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PN2 RN > Test 3 CG Inflammation And Immunity > Flashcards

Test 3 CG Inflammation And Immunity Flashcards

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1
Q

Urate crystals deposit in joints and other body tissues causing inflammation

Can occur from Renal insufficiency, crash diets, chemo, diuretics

Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body.

A

Gout

Also called gout arthritis

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2
Q

Drug therapy for gout

What to take and why

A

Colchicine and NSAIDS for acute episodes -inflammation

Allopurinol (prevents Uric acid formation)

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3
Q

Diet for gout ?

A

Low protein diet

Avoid trigger foods

Push fluids

PH increases with alkaline foods

Low purine

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4
Q

Most common arthritis type
•Progressive loss of cartilage & bone in joints leading to loss of joint function & deterioration
•Cartilage disintegrates; bone & cartilage “float” in joint, causing crepitus & bone spurs
•Resultant pain & stiffness leads to decreased mobility

A

Osteoarthritis

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5
Q

S/s of osteoarthritis

Physical assessment/clinical manifestations

A

Older than 60/ history

•Joint pain & stiffness

Joint pain in the hands, neck, lower back, knees, or hips is the most common symptom.

  • Crepitus
  • Heberden’s nodes
  • Bouchard’s nodes
  • Joint effusions
  • Atrophy of skeletal muscle
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6
Q

Tx options for osteoarthritis

A

Maintain proper nutrition to prevent obesity

Avoid injuries such as contact sports

Take breaks at work to rest joints

Decrease repeatative movements

Stay active and maintain a healthy lifestyle

NSAIDs - short term use

Acetaminophen/ analgesics

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7
Q

Rheumatoid arthritis complications and associated syndromes

A 
Weight loss, fever, extreme fatigue
•Subcutaneous nodules-not problematic
•Respiratory, cardiac inflammation
•Vasculitis
•Periungual lesions-due to vasculitis/ischemia
•Paresthesias-decreased circulation
  • Associated syndromes
  • Sjögren’s syndrome
  • Felty’s syndrome
  • Caplan’s syndrome
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8
Q

Tx for RA- drug therapy

A

Common connective tissue disease
•Chronic, progressive, systemic inflammatory autoimmune disease; affects primarily synovial joints but any connective tissue
•Autoantibodies (rheumatoid factors) form & attack healthy tissue, causing inflammation, erosion of cartilage & bone, fibrous adhesions & ankyloses
•Remissions & exacerbations common

  • DMARDs
  • BRMs
  • NSAIDs
  • Other
  • Glucocorticoids
  • Immunosuppressive agents
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9
Q

Non Pharm tx for RA

A 
Adequate rest
•Proper positioning
•Ice & heat application
•Complementary & Integrative therapies
•Promotion of self-management
•Management of fatigue
•Enhance body image
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10
Q

Pathophysiology of RA (cause)

A

The body’s immune system attacking the tissues of the joints, causing pain and inflammation.
RA can cause permanent damage to joints, especially in the early years of the disease.

  • Common connective tissue disease
  • Chronic, progressive, systemic inflammatory autoimmune disease; affects primarily synovial joints but any connective tissue
  • Autoantibodies (rheumatoid factors) form & attack healthy tissue, causing inflammation, erosion of cartilage & bone, fibrous adhesions & ankyloses
  • Remissions & exacerbations common
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11
Q

RA s/s

A
  • Physical assessment
  • Early—joint stiffness, swelling, pain, fatigue, generalized weakness
  • Late—joints become progressively inflamed & quite painful, swollen due to effusion in joint, deformities, osteoporosis, severe fatigue, muscle atrophy-spindle like fingers, decreased ROM; vasculitis (inflammation of the blood vessels)-this leads to organ involvement
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12
Q

S/s of lupus

A 
Skin involvement
•Butterfly rash from UV 
Fever-infection 
Weight loss 
•Polyarthritis
•osteonecrosis
•Alopecia-hair loss 
•Mouth ulcers
•Muscle atrophy
•Fever and fatigue
•Renal involvement
Heart problems /inflammation / raynauds 
Hematologic disorders
Neurological disorders 
Fatigue 
Arthritis 
•Symptoms are not usually fatal
**CHART 18-11, pg. 326
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13
Q

Patho / cause of lupus

A

Chronic progressive inflammatory connective tissue disorder

Can cause major body organs and systems to fail

Spontaneous remission and exacerbations

Complexes tend to be attracted to glomeruli of the the kidneys (lupus nephritis-leading cause of death)

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14
Q

Tx for lupus

A

Topical cortisone drugs

Plaquenil

Tylenol

NSAIDs

Chronic steroid therapy

Immunosuppressive agents

First drug approved in 60 years- belimumab-immune modulator

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15
Q

Contributing factors to lupus - may make it worse

A

Powder /drying agents

Rubbing skin

Strong soaps

Direct sunlight, uv light

Not wearing sunscreen

Not taking rest periods/stress

Infection

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16
Q 
Life-threatening type I hypersensitivity reaction
•Rapid, systemic
•Blood vessel dilation
•Bronchoconstriction
•Decreased CO
•Can be fatal
A

