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1. Health Alterations > Immune system > Flashcards

Immune system Flashcards

1
Q

SS of local inflammation

A
  • FIRE
  • Feeling pain
  • induration
  • redness
  • edema
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2
Q

for fever, don’t give tylenol until

A

> 101.5

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3
Q

bands

A
  • shift to left

- baby neutrophils

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4
Q

interferon

A

-acts to inhibit the replication of viruses

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5
Q

actions in inflammatory process

A
  1. hemodynamic changes- fever
  2. increased permeability
  3. higher HR, higher BP, less blood volume
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6
Q

chemical mediators

A
  1. prostaglandins
  2. histamine
  3. leukotrienes
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7
Q

histamine

A
  • dilation of capillaries
  • decrease BP
  • constrict smooth muscle in bronchi & uterus
  • increase gastric secretions
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8
Q

leukotrienes

A

occur in WBCs with effects similar to histamine

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9
Q

cortisol

A
  • 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
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10
Q

active immunity

A
  • when individual’s immune system responds to antigen by stimulating production of antibodies
  • Vaccines(Acquired)
  • Diseases process (natural)
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11
Q

passive immunity

A
  • ind. receives antibodies to a specific agent that were produced by another individual
  • transplacental
  • artificial (IVIG)
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12
Q

IgG

A

-viruses, bacteria, fungi

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13
Q

IgM

A

ABO/Blood type

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14
Q

IgA

A

breast milk

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15
Q

IgE

A

Allergic reactions and parasitic

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16
Q

IgD

A

Assists in differentiation of B-cells

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17
Q

Cell- mediated acquired immunity

A
  • T-cells (CD4-helper, CD8- cytotoxic)
  • delayed response
  • ratio 2:1 helper-suppressor cells
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18
Q

CD4

A
  • regulates cell-mediated immunity and the humoral antibody response
  • cheerleader to T-cells and B-cells
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19
Q

natural killer cells

A
  • cell mediated
  • not B or T
  • large WBC
  • kills foreign invaders
  • attacks TRANSPLANTED tissues or organs
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20
Q

dendritic cells

A
  • captures antigens at contact site
  • brings antigen to T-cell specific for antigen
  • t-cell destroys antigens
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21
Q

cytokines

A
  • messengers
  • soluble factors secreted by WBC
  • instruct cells to alter proliferation, differentiation, secretion, activity
  • have beneficial role in hematopoiesis
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22
Q

RBC

A

F: 3.8-5.1
M: 4.3-5.7

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23
Q

HGB

A

F: 11.7-15.5
M:13.2-17.3
-gas carrying capacity of RBC

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24
Q

HCT

A

F: 35-47%
M: 39-50%
-measure of packed cell volume of RBCs

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25
Q

WBC

A

4,000-11,000

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26
Q

platelets

A

150,000-400,000

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27
Q

ANC counts

A
  • % of neutrophils X total WBC

- higher % is desirable (ex. 70% of 5k vs. 50% of 4k)

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28
Q

shift to the right

A

-body is overwhelmed and does not have enough neutrophils

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29
Q

shift to the left

A
  • neutrophil levels high

- fighting infection

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30
Q

neutrophil range

A
  • 2500-8000

- 50-70%

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31
Q

lymphocytes range

A
  • 1000-4000

- 20-40%

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32
Q

monocytes range

A
  • 100-700

- 4-8%

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33
Q

eosinophils range

A
  • 50-500

- 1-4%

34
Q

basophils range

A

25-100

-0.5-2.0%

35
Q

Hemoglobin S

A

Abnormal HGB that causes erythrocyte to stiffen and elongate , taking a sickle shape in response to low O2 levels

36
Q

Warning Signs of cancer

A

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
37
Q

4 SE of chemp

A
  1. bone marrow suppression (neutropenia, thrombocytopenia, anemia)
  2. GI (nausea, diarrhea, mucositis, anorexia)
  3. Integumentary (alopecia, skin infections)
  4. reproductive dysfunction
    - peripheral neuropathy
    - cardio toxicity
    - fatigue
38
Q

SVC (superior vena cava syndrome)

A

Oncologic emergency manifested by facial edema, periorbital edema, JVD, headache and seizure.

39
Q

sickle cell crisis presenting symptom

A

pain

40
Q

Removal of this places a client with sickle cell at high risk of an immunocompromised state.

A

spleen

41
Q

Nursing interventions that help prevent the recurrance of sickle cell crisis.

A
  • push fluids
  • avoid high altitudes
  • avoid high stress
  • early treatment of infection
  • oxygen therapy for hypoxia and pain management
42
Q

Three complications of a vaso-occlusive crisis.

