Med 2052 Exam #1

Question 1

Risk factors of SLE

Answer 1

Females between ages 20-40
African American, Asian, Native American
Incidence of lupus declines in women following menopause

Question 2

S/S of SLE

Answer 2

Fatigue/malaise
Alopecia
Blurred vision
Pleuritic pain
Anorexia, weight loss
Depression
Joint pain, swelling tenderness

Question 3

Pathophysiology of SLE

Answer 3

The body produces antibodies against components of its own cells, such as antinuclear antibody, and immune complex disease then follows.
Client w/ SLE may produce antibodies against many different tissue components: RBCs, neutrophils, platelets, WBCs, or almost any organ or tissue in the body.

Question 4

Discharge teaching for client w/ SLE

Answer 4

Avoid UV and sun exposure. Use sunscreen when outside and exposed to sunlight.
Use mild protein shampoo, and avoid harsh hair tx.
Use steroid creams for skin rash
Report peripheral and periorbital edema promptly,
Report evidence of infection r/t immunosuppression.
Avoid crowds and individuals who are sick, because illness can precipitate an exacerbation.
Instruct clients of childbearing age regarding risks of pregnancy w/ lupus and tx medication

Question 5

Define autoimmunity

Answer 5

The failure of an organism to recognize its own parts as self

Question 6

Discuss nature of T-cells

Answer 6

migrate from bone marrow to thymus gland; differentiate into CD4 helper cells, CD8 suppressor cells,, cytotoxic T and memory cells

Question 7

Platelet

Answer 7

150,000-400,000

Question 8

WBC

Answer 8

5,000-10,000

Question 9

RBC

Answer 9

F:4.2-5.4
M:4.7-6.1

Question 10

B-cells

Answer 10

migrate from bone marrow to lymphoid tissue; transform into plasma cells which make antibodies and memory cells

Question 11

Angioedema

Answer 11

Forms of urticaria in subcutaneous tissue
s/s-burning, pruritis, acute pain, respiratory distress.
Tx-antihistamines, epinephrine, corticosteroids, cold compress

Question 12

List medications used to tx allergic rhinitis

Answer 12

antihistamines, decongestants and nasal corticosteroids

Question 13

List 4 Autoimmune disorders

Answer 13

Pernicious anemia
ulcerative colitis
crohn's disease
RA
SLE

Question 14

List the medications, including the classification, used to treat systemic lupus erythematosus

Answer 14

NSAIDs
Corticosteroids (prednisone)
Immunosuppressant agents-methotrexate and azathiorine (imuran)
antimalarial-hydroxychloroquine (Plaquenil)

Question 15

Active-natural immunity

Answer 15

develops when the body produces antibodies in response to exposure to live pathogen

Question 16

Active-artificial immunity

Answer 16

develops when a vaccine is given and the body produces antibodies in response to expose to a killed or attenuated virus

Question 17

Passive-natural

Answer 17

occurs when antibodies are passed from the mother to the fetus/newborn through the placenta and breast milk

Question 18

Passive-artificial

Answer 18

immunity occurs after antibodies in the form of immune globulins are administered to an individual who requires immediate protection against a disease where exposure has already occurred. After several weeks or months, the individual is no longer protected.

Question 19

Two ways to reduce the risk of blood transfusion reaction

Answer 19

Autologous for replacement therapy (use of own blood)

Question 20

Common signs of inflammation

Answer 20

redness, warmth, swelling, pain, and decrease function

Question 21

Nursing implications prior to administering varicella

Answer 21

Pregnancy, allergy to gelatin and neomycin, severe allergy after previous dose, severe immunodeficiency, recent transfusion w/ antibody-containing blood products.

Question 22

What should the nurse monitor in the client taking prednisone (Deltasone)?

Answer 22

Monitor for fluid retention, HTN, and renal dysfunction

Question 23

Describe the nursing interventions for suspected transfusion reaction

Answer 23

If reaction occurs: stop the transfusion immediately and administer normal saline by IV.
Administer steroids and diuretics as ordered.
Return blood to the lab/blood bank for testing.
Urine to lab to check for hemolysis.