test 1 Flashcards
three functions of immunity
defense
homeostasis
surveillance
innate immunity
present at birth, first line defense against pathogens but not antigen specific
acquired immunity
developed immunity, 2 types: active and passive
natural active
from natural contact with pathogen, develops slowly, and is specific
natural passive
from mother to child. last months
artificial active
immunization with antigen. last years
artificial passive
injection of serum with antibodies, last several weeks
mostly composed of proteins, recognized as foreign and triggers immune system to produce antibodies
antigen
produced by lymphocytes in response to antigens, also called immunoglobulins
antibody
involved in differentiation and maturation of T lymphocytes
thymus gland
produce RBC, WBC, and platelets
bone marrow
humoral immunity
involved is B cells
produces antibodies and memory cells
fights against bacteria, extracellular viruses, resp and GI pathogens
cell mediated immunity
involved is T cells and macrophages
produces sensitized T cells and cytokines, and memory cells
fights against fungus, intracellular viruses, tumors
largest componet to Ig, found in plasma and interstital fluid. only Ig that can pass thru placenta
Protects bodily fluids
IgG
found in body secretion, lines mucous memb
protects bodily surfaces
IgA
Ig found in plasma, primary immune response
Protects blood stream
IgM
found in body secretion, lines mucous memb
protects body surfaces
IgA
Ig whose role isnt known
IgD
Ig responsible for allergic response. Mediated type 1 hypersensitivity
IgE
number 1 cause of death of elderly
bacterial pneumonia
decline of immune system from age
immunosenescence
RBC level
4-6
WBC level
5-10
PLT level
150-300
Hgb level
11-14
Hct level
30%
common BP med that has possible side effect of angioedema
ace inhibitor
whats included in CBC
RBC, WBC, PLT, Hgb, Hct
apheresis
autoimmunity treatment,
blood is taken and bad things are removed
high lactic acid in blood
something is wrong
primary immune disorder
missing a type of immune cell
secondary immune disorder
from meds, malnutrition, cancer, radiation, stress
most common immunosuppressive therapy
cyclosporine
hyperactive organ rejection
within 24 hours
acute organ rejection
within 6 months
chronic organ rejection
over months to years, manage symptoms
small proteins that help control growth and activity of other immune and blood cells
cytokines
localized infection that spreaded
disseminated
infection through out body
systemic
infection throughout body
systemic
different type of pathogens
bacteria
virus
fungi
protozoa
multicellular parasite
diseases that newly appeared or have existed but have been rapidly increasing
emerging infections
health care associated infections
health care acquired pneumonia (HAP)
Clostridium difficile (c-diff)
surgical site infections
catheter associated urinary tract infection (CAUTI)
central line associated bloodstream infection (CLABSI)
methicillin-resistant staphylococcus aureus (MRSA)
What’s needed for contact precautions
gloves, gown
what’s needed for droplet precautions
surgical mask
whats needed for airborne precautions
N-95
How is HIV transmitted
blood
semen
vaginal secretions
breast milk
normal range of CD4 T cells
800-1200
what is HIV
a retrovirus that destructs immune system damaging CD4 T cells
What range of CD4 T cells start having immune issues
> 500
acute HIV
Happens 2-4 weeks after initial infection
mono like symptoms
asymptomatic HIV
stage between untreated infection and AIDS diagnosis, some symptoms may occur like fatigue, fever, night sweats
symptomatic HIV, or “stage 2”
CD4 T cells drop to 200-500
symptoms worsen and other issues arise
AIDS
CD4 cell count is less than 200
severe immune system suppression
diagnostic test for AIDS
ELISA (enzyme linked immunosorbent assay)
CD4 T cell count
occur in people with weakened immune system, from something that typically does not cause disease
opportunistic disease
opportunistic diseases associated with AIDS
pneumocystis carinii pneumonia (PCP)
mycobacterium avium complex (MAC)
cytomegalovirus
kaposi sarcoma
herpes virus
HIV management
monitor, ART, prevent and treat opportunistic, drug therapy
what moves into tissue when vasodilation occurs
serous fluid and albumin
what happens when bleeding occurs from inflammation
fibrinogen is activated to fibrin, clot
what is the first cell to move in for inflammation
neutrophils (within 6-12 hours)
what is pus
dead neutrophils, digested bacteria, and cell debris
what do monocytes turn into in tissue space
macrophages
what do macrophages do
eat debri, clean for healing process, can stay in tissues for weeks
local infection system
redness, heat, swelling
systemic infection symptoms
increased WBC, malaise, anorexia, increased pulse and RR, fever
nursing implementation of inflammation
RICE
serous exudate
thin, watery, straw colored fluid
would see this in something like a blister
serosanguineous exudate
blood and serous fluid
would see with something like a surgery wound
sanguineous exudate
bright red blood
from open fresh wound
purulent
thick, odorous buildup, from infection
fibrinous exudate
