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Medsurg Test 2 > Immune > Flashcards

Immune Flashcards

0
Q

Describe natural active immunity

A

Get the disease

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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
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2
Q

Describe active artificial immunity

A

Immunizations

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3
Q

Describe natural passive immunity

A

Breast milk, mother to baby

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4
Q

Describe artificially passive immunity

A

Immunolobin injections, rH

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5
Q

When would someone have HPV vaccine

A

11 or 12. 2 shots, second shot 2 months after first shot

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6
Q

MMR vaccine?

A

1 between age 19-49 and 1 after 50

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7
Q

TDap

A

Q 10 yrs

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8
Q

Hepatitis A

A

2 shots (high risk)

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9
Q

Hepatitis B

A

3 shots (high risk)

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10
Q

Influenza

A

Q year

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11
Q

Pneumococcal

A

At risk

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12
Q

Herpes Zoster

A

2 doses

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13
Q

Meningococcal

A

1-2 doses for students

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14
Q

Name 3 types of transplant rejection

A

Hyperacute-immediate
Acute 1 week-3 months
Chronic

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15
Q

5 types of WBC

A 
Neutrophil
Leukocyte
Monocytes
Basophils
Eosinophils
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16
Q

WBC responsible for acute bacterial or fungal infection

A

Neutrophil

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17
Q

WBC responsible for chronic bacteria infection

A

Leukocyte

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18
Q

WBC responsible for viral infections

A

Monocytes

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19
Q

WBC elevated in Leukemia

A

Basophils

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20
Q

WBC elevated in allergy or parasites

A

Eosinophils

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21
Q

Describe culture and sensitivity

A

Culture: identify microbe
Sensitivity: ID drugs to kill it

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22
Q

What could a rapid culture test identify (examples)

A

Strep, TB, influenza

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23
Q

Describe 3 phases of HIV

A

1- flu like (2-4weeks)
2- asymptomatic
3- aids

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24
Q

3 ways aids is transmitted

A

Sexual, perinatal, parental

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25
Q

CDC ABC safer sex

A

Abstinence
Be faithful
Proper condom use

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26
Q

What kind of History would u want to assess pt for at risk for HIV

A

Age, sex practices (stds), travel, illness, location

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27
Q

What is Kaposis sarcoma

A

Connective tissue disease specific to aids

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28
Q

What Tests can confirm HIV

A

Elisa, western blot

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29
Q

What are the primary goals of drug therapy and aids

A

Suppress virus, provide prophylaxis, stimulate hematopoietic response, treat opportunistic infections

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30
Q

Describe 5 types of hypersensitivity

A 
Type 1: allergy, latex, anaphylaxis
Type 2: cytotoxic 
Type 3: immune complex
Type 4: delayed
Type 5: stimulatory
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31
Q

Describe what’s involved in anaphylaxis

A

Histamines

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32
Q

Symptoms of anaphylaxis

A

Erythema, itching, hives, angioedema

Dyspnea, wheezing, hypoxia, bronchi spasms, stridor, hypotension

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33
Q

What are interventions of someone under anaphylaxis

A 
RRT
Epinephrine
Airway and oxygen
Antihistamines (Benadryl)
Inhalents (alupent/Proventil)
IV fluids
Education
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34
Q

How many mL of epinephrine in epipen

A

0.3-0.5 every 5 min

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35
Q

What food allergy could also indicate latex allergy

A

Banana

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36
Q

What are examples of type 2 hypersensitivity

A

Hemolytic anemia
Thrombocytopenia purpura
Hemolytic transfusion reactions
Good pastures syndrome

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37
Q

What interventions can be done for type 2 hypersensitivity

A

Remove

Plasmapheresis

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38
Q

Usual sites of type 3 immune complex reactions

A

Kidneys, skin, joints, small blood vessels

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39
Q

Name examples of immune complex reactions

A

Lupus, rheumatoid arthritis, serum sickness

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40
Q

What is responsible for type 4 delayed hypersensitivity

A

Reactive T lymphocyte

Lymphocytes and macrophages

41
Q

Examples of delayed hypersensitivity

A

Contact dermatitis, poison ivy, insect stings, tissue transplant rejection

42
Q

Intervention for delayed hypersensitivity

A

Avoid, steroids

43
Q

What is type 5 stimulatory reaction and give example

A

Autoantibody speeds up no regulation

Graves’ disease

44
Q

Difference between autoimmunity and alloimmunity

A

Autoimmunity: body attacks self
Alloimmunity: body attacks same species (blood transfusion)

45
Q

Hallmark of discoid lupus

A

Butterfly rash over nose (skin only)

46
Q

Systemic lupus clinical manifestations

A

HTN, edema, tacHycardia, pallor
Joint and muscle stiffness
Decreased breath sounds, chest pain
Fatigue, decreased urine output

47
Q

Interventions for lupus

A

NSAID, steroid, antimalarial
Small frequent meals
Avoid sun, mild soap, lotions, pat dry
Frequent rest periods

48
Q

Major organs affected by lupus

A

Kidneys, lungs

49
Q

What’s Sjögren’s syndrome

A

Dryness (eyes, mucous membranes)

