Unit 1 Flashcards
What is Immunity?
The body’s natural or induced response to fight infection and its associated conditions.
What is immunity?
The body’s natural or induced response to fight infection and its associated conditions.
What is inflammation?
a nonspecific response of the immune system.
What are the normal ranges of Leukocytes?
4,500-10,000
What is leukocytosis?
WBC count greater than 10,000
What are the primary cells involved in immune response?
Granulocytes and Monocytes
What are the primary cells involved in immune response?
Granulocytes and Monocytes
What are the functions of Eosinophils?
Phagocytosis, Protection against parasites and they are involved in allergic responses.
What are the functions of Basophils?
to release chemotactic substances
What are the functions of Monocytes and Macrophages?
Functions are trapping and phagocytosis of foreign substances and cellular debris.
What are the functions of T Cells?
function to control viral infections and destruction of cancer cell. involved in hypersensitivity reaction and graft tissue reaction.
What are the functions of B Cells?
Functions to produce antibodies (immunoglobulins) to specific antigens.
What are the functions of Natural Killer Cells?
Functions are cytotoxicity, killing tumor cells, fungi, viral infected cells, and foreign tissue.
What are the functions of Lymphoid Structures?
Site of activation of immune cells by antigens.
What are Basophils?
Not phagocytic, contains proteins and chemicals such as heparin, histamine, bradykinin, serotonin, and leukotrienes, released during hypersensitivity.
What are Basophils?
Not phagocytic, contains proteins and chemicals such as heparin, histamine, bradykinin, serotonin, and leukotrienes, released during hypersensitivity.
What are Monocytes?
Largest Leukocyte, Activates against chronic infections such as TB, Viral infections, intracellular parasitic infections.
What are Eosinophils?
Found in the respiratory or GI tract. Phagocytic. Less efficient than neutrophils, protect body from parasitic worms.
What is chemotaxis?
Monocytes mature into Macrophages that are drawn to inflamed area by chemicals released.
What are the five classes of immunoglobulins?
IgG, IgM, IgA, IgA, IgD
What is the immunoglobulin IgM function?
Produced 48-72 hrs after antigen enters body. responsible for primary immunity. produces antibodies against rheumatoid factors, gram negative organisms, and ABO group. does not cross placental barrier. low in newborns, increases by nine months.
What is the immunoglobulin IgG function?
results from secondary exposure to foreign antigen. responsible for antiviral and antibacterial activity. crosses placental barrier. response is stronger and longer than others.
What is the immunoglobulin IgA function?
found in secretions of respiratory system, GI, tears, and saliva. protects mucous membrane invading organisms. does not cross placental barrier. Congenital IgA deficiency makes one prone to autoimmune disease.
What is the immunoglobulin IgE function?
increases during allergic reactions and anaphylaxis.
What is the immunoglobulin IgE function?
increases during allergic reactions and anaphylaxis.
What is the function of lymph nodes?
Filter antigens and foreign products from lymph, support and house proliferation of lymphocytes and macrophages.
What are the two kinds of tissues in the spleen?
White pulp and Red pulp
What is the function of the white pulp in the spleen?
B cells predominate site for lymphocyte proliferation and immune surveillance.
What is the function of the red pulp in the spleen?
Phagocytic cells and damaged/aged RBC stored for future use.
What happens if the spleen is damages?
The liver and bone marrow takes place of its functions.
What are the normal flora of the skin?
staph epidermis, staph aureus, corynebacterium xerosis, micrococcus luteus.
What is the normal flora of the nasal passages?
staph aureus and staph epidermis
What is the normal flora of the oropharynx?
streptococcus pnuemonieae, strep sallivarus, Neisseria meningitis.
What is the normal flora of the intestines?
staph aureus, bacteriodes, bifidobacterium, eubacterium, clostridium, lactobacillus, and e. coli
What is the normal flora of the mouth?
Strep mutans, strep mitis, lactobacillus, actinomyces, and spirochetes
What is the normal flora of the mouth?
Strep mutans, strep mitis, lactobacillus, actinomyces, and spirochetes
What is communicable disease?
an illness that is directly transmitted from one individual or animal to another by contact with body fluids or indirect contact transmitted by contaminated objects.
What is infectious disease?
a communicable disease that is caused by microorganisms that are commonly transmitted from an individual or animal to another.
What is pathogenicity?
pathogens ability to produce disease
What is pathogenicity?
pathogens ability to produce disease
What is medical asepsis?
includes all practices intended to confine a specific microorganism to a specific area thus limiting the number of growth and transmission of microorganisms.
What is sepsis?
the whole body inflammatory process resulting in acute illness however the term is often used generally to refer to the state of infection
What is bacteria?
the most common infection causing microorganism
What is parasites?
microorganisms that live on other organisms?
