Immune system Flashcards
SS of local inflammation
- FIRE
- Feeling pain
- induration
- redness
- edema
for fever, don’t give tylenol until
> 101.5
bands
- shift to left
- baby neutrophils
interferon
-acts to inhibit the replication of viruses
actions in inflammatory process
- hemodynamic changes- fever
- increased permeability
- higher HR, higher BP, less blood volume
chemical mediators
- prostaglandins
- histamine
- leukotrienes
histamine
- dilation of capillaries
- decrease BP
- constrict smooth muscle in bronchi & uterus
- increase gastric secretions
leukotrienes
occur in WBCs with effects similar to histamine
cortisol
- hormone secreted by the adrenal cortex that helps body control inflammation
- slows release of histamine
- prevents influx of WBCs
- stabilizes lysosomal membranes
- 2:00 am peak, triggered by stress
active immunity
- when individual’s immune system responds to antigen by stimulating production of antibodies
- Vaccines(Acquired)
- Diseases process (natural)
passive immunity
- ind. receives antibodies to a specific agent that were produced by another individual
- transplacental
- artificial (IVIG)
IgG
-viruses, bacteria, fungi
IgM
ABO/Blood type
IgA
breast milk
IgE
Allergic reactions and parasitic
IgD
Assists in differentiation of B-cells
Cell- mediated acquired immunity
- T-cells (CD4-helper, CD8- cytotoxic)
- delayed response
- ratio 2:1 helper-suppressor cells
CD4
- regulates cell-mediated immunity and the humoral antibody response
- cheerleader to T-cells and B-cells
natural killer cells
- cell mediated
- not B or T
- large WBC
- kills foreign invaders
- attacks TRANSPLANTED tissues or organs
dendritic cells
- captures antigens at contact site
- brings antigen to T-cell specific for antigen
- t-cell destroys antigens
cytokines
- messengers
- soluble factors secreted by WBC
- instruct cells to alter proliferation, differentiation, secretion, activity
- have beneficial role in hematopoiesis
RBC
F: 3.8-5.1
M: 4.3-5.7
HGB
F: 11.7-15.5
M:13.2-17.3
-gas carrying capacity of RBC
HCT
F: 35-47%
M: 39-50%
-measure of packed cell volume of RBCs
WBC
4,000-11,000
platelets
150,000-400,000
ANC counts
- % of neutrophils X total WBC
- higher % is desirable (ex. 70% of 5k vs. 50% of 4k)
shift to the right
-body is overwhelmed and does not have enough neutrophils
shift to the left
- neutrophil levels high
- fighting infection
neutrophil range
- 2500-8000
- 50-70%
lymphocytes range
- 1000-4000
- 20-40%
monocytes range
- 100-700
- 4-8%
eosinophils range
- 50-500
- 1-4%
basophils range
25-100
-0.5-2.0%
Hemoglobin S
Abnormal HGB that causes erythrocyte to stiffen and elongate , taking a sickle shape in response to low O2 levels
Warning Signs of cancer
CAUTION
- change in bowel or bladder habits
- a sore that does not heal
- unusual bleeding or discharge from an orifice
- thickening or lump in breast or elsewhere
- indigestion or difficulty swallowing
- obvious change in wart or mole
- nagging cough or hoarseness
4 SE of chemp
- bone marrow suppression (neutropenia, thrombocytopenia, anemia)
- GI (nausea, diarrhea, mucositis, anorexia)
- Integumentary (alopecia, skin infections)
- reproductive dysfunction
- peripheral neuropathy
- cardio toxicity
- fatigue
SVC (superior vena cava syndrome)
Oncologic emergency manifested by facial edema, periorbital edema, JVD, headache and seizure.
sickle cell crisis presenting symptom
pain
Removal of this places a client with sickle cell at high risk of an immunocompromised state.
spleen
Nursing interventions that help prevent the recurrance of sickle cell crisis.
- push fluids
- avoid high altitudes
- avoid high stress
- early treatment of infection
- oxygen therapy for hypoxia and pain management
Three complications of a vaso-occlusive crisis.
uncontrolled pain, acute chest syndrome, dactylitis, priapism and CVA?
cause of hemophilia
deficiency of one of the coagulation factors (VIII, IX or XI)
priority nurse DG for child with hemophilia
risk for injury
Most common sites of bleeding for children with hemophilia
muscles and the joints(especially the knees)
what parents should know about home care for their child with hemophilia.
