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Protection, Regulation, & Perfusion > Study Guide!!!! > Flashcards

Study Guide!!!! Flashcards

1
Q

SATA Which of these therapies can be used for Pernicious anemia?

  1. Blood transfusion
  2. Corticosteroids
  3. Short-term B12 therapy
A

Answer: 2 page (307-308)

Corticosteroids are used if the problem is caused immunologically, otherwise, B12 therapy is needed (for life!!!!).

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2
Q

SATA A licensed practical nurse is caring for a pt with pernicious anemia what care measures must she perform?

  1. Nurse should be sure to educate the pt regarding oral and parenteral care
  2. Nurse should ensure that the patient ambulates with frequent rest periods
  3. pt should perform their own ADLs and take frequent rest periods.
  4. Nurse should educate both pt and family regarding care
  5. It is important that pt know the times for their injection and not to miss them, and that they must have periodic B12 tests or follow-up appointments.
A

Answer: 2,5 page (307-308)

The nurse should (reinforce), not educate the client and family regarding oral and parenteral care.

pt should be provided with assistance as indicated by their activity tolerance.

Not missing their B12 injection, and having periodic testing or follow-up appointments help to keep B12 levels stabilized.

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3
Q

SATA An LPN is caring for a pt diagnosed with pernicious anemia what signs and symptoms may indicate this?

  1. total anorexia
  2. weakness
  3. loss of appetite
  4. tongue inflammation
  5. pallor
  6. irritability
  7. numbness
  8. peripheral neuropathy
  9. confusion
  10. loss of skin integrity
A

Answer: Everything except for 1 and 10! page (307)

Tongue inflammation or infection=Glositis
Peripheral Neuropathy=Tingling in extremities

Loss of skin integrity is not a symptom it’s a trick!

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4
Q

SATA What are the diagnostic tests and factors that can indicate pernicious anemia?

  1. Microscopic examination of WBCs
  2. High folic acid levels
  3. Macrocytic anemia
  4. Low B12 levels
  5. Parietal cells, and intrinsic factor antibody tests
  6. Methylmalonic acid levels, and low homocysteine
  7. Decreased serum cobalamin
  8. Gastric secretion analysis
  9. High hydrochloric acid levels
  10. Schilling test
  11. Radioimmunoassay
  12. enzyme-linked immunosorbent assay
A

Answer: 3,4, 5, 7, 8, 10, 12 page (307-308)

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5
Q

A pt is in the beginning phases of Hashimoto’s Thyroiditis which symptoms are first reflected?

  1. Hyperthyroidism
  2. Hypothyroidism
  3. Goiter
  4. Slowed mental state
A

Answer 1 page (308)

During the beginning phase of Hashimotos Thyroiditis hyperthyroidism is taking place, then hypothyroidism, which goes along with goiter and a slowed mental state.

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6
Q

SATA Which of these diagnostic tests are related to Hashimoto’s Thyroiditis?

  1. Immunofluorescent assay
  2. Low TSH levels
  3. High T3
  4. Low T4
A

Answer: 1, 4 page (308)

TSH will be raised, T3 and T4 will be low.

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7
Q

Which is the most important therapeutic measure for Hashimoto’s Thyroiditis?

  1. Life long thyroid replacement therapy (Thyroxine)
  2. Putting pt on a soft diet
  3. Antiembolic stockings
  4. Avoidance of iodine high foods
A

Answer: 1 page (308)

Life-long thyroid hormone replacement particularly of (thyroxine) is super important.

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8
Q

SATA Which of these should a pt on Levothyroxine take at a minimum 4 hrs before?

  1. Cholestyramine
  2. Tyramine
  3. Ferrous Sulfate
  4. Lauryl Sulfate
  5. Sucralfate
  6. Tumms
  7. Iron-containing multivitamins
  8. calcium carbonate
A

Answer: 1, 3, 5, 7, 8 page (309)

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9
Q

Systemic Lupus Erythematosus is a progressive systemic inflammatory disease what differentiates it from rheumatoid arthritis?

A

Answer: The body organs are involved much sooner than in rheumatoid arthritis.

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10
Q

Which of these are true about IgE antibodies?

  1. Used during allergic reactions
  2. Used along with Esonophils during an allergic reaction
  3. Released with masts cells to reduce histamine
  4. Found in basophils
A

Answer: 1, 2,4 page (282)

  1. Released with mast cells to (release) histamine.
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11
Q

What is true about Cell-Mediated Immunity?

  1. Used against intracellular pathogens such as viruses, fungi, malignant cells, grafts, and foreign tissue.
  2. Used against extracellular pathogens such as viruses, fungi, malignant cells, grafts, and foreign tissue
  3. Used in the production of antibodies
  4. Produces memory B-cells
A

Answer: 1 page (281)

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12
Q

What antibody is important for long-term immunity, and also provides passive immunity?

