Final Review Flashcards
Chain of Infection
( 6 things)
- Causative Organism
- Reservoir
- Portal of exit
- Route of transmission
- Susceptible Host
- Portal of Entry
4 types of Hypersensitivity
Type1: Anaphylactic
Type 2: Cytotoxic
Type 3: Immune Complex
Type 4: Delayed
Type 1 Anaphylactic Hypersensitivity
Most Severe. Rapid onset.
edema in many tissues, including the larynx, and is often accompanied by hypotension, bronchospasm, and cardiovascular collapse in severe cases.
Type 2 Cytotoxic Hypersensitivity
ex: wrong blood given during a transfusion
occurs when antibodies are directed against antigens on cells or basement membranes of tissues. This reaction can lead to cell lysis and tissue damage.
Type 3 Immune Complex Hypersensitivity
ex: Rheumatoid Arthritis
damaging inflammatory reaction caused by the insoluble immune complexes formed by antigens that bind to antibodies.
Type 4 Delayed Hypersensitivity
ex: TB infection
T cell–mediated immune reaction after exposure to an antigen. This immune reaction typically occurs 24 to 48 hours after exposure to an antigen.
Airborne Precautions
Live on air on MTV
Measules
TB
Varicella
Hospitalized patient should be
in a negative pressure room with
the door closed; health care
providers should wear an N-95
respirator (mask) at all times
when in the room
Droplet Precautions
Pimp my ride Drop cars
PIMP
Pertussis
Influenza
Meningitis
Pneumonia
Wear a face mask but door may
remain open; transmission is
limited to close contact
EPI PEN
Epinephrine
Used to prevent an anaphylactic reaction.
- inject in the middle of your outer thigh (upper leg)
-hold for 10 seconds
- through clothing, if necessary
Barrett Esophagus
liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage
Cirrhosis
Scarring of the liver
-Nutritional deficiency with reduced protein intake contributes to liver destruction in cirrhosis, but excessive alcohol intake is the major causative factor in fatty live
Common cause of * Osteomyelitis
Staphylococcus aureus
DIGOXIN (cardiac glyceride) digs for a deeper contraction
Deep contractions.
Decreases the HR
Digoxin is a TOXIN (over 2)
Monitor Kidney function. Creatine Labs
Monitor potassium if its getting too low. (MONITOR ELECTROLYTES)
- digoxin is used in HF and to control ventricular response to afib. (antiarrhythmic)
Diuretics
Decrease BP
Draining fluid
Dehydrate
Potassium wasting: end in IDE. Furosemide
Potassium Sparing: spironolactone spares and blocks aldosterone.
Diagnostic Test: CARDIAC CATHETERIZATION
* Remember you give contrast (iodine)
two types: Left or Right.
Test is used to show blockages and heart function. It can also be used to place a cardiac stent in the heart valves IF there is a blockage or a MI.
Nursing CONCERNS:
-Circulation (check peripheral pulses)
- Hematoma/ Bleeding
- hypotension due to loss of blood
- Evaluate temperature, color, and capillary refill of affected extremity
- Screen for arrhythmias
- Maintain bed rest 2 to 6 hours
Heart Failure (HF)
a disorder that impairs the ability of the ventricle to fill or eject blood; thus, the heart is unable to pump enough blood to meet the body’s metabolic demands or needs.
Right Sided HF
Right side ROCKS the body with fluid
Right side is TOO WEAK TO PUMP USED BLOOD TO the LUNGS.
- Peripheral Edema
- Weight Gain= water gain
- Hepatomegaly (big liver)
- Splenomegaly (big spleen)
- JVD (big neck veins)
- Ascites
Left-sided HF
Lung Fluid
Caused by damage to the myocardia heart muscle.
Left side of your heart pumps FRESH BLOOD to the rest of your body THROUGH YOUR CIRCULATORY SYSTEM. The left ventricle is larger and stronger than the right because it must pump blood through your whole body.
-Pulmonary Edema
- Crackles (rales) in the lungs
- Dyspnea and Orthopnea (SOB lying flat)
- S3 or ventricular gallop
- pink frothy sputum
- low O2
- oliguria
- non productive cough
- Cyanosis
hydrochloroTHIAZIDE
IS A POTASSIUM SPARING DIURETIC. aids in reducing BP
B-Type Natriuretic Peptides (BNP) Lab
Diagnosing HF
BNP BULGING VENTRICLES
100 & Less is Normal
300+ Mild
600+ Moderate
900+ Severe
Digoxin Dose, Side effects and Toxicity
Dose: 0.5-2
Side effects: anxiety, hallucinations, unusual tiredness and fatigue
CV: : dysrhythmias, including bradycardia or tachycardia
CNS: headaches, fatigue, malaise, confusion, convulsions
Poisoning and toxicity:
- Visual Disturbances
- Nausea/vomiting
- Arrhythmias
- Electrolyte imbalances
Antidote: Digibind (digoxin immune fab). It binds to the digoxin molecules.
