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202 Final > Immune > Flashcards

Immune Flashcards

1
Q

5 cardinal symptoms of inflammation

A

warmth, erythema, pain, decreased function, edema

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2
Q

HIV transmission

A

babies, banging, blood

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3
Q

at which stage of HIV is it spread the most? why?

A

primary, 2nd place asymptomatic; patient doesn’t realize they have it

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4
Q

why might a pt not know they have HIV at first?

A

very general nonspecific flu like symptoms

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5
Q

what is AIDS

A

T cells drop below 200, immune system is significantly impaired, no ability to fight infection

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6
Q

what infections are AIDs pts most at risk for

A

any - most get opportunistic infections like pneumonia, TB, thrush, cellulitis

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7
Q

GI s/s of AIDs

A

anorexia, n/v, chronic severe diarrhea, weight loss, wasting syndrome

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8
Q

what is wasting syndrome

A

loss of at least 10% of body weight

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9
Q

complications of thrush

A

can cause sternal pain, ulcers, painful swallowing - makes pt’s more anorexic

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10
Q

Kaposi Sarcoma

A

skin malignancy, small, painless purplish/brown raised lesions on skin, progresses throughout all of the body - lymph nodes, lungs, etc.

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11
Q

integumentary s/s of aids

A

dry, itchy, irritated skin, prone to rashes, eczema, psoriasis
petechiae, bleeding gums

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12
Q

pt education- when AIDs positive

A

med adherence, notify all partners, limit spread through not engaging in risky behaviors, cannot donate blood, plasma, sperm

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13
Q

as a healthcare worker, what should you do when exposed to a patient’s blood

A

wash area thoroughly/flush eyes for at least 1 minute, report it (both u & pt need to be tested), practice safe sex until you are confirmed negative

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14
Q

PrEP

A

pre-exposure prophylaxis

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15
Q

who is PrEP for?

A

those whose behavior puts them at risk for getting HIV - sexual partner with HIV, needle sharer

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16
Q

PrEP pt education

A

MUST take consistently, need regular follow ups with HCP

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17
Q

who is post-exposure prophylaxis for?

A

healthcare workers exposed, individuals exposed through high risk sex/needle sharing

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18
Q

post-exposure prophylaxis considerations

A

4 week intensive course, must start within 72 hours of exposure, not to be treated as a plan b

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19
Q

HIV treatment

A

antiretroviral therapy - not a cure, reduces spread and prolongs life

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20
Q

antiretroviral therapy pt education

A

start as soon as possible, must adhere, will need routine follow ups

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21
Q

nonadherence of antiretroviral therapy leads to -

A

more expensive, more complicated, less successful treatment

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22
Q

what is being tested in follow up appts for antiretroviral therapy

A

HIV viral load, T cells, liver & kidney labs

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23
Q

lipodystrophy syndrome s/s

A

fat loss in arms, legs, and face; fat buildup in abdomen & neck; gynecomastia

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24
Q

lipodystrophy syndrome cause

A

side effect of antiretroviral therapy

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25
Q

lipodystrophy syndrome complications

A

increased risks of hypercholesterolemia, heart disease, DM

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26
Q

pt teaching to prevent infection

A

do not clean litter boxes/bird cages, no rare/undercooked meat, frequent oral care, monitor own temp, urine, mouth - report changes immediately

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27
Q

what should nurse assess for/monitor related to infection

A

labs - WBC, ANC, viral load, T cells; watch for AMS
mouth for thrush, lung sounds for pneumonia, urine for UTI indicators

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28
Q

what meds may be given for pneumonia in HIV pt

A

bronchodilators, glucocorticoids

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29
Q

cachexia interventions

A

be gentle, get another person when moving them, use air mattress, reposition frequently

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30
Q

what kind of diet should HIV pt be on

A

low fat, high protein, high calorie diet; dietary supplements, small frequent meals

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31
Q

what should pt avoid to help w HIV diarrhea

A

high fiber foods, alcohol, caffeine, spicy foods

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32
Q

what med may be given to help w HIV diarrhea?

A

scheduled loperamide

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33
Q

anaphylaxis

A

body releases excess histamine in response to a normally nontoxic allergen - leading to widespread edema

34
Q

anaphylaxis s/s

A

hypoTN, bronchospasm, LOC, flushing, itching, wheezing, sense of impending doom, severe dyspnea, shock, MI

35
Q

priority interventions for pt experiencing anaphylaxis

A

1 - stop med if being infused
2 - subQ epi, IV if that’s ineffective
3 - assess resp & CV status

36
Q

what medications will be given to someone experiencing anaphylaxis

A

immediate epi
IV fluids, pressors, antihistamines, corticosteroids, bronchodilators

37
Q

when can a rebound reaction occur? why is this important

A

4-12 hours; pts must call 911 immediately even if they gave themselves epi; must monitor closely

38
Q

pt education for anaphylaxis

A

strict avoidance, wear ID bracelet with allergies, always carry an epi-pen

39
Q

how do you use an epi-pen

A

remove from tub, remove cap, jab firmly, perpendicular into outer thigh until a click is heard - push injector, remove & massage site for 10 seconds

40
Q

what should a pt do immediately after using an epi-pen

A

call 911 to get ambulance to hospital

41
Q

why is getting an ambulance important after epi-pen administration?

