Exam 5 - Immune/Malignant & Hematology Flashcards
What is cell mediated immunity?
An immune response that does not involve antibodies. Rather, cell-mediated immunity is the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen.
How are autoimmune disorders defined?
These disorders happen when the body’s natural defense system can’t tell the difference between its own cells and foreign cells, causing the body to mistakenly attack normal cells
How is SLE defined?
Systemic Lupus Erythematosus (SLE) is an autoimmune disorder where the body attacks itself, causing major inflammation in the skin, joints, kidneys, & heart resulting in organ failure over time, most often in the kidneys.
Who is at risk for SLE?
Cause is unknown
Most cases: Women 14 - 45 years.
UV radiation from the Sun makes
it worse
What teaching is needed for a patient who takes an immunosuppressive agent?
Explain to the patient the importance of reporting fever, signs and symptoms of infection, any change in skin and mucous membranes, including rash, or other changes in health status.
Also teach him or her to report a cough, burning on urination, pain around the venous access site, or new drainage from a wound or any area of the body.
Good hand hygiene!
A patient receiving external radiation for the treatment of cancer should have what education?
Teach patients receiving radiation therapy how to care for the skin in the radiation path.
Very hard on the skin: red, dry & itchy
* NO hard scrubbing of skin
* NO tape or deodorants
* NO shaving
* NO lotions, creams, perfumes, powders,
makeup cosmetics
What is stomatitis? Patient education should include?
It is inflammation of the mouth/lips. It is a common side effect of chemotherapy.
* Do not use alcohol based mouthwash!
* Use a soft toothbrush.
* Avoid acidic, spicy, dry, or crunchy foods.
* Cut food is smaller bites.
* Use a straw.
How does chemotherapy affect the older patient?
Older adults are at even greater risk for treatment-related complications and exacerbations of pre-existing comorbidities.
Caring for the older adult receiving cancer treatment is challenging because physiologic changes with aging and comorbidities may affect the ability to tolerate treatment and recover following treatment.
Goals of care can include medication management, maintaining functional status, and managing cardiac, pulmonary, and diabetes processes
What nursing interventions/education should the nurse include for a patient with chemotherapy that complains of nausea?
Many cancer drugs are emetogenic (vomiting inducing); some agents cause more nausea and vomiting than others. N&V is the most common SE of chemotherapy.
Administering antiemetics before treatment
Non-pharmacological measures: music/relaxation therapy, dietary considerations
What is thrombocytopenia?
Low platelet level can have causes that aren’t due to underlying disease.
Examples include pregnancy, altitude, or medication side effects.
Normal: 150,000 - 400,000
Thrombocytopenia:
150,000 or less
100,000 = MAJOR RISK
50,000 or Less = DEADLY
What nursing care is implemented for a patient with thrombocytopenia?
Platelets below 20,000 may have spontaneous bleeding that may not stop
* Need platelet transfusion
What are neutropenic precautions?
Neutropenia is the very low white blood cell (WBC) count - normally 5,000 - 10,000.
This happens when clients with cancer undergo chemotherapy & radiation which kill the cancer cells, but also kill the bone marrow where WBCs are produced.
Clients have HUGE risk for infection!
NO fresh flowers, or fresh fruits
AVOID crowds & sick people!
FEVER is a priority OVER 100.3 F (38 C)!
What foods contain high amounts of iron?
Meat, Fish, Poultry
Spinach “green leafy” & whole grains
Legumes
What types of patients are at risk for iron deficiency anemia?
The most common anemia worldwide, especially among women, older adults, and people with poor diets.
It is a decreased iron supply that results from blood loss, poor GI absorption of iron, and an inadequate diet.
Common causes of folic acid deficiency
Poor nutrition, malabsorption, and drugs.
Poor nutrition, especially a diet lacking green leafy vegetables, liver, yeast, citrus fruits, dried beans, and nuts, is the most common cause.
Malabsorption syndromes, such as Crohn’s disease, are the second most common cause.
Anticonvulsants and oral contraceptives can contribute to folic acid deficiency and anemia.
