Immunological Dx Flashcards
Scleroderma & 3 main comps
Rheumatic, conn tissue dx associated w impaired immune responses; Vascular: Raynauds, constant recurrent restriction of BVs=pulm HTN & decreased esophageal motility. Fibrotic: thick/burning skin, restrictive lung disease. Autoimm: B-cell prod antibodies > genetic/environmentallty induced; most often women
Limited Scleroderma
Skin involvement w good prognosis & linear scleroderma=bands of thicker skin w good prognosis
Systemic Scleroderma
Of internal organs=life threatening; CREST syndrome w good prognosis: Calcinosis, Raynauds, Esophageal dysfun; Sclerodactyly of fingers/toes & Telangiectasis or red spots covering hands/feet/forearms/face/hips
Tx for Raynauds (Scleroderma)
Dress in layers - clothing modification (fingers/toes); Biofeedback - guided imagery to focus on distal circulation; Edu on skin inspection; Activity mod to prevent trauma to fingers/toes
Tx for Contractures rel to Scleroderma
Splint at optimal resting length for hands/wrists to slow development; Silicone gel in plams; Electrical/mechanical muffled vibration to stim rapidly adapting A-type nerve fibers & decrease burning sensation
Gen tx for Scleroderma
Nasal O for pulmonary artery probs, diet mods for Gi probs, cessation of exercise if myositis, protective gloves(cotton, insulated, mildly compressive) if fibrosis skin probs
AIDs: Acquired Immunodeficiency Disease
Acquired through unprotected sex/blood or body fluids.
HIV: Human Immunodeficiency Disease
Retrovirus (DNA); Attacks lymphatic system (immunity system) - T cells/CD4 attack body
4 Stages of HIV Infection
Acute: flu-like. Asymptomatic: HIV replicated and affects imm system but does not show signs other than blood abnormalities. Symptomatic: signs/symptoms appear. Advanced: severely compromised immunity; CD5 (T cell) levels drop
HIV Symptoms
Enlarged lymph nodes, fatigue, weight loss/malabsorption of nutrients, fever, diarrhea, decreased act tol, neurolog impairment: cog, affective, sensory, ADL impairments, myelopathy, peripheral neuropathy, visual impairment
Hep A/B
Viral infections. A= contaminated seafood/protective imm possible. B/C/Others= body or blood borne exposure/protective imm possible for B. HC workers are most susceptible to B. Fever, fatigue, decreased act tol & cirrhosis (liver degen)
Methicillin-Resistant Staphylococcus Aureus: MRSA
Usually mild infections (pimps/boils) > can be more serious including in surgical wounds. Can be local or systemic thru bloodstream affecting lungs or urinary tract. Risks: Weakened immune system, hosp confinement, close quarter living, direct contact (sports) or secondary (towels). Resists most antiboticis
MRSA Signs/Symptoms
Red/swelling/pain at wound, drainage, fever, skin abscess, chest pain, cough, fatigue, head/mus ache, rash, SOB - chance of reoccurring in future
Tx for Acute Hosp of Imm System Disorders
Early mobilization, preservation of function, positioning, psychological/emo support, prevent LT disability
Tx for In Pt Rehab of Imm System Disorders
Eval/restoration of fx’al abilities: ADL, IADL, econ, work simp, restoration of activity/ex tol, achievement /maintenance of QOL, role adjustment intervention, plan comm re-integ
Home Care for Imm System Disorders
Collab assessment (COPM) to set goals, eval/restore of fx’al ability, restore act/ex tol, comm mobility
Type 1 Diabetes
Insulin-dependent (only 5-10%); Autoimmune, genetic & environmental factors contribute
Type 2 Diabetes
Non-insulin dependent (90%); Older age, obesity, fam hx, prior hx of gestational dx, impaired glucose tolerance, physical inactivity, race
Other Diabetes
Gestational (2-5% of all pregs-40% may develop Type 2): usually resolves after preg, obesity/race are risk factors. Genetic syndromes, surgery, drugs, malnut, infections.