A

high risk of arresting within 5-30 minutes

42
Q

articular features of RA

A

joint inflammation - pain, swelling, warmth, redness, decreased fx; morning stiffness; joints feel spongey/soft
can get deformities in hands/feet

43
Q

how long can someone be in the asymptomatic phase of HIV

A

decades - risk of spread

44
Q

extra-articular s/s of RA

A

fever, weight loss, fatigue, anemia, Raynaud’s, scleritis, pericarditis, splenomegaly, Sjogren’s

45
Q

Sjogren’s

A

associated w RA - excessive dryness in eyes & mucus membranes

46
Q

symptom of RA - indicates poor prognosis

A

nontender, moveable nodules in subQ tissue

47
Q

elevated ESR and CRP indicate

A

inflammation somewhere in the body

48
Q

arthrocentesis

A

pulls out synovial fluid for testing, also relieves some swelling/pain

49
Q

arthrocentesis post-procedure

A

have pt rest or “baby” extremity, monitor puncture site for infection

50
Q

what NSAIDs may be used for RA

A

ibuprofen, celecoxib

51
Q

purpose of NSAIDs for RA

A

don’t prevent joint damage, helps inflammation short term until other drugs kick in

52
Q

what glucocorticoids may be used for RA

A

prednisone, methylprednisolone, dexamethasone

53
Q

purpose of glucocorticoids for RA

A

high dose during exacerbations & at beginning of treatment, commonly used when changing meds/waiting for meds to kick in

54
Q

most common DMARD

A

methotrexate

55
Q

s/e of methotrexate

A

anemia, GI bleeding, infection, photosensitivity, immunosuppression

56
Q

what test must be done before starting methotrexate/periodically during treatment, why?

A

pregnancy test
causes SEVERE birth defects

57
Q

when are biologic drugs used for RA

A

moderate-severe RA, pt doesn’t respond to DMARDs

58
Q

ex of biologic drugs

A

adalimumab

59
Q

adalimumab considerations

A

given through subQ injection, increases risk of infection

60
Q

what kind of exercise is good for RA patients

A

water aerobics/swimming

61
Q

synovectomy

A

removes inflamed synovial fluid

62
Q

total joint arthroplasty for RA

A

only done when nothing else works to relieve pain

63
Q

plasmapheresis

A

removes circulating antibodies from plasma - only done with life threatening heart/lung involvement

64
Q

telltale sign of lupus

A

butterfly facial rash

65
Q

s/s of lupus

A

severe photosensitivity, muscle aches/inflammation in feet/hands, pancytopenia, kidney damage (protein & casts in urine), discoid lesions, alopecia, psychosis, seizures

66
Q

what s/s will a lupus pt have in a flare up

A

fever

67
Q

causes of lupus exacerbation

A

UV/sunlight exposure, fatigue, stress

68
Q

common cause of death in lupus

A

kidney damage - AKI/CKD

69
Q

how can NSAIDs be used for SLE

A

decrease pain & inflammation, used until antimalarials kick in

70
Q

how can corticosteroids be used for SLE

A

decrease pain, immunosuppressive; used until antimalarials kick in

71
Q

how can DMARDs be used for lupus

A

immunosuppressive

72
Q

main treatment for SLE

A

antimalarials - hydroxychloroquine

73
Q

side effects of hydroxychloroquine

A

visual changes, GI upset, rash, photosensitivity, headache, hair changesp

74
Q

hydroxychloroquine considerations

A

takes 2-4 months to kick in; pt should have routine eye exams & report visual changes immediately

75
Q

pt education SLE

A

use gentle moisturizing cosmetics w/ SPF, no harsh chemicals/perfume, avoid nicotine, exercise but don’t overdo it, go to follow-up appts, no exposure to UV/sunlight

76
Q

when does the bullseye rash develop

A

1-28 days after being bitten

77
Q

s/s in stage 1 of lymes

A

fever, myalgia, neck stiffness, headache

78
Q

stage 1 lymes tx

A

10 day course of doxy

79
Q

s/s of stage 2 lymes

A

pain, malaise, flu like symptoms
possible joint & chest pain, palpitations, SOB, headache, dizziness, eye pain

80
Q

stage 2 lymes tx

A

IV abx

81
Q

s/s of stage 3 lymes

A

joint/muscle pain/inflammation, rarely arrythmias & conduction issues

82
Q

proper tick removal

A

make sure entire tick is removed, clean area thoroughly, monitor for bullseye rash

202 Final (17 decks)

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