Module 13 Material Flashcards

1
Q

Arteriosclerosis

A

Hardening of the arteries

Diffuse process whereby the muscle fibers and the endothelial lining of the walls of small arteries and arterioles become thickened

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Atherosclerosis

A

Accumulation of lipids, calcium, blood
components, carbohydrates, and fibrous tissue on the intimal layer of the artery

Atheromas or plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Atherosclerosis

A

Accumulation of lipids, calcium, blood
components, carbohydrates, and fibrous tissue on the intimal layer of the artery

Atheromas or plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Peripheral Artery Disease (PAD)

A

Hallmark symptom is intermittent claudication

described as aching, cramping, or inducing
fatigue or weakness

Occurs with some degree of exercise or activity

Relieved with rest

Pain is associated with critical ischemia of the distal extremity and is described as persistent, aching, or boring (rest pain)

Ischemic rest pain is usually worse at night and often wakes the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

intermittent claudication

A

muscle pain that happens when you’re active and stops when you rest. It’s usually a symptom of blood flow problems like peripheral artery disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The nurse is teaching a patient diagnosed with peripheral arterial disease (PAD). What should be included in the teaching plan?

A. Elevate the lower extremities
B. Exercise is discouraged
C. Keep the lower extremities in a neutral or dependent position
D. PAD should not cause pain

A

C. Keep the lower extremities in a neutral or dependent position
Rationale: For patients with PAD, blood flow to the lower extremities needs to be enhanced; therefore, the nurse encourages keeping the lower extremities in a neutral or dependent position. In contrast, for patients with venous insufficiency, blood return to the heart needs to be enhanced, so the lower extremities are elevated. Exercise can be prescribed to aid in the development of collateral circulation. Some pain is associated with PAD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Raynaud’s Phenomenon

A

a condition that causes the blood vessels in the extremities to narrow, restricting blood flow. The episodes or “attacks” usually affect the fingers and toes. In rare cases, attacks occur in other areas such as the ears or nose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Venous Thromboembolism

A

a condition that occurs when a blood clot forms in a vein. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT occurs when a blood clot forms in a deep vein, usually in the lower leg, thigh, or pelvis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which patient is at highest risk for venous thromboembolism?

A. A 50-year-old postoperative patient
B. A 25-year-old patient with a central venous catheter in place to treat septicemia
C. A 71-year-old otherwise healthy older adult
D. A pregnant 30-year-old woman due in 2 weeks

A

A 25-year-old patient with a central venous catheter in place to treat septicemia
Rationale: Some risk factors for venous thromboembolism include but are not limited to age older than 65 years, patients undergoing surgery, central venous catheter placement, septicemia, and pregnancy. The client in this question with two risk factors is the 25-year-old with a central venous catheter in place to treat septicemia. All other patients only have one risk factor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

dry gangrene

A

where the blood flow to an area of the body becomes blocked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

wet gangrene

A

caused by a combination of an injury and bacterial infection. gas gangrene – where an infection develops deep inside the body and the bacteria responsible begin releasing gas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Varicose Veins Prevention

A

Avoid activities that cause venous stasis (wearing socks that are too tight at the top or that leave marks on the skin, crossing the legs at the thighs, and sitting or standing for long periods)
Elevate the legs 3 to 6 inches higher than heart level
Encourage to walk 30 minutes each day if there are no contraindications
Wear graduated compression stockings
Overweight patients should be encouraged to begin weight reduction plans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lymphangitis

A

inflammation or infection of the lymphatic channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lymphadenitis

A

inflammation or infection of the lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lymphedema

A

tissue swelling related to obstruction of lymphatic flow

Primary: congenital
Secondary: acquired obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which of the following is an effective strategy used to promote lymphatic drainage and prevent edema in clients with lymphedema?

A. Antibiotic therapy for 14 days
B. Constant elevation of the affected extremity
C. Application of heat therapy twice per day
D. Daily exposure to the sun

A

B. Constant elevation of the affected extremity

Rationale: Constant elevation of the affected extremity and observation for complications are essential. After surgery, antibiotics may be prescribed for 3 to 7 days. The patient is instructed to avoid the application of heating pads or exposure to sun to prevent burns or trauma to the area.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cellulitis Nursing Intervention

A

Elevate affected area 3 to 6 inches above heart level

Warm, moist packs to site every 2 to 4 hours

Educate regarding prevention of recurrence

Reinforce education about skin and foot care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

For patients with uncomplicated hypertension and no specific indications for another medication, what is the recommended initial medication?

A. Thiazide diuretic
B. Calcium channel blockers
C. Vasodilators
D. Angiotensin-converting enzyme (ACE) inhibitors

A

A. Thiazide diuretic

Rationale: For patients with uncomplicated hypertension and no specific indications for another medication, the recommended initial medication is thiazide diuretics for most patients. If blood pressure does not fall to less than 140/90 mm Hg, the dose is increased gradually, and additional medications are included as necessary to achieve control.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The nurse is preparing an education plan for a patient newly diagnosed with hypertension. Which of the following should be included in the education plan?

