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NCLEX: Med Surg > Immune System > Flashcards

Immune System Flashcards

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1
Q

Immunity that everyone is born with characterized by defense mechanisms that help protect the body by acting immediately against all antigens

A

Innate immunity

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2
Q

Components of innate immunity

A

Inflammatory response, skin, stomach acid, mucus, phagocytic cells within the body

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3
Q

Type of immunity by which we produce antibodies against specific antigens acquired through the action of B and T cells

A

Acquired immunity

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4
Q

First stage of inflammatory response

A

Expect warmth, erythema, edema, And decreased function and/or pain at the site of injury

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5
Q

Second stage of inflammatory response

A

White blood cells kill off the microorganisms and exudate containing those white blood cells as well as dead tissue cells would accumulate at the site of injury

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6
Q

Third stage of inflammatory response

A

Damage tissue replaced by scar tissue

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7
Q

Type of immunity by which the body is actively producing antibodies

A

Active

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8
Q

With _________ immunity, the body produces antibodies and response to exposure to a live pathogen

A

Active natural

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9
Q

With _________ immunity the body produces antibodies in response to exposure to a vaccine

A

Active artificial

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10
Q

Immunity by which the body is not making the antibodies, but the antibodies are given to you

A

Passive immunity

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11
Q

_________ immunity is characterized by the passing of maternal antibodies to baby through the placenta or breastmilk

A

Passive natural

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12
Q

_________ immunity is obtained through administration of immunoglobulins

A

Passive artificial

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13
Q

Incubation stage of infection

A

Pathogen enters the body and begins to multiply, no symptoms during this period

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14
Q

Prodromal stage of infection

A

Pathogen continues to multiply, onset of general symptoms (malaise, fever, not feeling well)

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15
Q

Illness stage of infection

A

Onset of specific symptoms related to the particular infection

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16
Q

Convalescent phase of infection

A

Symptoms subside and eventually disappear, gradual recovery from illness

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17
Q

Symptoms of a systemic infection versus local infection

A

Systemic: fever, malaise, chills, fatigue, tachypnea, tachycardia
Local: edema, pain, erythema, decreased function and warmth in a particular area of the body

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18
Q

Normal white blood cell count

A

5000 to 10,000

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19
Q

White blood cell count greater than 10,000

A

Leukocytosis, indicative of infection

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20
Q

White blood cell count less than 4000

A

Leukopenia — maybe due to cancer, auto immune disorders, or certain medications/infections; HIGH risk for infection

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21
Q

Normal neutrophil count

A

2500 to 8000

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22
Q

Neutrophil count less than 2000

A

Neutropenia

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23
Q

Banded neutrophils or left shift indicate

A

The body is fighting an overwhelming infection

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24
Q

Normal erythrocyte sedimentation rate (ESR)

A

Less than 20

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25
Q

ESR above 20 is a strong indicator of

A

Inflammation in the body

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26
Q

Normal levels of C reactive protein (CRP)

A

Less than three

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27
Q

Elevated CRP is indicative of

A

Inflammation in the body

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28
Q

Neutrophils may be elevated in

A

Acute bacterial infections

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29
Q

Lymphocytes may be elevated in the presence of

A

Bacterial or viral infections, leukemia, lymphoma

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30
Q

Monocytes may be elevated in the presence of

A

Bacterial infections, tuberculosis

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31
Q

Eosinophils are elevated with

A

Allergic reactions, parasitic infections

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32
Q

Basophils are elevated during

A

Allergic reactions

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33
Q

Chronic inflammatory and autoimmune disorder of the connective tissue resulting in production of antinuclear antibodies (ANA) and widespread inflammation and tissue damage

A

Systemic lupus erythematosus (SLE)

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34
Q

Lupus risk factors

A

Women, 20 to 40 years old age of onset, African-Americans, Native Americans, Asians

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35
Q

S/S of systemic lupus

A

Fatigue, joint pain, fever, butterfly rash across the face, Raynaud’s phenomenon, anemia, pericarditis, lymphadenopathy

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36
Q

Labs associated with lupus

A

Positive ANA titer, decreased serum complement (C3 and C4), decreased RBCs, WBCs, and platelet counts, increased BUN and creatinine with kidney involvement

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37
Q

Treatment of lupus

A

NSAIDs, immunosuppressants like prednisone and methotrexate, hydroxychloroquine, topical steroid cream

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38
Q

Nursing care of lupus

A

Monitor for complications including renal failure, provide important patient teaching: avoid UV and sun exposure to prevent skin damage, avoid infection and sick people, frequent rest periods

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39
Q

Chronic inflammatory and autoimmune disorder of the connective tissue resulting in damage and occlusion to the blood vessels (vasculitis) and overproduction of collagen which causes tissues to become inflamed, fibrotic, and sclerotic

