Exam 1 Study Guide Flashcards
Normal white blood cell count
5,000-10,000mm3
Leukopenia
- definition
- causes
- Definition: WBC count less than 4,300mm3
- Causes: chemotherapy, compromised immune system, some viral infections
Leukocytosis
- definition
- causes
- Definition: WBC count great than 10,000mm3
- Causes: idicates an inflammatory response too a pathogen or disease
Adaptive immunity
develops as a result of prior exposure too an antigen through immunizations, or by contacting a disease, both of which generate a protective immune response
Active acquired immuntiy
- definition
- time frame of immunity
- Definition:immunologic defenses developed by the person’s own body
- Time: many years or even a lifetime
Passive acquired immunity
temporary immunity that has developed through previous diseases or immunizations (example is breastfeeding)
Normal CD4 T lymphocyte count
500-1500 cells/mm3
During primary HIV infection, 40-90% of patients will experience acute retro-viral symptoms.
-symptoms
- Fever
- Enlarged lymph nodes
- Pharyngitis
- Flu-like symptoms for a few days
Chronic asymptomatic infection
-CD4 count
more than 500 CD4 T lymphocytes
HIV symptomatic
-CD4 count
200-499 CD4 T lymphocytes
Symptoms of HIV
- Thrush
- Cervical dyplasia (in women)
- Shingles
- Peripheral neuropathy
AIDS
-CD4 count
fewer than 200 CD4 T lymphocytes
Normal adult dose of epinephrine (allergic reactions)
IM 0.3cc
-wears off in 20-30 minutes
Intracellular fluid contains what?
Potassium
Extra cellular fluid is made up of what 2 components?
- interstitial fluid (fluid that surrounds the cell)
- blood vessels
Osmosis
- definition
- goal
- water moves through a semipermeable membrane
- balance the fluid
Diffusion
-definition
-transport of most electrolyses and particles through cell membranes
Glucose cannot enter most cell membranes without the help of __________.
Insulin
Minimum amount of urine need to excrete toxic waste products.
400 to 600 mL
Normal adult output
1-2 liters
Hypovalemia
-definition
-low blood pressure and dehydration; fluid intake is less than what is needed to meet the body’s fluid needs, resulting in a fluid volume deficit
Major electrolyte imbalance with dehydration (2)
- Sodium goes up
- Potassium goes down
- *if patient is in renal failure may seem Potassium go up some
Hypovolemia (dehydration/ low blood volume)
- cardiac changes (4)
- respiratory changes (1)
- skin changes (3)
- neuro changes (4)
- renal changes (3)
- lab assessment (4)
Cardiac Changes: decreased BP, orthostatic HTN, increased HR (in response to to BP and ortho HTN)
*flat neck veins
Respiratory
: shallow, rapid respirations
Skin Changes: dry mucous membrane, sunken eyeballs, cool & clammy skin due to vasoconstriction
Neuro Changes: confusion, lethargy, seizures, decrease level of consciousness
Renal Changes: decreased output, very concentrated urine, crystals
Lab Assessment: increased BUN, hemoglobin and hematocrit; elevated or decreased electrolytes
**patient should stay away from caffeine, will aggravate the GI system
Hypervalemia (excess of fluid)
- reasons (3)
- cardiac changes (5)
- respiratory changes (3)
- skin changes (2)
- neuro changes (3)
- renal changes (2)
- lab assessments (4)
Reasons: heart failure, renal failure, water intoxication
Cardiac Changes: S3 sound, bounding pulse, fast cap. refill, increase BP
*distended neck veins
Respiratory Changes: crackles (indication of pulmonary edema), dyspnea, labored breathing
Skin Changes: edema, moist mucous membranes
Neuro Changes: headaches, cerebral edema=seizures, decrease consciousness
Renal Changes: increase output, increase weight
Lab Assessment: decrease BUN, hemoglobin, hematocrit, and sodium
Nursing Assessment: edema, ascultating lungs (monitoring fluid in lungs), I/O, semi-fowlers position to maximize breathing
Hyponatremia
- causes (4)
- cardiac changes (2)
- skin changes (2)
- neuro changes (5)
- renal changes (1)
- nurse implications (2)
<135 mEq/L
Causes: increase fluid, diuretics, burns, profuse sweating
Cardiac Changes: decrease BP, decrease HR (depending on the cause)
Skin Changes: edema, moist and/or dry mucous membranes (dependent on cause)
Neuro Changes: decrease DTR, lethargy, cramps, confused, seizures
Renal Changes: increase urinary output
Nursing Implications: sodium supplements (deli meat, canned foods, fried foods), fluid restrictions (800mL/24hrs)
Sodium
- primary issues
- vital for what functions
135-145mEq/L
Primary issue: neurological
Vital for: skeletal muscle contraction, cardiac contraction, nerve impulse transmission
Hypernatremia
- causes (1)
- cardiac changes (2)
- skin changes (2)
- neuro changes (3)
- renal changes (1)
- nurse implications (4)
Cause: dehydration
Cardiac changes: increase HR, decrease contractility
Skin Changes: dry mucous membrane, rough/dry tongue
Neuro Changes: twitching, seizures, coma
Renal Changes: decreased urinary output
Nursing Implications: low sodium, increase water, seizure precautions, fall precautions
Potassium
- primary issues
- vital for what functions
- regulator of potassium(organ)
3.5-5mEq/L
Primary issue: cardiac
Vital for: depolarization and generation of action potentials, regulates protein synthesis and glucose use and storage
Regulator: kidneys
Hypokalemia
- causes (3)
- respiratory changes (3)
- neuro changes (4)
- cardiac changes (4)
- intestinal changes (3)
- implications (5)
> 3.4mEq/L
Causes: diuretics, GI losses, dietary intake
Respiratory Changes: weak, shallow respirations, dyspnea
Neuro Issues: weakness, leg cramping, increased anxiety, lethargy
Cardiac Changes: EKG changes: ST segment depression and U wave (very abnormal), weak/thready pulse, decrease BP, orthostatic HTN
Intestinal Changes: decrease peristalsis, constipation, nausea
Implications: monitor O2 stats,open airway, fall precautions, heart monitor, increase potassium in diets (bananas, OJ, citrus fruits
NEVER IVP POTASSIUM
Hyperkalemia
- causes (3)
- cardiac changes (5)
- neuro changes (2)
- intestinal (2)
- drug therapy (4)
> 5.0 mEq/L
Causes: salt substitutes, renal failure, burns
Cardiac Changes: decrease BP, irregular HR, decrease HR, QRS widened, peaked T wave
Neuro Changes: cramps, paralysis
Intestinal Changes: increase bowel sounds, diarrhea
Drug therapy: Kayexalate, insulin, cardiac monitoring, health teachings
