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Term 3 Stanbridge > MED 2052 Exam #1 - Immunity > Flashcards

MED 2052 Exam #1 - Immunity Flashcards

1
Q

list types of foods the immunosuppressed client should avoid

A

Raw food, fruits and veggies unless cooked.

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2
Q

list the fx of macrophages and neutrophils

A

Macrophages become active (phagocytic immune response) and engulf and destroy antigens.

Neutrophils

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3
Q

discuss the patho of scleroderma

A

hardening of the skin.

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4
Q

list the common signs of inflammation

A

redness, swelling, warmth, pain, and decreased function

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5
Q

describe Raynaud’s phenomenon

A

condition that is characterized by spasmodic construction of arteries supplying the extremities. affects fingers and toes, often only the fingers. cold and emotional stress can make the condition worse. cause is unknown.

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6
Q

discuss the nursing implications/client teaching for the nurse administering prednisone

A

take with food. take exactly how prescribed. do not stop it abruptly. avoid alcohol during therapy. avoid people with contagious infections. caution vaccinations. check blood glucose often

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7
Q

discuss the fx of basophils during an allergic reaction

A

basophils are involved in INFLAMMATION. they contain HISTAMINE, heparin, bradykinin, and serotonin.

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8
Q

list three precautions to include in the plan of care for the client who is immunosuppressed

A

no not eat raw uncooked food
cook fruits and veggies
wash hands/shower daily

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9
Q

discuss plasmapheresis

A

a procedure in which antibodies are removed from the blood.

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10
Q

discuss the “scratch test” that tests for allergies

A

A skin test that tests for allergies with the use of intradermal injections or scratching of the superficial layer.

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11
Q

define leukocytosis

A

condition where WBC increase by the number

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12
Q

discuss the priority of care for the client with a bee sting

A

take out bee stinger with a credit card. apply ice. elevate. antihistamine.

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13
Q

list the s/s in a client with an immunodeficiency

A

Frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections. Inflammation and infection of internal organs. Blood disorders, such as low platelet counts or anemia.

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14
Q

give 3 examples of lymph tissue

A

white blood cells (leukocytes), bone marrow, and the thymus, spleen, and lymph nodes.

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15
Q

list the side effects of immune suppression

A

.

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16
Q

Identify the location in the body of the thymus, spleen, stomach, and liver

A 
Thymus - center sternum
Spleen - Left middle quadrant
Bone Marrow
Appendix - end of Small intestine into large
lymph nodes everywhere
Tonsils and adenoids - back of throat
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17
Q

define desensitization, immunotherapy, and immunity

A

Immunotherapy is more trying to cure the body with meds to bring the body back to homeostasis.

Desensitization - consists of giving minute doses of allergens subQ. “allergy shots” are gradually increased to enable the client slowly develop an immunologic tolerance to the allergen.

Immunity - condition of being non-susceptible to a certain disease.

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18
Q

discuss the discharge teaching for the client with systemic lupus erythematous (SLE)

A
  • avoid UV and sun exposure. sunscreen
  • mild shampoo. avoid harsh hair treatments
  • steroid cream for rash
  • report peripheral/periorbital edema
  • report evidence of infection
  • avoid crowds
  • risk w/childbearing age
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19
Q

how are rheumatoid arthritis (RA) and systemic lupus erythematous (SLE) similar

A

joint pain including swelling and tenderness. also energy levels are low

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20
Q

explain the lab test “culture and sensitivity”

A

lab test ordered when infection is suspected or known.

  • identifies the pathogenic microorganism
  • determines which tx will eliminate
  • monitors the microorganisms response to therapy

do before prescribing medication

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21
Q

discuss the patho of systemic lupus erythematous (SLE)

A

AUTOIMMUNE
- body produces antibodies against components of its own cells, such as the antinuclear antibody (ANA), and immune complex disease then follows

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22
Q

list three symptoms the client might have if having an allergic reaction to a medication

A

edema, dyspnea, anaphylaxis

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23
Q

list the side effects of anti-rejection medications

A

Kidney toxicity, neurotoxicity, hypertension, gout, high potassium levels, hyperlipidemia

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24
Q

list the vaccines that are recommended for the older adult

A 
flu
tetanus 
pneumococcal 
Hep A and B
HPV
MMR
varicella
shingles
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25
Q

describe the s/s of systemic lupus erythematous (SLE)

A
  • fatigue/malaise
  • alopecia
  • blurred vision
  • pleuritic pain
  • anorexia, weight loss
  • depression
  • joint pain, swelling, tenderness
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26
Q

Difference between natural and artificial active immunity. example of each

A

Active Natural - Develops when the body produces antibodies in response to exposure to a live pathogen.

Active Artificial - Develops when a caving is given and the body produces antibodies in response to exposure to skilled or attenuated virus.

