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Basic Med-Surg > Immunity, Infection, Antibiotics > Flashcards

Immunity, Infection, Antibiotics Flashcards

1
Q

What are parts of the immune system?

A

Self-tolerance, human leukocyte antigens (HLA’s), leukocytes (WBCs)

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2
Q

The body’s specific protective response to a foreign agent or organism.

A

Immunity

Not automatic, different types.

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3
Q

Clostriduim tetani bacteria. Toxin. Occurs if not previously immunized or incomplete series. Manifestations?

A

Inability to open jaw, lockjaw, trismus, difficulty swallowing, headache, fever

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4
Q

What composes an adult tetanus immunization?

A

Primary is three IM injections. the second is 4-8 wks after the first, and the third is 6-12 months after the second. Hypersensitivity provokes a severe response if the booster is given more frequently than every ten years.

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5
Q

What composes an adult influenza vaccine?

A

One IM injection every year. Best time is mid-Oct to mid-Nov through April. Avoid if allergy to eggs or egg products.

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6
Q

Who should get the flu vaccine?

A

All adults age 50 or older, children and teens age 6 months-18 years. Residents of LTC, nursing homes, chronic-care places. Anyone with chronic diseases. Healthcare personnel.

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7
Q

What composes the adult pneumonia vaccine?

A

Single injection at age 65. Not given annually, every five years instead. Can be given with the flu vaccine. For people with chronic illnesses too, immunosuppressant illnesses.

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8
Q

What vaccine reduces the risk of shingles? What composes it?

A

Herpes zoster vaccine, Zostavax. Single injection at 60 years of age or older. Given one time.

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9
Q

Natural immunity, innate response initiated by injury (mechanical, microbial, thermal).

A

Inflammation. Does not always indicate infection. Complex reaction to death-injury of cells/tissues. Defense mechanism.

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10
Q

Sequence of inflammatory response, five cardinal manifestations?

A

Heat, redness, swelling, pain, loss of function

Calor, rubor, tumor, dolor, functio laesa

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11
Q

Follows the invasion of cells and/or tissues by living organisms. Can initiate the inflammatory process. Three types?

A

Infection. Bacteria, viruses, fungi.

Localized, systemic, colonization

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12
Q

S/s of localized infections?

A

Pain, tenderness, warmth, swelling, pruritus, drainage

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13
Q

Later s/s of infections, more systemic?

A

Chills, tachycardia, hypotension, change in mental status, shock, convulsions

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14
Q

What should be done when an infection is suspected? Certain site vs no certain site?

A

A culture is done. If a certain site is suspected, the culture comes from there. If no certain site, then all lines and sites should be cultured. Obtain cultures before antibiotics are started.

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15
Q

Provide protection after the substance enters the body.

A

Neutrophils.

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16
Q

What is the progression of SIRS?

A

Systemic inflammatory response syndrome (SIRS)
Sepsis
Severe sepsis
Septic shock and multiple organ dysfunction syndrome (MODS)

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17
Q

SIRS screening requires the presence of two or more of what to be positive?

A

Temp greater than 100.4 F or less than 96.8 F.
HR greater than 90 bpm.
Respiration greater than 20/min or O2 less than 32.
WBC greater than 12,000 cells/mm3 or less than 4,000 cells/mm3, and/or greater than 10% bands

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18
Q

Most common infectious cause of limbs swelling, skin barrier compromise. Inflammation. Higher incidence in communal living environments.

A

Cellulitis. Spread by rubbing or scratching the infected area. Secondary infection of open wound. If the infection isn’t responsive to antibiotics, then it may infect the blood leading to sepsis and death.

19
Q

S/s of cellulitis? Distribution?

A

S/s: Localized inflammation, redness, warmth, edema, tenderness, pain. May have blisters, fever. Lymphadenopathy.
Distribution: lower legs, areas of persistent edema, areas of skin trauma

20
Q

Most antibiotics work by?

A

Inhibiting cell wall formation, blocking protein synthesis, disrupting cell membranes, interfering with nucleic acid synthesis, preventing synthesis of folic acid.

21
Q

What factors can affect antibiotic therapy?

A

Microbial resistance to antibiotic, identifying bacteria causing the infection, site of infection, other drugs the pt is taking, pt’s clinical status

22
Q

What is looked at to decide which antibiotic to use?

A

Identify the organism. Broad spectrum antibiotics until culture and sensitivity results are available. Site of infection. Pt’s clinical status: assess history of antibiotic hypersensitivity, renal and hepatic function are important

23
Q

What are some side effects of antibiotics?

