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BEACON MedSurg/Peds > Test 2 > Flashcards

Test 2 Flashcards

1
Q

humoral imune response vs. cell mediated response

A

Humoral: comprised of B cells, plasma cells are produced and secrete antigen-specific antibodies, memory cells
Cell-Mediated: comprised of a variety of T cells, Th (Helper T)

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2
Q

categories of insulin

A
  • Rapid acting: lispro, aspart (w/i 10-15 min)
  • Short acting: regular (w/i 30 min)
  • Intermediate acting: NPH
  • Premixed insulins: 70% NPH/30% regular
    • 70% NPL/30% regular
    • 50% NPL/50% regular
  • Long acting: glargine, determir
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3
Q

S/S:

  • normal or elevated BS at bedtime
  • decreased BS at 2-3 am to hypoglycemic levels
  • increased BS in AM caused by production of counter-regulatory hormones
A

Somogyi effect

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4
Q

somogyi effect treatment

A

decrease evening dose of intermediate-acting insulin or increase bedtime snack

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5
Q

S/S:

  • relatively normal BS until about 3-4 AM, then glucose levels begin to rise
  • nocturnal surge of growth hormone
A

dawn phenomenon

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6
Q

treatment of dawn phenomenon

A

change time of evening intermediate-acting insulin from dinnertime to bedtime

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7
Q

how to differentiate somogyi effect from dawn phenomenon

A

measure BS at 3am, if rising BS levels, then dawn phenomenon, if decreased BS: Somogyi

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8
Q

agent: Paramyxovirus
incubation: 14-21 days
communicable: immediately before and after parotid gland swelling
source: saliva of infected persons, possible urine
transmission: direct contact with droplet
assessment: jaw or ear pain, parotid glandular swelling, may cause orchitis and encephalitis
precautions: droplet

A

Mumps

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9
Q

type of hypersensitivity response:

immediate: IgE mediated
ex: rhinitis/anaphylaxis

A

Type 1 hypersensitivity reaction

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10
Q

type of hypersensitivity response:

cytotoxic: antibody-mediated
- ex: transfusion reaction

A

Type 2 hypersensitivity reaction

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11
Q

type of hypersensitivity response:

mediated: Immune complex
- ex: Rheumatoid arthritis

A

Type 3 hypersensitivity reaction

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12
Q

type of hypersensitivity response:

delayed: t-cell mediated
- ex: poison ivy, PPD

A

Type 4 hypersensitivity reaction

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13
Q

phase 1 type hypersensitivity reactions (2)

A

Initial or early response:

  • 5-30 minutes
  • vasodilation, vascular leakage and smooth muscle spasm

Secondary response:

  • 2-8 hours after exposure
  • swelling of mucosal tissues, mucous production, leukocyte infiltration and bronchospasm
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14
Q
  • Reaction of humoral response system
  • Occurs within 15-30 minutes of exposure
  • Examples: Transfusion reactions, drug reactions, myasthenia gravis, thyroiditis, autoimmune hemolytic anemia
A

Type II Hypersensitivity

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15
Q
  • AKA tissue specific reactions
  • IgG or IgM antibodies bind with cells or tissue specific antigens
  • cell/tissue destruction
  • Activation of compliment: cell lysis, phagocytosis
  • Antibody mediated: target
A

Type II- antibody mediated cytotoxic disorders

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16
Q
  • antibody binding to surgace antigens on cell
  • C 5-9 complex with the antibody to form membrane attack complex
  • resulting in cell lysis
  • example: ABO blood type incompatibility
A

activation of complement cell lysis

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17
Q
  • antibody binding to surgace antigens on cell
  • tissue macrophages bind to the cell surface by opsonization
  • cell is destroyed by?
A

activation compliment phagocytosis

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18
Q

-antigens on the cell surface bind with antibodies
-natural killer T cells bind with the antibodies and kill the cell
-

A

antibody mediated cell lysis

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19
Q

In ________ clinical manifestations are dependent upon the specific tissue?