Anaphylaxis

17
Q

Tx for anaphylaxis

A

Assess gas exchange first!!

establish or Stabilize airway

Stay with pt

Ensure airway care is available

Epinephrine -IV (preferred) OR IM

Antihistamines

Oxygen, ABGs, suction

Beta-adrenergic agonist

Corticosteroids, oral steroids

18
Q

S/s of anaphylaxis

A
  • Feelings of uneasiness, apprehension, doom
  • Generalized itching, urticaria
  • Erythema, angioedema of face
  • Wheals or hives
  • Congestion, rhinorrhea, dyspnea, bronchoconstriction, wheezing/stridor, respiratory distress & failure due to edema, suffocation, & hypoxemia
19
Q

A severe type I hypersensitivity reaction that involves the blood vessels & all layers of the skin, mucous membranes, & subcutaneous tissues in the affected area
•Most common cause from drugs is ACEI’s & NSAIDS

A

Angioedema

20
Q

Assessment and s/s of angioedema

A 
History
•Physical assessment
•Deep, firm swelling
•Face, lips, tongue, and neck
•Immediate intervention for inability to swallow, feeling a lump in the throat, & stridor
•Psychosocial assessment
21
Q

Tx for angioedema

A

Maintain airway

Reduce anxiety

Severe angioedema is an emergency - call 911

22
Q

Patient education to prevent anaphylaxis

A

Avoid allergens when possible

Wear medical alert bracelet

Carry anaphylaxis kit or epinephrine injector

Make sure medical records state allergens

Precautions of drug or agent must be used despite of allergy reaction

23
Q

Increased response to antigen exposure

A

Allergies/hypersensitivity

24
Q

Most common type of allergy

May only occur in area of exposure of antigen

Caused by increased production of antibody which causes inflammation

Allergens contracted by
•Inhalation (pollens, spores, animal dander, dust, grass, ragweed)
•Ingestion (foods, food additives, drugs)
•Injection (bee venom, drugs, biologic substances)
•Contraction (latex, pollens, foods, environmental proteins)

A

Type 1 rapid hypersensitivity - atopic allergy

25
Q 
Triggered by 
Plant pollens 
Molds 
Dust
Animal dander 
Wool 
Food 
Air pollutants
A

Allergic Rhinosinusitis or hay fever

26
Q

Examples. Of type 3 complex reactions where the body makes antoantibodies directed against self cells that have foreign protein attached to them

A

Type 2 reactions

27
Q
  • Reactive cell is T-lymphocyte (T-cell)
  • Antibodies & complement not involved
  • Local collection of lymphocytes & macrophages causes edema, induration, ischemia, tissue damage at site of exposure
  • Example
  • PPD-in a person previously exposed, intradermal injection causes T-cells to clump at the injection site, causes erythema
  • Contact dermatitis from poison ivy, insect bites
A

Type 4 delayed hypersensitivity reaction

28
Q

Development of inappropriate immunity

Antibodies and lymphocytes work against healthy cells and tissues (autoantibodies)

Immune system then fails to recognize certain body cells and tissues as self, which triggers immune reactions

A

Autoimmunity

29
Q

Is there a cure for autoimmune disease?

What consists of immunosuppressive therapy?

A

No

Corticosteroids

Cytotoxic drugs

Selective immunosuppressive therapy

Anti-proliferative drugs

Disease modifying anti-rheumatic drugs

30
Q

Chronic inflammatory autoimmune connective tissue disease

Hardening of the skin

A

Scleroderma

31
Q

Standing after hip replacement

A

One foot straight in front face forward and the other leg bent down forward inner body with foot flat

32
Q

Bony protrusion under nails near tip on fingers

A

Herberdens nodes

33
Q

Tophi is what?

A

deposit of monosodium urate crystals, in people with longstanding high levels of uric acid in the blood

Can be on bones of fingers etc

34
Q

Results from deer tick bite

Flu like symptoms and memory problems

Bulls eye appearance

Antibiotics treat it

A

Lyme disease

35
Q

Skin Condition characterized by scaly itchy rash available’s knees and scalp

Joints are stiff especially in the morning

Manage pain and controlling skin lesions. Immuno suppressant’s

A

Psoriatic arthritis

36
Q

Chronic pain syndrome

Knawing burning Nerve pain, stiffness, tenderness at certain areas of the neck upper chest trunk Loback extremities that
worsen in times of stress and increased activity and weather

Treated with Lyrica, gabapentin, SNRI, sleep, tramadol, muscle relaxers

Promotion of exercises, stretching, low impact

A

Fibromyalgia syndrome

PN2 RN (17 decks)

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