A

Systemic sclerosis or scleroderma

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40
Q

Scleroderma risk factors

A

Women, Age of onset typically between 30 and 50 years

41
Q

Symptoms of scleroderma

A

Arthralgia, Raynaud’s phenomenon, pitting edema in the hands with taut, shiny skin; with organ involvement — GI dysfunction, reflux, Dysphagia, arrythmias, dyspnea, malignant hypertension

42
Q

Labs associated with scleroderma

A

Positive ANA titer, elevated ESR

43
Q

Scleroderma treatment

A

Supportive, no cure. Immunosuppressants such as prednisone or methotrexate, ACE inhibitors

44
Q

Scleroderma patient teaching

A

Moisturize skin, frequent rest periods, avoid stress and cold (d/t Raynaud’s)

45
Q

Retrovirus that enters the body through the blood or bodily fluids and targets CD4+ cells causing decreased immunity and increase susceptibility to infections

A

HIV

46
Q

HIV risk factors

A

Unprotected sex, multiple sex partners, perinatal exposure, IV drug use, healthcare workers

47
Q

Symptoms of HIV

A

Lymphadenopathy, thrush, weakness, night sweats, fever, weight loss, and rashes

48
Q

Labs associated with HIV

A

Decreased WBCC, CD4+ cells (<500)

49
Q

CD4+ cells below _____ is indicative of AIDS

A

200

50
Q

Symptoms of AIDS

A

Kaposi’s sarcoma (cancer of the skin and soft tissue), tuberculosis, pneumonia, wasting syndrome, candidiasis of the airways, etc.

51
Q

HIV/AIDS treatment

A

Anti-retroviral therapy (ART) for the rest of life

52
Q

Preventing infection for patients with HIV/AIDS

A

Hand hygiene, Bathe daily with anti-microbial soap, avoid raw and undercooked foods and fresh plants, do not clean cat litter boxes, avoid crowds and sick people

53
Q

Three processes of cancer

A

Initiation, promotion, progression

54
Q

Initiation stage of cancer

A

Damage or mutation to the DNA causes excessive cell division due to excessive oncogene function, but decreased suppressor gene function

55
Q

Promotion stage of cancer

A

Mutated cells are exposed to promoters that enhance their growth (estrogen is an example of a promoter)

56
Q

Progression stage of cancer

A

Two more cells acquire additional mutations, and their growth rate increases allowing them to metastasize and become resistant to therapy

57
Q

Cancer risk factors

A

Older age, genetics, immunosuppression, viruses, smoking, sun exposure, and a high-fat low-fiber diet

58
Q

General signs and symptoms of cancer

A

Unexplained weight loss, fatigue, infection, and bleeding

59
Q

Gold standard for diagnosing cancer

A

Biopsy

60
Q

Cancer treatment

A

Chemotherapy via implanted port or central line (destroys rapidly dividing cells), hormonal therapy, immunotherapy, radiation, surgical removal of tumors

61
Q

Potential and common complications of cancer

A

Malnutrition, infection, mucositis (inflammation and ulceration of mucosa in mouth), anemia, thrombocytopenia, alopecia

62
Q

Cancer that originates in the epithelial tissue

A

Carcinomas

63
Q

Cancer that originate in the supportive or connective tissues of the body, including bones, muscle, tendon, cartilage, and fat

A

Sarcomas

64
Q

Cancer that originates in the bone marrow

A

Leukemia

65
Q

Cancer that originates in the plasma cells specifically in the bone marrow

A

Myeloma

66
Q

Cancer that originates in the lymphatic glands or nodes, or an organs such as the thymus or spleen

A

Lymphoma

67
Q

Cancer grading refers to

A
  • Comparing the cancer to the tissue of origin
  • Grades 1-4.
  • Grade 1: cancer is well differentiated and resembles the tissue of origin
  • Grade 4: cancer has no similarity to the tissue of origin
68
Q

TNM cancer staging

A

Tumor (T): T1, T2, T3, T4 — based on size and extend of tumor
Node (N): N0, N1, N2, N3 — number of regional lymph nodes involved/affected
Metastasis (M): M0 (no metastasis) or M1 (indicated metastasis to other areas of body)

69
Q

Brachytherapy precautions

A

Keep door to pts room closed at all times, place warning sign on door, limit visitors to 30 min and stay at least 6 ft from patient, nurse should wear lead apron and dosimeter badge (tracks radiation exposure), always face patient so that lead apron can protect from radiation

70
Q

External radiation patient education

A

Do NOT wash off markings (indicates area undergoing radiation), be gentle with area of skin being treated with radiation (wash with gentle soap, pat dry), DO NOT apply lotions, powders, or ointments over area unless prescribed, wear loose and soft clothing, avoid sun and heat exposure to area receiving radiation