A

type II disorders

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20
Q
  • reaction of the humoral response system
  • failure to remove antigen-antibody complexes from the circulation and tissues
  • longer response time
  • Examples: glomerulonephritis, systemic lupus erythematosis, rheumatoid arthritis
A

type III hypersensitivity

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21
Q
  • circulating antigens
  • formation of insoluble antigen-antibody (A-A) complexes
  • A-A deposition in vessel walls and tissues–>compliment activation
  • Acute inflammation
  • tissue damage
A

type III immune complex disorders

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22
Q

_______ & _______ can cause type III reactions along with IV, drugs, foods, and some insect bites

A

viruses and bacteria

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23
Q

serum sickness

A
  • serum acts as foreign body or antigen
  • symptoms of serum sickness include: rash, lymphadenopathy, arthralgia
  • symptoms develop 7 days post exposure
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24
Q
  • delayed hypersensitivity
  • cell-mediated response
  • tissue is damaged as a result of a delayed T-cell reaction to an antigen
  • normally occurs within 1-14 days after exposure
  • ex: contact dermatitis from latex allergy, tuberculin reactions, transplant rejections
A

type IV hypersensitivity

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25
Q
  • direct cytotoxicity–>tissue destruction
  • delayed type hypersensitivity: inflammation, swelling, pruritis
  • patho: cell mediated and antibody driven
A

type IV cell mediated manifestations

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26
Q

graft vs. host disease etiology and patho

A

etiology: bone marrow transplant, blood or blood product transfusion in the severely immunocompromised
patho: donor t cells attack host tissue antigens

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27
Q

clinical manifestation of graft vs host acute

A
  • rash on the soles and palms spreading to entire body
  • GI, bloody stools, nausea and abdominal pain
  • liver dysfunction
  • may resolve or become chronic > 100 days
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28
Q

k-12 vaccines (5)

A
  • Dtap/Tdap
  • polio
  • measles/mumps/reubella
  • hep B
  • Varicella
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29
Q

Pre-K vaccines (6)

A
  • dtap/DT
  • polio
  • measles/mumps/reubella
  • hep b
  • varicella
  • hib
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30
Q

recommended immunizations adolescent (6)

A
  • Tdap
  • influenza
  • pneumococcal if they have chronic disease
  • meningococcal
  • hep B
  • HPV
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31
Q

college immunizations (2)

A
  • meningococcal disease

- hep B

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32
Q

recommended immunizations adults (6)

A
  • hep B
  • influenza
  • pneumococal
  • pertussis
  • varicella
  • TD
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33
Q

rotavirus vaccine

A
  • causes vomiting and diarrhea–>dehydration in infants–>hospitalization
  • highly contagious
  • 2 vaccines: administered orally, rotateq 3 doses, rotarix 2 doses
  • cont. ind.: allergy to previous immunization or latex
  • precautions: moderate to severe illness, gastroenteritis, pre-existing gastrointestinal disease
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34
Q

pertussis

A
  • incubation: 6-20 days
  • communicable: presence of resp. secretions
  • source: discharge from rep. tract of infected person
  • transmission: droplet, direct contact, indirect contact with freshly contaminated objects
  • course:
  • catarrhal stage: 9-14 days, mild fever, headache, anorexia, persistent couch with tearing
  • paroxysmal- 14-28 days, flushed face, cyanosis, dyspnea, lymphocytosis
  • convalescent: 21 days, cough and vomiting less
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35
Q

roseola

A
  • agent: human herpes virus type 6
  • incubation: 5-15 days
  • communicable period: unknown
  • assessment: sudden high fever, rose pink macular rash, nursing care is supportive
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36
Q
  • agent: paromyxovirus
  • incubation: 10-20 days
  • communicable period: 4 days before to 5 days after appearance of rash
  • source: resp. tract secretions, blood, urine
  • transmission: airborne particles, direct contact with droplets, transplacental
  • assessment: cough, conjunctivitis, fever, malaise, red, maculopapular rash, KOPLIK’S SPOTS
  • precautions: airborne droplet
A

Rubeola

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37
Q
  • incubation: 14-21 days
  • communicable: 7 days before to 5 days after appearance of rash
  • source: nasopharyngeal secretions, blood, urine, or feces of infected person
  • transmission: airborne or direct with droplets transplacental
  • assessment: fever, malaise, pink red maculopapular rash, petechiae red, pinpoint spots on soft palate
  • precautions: airborne, isolate from pregnant women
A

