Immune Flashcards
0
Q
Describe natural active immunity
A
Get the disease
1
Q
Name and describe the four antibody classes
A
IgG- most abundant (long term) IgE- allergic response, parasites IgA - mucous secretions IgM- first antibody IgD - unclear
2
Q
Describe active artificial immunity
A
Immunizations
3
Q
Describe natural passive immunity
A
Breast milk, mother to baby
4
Q
Describe artificially passive immunity
A
Immunolobin injections, rH
5
Q
When would someone have HPV vaccine
A
11 or 12. 2 shots, second shot 2 months after first shot
6
Q
MMR vaccine?
A
1 between age 19-49 and 1 after 50
7
Q
TDap
A
Q 10 yrs
8
Q
Hepatitis A
A
2 shots (high risk)
9
Q
Hepatitis B
A
3 shots (high risk)
10
Q
Influenza
A
Q year
11
Q
Pneumococcal
A
At risk
12
Q
Herpes Zoster
A
2 doses
13
Q
Meningococcal
A
1-2 doses for students
14
Q
Name 3 types of transplant rejection
A
Hyperacute-immediate
Acute 1 week-3 months
Chronic
15
Q
5 types of WBC
A
Neutrophil Leukocyte Monocytes Basophils Eosinophils
16
Q
WBC responsible for acute bacterial or fungal infection
A
Neutrophil
17
Q
WBC responsible for chronic bacteria infection
A
Leukocyte
18
Q
WBC responsible for viral infections
A
Monocytes
19
Q
WBC elevated in Leukemia
A
Basophils
20
Q
WBC elevated in allergy or parasites
A
Eosinophils
21
Q
Describe culture and sensitivity
A
Culture: identify microbe
Sensitivity: ID drugs to kill it
22
Q
What could a rapid culture test identify (examples)
A
Strep, TB, influenza
23
Q
Describe 3 phases of HIV
A
1- flu like (2-4weeks)
2- asymptomatic
3- aids
24
3 ways aids is transmitted
Sexual, perinatal, parental
25
CDC ABC safer sex
Abstinence
Be faithful
Proper condom use
26
What kind of History would u want to assess pt for at risk for HIV
Age, sex practices (stds), travel, illness, location
27
What is Kaposis sarcoma
Connective tissue disease specific to aids
28
What Tests can confirm HIV
Elisa, western blot
29
What are the primary goals of drug therapy and aids
Suppress virus, provide prophylaxis, stimulate hematopoietic response, treat opportunistic infections
30
Describe 5 types of hypersensitivity
```
Type 1: allergy, latex, anaphylaxis
Type 2: cytotoxic
Type 3: immune complex
Type 4: delayed
Type 5: stimulatory
```
31
Describe what's involved in anaphylaxis
Histamines
32
Symptoms of anaphylaxis
Erythema, itching, hives, angioedema
| Dyspnea, wheezing, hypoxia, bronchi spasms, stridor, hypotension
33
What are interventions of someone under anaphylaxis
```
RRT
Epinephrine
Airway and oxygen
Antihistamines (Benadryl)
Inhalents (alupent/Proventil)
IV fluids
Education
```
34
How many mL of epinephrine in epipen
0.3-0.5 every 5 min
35
What food allergy could also indicate latex allergy
Banana
36
What are examples of type 2 hypersensitivity
Hemolytic anemia
Thrombocytopenia purpura
Hemolytic transfusion reactions
Good pastures syndrome
37
What interventions can be done for type 2 hypersensitivity
Remove
| Plasmapheresis
38
Usual sites of type 3 immune complex reactions
Kidneys, skin, joints, small blood vessels
39
Name examples of immune complex reactions
Lupus, rheumatoid arthritis, serum sickness
40
What is responsible for type 4 delayed hypersensitivity
Reactive T lymphocyte
| Lymphocytes and macrophages
41
Examples of delayed hypersensitivity
Contact dermatitis, poison ivy, insect stings, tissue transplant rejection
42
Intervention for delayed hypersensitivity
Avoid, steroids
43
What is type 5 stimulatory reaction and give example
Autoantibody speeds up no regulation
| Graves' disease
44
Difference between autoimmunity and alloimmunity
Autoimmunity: body attacks self
Alloimmunity: body attacks same species (blood transfusion)
45
Hallmark of discoid lupus
Butterfly rash over nose (skin only)
46
Systemic lupus clinical manifestations
HTN, edema, tacHycardia, pallor
Joint and muscle stiffness
Decreased breath sounds, chest pain
Fatigue, decreased urine output
47
Interventions for lupus
NSAID, steroid, antimalarial
Small frequent meals
Avoid sun, mild soap, lotions, pat dry
Frequent rest periods
48
Major organs affected by lupus
Kidneys, lungs
49
What's Sjögren's syndrome
Dryness (eyes, mucous membranes)
50
What's good pastures syndrome
Autoantibodies against glomerular basement membrane and neutrophils
51
Symptoms of Goodpastures syndrome
Sob, hemoptysis, decreased urine output, weight gain, edema, htn, tachycardia
52
Treatment for Goodpastures syndrome
High dose steroids
53
Name contact precaution diseases
Mrsa, rsv, cdiff, scabies
54
Name droplet precautions which diseases
Stand 3 feet away, gowns gloves and mask
| Influenza, mumps, pertussis, meningitis
55
Name airborne precautions and diseases