A

uncontrolled pain, acute chest syndrome, dactylitis, priapism and CVA?

43
Q

cause of hemophilia

A

deficiency of one of the coagulation factors (VIII, IX or XI)

44
Q

priority nurse DG for child with hemophilia

A

risk for injury

45
Q

Most common sites of bleeding for children with hemophilia

A

muscles and the joints(especially the knees)

46
Q

what parents should know about home care for their child with hemophilia.

A
  • 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
47
Q

Method of acquiring hemophilia

A

via X-linked recessive? (female carriers passing on defect to affected males)

48
Q

Inhibition of bone marrow resulting in reduced platelets, RBC’s and WBC’s

A

myelosuppression

49
Q

Erythropoietin is synthesized here.

A

kidneys

50
Q

causes of neutropenia

A
  • chemotherapy
  • medications (anti-rejection, steroids)
  • cancer (esp. leukemia), -autoimmune reactions -congenital conditions (SCID)
51
Q

priority DG for client with neutropenia

A

risk for infection

52
Q

nursing interventions for a client with neutropenia

A

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

53
Q

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.

A

SCID (Severe Combined Immunodeficiency Disease)

54
Q

Platelet value for diagnosis of thrombocytopenia.

A

< 150,000

55
Q

Main clinical manifestations of thrombocytopenia.

A

bleeding (mucosal or skin), prolonged bleeding after injections or injury or vascular ischemia problems (headache, seizures)

56
Q

Normal length of survival of a platelet.

A

8-10 days

57
Q

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

a spontaneous cerebral bleed

58
Q

treatment options for ITP

A

corticosteroids, splenectomy, IVIG, platelet transfusion, and avoidance of NSAID’s

59
Q

Immunoglobulin responsible for allergic reactions

A

IgE

60
Q

Immunoglobulins are antibodies formed from these plasma cells

A

B-lymphocytes

61
Q

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

A

cytokines

62
Q

Cytokine used to treat neutropenia

A

Granulocyte-macrophage colony-stimulating factor (GM-CSF) (Neupogen)

63
Q

Cytokine (glycoprotein) that inhibits the replication of viruses

A

interferon

64
Q

Clinical lab value for diagnosis of neutropenia.

A

differential neutrophil count of less than 1-1.5 X 109/L or absolute neutrophil count of less than 1.0 X 109/L

65
Q

hallmark of tumor lysis syndrome TLS

A

hyperuricemia, hyperphosphatemia, hyperkalemia and hypocalcemia

66
Q

Lymphocytes responsible for recognizing and killing tumor cells

A

NKC

67
Q

An increased percentage of neutrophils in a CBC.

A

shift to the left

68
Q

Definitive diagnostic test for leukemia

A

bone marrow biopsy

69
Q

most common childhood cancer

A

ALL (acute lymphocytic leukemia)

70
Q

priority nursing diagnosis for a child with leukemia

A
  • impaired respiratory
  • risk for infection
  • risk for injury
  • knowledge deficit
  • ineffective coping (individual or family)
  • pain (acute or chronic)
  • impaired skin integrity
71
Q

Preferred medical treatment option for a child with leukemia.

A

combination chemotherapy (based on trial protocols)

72
Q

SS of leukemia

A

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

73
Q

Name groups that are at risk of iron deficiency anemia

A

menstruating women, pregnant women, older adults, and clients with lower socio-economic status

74
Q

Number one nursing priority in patient with severe anemia.

A

respiratory status

75
Q

Most common cause of IDA in children under 12 months of age.

A

prematurely switching to cow’s milk?

76
Q

Proper method for administering IM iron.

A

a 2-3 inch needle, deep into the glutteal muscle, using z-track and with an air bubble

77
Q

Length of time hemoglobin levels take to return to normal after initiation of iron therapy.

A

2-3 months

78
Q

Number one priority of patients presenting with an anaphylactic reaction

A

airway

79
Q

Hormone secreted by the adrenal cortex that helps to slow the release of histamine

A

cortisol

80
Q

Blood transfusion reaction in which a patient develops a fever with HA, flushing, anxiety and vomiting.

A

febrile, non-hemolytic transfusion reaction

81
Q

Treatments for a client experiencing an anaphylactic reaction.

A

oxygen, epinephrine, steroids, anti-histamines (Benadryl), and avoidance of exposure

82
Q

Hypersensitivity reaction involving a cell-mediated delayed response

A

Type IV hypersensitivity reaction

1. Health Alterations (11 decks)

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