Rubella

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38
Q

etiology: hypersensitivity of tracheobronchial tree to various stimuli. Reactive airway disease. exposure to inhaled and occasionally ingested irritants, pollen, dust mites, mold
-extrinsic: allergic
-intrinsic: non-allergic
-IgE mediated Type I hypersensitivity
Clinical manifestations: episodic wheezing, chest tightness (worse at night), prolonged expiration, airtrapping, dyspnea, fatigue

A

asthma

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39
Q

asthma dx tests

A 
CXR: hyperinflation of lung
CBC: increased eosinophils
Sputum: increased eosinophils
Serum theophylline levels
PFT: forced expiratory volume decreased 
ABG's
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40
Q

asthma long-term control meds and quick relief meds

A
  • long term: inhaled corticosteroids, inhaled long-acting beta2-agonist, leukotriene modifiers, mast cell stabilizers, theophylline
  • Quick relief measures: inhaled short-acting beta2-agonist
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41
Q

emphysema patho

A

decrease a1-antitrypsin activity–>destruction of elastic tissue–>destruction of alveoli–>impaired gas exchange

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42
Q

ABG normals

A 
ph: 7.35-7.45
PCO2: 38-42
PO2:80-100
HCO3: 24-21
Base excess/deficit: + or - 2
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43
Q

adenoiditis

A
  • stertorous breathing: snoring, nasal quality speech

- pain in ear, recurring otitis media

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44
Q

bronchiolitis/RSV clinical manifestations

A

tachypnea, tachycardia, wheezing, crackles, rhonchi, intercostal and subcostal retractions, cyanosis, difficulty feeding

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45
Q

risk: smoking, chronic disease, impaired immune status
- manifestations: 2-10 days post-exposure, fever, dry cough, malaise, weakness, arthralgia, lethargy, CNS and GI symptoms, pneumonia and hyponatremia, diarrhea, confusion

A

legionare’s disease

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46
Q

common type 1 clinical manifestations

A

lethargy, stupor, weight loss, Kussmaul breathing (hyperventilation), smell of acetone, nausea, vomiting, ABD pain

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47
Q

Diabetes Mellitus dx

A
  • fasting BG>126
  • casual BG>= 200
  • oral glucose tolerence test>200
  • glycosylated hemoglobin (A1C or HbgA1c) > = 6.5%
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48
Q

neuropathy patho

A

hyperglycemia–>increased intracellular sorbitol interferes with ion pumps–>schwann cell damage–>decreased conduction velocity

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49
Q

hypoglycemia description

A

mild: 40-60
mod: 20-40
severe: less than 20
- “insulin reaction” occurs when BG falls less than 70
- caused by too much insulin or oral hypoglycemic agent, too much exercise, too little food
- treatment: (mild) 15 gm CHO
- if unconscious: 0.5-1.0 mg glucagon

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50
Q

difference between primary and secondary immune response

A
  • primary: 1st exposure to antigen, latent period

- secondary: rapid production of large amounts of antibodies. Immediate response, may last for several years

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51
Q
  • initiated when antigen binds with the antibody receptors on the surface of the mature B cell
  • triggers a sequence of events that results in production of plasma cells that secrete antibodies (immunoglobulin molecules) IgM, IgA, IgD, IgG, IgF
A

humoral immune response

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52
Q

total 24 hour chest tube drainage

A

500-1000 drainage

avg: no more than 100 during 1st 3 hrs. post op.

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53
Q

most vaccine are give IM, but ____, ____, & _____ are sub Q

A

IPV, MMR, Varicella

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54
Q

stage 2 HIV infection

A
  • no aids defining condition &
  • CD4+ T-lymphocyte count of 200-499 cells OR
  • CD4+ T-lymphocyte percentage of total lymphocytes of 14-28%
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55
Q

stage 1 HIV infection

A
  • no aids defining condition &
  • CD4+ T-lymphocyte count of > or = 500 cells OR
  • CD4+ T-lymphocyte percentage of total lymphocytes of > = 29%
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56
Q

insoluble A-A complexes deposit primarily in ____?