Signs/Symptoms of Diabetes
Frequent urination, excessive thirst, unexplained weight loss, extreme hunger, visual changes, sensory changes in hands/feet, fatigue, very dry skin, slow healing wounds, increased rate of infections > Hypoglycemia: vagueness, dizzy, tachycardia, pallor, weakness, diaphoresis, seizures and/or coma
Hyperglycemic Crisis
Ketoacidosis: dehydration, rapid/weak pulse, acetone breath. Hyperosmolar coma: stupor thirst, polyuria, neurolog abnorms. IV fluids/insulin req - call 991
Tx for Diabetes
Preventative ther ex, edu on compliance/med mngt for condition, psychosoc/emo support, lifestyle mod to complications, protective issues regarding peripheral neuropathy, early attn to wound mngt, edu on how to notice fx’al changes and edu on what to do
BMI: Body Mass Index
Calc by dividing weight in kilos by square of persons height in m. Overweight BMI=25-29.9, obesity=>30, morbidly obese=>40.
Health Risks Associated w Obesity
Metabolic syndrome, HTN, HLD, Type 2 DM, cardiovas disease, stroke, glucose intol, sleep apnea, gallbladder disease, menstrual irregs/infertility, Ca, and chronic LBP
Tx for Obesity
Lifestyle redesign, activity focused ex program, self monitoring ex responses, supportive coaching/counseling,, AT to max participation
Co-morbidities w Obesity
Cardiopulmonary: angina, SOB, increased BP, joint pain/altered biomechanics, increase risk of pressure ulcers d/t shear forces, increased occurrence of lymphedema, cellulitis, skin fold dermatitis/other skin infections, increased heat intol=risk of hyperthermia/heat exhaustion & increased risk of th. injury when using body mechanics
Symptoms of Lyme Disease
Fatigue, headache, chills/fever, mus/joint pain, swollen lymph nodes, rash, arthritis, numb, pain, bells palsy=weak on one side of face, meningitis
Tx of Lyme
Edu on arthritic flares, rest, anti-inflams, splinting/wrapping to protect/prevent overstretching, energy conservation, work simplification, safety assessment, coping w chronic pain, PAMs to reduce pain, stress mngt techs, neutral warmth, adaptive techs to avoid tigger mvmts, facial splint, e-stim to stim denervated mus, edu on using fingers to help close mouth, counseling on body image, pluse-ox
Conditions that Predispose pt to Decubitus Ulcers
Immobility/altered mobility, weight less, edema, incont, sensory deficiencies, circulation abnorms, dehydration, inadequate nutrition, obesity, patholog conditions/multiple co-morbidities and/or age related skin changes
Suspected Deep Tissue Injury
Localized discoloration of intact skin or blood blister resulting from damage of underlying soft tissue - could evolve, rapidly
Stage 1 Pressure Ulcer
Skin in tact w visible nonblanchable redness over localized area (bony prom), may be softer/firm or cooler/warmer than surrounding area, area may be painful/itchy, may be “at risk” but difficult to detect
Stage 2 Pressure Ulcer
Involves dermis w partial thickness loss which presents as a shallow, open ulcer that is shiny or dry or as a blister. Wound bed is red-pink w/o slough or bruising
Stage 3 Pressure Ulcer
Involves full thickness tissue loss w subcutaneous fat possible visible, Slough (dead matter) may be present, bone/tendon/mus not exposed, can range from shallow to very deep depending on location
Stage 4 Pressure Ulcer
Full thickness tissue loss w bone/tendon/mus visible or directly palpable. Can range from shallow to very deep depending on location.
Unstageable Pressure Ulcers
Invloves full thickness loss which the wound bed has slough and or eschar (scab/dark crusted ulcer) which covers base of ulcers
Tx for Pressure Ulcers
Prevention is most effective. Group 1: cushions/mattresses w non-elec means (air, foam, gel or h20), Group 2: dynamic, elec-powered devices (alternatinf and low air loss mattresses) for full thick/mod-high risk ulcers & Group 3: dynamic, elec-powered devices (air-fluidize beds) for pts w nonhealing, full thick ulcers, weight shifting and skin care
Heat Exhaustion is Characterized By
Rapid pulse, decreased BP, nausea, vom, cool pallid skin, mental confusion, headache and/or giddiness but no fever
Heat Stoke is Characterized By
*med emergency
Hot, dry, red skin; body temp higher than 104; slow deep respiration; tachycardia; dilated pupils; confusion > seizures/LOC