50
Q

What’s good pastures syndrome

A

Autoantibodies against glomerular basement membrane and neutrophils

51
Q

Symptoms of Goodpastures syndrome

A

Sob, hemoptysis, decreased urine output, weight gain, edema, htn, tachycardia

52
Q

Treatment for Goodpastures syndrome

A

High dose steroids

53
Q

Name contact precaution diseases

A

Mrsa, rsv, cdiff, scabies

54
Q

Name droplet precautions which diseases

A

Stand 3 feet away, gowns gloves and mask

Influenza, mumps, pertussis, meningitis

55
Q

Name airborne precautions and diseases

A

HEPA filter (N-95 mask)
Negative pressure room
TB, measles, chicken pox

56
Q

What does negative pressure rooms do

A

Keep pathogens in room

57
Q

What does positive pressure rooms do

A

Keep microbes out of room

58
Q

Clinical manifestations of infection

A

Fever, malaise, inflammation, lymphadenopathy

59
Q

Interventions of infection

A

Comfort
Containment
Isolation
Manage fever

60
Q

3 types of antimicrobials

A

Antibiotic
Antiviral
Anti fungal

61
Q

Staging of cancer

A

Tumor
Node
Metastasis

62
Q

How can cancer metastasize

A

Extension, blood, lymph

63
Q

Primary cancer prevention

A

True prevention

64
Q

Secondary Cancer prevention

A

Early detection, keep from getting worse

65
Q

Caution for signs of cancer

A 
Change in bowel
A sore throat that doesn't heal
Unusual bleeding
Thickening lump
Indigestion/dysphasia 
Obvious change in wart/mole
Nagging cough
66
Q

Types of diagnostic for cancer

A

Radiology xray
Biopsy (shave, needle, incision)
Tumor marker (PSA)

67
Q

Symptoms of cancer

A

Anorexia, bleeding, confusion

68
Q

Purpose of radiation and types

A

Destroy cancer cells minimizing damage to nL cells
External: zap
Brachytherapy: unsealed, sealed

69
Q

Side effects of radiation

A

Altered taste
Hair loss
Inflammation

70
Q

Nursing interventions for radiation

A

Teach accurate facts, don’t remove markings, skin care, avoid sun light, oral care, vulnerable to fracture, shield when possible

71
Q

Antimetabolites

A

Impair cell division

72
Q

Antitumor

A

Interrupt DNA or RNA sequence

73
Q

Antimiotic

A

Interrupt mitosis

74
Q

Alkylating

A

Bind DNA tightly preventing cell division

75
Q

Topoisomerase

A

Disrupt enzyme needed for DNA synthesis and cell division

76
Q

Chemo side effects

A 
Bone marrow suppression 
N/v
Mucositis
Alopecia
Neuropathy
Change in cognition
77
Q

What can be a result of bone marrow suppression

A

Anemia
Neutropenia
Thrombocytopenia

(Fatigue, bleeding, infection)

78
Q

Most common reason for chemo dose/schedule changes

A

Bone marrow suppression

79
Q

N/v in chemo pt care

A

Lasts 1-7 days
Antiemetic before, during, after
Take as prescribed

80
Q

Name antiemetic drugs

A 
Serotonin antagonist
Neurokinen antagonist
Steroids
Prokinetic
Benzo
81
Q

Nursing care for Mucositis and stomatitis

A

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
Q

Photodynamic therapy

A

Laser tumor destruction

12 weeks of photo sensitivity

83
Q

Immunotherapy side effects

A

Inflammatory reaction, peripheral neuropathy, skin rashes

84
Q

What’s DIC for oncologic emergency

A

Make clots continuously so clotting factor is used up (bleeding risk) - sepsis, blood transfusion

Give heparin then clotting factors

85
Q

SIADH oncologic emergency

A

Continue to release ADH-fluid excess
Pulmonary edema and crackles (usually lung/brain cancer)
Hyponatremia

86
Q

Spinal cord compression

A

Weakness, numbness, tingling, unsteady gait, paralysis

Steroids, radiation, surgery, braces on back/neck

87
Q

Superior vena cava syndrome

A

Collar sign (edema, dyspnea, erythema) usually lymphoma, breast, lung cancer

Radiation or stent

88
Q

Tumor lysis syndrome

A

Large rumors lysed rapidly, k+ leaks out (hyperkalemia), hyperuricemia-decreased urine output

TX- 3000-5000ml prevent
Antiemetic, diuretic
Dialysis

89
Q

2 most common cause of death

A

Heart disease and cancer

90
Q

Durable power of attorney

A

U can speak for me

91
Q

Living will

A

What I want

92
Q

3 types of euthanasia

A

Withdraw
Active
Physician assisted

93
Q

When is hospice ordered

A

6 month prognosis

94
Q

Dying clinical Manifestations

A

Cool extremities, cyanosis, increased sleeping, intake decrease, in continence, cheyne-stokes, disorientation, withdraw, fear, saying good bye, spiritual distress

95
Q

Weakness management for dying pt

A

Aspiration precautions
Mouth care
Altered med route

96
Q

Intervention for dyspnea for dying pt

A

Opioids, oxygen, steroid, bronchodilators, calm

97
Q

N/v for dying pt treatment

A

Antiemetic (compazine, decadron, reglan)

Comfortable room temp

98
Q

Restlessness agitation nsg interventions dying pt

A

Assess pain, urine output, constipation

Haldol, music

99
Q

Seizure nsg interventions dying pt

A

Protection

Benzo/barb

100
Q

Signs death occurred

A 
Heart/breathing stop
Pupils fixed and dialated
Body cools, pale, waxy
Muscles relax
Eyes may open
Jaw relaxes
Trickling fluids gas release
101
Q

Postmortem care

A 
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

Medsurg Test 2 (1 decks)

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