A

vessels, kidneys, joints, & heart (type III immune complex disorders)

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57
Q

clinical course typical, rapid, slow (HIV)

A
  • typical: aids develops 10-12 years after infection
  • rapid: aids develops less than 5 years from infection
  • slow: aids develops 15 years or more after infection
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58
Q

potent vasodilator, increased cap permeability, contraction of bronchial smooth muscle, dilation of the small blood vessels

A

Histamine (H1)

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59
Q

increased gastric acid secretion, decreased release of histamine from mast/basophil cells

A

Histamine (H2)

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60
Q

attract neutrophils and eeosinophils

A

Chemotactic factors

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61
Q
  • reaction of humoral response system
  • responses are immediate and may be life threatening
  • reaction may occur within 15-30 minutes of exposure
A

type I hypersensitivity

62
Q

inflammatory vs. immune

A

inflammatory (innate): non-specific, first line of defense, immediate, passive (antibody transfer), active (immunizations)
-imune (adaptive): specific, sustained, antibody or cell mediated, natural, passive (maternal), active (infection)

63
Q

when resented with an antigen, helper T-cells produced signaling substances such as interferon, interleukin, and tumor necrosis. Inflammation and other body activities are promoted

A

cell-mediated immune response

64
Q
  • antigen-recognition by T-cells, macrophages
  • immunity against pathogens that live inside cells (viruses)
  • fungal infection
  • rejection of transplanted tissues
  • contact hypersensitivity reactions
  • tumor immunity
A

cell-mediated immunity

65
Q

factors impacting immune response

A
  • stress
  • chronic illness
  • exercise
  • increased IgG and IgM
  • nutrients: Vit A, C, D, E, B6, folate, B12, copper, selenium, and zinc
  • ginseng ist thought to boost immune system
  • yogurt
66
Q

systemic (anaphylactic) vs. local (atopic)

A

*both are type I reactions
Systemic: ingestion or injection of the antigen. Generalized response of hypotension, respiratory distress, GI cramping, hives, itching, angioedema
Local: allergic rhinnitis, some food allergies, allergic dermatitis, asthma

67
Q

second exposure

A

antigen binds with the IgE–>degranulation of the mast cell or basophil–>release of allergy producing mediators–>histamine and chemotactic factors

68
Q

clinical progression of HIV infection

A

Primary: “widow period”, contagious, acute seroconversion illness, HIV antibody will test negative
Latent phase: asymptomatic and symptomatic, gradual CD4+ count drop
AIDS: overt symptoms of immunodepression, CD4+ count <200 &/or an AIDS defining illness

69
Q

stage III HIV infection

A

AIDS: CD4+ T-lymphocyte count <200 or percentage total lymphocytes of 14% or documentation of AIDS defining condition

70
Q

Diphtheria

A

incubation: 2-5 days
communicable: 2-4 weeks
source: discharge from mucous membranes, skin, other lesions
transmission: direct contact with infected person, carrier, contaminated objects

71
Q

diphtheria pt. centered care

A

risk for transmission: droplet precautions, administer diphtheria antitoxin, administer antibiotics

72
Q

inactivated polio vaccine

A

sub Q, given @ 2 months, 4 months, 6-18 months, 4-6 years

contraindicated: allergy to previous immunization or vaccine component

73
Q

varicella

A

incubation: 13-17 days
communicable: 1-2 days before rash, 6 days after 1st crop of vesicles when crust have formed
source: resp tract secretions of infected person, skin lesions
transmission: direct contact, airborne droplet, objects
assessment: macular rash, slight fever, malaise, anorexia
* droplet and contact precautions (isolation)

74
Q

fifth disease

A

agent: human parovirus B19
incubation: 4-14 days
source: infected person
transmission: unknown, possibly respiratory and blood
assessment: 3 stage rash, slapped appearance 1-4 days, macular papular rash on extremities 7 days or more, rash subsides but may reappear to stressors

75
Q

Slapped face appearance, macular papular rash starting on extremities

A

fifth disease

76
Q

acid/base pneumonic

A 
ROME
Respiratory
Opposite (ph up, PCO2 down: alkalosis)
              (ph down, PCO2 up: acidosis)
Metabolic
Equal  (ph up, HCO3 up: alkalosis)
          (ph down, HCO3 down: acidosis)
77
Q

chronic bronchitis clinical manifestations

A

“Blue Bloaters”