A

IgG

page (282)

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13
Q

What antibody is found in bodily secretions, and mucous membranes? That is also responsible for passive immunity and (cannot be replaced).

A

IgA

page (282)

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14
Q

What antibody is produced first during an allergic response?

A

IgM

page (282)

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15
Q

What antibody is responsible for the antigen-specific receptors on B-lymphocytes?

A

IgD

page (282)

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16
Q

What antibody is released inside basophils and mast cells, and is used with eosinophils and histamine during an allergic response?

A

IgE

page (282)

17
Q

What organs if removed can lower immunity, and severely affect the humoral immune response?

A

Answer: Spleen

page (286)

18
Q

What organ if removed can affect your cell-mediated immune response, and lower general immunity?

A

Answer: Thyroid

page (286)

19
Q

What may be the only symptom of someone with a suppressed immune system?

  1. Rash
  2. Increased respirations
  3. Increased heart rate.
  4. High fever
  5. Low fever
A

Answer: 5

page (288)

20
Q

What is the normal Eosinophil range?

A

0.05-05

21
Q

Which of these is an example of artificially acquired passive immunity?

  1. Antibodies passed from mom to baby
  2. Antibodies stimulated by a vaccine
  3. Antibodies provided via a monoclonal
  4. Antibodies provided after a person recovers from infection
A

Answer: 3

  1. Naturally acquired passive immunity
  2. Artificially acquired active immunity
  3. Naturally acquired active immunity
22
Q

SATA which of these are medications used during anaphylaxis?

  1. diphenhydramine
  2. Benadryl
  3. epinephrine auto-injector
  4. Adrenaclick
  5. AUVI-Q
  6. Epipen
A

Answer: All of them!

page (292)

23
Q

After the use of auto-injected epinephrine, why should a pt go in for emergency medical care (immediately)?

A

Answer: The effects of this medication are weak lasting only 15 minutes, after that the anaphylactic reaction can relapse.

page (292)

24
Q

What are the risk factors for Pernicious Anemia?

A

Answer: Family tendency, any gastric or bowel resection, with no or inadequate B12 or intrinsic factor.
page (307)

25
Q

Which of these laboratory dx tests can be used to confirm a SLE diagnosis?

  1. Skin biopsy of discoid lesion for inflammation
  2. ESR to detect inflammation
  3. (anti-dsDNA)
  4. (anti-Sm)
  5. Blood test for SR
A

Answer: Non of them

No laboratory test can diagnose SLE, only support the dx

page (310)

26
Q

Med Card Chloroquine

A

Class: Antimalarial

Action: reduces inflammation, and decreases platelet aggregation while lowering plasma lipid levels.

pt Education: Give before or after meals at the same time each day, (may take weeks or months for effects to be noticed).

page (312)

27
Q

SATA What are the symptoms of SLE?

  1. Pain
  2. Pruritis
  3. Butterfly rash
  4. Photosensitivity
  5. Discoid
  6. Purple striae along hips and thighs
A

Answer: 3, 4, 5

page (309)

28
Q

The nurse is asking the pt questions regarding what may have caused SIADH, which of these questions accurately depicts this?

  1. Have you had a recent elbow injury?
  2. Do you use any aspirin or antiplatelet medications at home?
  3. Any previous autoimmune disorders?
  4. Do you have a history of scarlet fever, or mumps, possibly when you were younger?
  5. Do you use any antipsychotics at home?
A

Answer: 5

SIADH can be categorized into 4 categories

  1. Nervous system (e.g meningitis/head trama)
  2. Pulmonary system (e.g cystic fibrosis/COPD)
  3. Medication (e.g antipsychotics/histamines)
  4. Cancer (e.g of brain/lungs)

page (792)

29
Q

SATA A nurse is (data collecting) for a pt who may have hyponatremia, which can cause a coma! What manifestation should the nurse report?

  1. Weak pulse
  2. Elevated or normal BP
  3. Myasthenia
  4. Convulsions
  5. Constipation
  6. Headache
A

Answer: 2, 3, 4, 6

Manifestations include:
Bounding pulse
Elevated or normal BP
Muscle Weakness (Myasthenia)
Headache
Personality Changes
Nausea 
Diarrhea
Convulsions
Coma

page (792)

30
Q

SATA A pt is experiencing hypothyroidism what s/s may they present with?