A. Engage in regular aerobic physical activity such as brisk walking (at least 30 min/day most days of the week)
B. Eliminate alcoholic beverages from the diet
C. Reduce sodium intake to no more than 200 mmol/day
D. Maintain a normal body weight with BMI between 18 and 30 kg/m2

A

Engage in regular aerobic physical activity such as brisk walking (at least 30 min/day most days of the week).

Rationale: The nurse assists the patient to develop and adhere to an appropriate exercise regimen (as described above), because regular activity is a significant factor in reducing blood pressure. Alcoholic beverages can be consumed in moderation. Sodium should be reduced to no more than 100 mmol/day, and the patient should maintain a normal body weight with a BMI between 18.5 and 24.9 kg/m2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which of the following is a priority nursing assessment when caring for the patient in a hypertensive crisis receiving intravenous vasodilators?

A. Pain
B. I&O
C. Vision
D. Family history

A

B. I&O

Rationale: Assessing the individual’s fluid volume status is recommended because if there is volume depletion secondary to natriuresis caused by the elevated blood pressure, then volume replacement with normal saline can prevent large sudden drops in blood pressure when antihypertensive medications are administered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Immunity

A

the body’s specific protective response to foreign agent or organism; resistance to a disease, specifically infectious disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Immunopathology

A

the study of diseases that results from dysfunction within the immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is the following statement true or false?

Immunity refers to the body’s nonspecific protective response to an invading foreign agent or organism.

A

False

Immunity refers to the body’s specific protective response to an invading foreign agent or organism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where do B lymphocytes mature?

A

in the bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where do T lymphocytes mature?

A

in the thymus, where they also differentiate into cells with various functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Phagocytosis

A

monocytes responsible for engulfing and destroying foreign bodies and toxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Natural immunity

A

nonspecific response to any foreign invader

White blood cell action: release cell mediators such as histamine, bradykinin, and prostaglandins and engulf (phagocytize) foreign substances
Inflammatory response
Physical barriers, such as intact skin, chemical barriers, and acidic gastric secretions or enzymes in tars and saliva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Acquired immunity

A

specific against a foreign antigen

Result of prior exposure to an antigen
Active or passive

29
Q

Active Immunity

A

Immunologic defenses developed by person’s own body

Lasts many years; may last a lifetime

30
Q

Passive Immunity

A

Temporary

Results from transfer of a source outside of the body that has developed immunity through previous disease or immunization
Examples: transfer of antibodies from mother to infant through breast feeding; receiving immune globulin through injections

31
Q

Which leukocytes are associated with inflammation?

A. Basophils
B. Eosinophils
C. Monocytes
D. Neutrophils

A

D. Neutrophils

Neutrophils (polymorphonuclear leukocytes) are the first cells to arrive at the site where inflammation occurs.

32
Q

Four Stages in Immune Response

A

Recognition
Proliferation
Response
Effector

33
Q

Recognition Stage

A

Recognition of antigens as foreign

Use of lymph nodes and lymphocytes for surveillance

Lymphocytes recirculate from the blood to lymph nodes and from the lymph nodes back into the bloodstream in a continuous circuit

34
Q

Proliferation Stage

A

Circulating lymphocytes containing the antigenic message return to the nearest lymph node

Stimulate some of the resident T and B lymphocytes to enlarge, divide, and proliferate

T lymphocytes differentiate into cytotoxic (or killer) T cells

B lymphocytes produce and release antibodies

35
Q

Response Stage

A

Begins with the production of antibodies by the B lymphocytes in response to a specific antigen

Cellular response stimulates the resident lymphocytes to become cells that attack microbes; (killer) T cells

Viral rather than bacterial antigens induce a cellular response

Most immune responses to antigens involve both humoral and cellular responses, although one usually predominates

36
Q

Effector Stage

A

Humoral immunity
Interplay of antibodies

Cellular immunity
Action by cytotoxic T cells

37
Q

Humoral or antibody response

A

Antibody response; B lymphocytes transform themselves into plasma cells that manufacture antibodies

38
Q

Cellular immune response

A

T lymphocytes; cytotoxic killer cells that can attack pathogens

39
Q

IgM

A

M is for miserable

FIRST response to both bacterial and viral infections

40
Q

IgG

A

G is for GONE

eliminated most, lab results change

41
Q

IgE

A

ALLERGY

allergic/parasitic results

42
Q

T lymphocytes: cellular immunity

A

Attack invaders directly, secrete cytokines, and stimulate immune system responses

Helper T cells

Cytotoxic T cells

Memory cells

Suppressor T cells (suppress immune response)

43
Q

Null cells

A

Destroy antigen coated with antibody

44
Q

Natural killer cells

A

Defend against microorganisms and some malignant cells

45
Q

Complement System Functions

A

Defend the body against bacterial infection

Bridge natural and acquired immunity

Dispose of immune complexes and the by-products

46
Q

Is the following statement true or false?