  • productive cough
  • frequent resp infections
  • early dyspnea on exertion (DOE)
  • wheezes and crackles
  • hypercapnia
  • hypoxemia
78
Q

chronic respiratory acidosis with metabolic compensation, PaCO2>50

A

hypercapnia

79
Q

cyanosis, pulmonary HTn and Cor Pulmonale, increased erythropoietin: secondary polycythemia
-PaO2<60

80
Q

compare bronchitis and emphysema

A

Bronchitis: inflammation and structural changes, increased mucous (bronchioles)
Emphysema: destruction and enlargement of air spaces (alveoli)

81
Q

chambers of chest tubes

A
  1. collects fluid draining from pt.
  2. water seal prevents air from re-entering pleural space
  3. suction control system
82
Q

trachea position child & adult

A
  • bifurcation in children @ T3 level, right mainstem bronchus has steeper slope than adults
  • bifurcation in adults is at T6 level
83
Q

eustachian tube in children

A

position is at less of an angle (more horizontal) in the young child, resulting in decreased drainage
-end of eustachian tube in nasal pharynx opens during sucking

84
Q

nasopharyngitis young child vs older child

A

young child: fever, sneezing, vomiting, diarrhea

older child: dryness and irritation of nose/throat, sneezing, aches, cough

85
Q

pharynitis young child vs older child

A

young child: fever, malaise, anorexia, headaches

older child: fever, headache, dysphagia, abd pain

86
Q

tonsilitis

A

masses of lymphoid tissue in pairs

  • often occurs with pharyngitis
  • characterized by fever, dysphagia, or respiratory problems forcing breathing to take place through nose
87
Q

otitis media with effusion

A

inflammation of the middle ear in which a collection of fluid is present in the middle ear space

88
Q

chronic otitis media with effusion

A

middle ear effusion that persists beyond 3 months

89
Q

acute otitis media

A

a rapid and short onset of signs and symptoms lasting approx. 3 weeks

90
Q

antibiotic for otitis media

A

oral amoxicillin

91
Q

croup

A
  • hoarseness, resonant cough, “barking” or “brassy”
  • caused by swelling or obstruction in the region of the larynx
  • usually described according to primary anatomic area affected ex: laryngitis, laryngotrachiobronchitis (LTB)
92
Q

croup vs. epiglotitis

A

croup: VIRAL, fever, hoarseness, resonant cough, inspiratory strider, risk for significant narrowing airway with inflammation, humidity for treatment
epiglotitis: BACTERIAL, high fever, rapidly progressive course, dysphagia, drooling, dysphonia, distressed inspiratory efforts, antibiotics needed

93
Q

bronchitis vs. bronchiolitis

A

bronchitis: excess mucous narrows airways
bronchiolits: excess swelling of bronchiole walls narrows airways

94
Q

bronchiolitis/RSV

A
  • rhyno syncytial virus
  • 2-6 month olds
  • infection of bronchial mucosa leading to obstruction
  • starts out with upper respiratory infection and progresses to respiratory distress
  • diagnosed with RSV wash
95
Q

bronchiolitis/RSV meds

A
  • bronchodilators
  • steroids
  • Beta-antagonists
  • antiviral: virazole
  • sunagis and RespiGam are prevention drugs
96
Q

“glucose intolerance”

  • fasting BG >126
  • disorder of endocrine pancreas
  • deficiency of insulin secreted by the beta cells of the islet of Langerhaus OR defective insulin receptors, early destruction of insulin
A

diabetes mellitus

97
Q
  • absolute insulin deficiency

- autoimmune mediated specific loss of beta cells in the pancreatic islets

A

Diabetes type 1

98
Q
  • fasting hyperglycemia despite availability of insulin
  • impaired release of insulin, inadequate or defective insulin receptors increase hepatic glucose production
  • increased resistance to action of insulin
  • impaired suppression of glucose production in liver, increasing circulating FFA’s
A

diabetes type 2

99
Q

-increased free fatty acids?

A
  • insulin resistance in peripheral tiddue leads to inhibition of glucose uptake and storage of glycogen
  • increased liver FFA’s–>decreased sensitivity to insulin–>increased glucose production–>stimulation of B cell–>B cell exhaustion
100
Q

metabolic syndrome dx requires?