  1. Diarrhea
  2. Hunger
  3. Bradycardia
  4. Mental dullness
  5. Altered fat metabolism
  6. Hyperlipidemia
  7. Hypolipidemia
  8. Pitting Edema (on face, hands, and feet)
  9. Shortness of breath
A

Answer: 3, 4, 5, 6

S/S
fatigue
weight gain
bradycardia
constipation
mental dullness
feeling cold
shortness of breath
decreased sweating
dry skin/hair
HF due to decreased pumping strength
altered fat metabolism, causing hyperlipidemia, causing cardiovascular disease
myxedema (non-pitting edema on face hands and feet)

page (796)

31
Q

SATA What are the signs of a Myxedema Coma?!

  1. Trauma
  2. Infection
  3. Heat exposure
  4. Drop in cardiac output
  5. Raise in glucose
  6. Reduced kidney perfusion
  7. HF
  8. Temp > 35 C
A

Answer: 1, 2, 4, 6, 7

Stress can trigger a myxedema coma through trauma, infection, cold exposure, or temp 35 C

32
Q

SATA What signs & symptoms may not be associated in a pt with Cushing’s Syndrome?

  1. Central obesity with (thin arms, and fat legs)
  2. Fat pads on upper back
  3. deposits of adipose tissue found in different areas of the body
  4. Moon-face
  5. glucose intolerance
  6. Diabetes mellitus
  7. pathological fractures
  8. vertebrae compression
  9. hyperpigmentation
  10. psychosis
  11. hypokalemia
  12. acne
A

Answer: 1

S/S
weight gain
central obesity with thin arms and legs
fat pads on upper back (buffalo hump)
moon face
insulin resistance, causing gluconeogenesis, causing glucose intolerance
muscle wasting
thin skin with purple striae
osteoporosis
pathological fractures
pain due to vertebrae compression
risk for infection due to anti-inflammatory and immunosuppressive response
hyperpigmentation
irritability
psychosis
sodium & water retention
hypokalemia
acne 
facial hair growth
abscess of menses in women

page (809)

33
Q

SATA What are the signs & symptoms related to ketoacidosis?

  1. Rapid respiration
  2. Kussmal Respirations
  3. Deepening respirations
  4. Fruity odor
  5. Odor mistaken for alcohol
  6. Hyperkalemia
  7. Hypokalemia
  8. Increases blood volume
A

Answer: 2, 3, 4, 5, 6, 7

S/S
Deepening respirations to blow off excess carbon dioxide. This deep signing pattern is called (Kussmaul Respiration).
The air they breathe, out will have a fruity smell sometimes mistaken for alcohol
Due to high blood glucose and polyuria, the body dehydrates very quickly resulting in tachycardia, hypotension, and even shock
Acidosis can either cause potassium to leave cells and enter blood (hyperkalemia), or the potassium can be lost in the large amount of urine lost (hypokalemia)

The combo of acidosis, dehydration and potassium imbalance results in the pt having flu-like symptoms including abdominal pain and vomiting

If untreated this can result in loss of consciousness and even death!

page (829)

34
Q

What are the 3 Classic Symptoms of Diabetes?

A

polydipsia, polyuria, and polyphagia

35
Q

Med Card Truvada & Ziagen

A

Class: Nucleoside/Nucleotide Reverse Transcription Inhibitors (NRTIs/NtRTIs)

Action: Binds to the reverse transcription enzyme keeping it from converting HIV RNA to HIV DNA

Nursing Implications:
Monitor for peripheral neuropathy, bone marrow suppression, lactic acidosis, kidney, and liver function.

Report flu-like symptoms immediately as a life-threatening condition may be developing

Monitor for hepatomegaly with steatosis and for lactic acidosis which can be (fatal especially in women!!!)

Take 2 hrs before or 1 hr after taking didanosine

36
Q

Why can’t type 1 Diabetic pts take oral medication?

A

Type 1 diabetic pts do not produce insulin, unlike type 2 pts who produce some insulin. Oral meds will not work because the pancreas doesn’t work.

37
Q

Which of these is not a cause of hypoparathyroidism?

  1. Heredity
  2. Accidental removal of parathyroid glands
  3. Purposeful removal of parathyroid glands
  4. Hypermagnesium
A

Answer: 4

Hypomagnesium due to chronic alcoholism or certain nutritional issues can inhibit PTH secretion.

page (805)

38
Q

Which of these are the symptoms of hypoparathyroidism?

  1. nueromuscular irratability
  2. tetany
  3. Chronic hypercalcemia
  4. psychosis
  5. HF
  6. Laryngospasms
A

Answer: 1, 2, 4, 5, 6

39
Q

What is the difference between diabetes insipidus & diabetes?

A

Answer: Diabetes involves sugar, while diabetes insipidus does not

Protection, Regulation, & Perfusion (4 decks)

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