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Holistic NURS-376 > Exam 1: Module 2 > Flashcards

Exam 1: Module 2 Flashcards

1
Q

What is RA
- it is the inflammation of what

A

a chronic progressive autoimmune disorder
- inflammation of connective tissues and gradually affects joints producing synovitis

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2
Q

What is the pathophysiology of RA

A
  1. Synotivitis
    - inflammation of the synovium
    - synovial membranes become inflamed and thickens
  2. Pannus formation
    - Abnormal layer of vascula fibrous tissue that forms
    - Inflammation extends into the cartilage and bones
  3. Fibrous Ankylosis
    - Joint begins to be invaded by fibrous connective tissue
    - Joint deformity and bone erosion occurs
  4. Bony Ankylosis
    - Bones become fused together decresaing the joints ROM and function
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3
Q

what is the cause of RA

A

unknown

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4
Q

what is the most common form of arthritis in older adults

A

Osteoarthritis

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5
Q

What is the most ommon form of autoimmune arthritis

A

RA

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6
Q

does RA affect women or men more

A

Women, 3x more

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7
Q

Children <16 years of age but have arthritis is called what type of arthritis?

A

Juvenile Idiopathic Arthritis

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8
Q

What are the risk factors for RA (What makes people more prone to RA?)

A

Female
- age 30-60 yrs old
- Family Hx of RA
- smoking
- environmental factors

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9
Q

What are the clinical manifestations of RA
- does it happen fast or gradual?
- what are the 4 S’s
- what are other complaints and symptoms of RA?

A

Gradual onset
- 4 S’s
- symmetric joint pain discomfort (EARLY)
- Symptoms are typically BILATERAL
-Stiffness in the morning
- Swelling of the joints

Other complaints:
- Loss of mobility in joint
- Joint deofrmities (LATE DISEASE)
- early affects fingers, thumbs, toes, wrists
Other symptoms:
- Fatigue (early)
- low-grade fever
- weight loss
- depression

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10
Q

If a patient has RA, what other diseases have an increased risk for developing it?
- chronic inflammation accelerates the progressin of what cholesterol issue?

A
  • Coronary Heart Disease
  • Atherosclerosis
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11
Q

Because RA have an increased complication with CHD, what do they have an increased risk for?

A
  • low HDL
  • High LDL and triglycerides
  • HTN
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12
Q

What diagnostic Tests show RA

A

Rheumatoid Factor (Obvious)
- Anti-Cyclic Citrullinated Peptide
- C-reactive protein (CRP)
- CBC

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13
Q

What pharmacological are used with RA?
What do DMARDS do?

A
  • NSAIDS
  • Corticosteroids
  • DMARD’s
  • slow the progression of RA and suppress the immune systems reaction to RA that causes pain & inflammation
  • takes weeks for results
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14
Q

When taking Hydrochloroquine, what needs to be examined every 6 months?

A

An antimalarial rug, Eye exams need to be done every 6 months

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15
Q

What are the 3 surgical treatments for RA?

A

Synovectomy: Performed early in the disease process
- Removal of inflamed synovial membrane

Arthrodesis: Joint fusion to stabilize joints in the cervical vertebrae, writs, and ankles

Arthroplasty: Complete joint replacement may be needed if severe deformity or joint destruction not responded to medication

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16
Q

What are 2 complimentary health alternatives to surgery for RA

A

Acupuncture or Hydrotherapy

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17
Q

What are the 3 types of Juvenile Idiopathic Arthritis?

A

Pauciarticular arthritis:
- occurs more freq. in females
- affects primarily the knees, ankles, and elbows
- affects < 4 joints within 6 months

Systemic Arthritis:
- Symptoms of high fever, poly arthritis, and rheumatoid rash
- can affecet internal organs and joints

Polyarticular arthritis:
- Involves multiple joints (5 or more) within the first 6 months
- Typically affeects the SMALL JOINTS of hands and fingers, but can also affect other joints

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18
Q

What are the risk factors for JIA (What would increase the likelihood of developing JIA?)

A
  • Immune susecptibility
  • Environmental Triggers
  • Genetic/Family Hx
  • Female Gender
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19
Q

What are the. JIA symptoms

A
  • Fever
  • Rash
  • Joint swelling and stifness
  • mobility limitations
  • Slow growth/uneven growth of extremities
  • abnormal gait
  • eye pain (Uveitis)
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20
Q

Just like RA patients are at risk for Cadiac complications, are JIA at the same risks?