Autoimmune disorders are more common in women than men.

A

True

Many autoimmune diseases have a higher incidence in females than in males, a phenomenon believed to be correlated with sex hormones. Research has revealed that sex hormones are integral signaling modulators of the immune system. Sex hormones play definitive roles in lymphocyte maturation, activation, and synthesis of antibodies and cytokines. In autoimmune disease, expression of sex hormones is altered, and this change contributes to immune dysregulation

47
Q

Stem cells

A

basic building blocks

48
Q

Primary Immune Deficiency Disorders (PIDD)

A

Genetic

Majority diagnosed in infancy; some may be diagnosed during adolescence

Male-to-female ratio of 5 to 1

Occasionally, adults may present with persistent, recurrent, or resistant infections

Prevent body from developing normal immune responses

May affect phagocytic function, B cells or T cells, or the complement system

49
Q

Is the following statement true or false?

Primary immune deficiency disorders result from external factors such as infection.

A

False

Rationale: Primary immune deficiency disorders are genetic.

50
Q

PLWHA

A

persons living with HIV/AIDS

51
Q

HIV: Modes of Transmission

A

Blood and blood products
Seminal fluid
Vaginal secretions
Mother-to-child: Amniotic fluid, breast milk
Not through casual contact

52
Q

Postexposure prophylaxis (PEP)

A

Antiretroviral medications within 72 hours of exposure

2 to 3 drugs prescribed for 28 days

53
Q

Antiretroviral medications as postexposure prophylaxis for health care workers are started within how many hours of exposure?

A. 24 hours
B. 12 hours
C. 36 hours
D. 72 hours

A

D. 72 hours

Rationale: Antiretroviral medications are started as soon as possible, but no more than 72 hours (3 days) after possible HIV exposure.

54
Q

HIV: Pathophysiology

A

HIV is in the subfamily of lentiviruses and is a retrovirus because it carries its genetic material in the form of ribonucleic acid (RNA) rather than deoxyribonucleic acid (DNA)

HIV targets cells with CD4+ receptors, which are expressed on the surface of T lymphocytes, monocytes, dendritic cells, and brain microglia

55
Q

HIV: Stage 0

A

Early HIV infection; inferred from laboratory testing

56
Q

HIV: Stage 1

A

Primary/acute

Period from infection with HIV to the development of HIV-specific antibodies

Dramatic drops in CD4+ T-cell counts normally 500 to 1500 cells/mm3 of blood

57
Q

HIV: Stage 2

A

Occurs when T-lymphocyte cells are between 200 and 499 cells/mm3

58
Q

HIV: Stage 3

A

CD4+count drops below 200 cells/mm3 of blood

Considered to have AIDS for surveillance purposes

59
Q

HIV: Unknown stage

A

No information on CD4+ T-lymphocyte count or percentage

60
Q

Antiretroviral therapy: ART

A

Treatment

Overarching goal to suppress HIV replication

Reduce HIV-associated morbidity and prolong duration and quality of life

Restore and preserve immunologic function

Maximally and durably suppress plasma HIV viral load

Prevent HIV transmission

61
Q

Which of the following is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV infection?

A. Cryptococcal meningitis
B. Neuropathy
C. Progressive multifocal leukoencephalopathy
D. HIV encephalopathy

A

D. HIV encephalopathy

Rationale: Formerly referred to as AIDS dementia complex, HIV encephalopathy is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV infection.

62
Q

Pneumocystis pneumonia (PCP)

A

caused by P. jirovecii (formerly P. carinii) (Panel on Opportunistic Infections in Adults and Adolescents with HIV [OI-Panel], 2019) and is associated with CD4+ T-lymphocyte (CD4+) cell counts less than 200 cells/mm3. The most common manifestations of PCP are subacute onset of progressive dyspnea, fever, nonproductive cough, and chest discomfort that worsens within days to weeks.

63
Q

PEP-In-Your-Pocket (PIP)

A

is a good fit for people who may find themselves at increased risk of HIV transmission.

64
Q

Telangiectasia

A

Vascular lesions caused by dilated blood vessels

65
Q

A nurse is monitoring the client’s progression of human immunodeficiency virus (HIV). What debilitating gastrointestinal condition found in up to 90% of all AIDS clients should the nurse be aware of?

A

Chronic diarrhea

66
Q

Ataxia

A

uncoordinated muscle movement.

67
Q

A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?

A

Trimethoprim-sulfamethoxazole

(TMS)

68
Q

Which statement best explains the goal of HAART (highly active antiretroviral therapy) when used for HIV/AIDS?

A

This answer is correct because HAART utilizes several different classes of drugs that prevent the virus from entering the body’s CD4 cells, as well as disabling proteins required for the virus to replicate. This results in decreasing the viral load and restoring the CD4 level to help immune function. HAART therapy reduces the complications from HIV, as well as transmissions to others.