A

Direct toxicity, allergic reaction, super infection

24
Q

What do penicillins and cephalosporins do?

A

Bactericidal amor bacteriostatic actions. Elimination. Used for both gram positive and negative.

25
Q

Explain ampicillin (Omnipen)?

A

(PCN family). Broad spectrum. Leading cause of colitis with antibiotic use. May cause rash that is not an allergic reaction, oral contraceptives to be less effective.

26
Q

These are common and may occur at any time during therapy.

A

Allergic reactions. Pt’s should be observed for at least 30 minutes at the beginning of new therapy. Always ask about allergies. Cross-sensitives.

27
Q

PCN allergic reactions?

A

Skin rash, urticaria, anaphylaxis, GI upset. Cannot be given with aminoglycosides, synergistic reaction

28
Q

Nausea, flushing, occurs mostly if vancomycin is given IV too rapidly.

A

Red Man Syndrome

29
Q

What can happen with NSAIDS?

A

Decreased pain and inflammation without the same risk of GI upset. Also impair renal function, can cause high BP. Can increase the risk of MI and strokes.

30
Q

Reasons for taking cephalosporins, broad spectrum

A 
Respiratory infection
Skin infection
Pneumonia
UTI
Improves appetite and well-being
31
Q

Nursing implications and adverse reactions for broad spectrum cephalosporins

A 
Culture and sensitivity
Assess for PCN allergy
Monitor for diarrhea, nausea, vomiting, rash
Monitor for changes in bowel
Adverse is Anaphylaxis
Stevens-johnson syndrome
32
Q

Reasons for raking quinolone: cipro. Nursing implications, adverse reactions

A

Respiratory infection, UTI, anthrax
Contraindicated in pt history, myasthenia gravis, C/S
Monitor changes in bowel
Adverse: Anaphylaxis, tendonitis, Stevens-johnson syndrome

33
Q

Reasons for taking the macrolides Zithromax and erythromycin (broad spectrum)

A

Whooping cough
Diphtheria
Chlamydial infection
Acne (topical)

34
Q

Nursing implications and adverse for macrolides Zithromax and erythromycin

A 
Monitor bowel function
Monitor QT interval
Adverse is Pseudomembranous colitis
Angioedema
Stevens-johnson syndrome
Anaphylaxis
35
Q

Why take vancomycin? How to know it’s working?

A

C. diff
MRSA
PCN allergy
Working when improved appetite and decreased diarrhea

36
Q

Nursing implications and adverse for vancomycin

A 
Monitor changes in bowel
Monitor n/v
Monitor renal functions 
Adverse is ototoxicity
Nephrotoxicity
Red man syndrome
37
Q

Why take broad spectrum tetracyclines? Adverse reactions?

A 
Tetracycline-sensitive infection
Acne
Periodontal disease
Adverse is Hepatotoxicity
Nephrotoxicity
Photosensitivity
38
Q

Nursing implications for tetracyclines

A

Take on an empty stomach
Avoid giving to pregnant and breastfeeding women, and kids under the age of 5
Monitor for superinfection: CDAD, fungal
Monitor renal functions

39
Q

Why take board spectrum aminoglycosides like gentamicin? Nursing implications?

A

Serious gram negative infections
Implications are Monitor: inner ear functions
Renal functions
Serum drug level, the peak and trough

40
Q

How to know ahminoglycosides are working? Adverse?

A

WBCs decrease, no temp

Adverse are ototoxicity and nephrotoxicity

41
Q

Why take NSAIDS?

A

Decreased inflammation
Analgesia
Antipyretic
Decreased platelet aggregation

42
Q

Nursing implications and adverse for NSAIDS?

A 
Give with food
Monitor pain level
Monitor for bleeding
Adverse: Reye’s syndrome
GI bleeding
Anaphylaxis
43
Q

Why take glucocorticoids like corticosteroids? Implications?

A 
Decreased normal immune response
Inflammation
Implications are Assess system involved
PO give with food
Monitor for infection and blood sugar
Taper off
44
Q

How to know glucocorticoids are working? Adverse?

A 
Decreased inflammation
Decreased rejection of organ transplant
Suppression of s/s to an acceptable level
Adverse:Osteoporosis
Infection
Hyperglycemia
Peptic ulcer disease
Adrenal insufficiency

Basic Med-Surg (11 decks)

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