Allooy or antimicrobial covering
- Deliberate failure to take
- Accidentally not taking
- Noncompliance
- Nonadherence
Best management for biofilms/glycocalyx
Mechanical disruption
What clues can you look for with infected pts?
Incubation times
Lymphadenopathy
Swollen lymph nodes, accompany infection
Blood test that can reveal inflammatory activity in your body
ESR (>20mm/hr for infection)
NU Dx’s associated with infection
- Risk for fluid volume deficit
- Impaired comfort
- Hyper/hypothermia
- Ineffective protection
Teach patient SE after giving antipyretics
- Waves of sweating may occur, increase fluid intake
- Observe for N/V, rash
NU interventions for fevers
- Ice paks, hypothermia blankets, sponging with tepid, cool compresses to skin and pulse points
- Don’t use fans
- Shivering can indicate they’re cooling too quickly