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NCLEX > Immunology > Flashcards

Immunology Flashcards

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1
Q

What does m. TB Organism affect

A

Primarily the lungs in the upper airway where oxygen content is the highest

Also - the brain intestines peritoneum kidneys joints and liver

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2
Q

What can happen in the active phase of Tb

A

Necrosis and cavitation in the lesions which can lead for rupture and the spread of necrotic tissue

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3
Q

What are the clinical manifestations of TB

A

May be asymptomatic I the primary infection
Fatigue
Lethargy
Anorexia
Weight loss
Low grade fever
Chills
Night sweats
Persistent cough and production of mucous and mucopurulent sputum which is occasionally streaked with blood
Chest tightness And a dull aching chest pain may accompany the cough

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4
Q

Presence of what on an X-ray suggests TB

A

Multinodular infiltrates with calcification in the upper lobe

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5
Q

On X-ray what would indicate active disease TB

A

Caseation and inflammation

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6
Q

Describe advanced TB

A

Dullness with percussion over involved parenchymal areas
Bronchial breath sounds
Ronchi and crackles

Partial obstruction of the bronchus caused by endobronchial disease or compression by lymph nodes may produce localized wheezing and dyspnea

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7
Q

QuantiFERON TB GOLD test - what is it and what is it for

A

Blood analysis test by an enzyme linked immunosorbent assay

A sensitive and rapid test that assists in diagnosis

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8
Q

TB SPUTUM cultures - what are they looking for

A

M. Tuberculosis confirms the diagnosis

After medications are started sputum samples are obtained again to determine the effectiveness of therapy

Most are negative after 3 months of therapy

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9
Q

Tuberculin skin test - what does it mean when the skin shows a positive reaction ?

A

Does not mean that the disease is active

Indicates previous exposure to TB or the presence of a dormant disease

Once the test is positive it will be positive in any future tests

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10
Q

What happens after a positive skin test

A

CXR

To rule out active TB Or to detect old healed lesions

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11
Q

Isolation precautions for TB

A

Airborne isolation
Negative pressure room
Door must be tightly closed to remain negative pressure
Nurse requires N95 mask
Hand washing
If client needs to leave the room pt needs a mask
When no longer infectious precautions are done

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12
Q

How long does it take for the transmission risk to reduce in TB

A

2-3 weeks of therapy

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13
Q

What happens if clients are not compliant with TB MEDS

A

Mutations in the tubercle bacilli resulting in resistant strains MDR -TB

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14
Q

What happens to those who have been close to TB PTS

A

TST

And chest X-ray

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15
Q

Steps of TB progression

A
  1. Droplets enter lungs tubercle lesion is formed
  2. Defence system makes a scar of lesion
  3. If encapsulation does not occur, bacteria may enter the lymph system, travel to the nodes and cause an inflammatory response
    - granulomatous inflammation
  4. Primary lesions form - may become dormant and become reactivated and become a secondary infection when reexposed to the bacteria
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16
Q

Individuals who have received what vaccine are at risk for TB

A

Bacilli calmette guerin will have a positive test result and should receive an X-ray as the vaccine has attenuated tubercle bacilli

17
Q

TST Induration of 5 >5mm considered positive in

A

HIV Infected persons
Recent contact of a person with TB disease
Persons with fibrotic changes on CXR consistent with prior TB
Clients with organ transplants
Persons immunosuppressed for other reasons

18
Q

Indication 10 or >10mm considered positive in

A

Recent immigrants from high prevalent countries
Injection drug users
Residents and employees in high risk settings
Labs
Persons with clinical conditions that place them at high risk
Children under four
Infants children and adolescents exposed to adults in high risk categories

19
Q

Induration of 15 or >15 mm positive in

A

Any person including persons with no known risk factors for TB

20
Q

What foods are recommended for TB PTS

A

Foods high in iron protein and vitamin c

21
Q

Who is respiratory Isolation not necessary for

A

Family members because they have already been exposed

22
Q

What should TB PTS avoid

A

Exposure to silicone because this can further lung damage

23
Q

What are the names of the fist line medications for TB

A 
Isoniazid 
Rifampin
Ethambutol
Pyrazinamine 
Rifabutin 
Rifapentine
24
Q

What are the second line medications for TB

A 
Capreomycin sulfate 
Antibiotics 
 - aminoglycosides 
- fluroquinolones (not for children) 
Bactericidal

Ethionamide
Aminosalicylic acid
Cycloserine
Streptomycin

25
Q

What can many TB medications cause

A 
Hepatotoxicy 
Nephrotoxicity 
Neurotoxic 
Optic neuritis
Ototoxic
26
Q

What is a pulmonary embolism

A

Occurs when a thrombus forms - commonly in a deep vein

Detaches travels to the right side of the heart and then lodges in the pulmonary Artery

27
Q

Assessment findings of a pulmonary embolism

A 
Apprehension and restlessness 
Blood tinged sputum 
Chest pain 
Cough 
Crackles and wheezes on auscultation 
Cyanosis 
Distended neck veins 
Dyspnea accompanied by anginal and pleuritic pain - exacerbated by inspiration
Feeling of impending doom 
Hypotension 
Petechia over abdomen and axilla
Shallow respirations
Tachycardia and tachypena
28
Q

What do you do if you suspect a pulmonary embolism

A

Notify the response team
Reassure the client and elevate the HOB
Prepare to administer oxygen
Obtain vital signs and check lung sounds
Prepare to obtain arterial blood gas
Prepare for the administration of heparin therapy or other therapies
Document

29
Q

What is TB caused by ?

A

Myobacterium tuberculosis - aerobic organism

30
Q

What is systemic lupus erythematosus

A

Chronic
Progressive
Systemic inflammatory disease
Major organs and systemic systems to fail

31
Q

What happens with SLE

A

Connective tissue and fibrin deposits collect in blood vessels on collagen fibres and on organs

Deposits lead to necrosis and inflammation in the blood vessels lymph nodes GI tract and pleura

No cure but remissions for those who manage well

32
Q

SLE ASSESSMENT

A 
Assess for precipitating factors 
Butterfly rash 
Dry scaly raised rash on the face or upper body 
Fever
Weakness malaise and fatigue 
Anorexia 
Weight loss 
Photosensitivity 
Joint pain
Erythema of the palms 
Anemia 
Positive ANA test and LE prep 
Elevated ESR rate and C reactive protein

NCLEX (10 decks)

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