Targeted Med-Surg: Immune Flashcards
When should a male examine their testicles?
Examine testicles immediately after showing because it’s easier to palpate
A pt with viral pneumonia and a hx of COPD. What should the nurse report?
- Consolidation in lower lobes
- Left shift in WBC differential
- Oxygen sat 90%
- Orthostatic hypotension
Left shift in WBC differential b/c it indicates that the pneumonia is of bacterial origin, rather than viral
A pt with systemic lupus erthematosus (SLE). Which statement indicates an understanding of the teaching?
- I should use a sunscreen with an SPF of at least 20
- Long-term immunosuppressive therapy will cure the disease
- I should wear gloves in cold weather
- SLE will not affect my breathing or lungs
I should wear gloves in cold weather.
Raynaud’s Syndrome Commonly a companies SLE and can cause painful vasoconstriction in the fingers when they are exposed to cold temperatures.
What can place a pt at increased risk for contracting Hep B?
- Residing in institutional setting
- Engaging in unprotected sexual intercourse
- Working with hazardous chemical waste materials
- Traveling to a foreign country
Engaging in unprotected sexual intercourse because its transmitted by sexual contact
What should the nurse teach the pt about rheumatoid arthritis?
- Take cool bath in evening
- Exercise every other day
- Use pillow to support joints while in bed
- Ask family members to help with household chores
Ask family members to help with household chores b/c it gives the pt an opportunity to rest
Pt has Hodgkin’s lymphoma. Which finding should nurse expect?
- Overgrowth of B-lymphocyte plasma cells
- Reed-Sternberg cells
- Epstein-Barr virus
- Overproduction of blast phase cells
Reed-Sternberg cells are cancer cells specific to Hodgkin’s lymphoma and found in lymph nodes
Amoxicillin teaching is correct:
- Birth control less effective
- Take med on empty stomach
- Expect constipation
- Keep taking medication until I feel better
Birth control is less effective while on this med
Non-Hodgkin’s lymphoma priority assessment finding?
- Loos of body hair
- Report anorexia
- Mucositis of oral cavity
- Erythema at IV insertion site
Erythema at IV insertion site has greatest risk in injury to tissue due to extravasation and infection
Correct instruction about pt with Hodgkin’s lymphoma and undergoing external radiation tx:
- Use antibacterial soap to cleanse skin
- Was ink marking off when showering
- Rub skin with towel when drying
- Avoid direct sun exposure to skin
Avoid direct sun exposure to skin b/c it can be damaging to skin being exposed to additional radiation
Pt reports skin change. Nurse should report what to provider?
- Asymmetrical papule that is pigmented
- Patch of silvery-white scales with red epidermal base
- Collection of irregular dry papules that are black
- Elevated red lesion that arises from a scar
Asymmetrical papule that is pigmented can indicate malignant melanoma
Teaching about Lyme disease:
- If bitten by tick, get tested immediately
- If tick embedded in skin, apply a lit match to remove it
- Wear dark-colored clothing to deter ticks from biting
- If pain and stiffness in joins, see your doctor
Pain and stiffness in joints- Stage 1: bull’s eye, rash, muscle and joint pain and stiffness
Discharge teaching for pt who is HIV-positive:
- Clean bathroom surfaces with full-strength bleach
- Discard beverages that’s been unrefrigerated for 1 hr.
- Wash laundry soiled with body fluid in warm water
- Work in garden for exercise
Discard beverages because they can support bacteria
Expected finding for acute leukemia:
- WBC 21,000/mm3
- Hgb 14 g/dL
- Hct 40%
- Platelets 170,000/mm3
WBC 21,000
Typically have elevated WBC
Diagnosis to confirm bacterial pharyngitis:
- Indirect laryngoscopy
- Chest x-ray
- Throat culture
- Monospot test
Throat culture
Risk factor for skin cancer:
- Light skin pigmentation
- Psoriasis
- Hx of frostbite
- Immunodeficiency disorder
Light skin pigmentation
Teaching for methotrexate:
- Avoid crowds
- Expect sx to subside in 1 - 2 weeks
- Increase intake of vit. D
- Anticipate constipation
Avoid crowds b/c it can decrease WBC and platelet levels, thus increasing risk for infection
Which finding should the nurse expect from a pt with systemic lupus erythematosus (SLE):
- Subcutaneous nodules
- Decreased urine output
- Renal calculi
- Butterfly rash
- Joint inflammation
Decreased urine output
Butterfly rash
Joint inflammation
What would cause the nurse to suspect that a pts HIV has progressed to AIDS?
- Small purple-colored skin lesions
- Fever and diarrhea lasting longer than 1 month
- Persistent, generalized lymphadenopathy
- CD4-T cells decreased to 750 cells/mm3
Small purple-colored skin lesions means acquired kaposi’s sarcoma, which is an AIDS-defining illness.
Guidelines for the human papilloma virus (HPV) vaccine:
- One dose given at birth and another at 5 years
- Vaccine does not protect males
- Vaccine protects against chlamydia
- 3 doses should be given starting at age 11 or 12
3 doses should be given starting at age 11 or 12
Who is at greatest risk for pneumonia?
- School-aged child who has a history of allergies and asthma
- Young adult living in a college dorm room
- Middle age adult using an incentive spirometer following surgery
- Older adult transferred from a long-term care facility who has dysphasia
Older adult who has dysphagia
Instructions in the teaching for a patient with bone marrow suppression:
- Take aspirin for minor aches and pains
- Rinse the toothbrush with warm water after each use
- Avoid eating fresh fruits and vegetables
- wear clothing that will minimize sun exposure
Avoid eating fresh fruits and vegetables because they contain bacteria
What procedure will the client undergo if they have elevated prostate-specific antigen levels:
- Palpation of testes and lymph nodes
- Human chronic gonadotropin lvls
- Digital rectal examination
- Pelvic ultrasound
Digital rectal examination determines size and consistency of the prostate
Teaching for a client who has an allergy to peanuts:
- Inform other healthcare professionals of the allergy
- Where a medical identification tag
- Carry an emergency anaphylaxis kit
- Read food labels
Carry emergency anaphylaxis kit b/c greatest risk is injury from an anaphylactic reaction
What is the papanicolaou (pap) test testing for?
- Uterine cancer
- Cervical cancer
- Ovarian cyst
- Hemorrhoids
Cervical cancer