71
Q

Nursing care for malnutrition related to chemotherapy

A

Provide antiemetics 30 min prior to therapy, administer appetite stimulant (megestrol), teach patient to: avoid drinking liquids with their meals, room temp or cool foods may be indicated for nausea, may need supplements to ensure adequate calories and nutrients

72
Q

Nursing care for mucositis

A

Provide meticulous oral care before and after meals, teaching: avoid mouthwash containing glycerin or alcohol, rinse mouth with saline solution 2x/day, use soft toothbrush, avoid foods that cause pain and damage to mucosa (instead, opt for soft foods like scrambled eggs)

73
Q

Nursing care for neutropenia

A

Implement neutropenic precautions, carefully monitor temp, restrict ill visitors, no fresh plants or flowers, keep dedicated equipment in room, Filgastrim to boost neutrophil count, teaching: take temp daily and report temp over 100 F to provider, avoid crowds and sick people, do NOT consume raw foods, avoid yard work or gardening, do NOT change cat litter box, wash dishes in hot water, wash toothbrush in dishwasher daily or use bleach solution

74
Q

Nursing care for anemia

A

Administer epoietan Alfa and ferrous sulfate, education: increase intake high in iron, folate, and B12, take extra rest periods

75
Q

Nursing care for thrombocytopenia

A

Monitor for blood in stool, urine, and vomit, avoid injections, hold prolonged pressure over venipunctures, education: use electric razor, soft toothbrush, avoid blowing nose vigorously, avoid NSAIDs, prevent falls

76
Q

Prevention of skin cancer

A

Avoid midday sun, wear sunscreen and protective clothing, perform regular skin checks (annual dermatology appts)

77
Q

Most common type of skin cancer that appears waxy nodules with pearly boarder

A

Basal cell carcinoma

78
Q

Skin cancer that originates in the upper layer of the epidermis and presents as an oozing , crusting lesion

A

Squamous cell carcinoma

79
Q

Cancer that arises from melanocytes and is the most deadly form of skin cancer as it is highly metastatic. Lesions are highly irregular with color changes.

A

Melanoma

80
Q

ABCDE skin cancer assessment

A

Asymmetry, borders (irregular), color (multiple colors), diameter (>6mm), Evolving (change in appearance over time)

81
Q

Skin cancer treatment

A

Excision, topical chemo (5-FU), Mohs surgery (take one layer off at a time and send to lab), cryotherapy (freezing of lesion)

82
Q

Hodgkin’s lymphoma will have the presence of

A

Reed-Sternberg cells (large cells with more than one nucleus)

83
Q

Hematologic blood cancer increase the patient’s risk for

A

Anemia, thrombocytopenia, and neutropenia

84
Q

Cancer of the inner lining of the uterus

A

Endometrial cancer

85
Q

Key risk factor for endometrial cancer

A

Prolonged exposure to estrogen without progesterone

86
Q

Key symptom of endometrial cancer

A

Postmenopausal bleeding

87
Q

Key symptom of cervical cancer

A

Painless, vaginal bleeding

88
Q

HPV vaccine

A

Prevents HPV and cervical cancer, three injections over a six month period of time

89
Q

Symptoms of ovarian cancer

A

Vague; GI disturbances

90
Q

Breast cancer risk factors

A

Genetics, early menarche, late menopause, long-term use of oral contraceptives, hormone replacement therapy, smoking, obesity

91
Q

Signs and symptoms of cancerous breast tumor

A

Firm, Immobile, non-tender lump, dimpling over skin of breast, nipple retraction, nipple discharge, nipple ulceration

92
Q

Breast cancer treatment

A

Hormone therapy such as tamoxifen, chemotherapy, radiation, surgical removal of tumor (lumpectomy) or breast (mastectomy)

93
Q

Nursing considerations and patient education for mastectomy

A

Do NOT administer any injections, draw blood or take blood pressure on affected side; education: wear sling when ambulating, wear loosed clothing, perform arm and hand exercises to prevent edema and increase ROM

94
Q

S/S of prostate cancer

A

Urinary retention, hesitancy and frequency. Frequent bladder infections, hematuria, nocturia

95
Q

Treatment for prostate cancer

A

Hormone therapy such as a leuprolide, chemotherapy, radiation, prostatectomy, orchiectomy (removal of testes)

96
Q

Screening tools for colorectal cancer

A

Fecal occult blood test (FOBT), colonoscopy (starting at age 50 every 10 years), sigmoidoscopy (every 5 years)

97
Q

Colorectal cancer risk factors

A

Older age, high fat and red meat diet, genetics, smoking, obesity, alcohol, physical inactivity

98
Q

Symptoms of colorectal cancer

A

Rectal bleeding, change in bowel color, shape, or consistency

99
Q

Symptoms of lung cancer

A

Cough, blood tinged sputum, chest pain, shortness of breath, weight loss, fatigue, and a dull chest percussion

NCLEX: Med Surg (10 decks)

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