Med surge exam Flashcards by Leila Matos

who is at the highest risk for systemic lupus

Africans American females

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s/s systemic lupus

butterfly rash

low grade fever

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what are some common symptoms of immune disorders

joint pain
low grade fever
fatigue

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what is the leading cause of death with

kidney disease

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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

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what causes exacerbations of lupus

medications

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anaphylaxis breathing symptoms

stridor
wheezing
SOB
EPINEPHERINE in a muscle

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what kind of reaction is Hives?

regular reaction

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early signs of anaphylaxis

angioedema

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what jewelry should a severely allergic pt. have?

medical ID bracelet

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Serum sickness

type 3 sensitivity 
penicillin and sulfa 
weeks later (7 days to 3 weeks) 
tissue damage 
necrosis

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who is at risk for serum sickness?

pt. who had penicillin or sulfa in the last few weeks

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pernicious anemia

low b12
pale
weak/tired
beefy tongue (glossitis)

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care plan for pernicious anemia

rest periods

infusions of b12

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what is hemolytic anemia? What are its manifestations?

red blood cells break down.
weak/tired
jaundice
SOB
tachycardia
hypertension

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hemolytic anemia treatment

blood transfusions
rest periods
assist with walking/ADL

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labs for hemolytic anemia

low hemoglobin
low hematocrit
RBC low

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Angioedema

swelling of the tissues
confusion/agitation/ restlessness
monitor airway
antihistamines/Benadryl if airway is not obstructed

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with older adults advocate for…?

flu
shingles
pneumonia

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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

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allergy treatments

antihistamines
normal saline for the nose
(flomax has a steroid component)

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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