alot of fibrin in exudate
catarrhal exudate
mucous production with WBC
found in sinus cavities
primary intention
wound is sutured shut
secondary intention
heals from inside out, usually scars
tertiary intention
wound is left open but will eventually be closed by suture
dehiscence
wound that was closed split open
evisceration
organs protrude
fistula
abnormal passage for things that typically dont connect
keloid
over scar tissue
most common in African americans
nutritional therapy for wound healing
protein, vitamin c
how does hyperbaric oxygen therapy work for healing wounds
increases oxygen
what is negative pressure wound therapy
wound vac
unstageable pressure injury
full thickness, nut cant see wound bed due to slough/eschar
must be stage 3 or 4
braden scale characters
mobility, nutrition, friction, activity, moisture, sensory perception
higher score=better
what does C reactive protein / sedimentation test help detect
inflammation
why does high blood sugar affect wound healing
blood moves slower
deep tissue injury
purple localized intact skin area or blood blister, looks similar to stage 1 ulcer
CNS disorder that is demyelination of myelin sheath
multiple sclerosis
what is most common type of MS
relapse remiting
what gender and age group does MS affect most
women, ages 20-50
lhermittes sign
electric shock feeling down spine when turning head, MS sign
how is MS diagnosed
evidence of 2 inflammatory demyelinating lesions at 2 locations
damage/attack occurring at 2 diff times
meds for MS
corticosteroids, muscle relaxants/antispasmodics, anticholinergic, immunomodulators, immunosupressants
neurodegenerative disease of CNS characterized by motor dysfunction
Parkinson’s disease
what causes parkinsons
lack of dopamine
lewy bodies
unusual clumps or protein, abnormal brain functioning
TRAP mnemoic
tremor
rigidity
akinesia
posture and balance
how is parkinson’s diagnosed/ confimed
no specific test diagnoses, but it’s confirmed by a positive response to antiparkinson drugs
drugs for parkinsons
levodopa/carbidopa (sinemet), anticholinergics, antiviral agents
side effects of anticholinergic drugs
everything is dry –> bladder, eyes, salvation, bowels
PNS autoimmune disease affecting neuromuscular junction
myasthenia gravis
what is happening in MG
antibodies attach acetylcholine (ACh) receptors, reduction in these sites prevents stimulation of muscle contraction
drugs/treatment for MG
anticholinesterase drugs
corticosteroids
immunotherapy
removal of thymus
myasthenic crisis
exacerbation of MG with resp failure, not enough meds, treatment is more. A Lot of muscle fatigue and trouble breathing
cholinergic crisis
ACh builds up, too much meds were given. treated by atropine.
neuromuscular disease characterized by loss of motor neurons, they gradually degenerate and die
lou gehigs/ ALS
What age group and gender does ALS affect more
men, age 45-75
treatment ALS
riluzole- drug that slows process
baclofen- muscle relaxant
PT/OT
hospice
genetically transmitted, autosomal dominant brain disorder
huntingtons
what causes huntington’s
too much dopamine
what is dementia characterized by a loss ( may just be one or two of these gone )
memory
orientation
attention
language
judgement
reasoning
most common form of dementia
alzheimer’s
vascular dementia
from impaired blood flow to brain
lewy body dementia
protein deposits (lewy bodies) develop in nerve cells in brain affecting motor control
- associated with parkinson’s
frontotemporal dementia
atrophy of frontal and temporal part of brain resulting in damage to neurons
dementia risk factors
Aging
Family history
Diabetes
Obesity
Smoking
Cad/htn
hypercholesterolemia
hearing loss
diabetes
excessive alcohol intake
what decreases risk of getting dementia
education
physical activity
social contact
what dementia can be seen well with MRI
lewy bodies, maybe vascular
alzheimer’s disease and characteristics
Chronic degenerative disease of the brain, most common form of dementia.
Gradual loss of connections between neurons and neuron death.
Result in structural damage
brain shrinks, amyloid plaques, neurofibrillary tangles
can only be diagnosed after death
nursing care for dementia
decreasing signs and symptoms, preventing harm, and supporting patient
does facial recognition help dementia patients
yes
delirium
can be med emergency
abrupt onset
disturbed sleep
has delusions and hallucinations
disorganized, distorted and slow speech
can last hours to weeks
demetia
slow progression
last years
difficulty with abstract thinking
sleeps during day, frequent awakenings at night. fragmented
often has misperceptions
stages of alzheimer’s
1- patients are unaware they have it, fully independent
2- memory begins to falter. not noticeable to others
3- difficulty concentrating and poor memory. usually this stage lasts years
4- a diagnosis is now possible. trouble with everyday tasks and need assistance
5- no longer can live independently, memory and communication deteriorates, this stage lasts 1.5 years
6- memory is severely impaired. patients confuse family members. personality changes
7- patients can no longer respond to their environment.