What is parasites?
microorganisms that live on other organisms?
What is colonization?
the process by which strains of microorganisms become resident flora. microorganisms may grown and multiply but they do not cause disease.
What is a systemic infection?
an infection that is widespread and affects many different areas of the body.
What are Healthcare Associated Infections (HAI’s)?
nosocomial infections or hospital acquired infections.
What are Healthcare Associated Infections (HAI’s)?
nosocomial infections or hospital acquired infections.
What is the chain of infection?
- Infectious agent- pathogen (etiologic agent)
- Reservoir- where they live, multiply (living and nonliving)
- Portal of Exit- bodily fluids, sneezing, cough, wounds.
- Method of Transmission- Direct, Indirect, Airborne
- Portal of Entry- mouth, nose, genitalia, wounds.
- Susceptible Host- someone at risk for infection
What is a primary infection?
The first time you infected by a specific migroorganism, ex. chickenpox
What is a primary infection?
The first time infected, ex. chickenpox
What is a secondary infection?
The second time you are infected by a specific microorganism, ex. shingles
What are some risk factors of infection?
Age, babies and elderly have weaker immune systems.
Health Status- one already having health issues are more susceptible
Lifestyle- Smokers, poor nutrition, etc
Environment- Works at places with lots of infections around, ex. hospital
What is an acute infection?
an infection with a sudden onset (common cold)
What is a chronic infection?
an infection with a longer duration (fungal infection)
What is a latent infection?
an infection with a period of no symptoms (TB, HIV, Herpes)
What is indirect transmission of infection?
Microorganism is transferred by other means. Vehicle-borne (fomite on inanimate object) or vector-borne (animal or insect bite) or airborne (droplet or dust)
What is indirect transmission of infection?
Microorganism is transferred by other means. Vehicle-borne (fomite on inanimate object) or vector-borne (animal or insect bite) or airborne (droplet or dust)
What are the stages of infection?
incubation, prodromal, illness, decline, and convalescence.
When is the incubation stage of infection?
time of infection to symptoms showing
When is the prodromal stage of infection?
when there is an appearance of mild symptoms (short time)
When is the illness stage of infection?
signs and symptoms most evident
When is the decline stage of infection?
the decline of signs and symptoms, number of pathogens decrease. returns to normal due to immune response or drug treatment.
When is the convalescence stage of infection?
The patient is recovering, no signs or symptoms. tissue repair and return to health.
During what stage of infection is a patient infectious?
Patient can be infectious at any stage of infection depending on the causative agent.
What is the OSHA requirement for handwashing within the hospital (non surgical)?
After every three times you clean them with an alcohol based rub. atleast 30 seconds, use warm water, clean under nails, rinse fingers pointed down, dry hands pointed up.
What is the OSHA requirement for handwashing within the hospital (non surgical)?
After every three times you clean them with an alcohol based rub. atleast 30 seconds, use warm water, clean under nails, rinse fingers pointed down, dry hands pointed up.
What are standard precautions?
a set of infection control practices used to prevent transmission of disease that can be acquired by contact with blood, body fluids, non-intact skin, and mucous membranes. Used for care of all patients. Hand hygiene, gloves, gown, mask, eye protection, or face shield.
What is protective isolation (or neutropenic precautions)?
protects the patient, also known as reverse isolation. used with immunocompromised patients. Includes private room, no visitors, no fresh fruits or veggies, no flowers or other plants.
What are Contact precautions?
Highly infectious, multidrug resistant bacteria that is spread by Direct or Indirect transmission. Standard precautions, gloves, gown, handwashing with soap and water not just alcohol-based rub.
What are Airborne precautions?
airborne are spread via small moist droplets or dust particles. Precautions are handwashing, gloves, gown, eye protection, N95 respirator mask, and reverse air rooms.
What are Airborne precautions?
airborne are spread via small moist droplets or dust particles. Precautions are handwashing, gloves, gown, eye protection, N95 respirator mask, and reverse air rooms.
What is the first line of defense against infection?
barrier protection- skin, hair, tears
What is the second line of defense against infection?
nonspecific immune response- inflammation, WBC increase, swelling, phagocytosis.
What is the third line of defense against infection?
humoral (antibody mediated) immunity and cellular (cell mediated) immunity
What are the alterations in the immune system?
hyperresponsiveness- allergies, auto immune disorders, reaction to transplants
impaired response- AIDS
What are ways to prevent infection?
good nutrition, rest, exercise, good hygiene, reduce stress, immunizations.
What is an endogenous HAI?
acquired by normal flora multiplying
What is an endogenous HAI?
acquired by normal flora multiplying
What does Pandemic mean?
infections that are widespread affecting everyone
What does Pandemic mean?
infections that are widespread affecting everyone
How many healthcare workers have latex sensitivity?