- how to apply gentle, prolonged pressure to superficial wounds
- call MD for any blunt trauma or head injury, establish a safe home environment, avoidance of contact sports
- reconstitution and administration of factor
- need to keep up to date with immunizations and routine cares
Method of acquiring hemophilia
via X-linked recessive? (female carriers passing on defect to affected males)
Inhibition of bone marrow resulting in reduced platelets, RBC’s and WBC’s
myelosuppression
Erythropoietin is synthesized here.
kidneys
causes of neutropenia
- chemotherapy
- medications (anti-rejection, steroids)
- cancer (esp. leukemia), -autoimmune reactions -congenital conditions (SCID)
priority DG for client with neutropenia
risk for infection
nursing interventions for a client with neutropenia
a private room with the door shut; gloves, masks and gown for all staff and visitors; no fresh flowers; no fresh fruits or vegetables; client wears mask when leaving room; no live virus injections and meticulous hand washing
Disease in which infants are born with deficiency in both B-cell and T-cells and therefore have an absence of both humoral and cell-mediated immunity.
SCID (Severe Combined Immunodeficiency Disease)
Platelet value for diagnosis of thrombocytopenia.
< 150,000
Main clinical manifestations of thrombocytopenia.
bleeding (mucosal or skin), prolonged bleeding after injections or injury or vascular ischemia problems (headache, seizures)
Normal length of survival of a platelet.
8-10 days
The wife of Mr. R. comes to the desk reporting a sudden onset of confusion. He is admitted with thrombocytopenia so your main concern is
a spontaneous cerebral bleed
treatment options for ITP
corticosteroids, splenectomy, IVIG, platelet transfusion, and avoidance of NSAID’s
Immunoglobulin responsible for allergic reactions
IgE
Immunoglobulins are antibodies formed from these plasma cells
B-lymphocytes
Any of several regulatory proteins, such as the interleukins and lymphokines, that are released by cells of the immune system and act as intercellular mediators in the generation of an immune response
cytokines
Cytokine used to treat neutropenia
Granulocyte-macrophage colony-stimulating factor (GM-CSF) (Neupogen)
Cytokine (glycoprotein) that inhibits the replication of viruses
interferon
Clinical lab value for diagnosis of neutropenia.
differential neutrophil count of less than 1-1.5 X 109/L or absolute neutrophil count of less than 1.0 X 109/L
hallmark of tumor lysis syndrome TLS
hyperuricemia, hyperphosphatemia, hyperkalemia and hypocalcemia
Lymphocytes responsible for recognizing and killing tumor cells
NKC
An increased percentage of neutrophils in a CBC.
shift to the left
Definitive diagnostic test for leukemia
bone marrow biopsy
most common childhood cancer
ALL (acute lymphocytic leukemia)
priority nursing diagnosis for a child with leukemia
- impaired respiratory
- risk for infection
- risk for injury
- knowledge deficit
- ineffective coping (individual or family)
- pain (acute or chronic)
- impaired skin integrity
Preferred medical treatment option for a child with leukemia.
combination chemotherapy (based on trial protocols)
SS of leukemia
are abnormal bleeding (mucosal or integumentary), fatigue, pallor, night sweats, fever of unknown origin, frequent infections, bone pain, hepatomegaly, splenomegaly, lymphandopathy, anorexia or weight loss
Name groups that are at risk of iron deficiency anemia
menstruating women, pregnant women, older adults, and clients with lower socio-economic status
Number one nursing priority in patient with severe anemia.
respiratory status
Most common cause of IDA in children under 12 months of age.
prematurely switching to cow’s milk?
Proper method for administering IM iron.
a 2-3 inch needle, deep into the glutteal muscle, using z-track and with an air bubble
Length of time hemoglobin levels take to return to normal after initiation of iron therapy.
2-3 months
Number one priority of patients presenting with an anaphylactic reaction
airway
Hormone secreted by the adrenal cortex that helps to slow the release of histamine
cortisol
Blood transfusion reaction in which a patient develops a fever with HA, flushing, anxiety and vomiting.
febrile, non-hemolytic transfusion reaction
Treatments for a client experiencing an anaphylactic reaction.
oxygen, epinephrine, steroids, anti-histamines (Benadryl), and avoidance of exposure
Hypersensitivity reaction involving a cell-mediated delayed response
Type IV hypersensitivity reaction