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27
Q

describe the physical assessment of a client with an immune-related disorder

A

check for fever, enlarged lymph nodes, fatigue, rashes, change in LOC, sore throat, cough.

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28
Q

list 3 functions of the immune system

A

defense, homeostasis, and surveillance.

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29
Q

discuss the documentation required after giving an immunization

A

administration of vaccines to include date, route, site, type, manufacturer, lot number, and expiration date of vaccine. Also document the name, address, and signature.

Include name, and title of the person administering the vaccine, and address of the facility where the permanent record is located.

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30
Q

explains the difference between helper T cells, B cells, natural killer cells, and suppressor T cells

A

T cells - move from bone marrow to thymus gland and become CD4 helper cells, suppressor cells, cytotoxic (natural killer cells), subtype of CD8 cells and MEMORY CELLS

B cells - migrate from bone marrow to lymphoid tissue. transform into plasma cells which make ANTIBODIES and MEMORY cells

Natural killer cells - cytotoxic T. Born just to kill bad things in the body. Only function.

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31
Q

describe “graft versus host disease”

A

complication of transplantation.

occurs when immunologically competent cells are introduced into an immuoincompetent host

32
Q

discuss the radioallergosorbent (RAST) test. When is this test positive

A

A blood test to determine sensitivity to various allergens.

A positive test by the IGE is attracted to an allergen, the amount measured on a scale of 0-5, with the higher number indicating a higher level of sensitivity

33
Q

describe the s/s of an anaphylaxis reaction

A 
urticaria, pruritis, sneezing
CYANOSIS
PALLOR
DYSPNEA
BRONCHOSPAM
WHEEZING
HYPOTENSION
DECREASED CARDIAC OUTPUT
TACHYCARDIA
34
Q

discuss cell-medicated immunity

A

Cell medicated immunity is produced by T lymphocytes. T cells come from the thymus. T cells become sensitized in the thymus and can combine with specific foreign antigens..

These cells are cancer fighting cells.

35
Q

discuss the fx of the lymph nodes, spleen and the liver

A

All are lymphoid tissue containing macrophages and lymphocytes. They are all areas where exposure to antigen causes lymphocytes to proliferate and form clones.

36
Q

define innate immunity and hypersensitivity

A

physical and chemical barriers to invading pathogens and protection from external environment.

includes sin and mucous membranes, cilia, stomach acid, tears, sebaceous glands, and secrets and flora of the intestines and vagina

1st LINE OF DEFENSE

present at birth

Hypersensitivity: extreme physical sensitivity to particular substances or conditions.

37
Q

discuss humoral immunity

A

In humoral immunity (humoral means boy fluid), macrophages engulf and destroy antigens after antibodies have identified them for destruction.

38
Q

list the complication of allergic rhinitis

A

angioedema. can cause one to not breath effectively

39
Q

list 4 autoimmune disorders

A

RA
Lupus
Graves disease
Autoimmune thyroiditis

40
Q

explain the difference between IgA, IgD, IgM. Which is most abundant.

A

IgA - protects mucosal surfaces (tears, saliva)

IgE - responsible for immediate types of ALLERGIC reactions

IgD - antigen found in B CELLS. regulates cell activation.

IgM - 1st ANTIBODY PRODUCED in response to antigen NONSPECIFIC

IgG - MOST ABUNDANT. for MEMORY and INFECTION. protects fetus against antitoxins, viruses and bacteria.

41
Q

define angioedema

A

swelling of the face

42
Q

why is the client with contact dermatitis prescribed topical corticosteroids

A

aid in reducing the inflammation and itching.

43
Q

list 2 conditions that may create a cellular response of t cells

A

when T lymphocytes relate lymphokine

44
Q

discuss the discharge instruction for the client recently diagnosed with a bee sting allergy

A

Elevate, use compress, use paste to stop itching. Careful for anaphylaxis and return if necessary.

45
Q

discuss the action and rationale for venom immunotherapy

A

Goal is to hopefully decrease allergy and anaphylaxis from 60% to 5% allergy next time bitten.

46
Q

define and discuss the function of T-lymphocytes, platelets, erythrocytes, and gamma globulin

A

platelets - clotting
erythrocytes - RBC carry o2 and co2
gamma globulin - eat bacteria/diseases
t cells - helper cells, suppressor cells, memory cells

47
Q

list the medications, including classifications, used to treat systemic lupus erythematous (SLE)

A
  • NSAIDS
  • Corticosteroids
  • -> prednisone
  • Immunosuppressant agents
  • -> methotrexate and azathioprine (Imran)
  • Antimalarial
  • -> hydroxychlorquine (Plaquenil)
48
Q

list the risk factors of systemic lupus erythematous (SLE)

A
  • female between ages of 20-40
  • african american, asian, native american descent
  • incidence of lupus following menopause, but remains steady in men
  • elderly
49
Q

discuss the treatment of the client who is rejecting a transplanted organ

A

a change in medication can fix the problem. Checks labs

50
Q

describe a hemolytic blood transfusion reaction

A

reactions may be mild, moderate, or severe.