A
  1. abdominal obesity: men >40 inches, women> 35 inches
  2. Triglycerides >=150
  3. decreased HDL: men 130/85
  4. Fasting Plasma Glucose >100
101
Q

hemoglobin A1C reference values

A
  1. 9%, poor diabetic control
102
Q
  • severe insulin deficiency–>hyperglycemia, glycosuria, increased lipolysis
  • etiology: severe stress (release of counter regulatory hormones), cortisol, epi, glucagon
  • infection
  • pregnancy
A

Diabetic Ketoacidosis

103
Q

Hyperglycemic, Hyperosmolar, Nonketotic Coma/Syndrom (HHNK/S)

A
  • Type 2 DM
  • severe hyperglycemia>600
  • etiology: incresed insulin resistance, excessive CHO intake
104
Q

diabetes hypoglycemia

A
  • BG <50-60
  • neuro: headache, vague feeling of abnormal sensorium, difficulty w/problem solving
  • SNS activation: sweating, shaking, paplitations, tachycardia
105
Q

specificity

A
  • reaction to one antigen
  • different immune response for each different antigen
  • antigen specific antibody production
106
Q

memory

A

long-lasting protection, residual set of cells that are specific to an antigen remain in the body

107
Q
  • inflammation of lung parenchyma
  • bacterial, viral, fungal, protozoan, lung infection
  • community acquired vs. hospital acquired
108
Q

clinical manifestations acute bronchitis

A

non-productive–> productive cough, clear or purulent, lasts 10-20 days. Wheezing, dyspnea on exertion, fever, chills, malaise, headache

109
Q

reversible inflammation of the mucous membrane of the trachea bronchial tubes, and bronchioles resulting from respiratory tract infection, usually viral.

A

acute bronchitis

110
Q

influenza antiviral drugs

A

tamiflu, relenza, symmetrel, glumadine, tylenol, nsaids, antitussives

111
Q
  • infant upright during bottle feeding and breastfeeding: no popping of bottles
  • avoid use of pacifiers
  • recognize initial signs
  • eliminate tobacco smoke and known allergens from environment
A

otitis media prevention

112
Q

otitis media when to call the doctor

A

decreased hearing, increased drainage, pain bleeding, fever

113
Q

inflammation of the middle ear without reference to etiology or pathogenisis

A

otitis media

114
Q

post op T/A surgery most obvious sign of early bleeding is?

A
  • the childs continuous swallowing of trickling blood

- when child is sleeping, note frequency of swallowing and notify surgeon immediately

115
Q

key to understanding prevention of URI

A

meticulous handwashing and avoiding exposure to infected persons

116
Q

atelectasis

A

collapse part or all of a lung

117
Q

hypercapnia aka hypercarbia

A

excess carbon dioxide in the blood

118
Q

hypoxemia

A

a low level of oxygen in the blood

119
Q

hypoxia

A

reduction in oxygen supply to the tissues

120
Q

kyphotic spine

A

dowager hump

121
Q

barrel chest

A

1:1 ratio of depth and width vs. the normal 2:1

122
Q
  • sweat chloride test
  • autosomal recessive disorder of chromosome 7
  • clinical course: slow progressive decline, respiratory, pancreatic:diabetes
  • complications: respiratory infection
A

cystic fibrosis

123
Q

-6-12 months age at dx: recurrent resp. infections, malabsorption, failure to thrive
Resp: persistent cough, frequent pulmonary infections, barrel chest, clubbing of the fingers
GI: oily stools, malnutrition

A

cystic fibrosis

124
Q

“pink puffers”
-early dyspnea, thin, barrel chest, increased lung capacity and residual volume, diminished breath sounds
etiology: antitrypsin deficiency (autosomal recessive), smoking, aging, air pollution, recurrent infection
characterized by: abnormal enlargement of the alveoli and alveolar ducts, destruction of alveolar walls, loss of elasticity, hyperinflation of lungs

125
Q
  • chronic excessive mucous production, chronic inflammation
  • hypertrophy of bronchial mucosal glands
  • goblet cells increase in number and size
  • loss of cilia
  • altered function of alveolar macrophages
A

chronic bronchitis

126
Q

varicella vaccine contraindicated ?

