Med surge exam Flashcards
who is at the highest risk for systemic lupus
Africans American females
s/s systemic lupus
butterfly rash
low grade fever
what are some common symptoms of immune disorders
joint pain
low grade fever
fatigue
what is the leading cause of death with
kidney disease
pt. education for a pt. with lupus
anything above 30 spf stay away from raw fruits or vegetables rest periods exacerbations or remission s/s of renal function coca cola frothy urine pain in the lower back
what causes exacerbations of lupus
medications
anaphylaxis breathing symptoms
stridor
wheezing
SOB
EPINEPHERINE in a muscle
what kind of reaction is Hives?
regular reaction
early signs of anaphylaxis
angioedema
what jewelry should a severely allergic pt. have?
medical ID bracelet
Serum sickness
type 3 sensitivity penicillin and sulfa weeks later (7 days to 3 weeks) tissue damage necrosis
who is at risk for serum sickness?
pt. who had penicillin or sulfa in the last few weeks
pernicious anemia
low b12
pale
weak/tired
beefy tongue (glossitis)
care plan for pernicious anemia
rest periods
infusions of b12
what is hemolytic anemia? What are its manifestations?
red blood cells break down. weak/tired jaundice SOB tachycardia hypertension
hemolytic anemia treatment
blood transfusions
rest periods
assist with walking/ADL
labs for hemolytic anemia
low hemoglobin
low hematocrit
RBC low
Angioedema
swelling of the tissues
confusion/agitation/ restlessness
monitor airway
antihistamines/Benadryl if airway is not obstructed
with older adults advocate for…?
flu
shingles
pneumonia
controlling allergies
wear a mask when mowing the grass take a antihistamine before going out filter in house hardwood over rugs blinds over curtains AC over windows open
allergy treatments
antihistamines
normal saline for the nose
(flomax has a steroid component)
common allergies
hay fever antibiotics (what happens?) latex peanuts pets
what is elevated when you have an allergic reaction?
IGE
education for transplant pt.
no well water
oral hygiene
take all medications fpr the rest of their life
HIV affects what cells?
T cells
CD4
when is aids diagnosed
t cell count is less than 200 develop a opportunistic infection pcp pneumonia candiias albacan ( nistatin and antiseptic mouthwash) soft diet cool liquids nothing spicy aids wasting syndrome( 10% of the body weight is lost) GI upset chronic diarrhea fatigue malasorption malnutrition high density protein small frequent meals educate healthy body right at diagnosis
what does thrush look like?
a white patch
HIV cognitive disorder affects
central nervous system unsteady gait confusion peripheral neuropathy hallucinations
What is ART?
antiretroviral therapy
a lot of medications
same time every day
How does ART work?
it attacks Hiv at different stages
How do you monitor if ART is working?
viral load
monitor monthly
40 copies per militer is undetectable
cannot be passed on at this point
how can HIV be spread?
unprotected sex
mother to baby
IV drug use/transfusions
breastfeeding
how to prevent HIV spread from blood transfusion?
autologous blood transfusion
for two weeks
you can spread HIV
what is the timeframe for antibody formation of HIV ?
it can take up to 3 months
if exposed at work to HIV. What should you do?
use soap and water at the site
mucous memebrane just use water
then report
PREP(trevada)
PREP is for
high risk behavior or exposure
PREP education
same time every day
how do you monitor the progression of HIV?
T CELLS
CD4
How do you prevent the spread of HIV
abstinence safe sex clean needle exchange programs autologus blood transfusions dental dam
early s/s of HIV
fatigue
aches
fever
s/s of aids
t-cell count below 200
opportunistic infections
Ziagan
flu-ike symptoms
epirire
low urine output liver enlarge increase jaundice pain in right lower quadrant peripheral neuropathy
T cells
Arises in red bone marrow
Passes through thymus for maturation
Then travel to spleen, lymph nodes and nodules
Perform a direct attack
Found throughout the body
Produce quick response
Destroy foreign cells, tumors, infected cells
natural killer cells
Arise in red bone marrow
Mature in bone marrow and migrate directly to lymphatic tissue
Differentiate into plasma cells that release antibodies for an indirect approach
B cells
what are antibodies that do not destroy antigens?
immunoglobulin
IGG
Blood, lymph, extracellular fluid
Provides long term immunity after a vaccination or illness recovery
(Crosses placenta and provides passive immunity in newborns)
IGA
External secretions
Found in secretions of all mucous membranes
(Provides passive immunity for breast fed infants)
in blood and lymph and
produced first during an infection
IGM
what is in B cells and are antigen specific receptors on B lymphocytes
IGD
IGE
in mast cells or basophils
important in allergic reactions
mast cells release histamine