A

Yes

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21
Q

Complication with JIA
- with there be changes in growth?
- can some joints be longer than others

A

yes and yes

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22
Q

What diagnostic tests would show JIA in children?

A
  • CRP
  • ESR
  • CBC
  • ANA
  • Rheumatoid Factor

All increased levels would show

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23
Q

Is JIA treatment similar to RA patients?

A

Yes, use aspirin, NSAIDS, DMARDS, and monitor labs regularly

  • Interprofessional collab. (PT, OT, Opthalmologist)
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24
Q

Discharge education for JIA
(PPATE)

A

provide - extra time or the child to complete ADL’s
Perform - ROM exercises are presribed
Apply - warm moist heat to affected joints
Take - meds as prescribed
Even - during exacerbation child should continue usual activities

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25
Q

What type of first dose is given immediatelty at birth

A

Hep B

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26
Q

Hep B has a series of 3 immunizations, when are they given

A

birth
- 1-2 months
- 6-18 months

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27
Q

How does Hep B spread

A

It spreads through bodily fluids and affects the liver

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28
Q

What vaccine is ONLY given orally?
What virus has the most common symptoms of diarrhea resulting in dehydration?

A

Rotavirus

29
Q

what ages is rotavirus administered

A

orally at 2 and 4 months (Rotarix)
- 2,4, and 6 months (RotaTeq)

30
Q

Which Diphtheria vaccine is for young children

A

DTaP

31
Q

Which Diphtheria vaccine is for young for adults

A

Td or Tdap

32
Q

Which Diphtheria vaccine is for young for preteens (11-12 yrs)

A

Tdap

33
Q

Diptheria bacteria is spread through…

A

Coughing, sneezing, and touch

34
Q

How is tetanus spread

A

found in soil and spreads through bloodstream such as a wound

35
Q

How is pertrussis spread?

A

Coughing (aka whooping cough)

36
Q

DTaP is a series of 5 immunizations. When are they scheduled?

A

2 months
4 month
6 months
15-18 months
4-6 years

37
Q

Tdap is given how many times at what age? (Teen age, not infant)

A

1 time immunization at 11-12 yrs old, then booster every 10 years

38
Q

HIB, what is it and what does it cause (clinical manifestations)

A

Causes invasive, life-threatening disease
- Blood infection
- Pneumonia
- Meningitis (inflammatin o membranes covering the brain and spinal cord

39
Q

For HIB vaccine, how many doses and when

A

3 doses or 4 doses

3 doses
- 2 months
- 4 months
- 12-15 months

4 dose schedule
- 2 months
- 4 months
- 6 months
- 12-15 months

40
Q

What is PCV and what is the dose schedule?

A

Pneumococcal conjugate
- prevent strep
- spread through resp. droplets

4 doses:
- 2 months
- 4 months
- 6 months
- 12-15 months

41
Q

how does Polio spread?
- what is the vaccine schedule for IPV (Inactivated Polio Vaccine)

A
  • Polio spreads mostly through exposure to feces

4 dose schedule:
- 2 months
- 4 months
- 6-18 months
- 4-6 years

42
Q

How early can first dose of infuenza be given
- how often given after that?
- nasal spray is available for over what age
WARNING WARNING**

A

as early as 6 months of age
- given yearly
- nasal flu spray available for over 2 years old (***its not a live virus and should NOT be given to certain individuals)

43
Q

What is MMR, what type of vaccine is it and what are the immunization schedules?
What are two common side effects?

A

MMR is measles, mumps, rubella
- Attenuated live vaccine
2 dose schedule
- 12-15 months
- 4-6 years

  • common side effects are fever and rash
44
Q

What is Varicella aka?
- if you had this disease what are you at risk for?
- what type of vaccine is it
- how many doses and what is the dose schedule

A

Chicken pox
- at risk for shingles
- attenuated live vaccine
2 dose schedule:
- 12-18 months
- 4-6 years

45
Q

Hep A, how does it spread and how many doses and at what age?

A
  • spreads when virus from an infected persons feces somehow gets into food/water

2 Dose schedule:
- 12-23 months
- 6-18 months following initial

46
Q

HPV, how many doses

A

2-3 doses series
2 dose schedule:
- First Dose: 11-12 yrs old
- Second Dose administer 6-12 months after first

3 dose schedule:
2nd dose: 1-2 months after 1st
3rd dose: within 6 months of 2nd

47
Q

What is meningococcal disease and what are the dose schedules?