A

contraindicated for pregnancy, allergy, immunodeficiency

127
Q

agent: group A beta-hemolytic streptococci
incubation: 1-7 days
communicable: 10 days during incubation period and clinical illness, during 1st 2 weeks of carrier stage
transmission: direct contact with person or droplet, contaminated objects, ingestion of contaminated milk, or other foods
assessment: high fever/flushed cheeks, vomiting, enlarged lymph node, red-fine sandpaper-like rash, desquamination sheet-like sloughing skin, white strawberry–> red strawberry tongue, tonsils & pharynx enflamed

A

scarlet fever

128
Q
  • 2 doses, 12-15 months, then kindergarten.
  • if no record, 11-12 year old visit
  • contraindicated: allergy, pregnancy, known immunodeficiency
  • postpone 3-6 months if child received immunoglobulins
A

MMR vaccine

129
Q

agent: enterovirus
incubation: 7-10 days
communicable: unknown
source: direct contact with oral pharyngeal or fecal
transmission: direct contact
symptoms: soreness and stiffness of trunk, neck, limbs, CNS paralysis
precautions: enteric, *resp status is huge in the individuals

130
Q
  • Administered via IM route
  • 3 dose series: birth, 1-2 months, 6-18 months
  • infant of HBsAG+ mother: receive within 12 hrs of brith
  • tested for antibody after series completion
A

Hepatitis B Vaccine

131
Q

prodromal

A

how long is the disease process (s/s) going to last

132
Q

incubation period

A

between invasion of organism to signs and symptoms

133
Q

premature infants and vaccines

A
  • receive full dose at same chronological age
  • contraindicated: significant febrile seizure, active seizure disorders, encephalopathy (DTAP)
  • infants with congenital heart and premature infants immunization agains RSV
134
Q

IM vs SubQ needle gauge and length

A

IM: 25 gauge (can be 22), 1” (can be 1 1/2)
SubQ: 25 (can be 22), 5/8”

135
Q

Stage 4 HIV

A
  • confirmed HIV

- no information available on CD4+ T-lymphocyte count or % and no information available on AIDS defining conditions

136
Q

AIDS clinical manifestations

A
  • HIV wasting syndrome: fever, diarrhea, weight loss
  • generalized lymphaenopathy
  • opportunistic infection
  • malignancy
137
Q

CD4+ T-lymphocytes (T-Helper cells, T4 lymphocytes)

A
  • cell mediated immunity
  • production of immunoglobulins and activation of T cells and macrophages
  • normal CD4+ 800-10,000
138
Q

2 strands of viral RNA, 3 enzymes: reverse transcriptase, integrase, protease

139
Q

Host vs. Graft types

A

Hyperacute: minutes to hours
Acute: usually within 1st six months
Chronic: ongoing

140
Q

Host vs Graft disease

A
  • aka “rejection”
  • immune response to transplant tissue
  • rejection of the transplanted organ by the recipients immune system
141
Q
  • genetic pre-disposition
  • gender (female: estrogen)
  • failure to delete auto-reactive T or B cells
A

mechanism of autoimmunity

142
Q

failure of the immune system to differentiate from non self

  • formation of auto-antibodies
  • failure of T-cells to recognize self
A

autoimmune disorders

143
Q

excessive immune response

A

autoimmune disease: failure of the body to recognize it’s own HLA. Antibody production against self. SLE, rheumatoid arthritis, scleroderma
Hypersensitivity/Allergic Response: Excessive response to an antigen. Type 1-IV response

144
Q

act as messengers between t cells, b cells, monocytes, & neutrophils

145
Q

acquired passive immunity

A
  • introduction of serum with antibodies
  • temporary because no direct stimulation of person’s immune response
  • gamma globulin to prevent hep A
146
Q

acquired active immunity

A
  • naturally acquired: result of immune ststems response to foreign substance. Most durable if developed during disease
  • artificially acquired: immunization, vaccines, toxoids
147
Q

natural immunity

A
  • not produced by immune response: present at birth

- mother’s antibodies pass through placenta to fetus

148
Q

oral hypoglycemics

A
  • used to treat type two

- glucophage (metformin) is drug of choice

149
Q

most common cause of end stage renal disease. Hyperglycemia along with HTN–>destruction of nephrons

A

nephropathy

150
Q

retinopathy

A

microaneurysms in the retinal arterioles–>hemorrhage–>scaring–>blindness

BEACON MedSurg/Peds (21 decks)

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