HEPA filter (N-95 mask)
Negative pressure room
TB, measles, chicken pox
56
What does negative pressure rooms do
Keep pathogens in room
57
What does positive pressure rooms do
Keep microbes out of room
58
Clinical manifestations of infection
Fever, malaise, inflammation, lymphadenopathy
59
Interventions of infection
Comfort
Containment
Isolation
Manage fever
60
3 types of antimicrobials
Antibiotic
Antiviral
Anti fungal
61
Staging of cancer
Tumor
Node
Metastasis
62
How can cancer metastasize
Extension, blood, lymph
63
Primary cancer prevention
True prevention
64
Secondary Cancer prevention
Early detection, keep from getting worse
65
Caution for signs of cancer
```
Change in bowel
A sore throat that doesn't heal
Unusual bleeding
Thickening lump
Indigestion/dysphasia
Obvious change in wart/mole
Nagging cough
```
66
Types of diagnostic for cancer
Radiology xray
Biopsy (shave, needle, incision)
Tumor marker (PSA)
67
Symptoms of cancer
Anorexia, bleeding, confusion
68
Purpose of radiation and types
Destroy cancer cells minimizing damage to nL cells
External: zap
Brachytherapy: unsealed, sealed
69
Side effects of radiation
Altered taste
Hair loss
Inflammation
70
Nursing interventions for radiation
Teach accurate facts, don't remove markings, skin care, avoid sun light, oral care, vulnerable to fracture, shield when possible
71
Antimetabolites
Impair cell division
72
Antitumor
Interrupt DNA or RNA sequence
73
Antimiotic
Interrupt mitosis
74
Alkylating
Bind DNA tightly preventing cell division
75
Topoisomerase
Disrupt enzyme needed for DNA synthesis and cell division
76
Chemo side effects
```
Bone marrow suppression
N/v
Mucositis
Alopecia
Neuropathy
Change in cognition
```
77
What can be a result of bone marrow suppression
Anemia
Neutropenia
Thrombocytopenia
(Fatigue, bleeding, infection)
78
Most common reason for chemo dose/schedule changes
Bone marrow suppression
79
N/v in chemo pt care
Lasts 1-7 days
Antiemetic before, during, after
Take as prescribed
80
Name antiemetic drugs
```
Serotonin antagonist
Neurokinen antagonist
Steroids
Prokinetic
Benzo
```
81
Nursing care for Mucositis and stomatitis
Sores- Luke warm, oral hygiene
Swish and spit or swish and swallow
Increase risk for bleeding (soft toothbrush)
Interfere with intake (monitor for fluid deficit and electrolyte imbalance)
82
Photodynamic therapy
Laser tumor destruction
12 weeks of photo sensitivity
83
Immunotherapy side effects
Inflammatory reaction, peripheral neuropathy, skin rashes
84
What's DIC for oncologic emergency
Make clots continuously so clotting factor is used up (bleeding risk) - sepsis, blood transfusion
Give heparin then clotting factors
85
SIADH oncologic emergency
Continue to release ADH-fluid excess
Pulmonary edema and crackles (usually lung/brain cancer)
Hyponatremia
86
Spinal cord compression
Weakness, numbness, tingling, unsteady gait, paralysis
Steroids, radiation, surgery, braces on back/neck
87
Superior vena cava syndrome
Collar sign (edema, dyspnea, erythema) usually lymphoma, breast, lung cancer
Radiation or stent
88
Tumor lysis syndrome
Large rumors lysed rapidly, k+ leaks out (hyperkalemia), hyperuricemia-decreased urine output
TX- 3000-5000ml prevent
Antiemetic, diuretic
Dialysis
89
2 most common cause of death
Heart disease and cancer
90
Durable power of attorney
U can speak for me
91
Living will
What I want
92
3 types of euthanasia
Withdraw
Active
Physician assisted
93
When is hospice ordered
6 month prognosis
94
Dying clinical Manifestations
Cool extremities, cyanosis, increased sleeping, intake decrease, in continence, cheyne-stokes, disorientation, withdraw, fear, saying good bye, spiritual distress
95
Weakness management for dying pt
Aspiration precautions
Mouth care
Altered med route
96
Intervention for dyspnea for dying pt
Opioids, oxygen, steroid, bronchodilators, calm
97
N/v for dying pt treatment
Antiemetic (compazine, decadron, reglan)
| Comfortable room temp
98
Restlessness agitation nsg interventions dying pt
Assess pain, urine output, constipation
| Haldol, music
99
Seizure nsg interventions dying pt
Protection
| Benzo/barb
100
Signs death occurred
```
Heart/breathing stop
Pupils fixed and dialated
Body cools, pale, waxy
Muscles relax
Eyes may open
Jaw relaxes
Trickling fluids gas release
```
101
Postmortem care
```
Ask family if they want to help wash pt
Remove cut tubes and lines
Close pt eyes
Insert dentures
Straighten pt lower bed to flat position
Place pillow under pt head
Waterproof pads under pt
Clean room
Allow visitation
Transfer to morgue/funeral home (wrap in shroud with identification)
Notify chaplain if requested
Sign death certificate with physician
```