HIV Human Immune Deficiency Virus
Immune deficiency is acquired:
-Due to medical treatment such as chemotherapy
-Infection from agents such as HIV
Despite advances in treating HIV, acquired immune deficiency syndrome (AIDS) remains a public health issue
Prevention, early detection, and ongoing treatment are important aspects for care
PLWHA—persons living with HIV/AIDS
Treatments/ Medications: Anti-Virals, Antiretroviral Drugs (used in combination).
Modes of Transmission of HIV
HIV-1 transmitted in body fluids that contain infected cells:
Blood and blood products
Seminal fluid
Vaginal secretions
Mother-to-child: Amniotic fluid, breast milk
Not through casual contact
Cancer that is opportunistic to HIV
Kaposi sarcoma in the mouth and back.
Appears first on the oral mucosa as red, purple or blue lesions
Lipid Panel what to do
NPO the night before so cholesterol is not altered.
Hepatic Encephalopathy
Ammonia (should be 15-45) building up, gets into the blood stream and can cause swelling of the brain.
Two major alterations underlie its development in acute and chronic liver disease
Hepatic insufficiency: the inability of the liver to detoxify toxic by-products of metabolism
Portosystemic shunting: collateral vessels develop allowing elements of the portal blood (laden with potentially toxic substances usually extracted by the liver) to enter the systemic circulation
Early signs: mental changes and motor disturbances
Standard Precautions
used for all patients
* The primary strategy
for preventing health
care–associated
infection (HAI)
- Hand hygiene
- Use of gloves and other
barriers - Proper handling of patient
care equipment and linen - Environmental control
- Prevention of injury from
sharp devices and needles - Patient placement
Contact Precautions
skin to skin
- Clostridium difficile
- Use of barriers and cautious techniques to prevent
transmission - Masks not needed
- COVID-19: combination of
transmission-based
precautions, increased use of
PPE, enhanced cleaning, and
adjusted visitor policies
Gerontologic
Considerations
Important to distinguish normal aging
changes from abnormal changes
* Structural and physiologic changes
* Motor and sensory alterations
* Temperature regulation and pain
perception
* As the body gets older, it is hard
to regulate body temperature.
Mostly due to the decrease in the
amount of fat below the skin
makes it harder to stay warm.
* Determine previous mental status for
comparison. Assess mental status
carefully to distinguish delirium from
dementia
Seizure Medication
Anticonvulsants are FIRST
Meningitis
Inflammation of the meninges
Bacterial : strep (septic) or Viral (Aseptic)
Bacterial Meningitis
- mostly caused by strep
Manifestations: Painful, stiff neck
with limited range of motion,
Headaches, High fever, Feeling
confused or sleepy, Bruising easily
all over the body, A rash on the
skin, Sensitivity to light. - Tx :Antibiotics: Rifampin,
Quinolones (eg, Ciprofloxacin),
Ceftriaxone
Viral Meningitis
- Is the most common type of
meningitis. - Caused by viral infections that may
include: Viruses such as herpes
simplex virus, HIV , mumps virus,
West Nile virus, etc. - Treatments vary
- Average recovery can be
between 7-10 days w/o
treatment - Can use antibiotics,
coticosteriods, fluids, etc
Management of Bell’s Palsy
Medical
* Corticosteroid therapy may be
used to reduce inflammation
and diminish severity of the
disorder
* Nursing
* Provide and reinforce
information and reassurance
that stroke has not occurred
* Protection of the eye from
injury; cover eye with shield
at night, instruct patient to
close eyelid, use of eye
ointment and sunglasses
* Facial exercises and
massage to maintain muscle
tone
Bell’s Palsy
Facial paralysis caused by
unilateral inflammation of the
seventh cranial nerve (facial nerve)
* Manifestations: unilateral
facial muscle weakness or
paralysis with facial
distortion, increased
lacrimation, and painful
sensations in the face; may
have difficulty with speech
and eating
* Most patients recover
completely in 3 to 5 weeks,
and the disorder rarely recurs
Gabapentin
Anticonvulsant and Nerve pain medication
Rheumatoid Arthritis
Paget’s Disease
Disorder of localized bone turnover. new bone that is abnormally shaped, weak, and brittle.
S/S skeletal deformities. mild to moderate aching pain
Pharm: antineoplastic therapy
-NSAIDS
- Calcitonin
- Biphosphates
- Plicamycin (antibiotic) for severe cases.
Rheumatoid Arthritis
RA=Rude Pain
Mainly seen in Hands
autoimmune disorder. body attacks its joints (causing major inflammation and joint deformity)
S/S: morning joint stiffness fatigue, anorexia, weight loss,
Diags: xray, mri, arthroscopy, synovial fluid aspiration, blood test( Rheumatic factor, ESR, c-reactive protien)
Rheumatoid Arthritis management
Pain control
low impact exercise (swimming or walking)
heat and cold to affected area/ joints
Pharm: NSAIDS or SEROIDS decrease swelling
METHOTREXATE: immunosuppressant
Lupus
Autoimmunie disorder. causing inflammation in the connecting tissues. (skin, joints, kidneys, and heart)
AVOID THE FOUR S’s
Sun/UV, Smoking, Stress (physical and emotional), Sepsis
Pleuritis: inflammation of the pleura tissues around the lungs. SCRATCHING sound heard in the lungs
