Stuff to know from immune slides Flashcards

1
Q

what is empiric therapy

A

abx therapy given before culture results

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2
Q

what is definitive therapy

A

abx given after culture results

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3
Q

what is prophylactic antibiotic therapy

A

preventative abx given before surgery

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4
Q

what is superinfection

A

abx eliminate or reduce normal flora, causing overgrowth of other bacteria or fungi

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5
Q

cause of pseudomembranous colitis or C. diff

A

abx disrupt normal gut flora creating overgrowth of c.diff

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6
Q

what does release of histamine in the body do

A

increase HR
vasodilation -> decreased BP
bronchoconstriction
increased gastric acid -> N&V

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7
Q

what does epinephrine help with

A

vasopressor (increase BP)
dilate airways
increase heart ability to pump blood
alpha/beta adrenergic agonists (receptor)

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8
Q

what are the requirements for SIRS (systemic inflamatory response syndrome)

A

Temp: <96.8 to >100.4F
Resp rate: >20
Heart rate: >90
WBC: > 12,000 or <4,000 &
>10% neutrophile bands

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9
Q

abnormal neutrophil range and band

A

50-70% normal >70% abnormal
0-8% normal >10% band abnormal

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10
Q

when to give antipyretic

A

> 102F

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11
Q

what conditions would the pt considered to be in sepsis

A

2 SIRS requirements
confirmed or suspect active infection

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12
Q

what condition is considered to be severe sepsis

A

confirmed sepsis, signs of end organ damage
Hypotension 120/80 normal (<90)
Lactate >4 mmol

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13
Q

what is considered septic shock

A

severe sepsis with persistent signs of end organ damage, hypotension, lactate >4 mmol

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14
Q

what does qSOFA score tell you

A

screen the likelihood of a pt having sepsis

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15
Q

list infections that are most commonly associated with sepsis

A

pneumonia
GI infections
kidney, bladder, urinary system infections
bacteremia (bloodstream infection)

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16
Q

normal WBC count

A

4.5-10 (4,500 - 10,000)

17
Q

normal neutrophil band

A

0-8%
>10 is a SIRS

18
Q

what is the CRP test tell you and range considered sepsis

A

C-reactive protein that the liver makes in response to inflammation
>3 is bad

19
Q

normal platelet count

A

140-450 (10^3)
140,000 - 450,000 cells/mcL

20
Q

Hbg count for male and female

A

male: 14 - 17
female: 12 - 15
overall 12- 17 ish

21
Q

symptoms that are considered sepsis

A

patches of discolored skin
decreased urination
changes in mental status
low platelet count
issues breathing
abnormal heart fxn
chills
unconsciousness
extreme weakness

SEPSIS acronym
S: shivering, fever, very cold
E: extreme pain or general discomfort
P: pale or discolored skin
S: sleepy, difficult to rouse, confused
I: I feel like I might die
S: short of breath

22
Q

4 nursing diagnosis that are related with sepsis

A

risk for deficient fluid volume
risk for decreased cardiac output
impaired gas exchange
risk for shock

23
Q

5 step process to Sepsis hour-1 bundle

A
  1. measure lactate lvl
  2. obtain blood culture before giving abx
  3. administer broad spectrum antibiotics
  4. begin 30mL/kg crystalloid IV
  5. give vasopressors if hypotensive during or after fluid resuscitation to maintain MAP >=65 mmHg
24
Q

what are the crystalloid solutions to give during sepsis

A

lactate or saline soln

25
what vasopressors to give during shock
epinephrine dopamine
26
definition of shock
cellular and tissue hypoxia
27
what counts as distributive shock
blood vessels lose their tone - anaphylactic shock septic shock neurogenic shock
28
3 big problems with septic shock
excess coagulation exaggerated inflammation impaired fibrinolysis
29
what does peak and trough mean
peak is when the conc of drug is highest in the BLOOD trough is when the conc of the drug is highest in the TISSUE
30
when should trough levels be taken
1hr before dose
31
when should peak levels be taken
2hrs ish afterfor vancomycin 30mins after for IV, 60mins IM for gentamicin and tobramycin (aminoglycosides)