s/s dermatitis, diarrhea, fever, chills, urticaria, cough, orthopnea, wheezing, back pain and hematuria

51
Q

list the lab ranges for WBC, RBC, PLT

A

WBC 5,000 - 10,000

RBC 0.5 - 6.1

PLT - 150,000 - 400,000

52
Q

describe the nursing interventions for a suspected transfusion reaction

A

STOP THE TRANSFUSION
administer normal saline by IV (separate line)
administer steroids or diuretics as ordered
return blood to la for testing
urine for lab to check for hemolysis

53
Q

explain why the client with systemic lupus erythematous (SLE) is typically prescribed glucocorticoid medications

A

used for immunosuppression and to reduce inflammation.

54
Q

explain how immune globulin works in the body

A

Protein substances that the plasma cells produce in response to a foreign protein (an antigen).

Called gamma globulins or immunoglobulins.

55
Q

list 4 adverse effects of glucocorticoid medications

A

ecchymosis, muscle weakness, petechiae, adrenal insufficiency.

56
Q

discuss the process of selecting an appropriate transplant recipient from an organ donor

A

Will checks blood type, make sure all labs are good, checks previous hx

57
Q

discuss the nursing plan of care and client education for at the client undergoing plasmapheresis

A

A machine can be used to remove the affected plasma and replace it with good plasma or a plasma substitute. This is also known as plasma exchange. checks labs and vitals.

58
Q

list 4 contraindications for administering immunizations

A
  • being immunocompromised
  • being sick within the last few weeks
  • an anaphlactyc reaction
  • fever
59
Q

list the adverse affects to look for in the client taking cyclosporine (Sandiummune)

A

nephrotoxic, monitor BUN and creatinine

60
Q

Difference between natural and artificial passive immunity. example of each

A

Passive Natural - When antibodies are passed form the mother to the fetus/newborn through the placenta and breast milk.

Passing Artificial - 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.

61
Q

discuss the client teaching following desensitization treatment

A

Client will be observed for 20 minutes minimum after administration since hypersensitivity reaction or anaphylaxis may occur. May cause throbbing headache. If a dose is missed, might have to reduce the following injection and back track.

62
Q

list the medications used in the client with anaphylaxis

A

epinephrine

63
Q

list the labs to be monitored in the client with systemic lupus erythematous (SLE)

A

SERUM COMPLEMENT (C3, C4) DECREASED

BUN AND SERUM CREATININE INCREASED

URINALYSIS POSITIVE FOR PROTEIN/RBCS

CBC - PANYTOPENIA

ana titer
anti-smith test is highly specific for SLE

64
Q

what happens to the thymus as we age?

A

It shrinks

65
Q

discuss the client teaching for the client with contact dermatitis

A

rinse area, burow’s solution, cool environment, cold compresses, daily baths with oil, keep nails short, loose light clothing

66
Q

what should the nurse monitor in the client taking prednisone (Deltasone)

A

Monitor fluid retention, hypertension, and renal dysfunction.

67
Q

discuss the nursing implications prior to administering the varicella vaccine

A

Check if pregnant = no go

Do not give if allergic to gelatin and neomycin.

Do not give if immunodeficient.

Do not give with recent transfusion with antibody containing blood products.

68
Q

discuss the teaching for the client being discharged after a kidney implant

A 
take anti rejection medications as necessary. 
rest as needed.
drink fluids.
exercise.
eat healthy
69
Q

list the medications used to treat allergic rhinitis

A

antihistamines.

70
Q

define autoimmune

A

When an organism doesn’t realize it’s its own self.

71
Q

which blood type is the universal donor and universal recipient

A

Universal Donor - O

Universal recipient AB+

72
Q

discuss the nature of the T Cells

A

They migrate from bone marrow to the thymus gland. differentiate into CD4 helper cells, CD8 suppressor cells, cytotoxic T (natural born killer cells), MEMORY CELLS

73
Q

list the complication of long-term steroid medication

A

increased appetite, fluid retention, weight gain, increased blood sugar (which can lead to diabetes), change in body shape (increase in fatty tissue on the trunk while the arms and legs get thinner), increased susceptibility to infections, acne, thinning of the skin, easy bruising.

74
Q

list the lab test(s) you would expect to be order for a client suspected of having an immune disorder

A
  • Antinuclear Antibody (ANA). Blood test
  • Anti-dsDNA (anti-double standard DNA) antibody test. blood test to identify or differentiate DNA antibodies found in SLE or RA
75
Q

list 2 ways to reduce the risk of blood transfusion reaction

A

2 licensed nurses much compare blood numbers to recipient blood numbers, and check identification bands.

Term 3 Stanbridge (9 decks)

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