A

Uncommon disease that can cause serious illness and death in people of all ages (meningitis)

2 dose schedule
- 11-12 years old
- 16 years old

48
Q

What are some complications/contraindications/precautions for immunizations?

A
  • allergic reaction possible
  • moderate illness with no fever is precaution for immunization
  • common cold is not a contraindication to immunizations
  • no live viruses (aka varicella/MMR) to child with immunosuppression, pregnant or acquired passive immunity (blood products) within 11 months
49
Q

3 common reactions to
Vaccines

A
  • Tenderness/Redness at injection site
  • Low grade fever
  • Irritable
50
Q

a bundle of what vaccines to take at 2 months

A
  • Hep B (2nd dose)
  • DTaP
  • Hib
  • Polio (IPV)
  • Pneumococcal (PCV13)
  • Rotavirus (RV)
51
Q

a bundle of what vaccines to take at 4 months

A
  • DTaP (2nd dose)
  • Hib (2nd Dose)
  • Polio - IPV (2nd Dose)
  • PCV13 (2nd dose)
  • Rotavirus (2nd dose)
52
Q

a bundle of what vaccines to take at 6 months

KEY: same as 2 months

A
  • DTaP (3rd dose)
  • Hep B (3rd dose) 6-18 months
  • Hib (3nd Dose)
  • Polio - IPV (3nd Dose)
  • PCV13 (3nd dose)
  • Rotavirus (3nd dose)
  • Influenza (Yearly)
53
Q

A bundle of what vaccines to take at 12-23 months

KEY same as 2(6) months but with 3 more immunizations

A
  • MMR (1st dose) 12-18 months
  • Hep A (1st Dose) 12-23 months
  • DTaP (4rd dose)
  • Hib (4nd Dose) 12-18 months
  • Polio - IPV (3nd Dose) 6-19 months
  • PCV13 (4th dose) 12-18 months
  • Influenza (Yearly)
54
Q

A bundle of what vaccines to take at 4-6 years

A
  • DTaP (5th dose)
  • Polio (IPV) 4th dose
  • MMR (2nd dose)
  • Varicella (2nd Dose)
  • Influenza (FLu)
55
Q

A bundle of what vaccines to take at 11-12 years

A
  • Meningococcal
  • HPV (2 doses o vaccine)
  • Tetanus, diptheria and whooping cough
  • Influenza
56
Q

2 vaccines to take at 11-12 years

A
  • Influenza every year
  • Meningococcal
57
Q

What is Hypersensitivity?

A

Altered immune response to an antigen

58
Q

anaphylaxis and transfusion reactions are exmples of what

A

Immediste hypersensitivity reactions

59
Q

hypersensitivity accounts for more than ___ million outpatient visitis per year

A

17 million

60
Q

Type I hypersensitivity reaction is what?

A

IgE Medicated Hypersensitivity
(allergic asthma, allergic rhinitis, hives)

61
Q

Can hypersensitivity be localized or systemic

A

They can be BOTH!

62
Q

What is Anaphylaxis

A

an acute systemic type I response that can result in shock and death
- reaction begins within minutes of allergin exposure

63
Q

What are three comon allergens that can trigger anaphylaxis?

A
  • Foods: Peanuts, shellfish, eggs, etc.
  • Insect bites/stings: Bees, wasps, etc.
  • Medications: Antibiotics, immunizations, etc.
64
Q

What are clinical manifestations of anaphylaxis?

A
  • Hives
  • Angioedema of eyelids, tongue, throat
  • sense of fear/doom
  • imcreased work of breathing
65
Q

What to do if patient is experiencing anaphylaxis?

A

Administer epipen, csll 911, administer albuterol

66
Q

for how many seconds do you hold down epipen to thigh?

A

3 full seconds

67
Q

Common side effects of epinephrine

A
  • pounding heartbeat
  • sweating
  • headache
  • weakness
  • NV
  • pale appearance
68
Q

what to do for severe allergy and anaphylaxis vs mild allergy reaction?

A

Severe: Give epinephrine
Mild: Monitor child

69
Q
A

Holistic NURS-376 (4 decks)

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