8-12% of healthcare workers
What do you do if a patient has a latex allergy?
remove all latex from the environment, thoroughly clean, put latex allergy precaution on the door, update medical record, alert other medical personnel, instruct family about the use of latex and the foods that commonly cause allergies in latex sensitive patients (tomatoes, bananas, avocados, kiwi, plums, peaches, potatoes, bell peppers, and chestnuts.
What do you do if a patient has a latex allergy?
remove all latex from the environment, thoroughly clean, put latex allergy precaution on the door, update medical record, alert other medical personnel, instruct family about the use of latex and the foods that commonly cause allergies in latex sensitive patients (tomatoes, bananas, avocados, kiwi, plums, peaches, potatoes, bell peppers, and chestnuts.
What is Medical Asepsis?
a state of cleanliness that decreases the potential for the spread of infections.
What is Surgical Asepsis?
or sterility, a practice that keeps all surfaces free of ANY microorganisms
What are the sterile principles?
only sterile items touch sterile items. sterile field only on a horizontal plane. any material hanging over sterile field is unsterile. one-inch margin around the drape is considered unsterile. never assume an item is sterile. never turn your back to a sterile field. avoid reaching over a sterile field (18 in forcefield) open sterile fields towards you. if any liquid gets on sterile field, it is unsterile.
What are the three phases of perioperative care?
preoperative phase, intraoperative phase, and postoperative phase
What are the three phases of perioperative care?
preoperatirve phase, intraoperative phase, and posteroperative phase
When is the preoperative phase?
from check-in to pre-op
When is the intraoperative phase?
The actual operation
What are the CDC Guidelines?
use of standard precautions (universal precautions). protects the healthcare worker. decreases transfers of pathogens.
What are the CDC Guidelines?
use of standard precautions (universal precautions). protects the healthcare worker. decreases transfers of pathogens.
What is the IOM definition of safety?
causes injury, with negative result.
What is the IOM definition of error?
doing the wrong thing
What is the IOM definition of adverse event?
procedure done correctly, but with a small error that has consequences.
What is the 3rd leading cause of death?
Medical Error
What is the concept of safety?
protection from injury or harm
What concepts are related to safety?
clinical decision making, infection, perioperative care, and quality improvement.
What are strategies to prevent safety hazards?
orientation to surroundings, education, non-skid footwear, needle guards, keep essential items within patients reach, respond to call light, use bed alarms.
What are common safety hazards for patients?
falls, infection, new meds, medical errors.
What are common safety hazards for patients?
falls, infection, new meds, medical errors.
What is the #1 preventable error?
Falls
What are the contributing factors to falls?
unfamiliar environment, poor vision, medications, lighting, medical equipment, cognitive impairment, ability to communicate, mobility status, and general safety.
What is the purpose of restraints?
to restrict movement, restrict normal access to the body, prevent patients from pulling out tubes, may be needed for those medicated, restless, with dementia, disoriented, etc.
What must restraints have?
A physician order, or physician order within one hour of RN placing restraints.
What are the three types of restraints?
physical- mitts, vests, limbs
mechanical- wheelchair trays
chemical- sedatives
What are the rules of application of limb restraints?
tie with quick release knot, tie to bed frame, 1-2 inch slack, and do not apply above an IV site.
What must be on the physician order for restraints?
behavior vs. nonbehavioral. reason for application. type of restraint (location). duration of use (24 hr or less). frequency of reassessment- check patient every __ minutes, release restraints every __ minutes (behavioral- 15 min, 2 hrs; nonbehavioral- 30 min, 2 hrs)
What are some alternatives for restraints?
bed alarms, music therapy, therapeutic massages, diversional activities, low beds, positioning wedges & cushions.
What is a Code Blue?
A life-threatening emergency.
Check for DNR. Call #44 ; state Code Blue with exact location. Provide CPR
What is a Code Red?
A Fire.
Remember R.A.C.E. and P.A.S.S.
Dial 594-2008, provide exact location
What is a Code Pink?
An abduction.
Call #44 ; state Code Pink with location, description of child if possible. Call protection.
What is a Code Green?
A medical emergency (visitor ill/injured)
Call #44 ; Code green with location and short description of emergency.
What is a Code Purple?
Disaster Alert
What must an RN document for restraint use?
Who ordered? time of application. reason for use. time of safety checks and actions taken.
What are vital signs?
means of assessing vital or critical body functions
When are assessments of vital signs performed?
every 8hr, 6hr, 4hr, etc. determined by physician order, judgement, etc.
What is a normal temperature?
98.7 degrees F or 37 degrees C
What are the sites used for temperature taking?
oral -> rectal -> tympanic
axillary for babies
What is the most accurate site for a temperature?
Rectal
What is another name for fever?
pyrexia
What is considered an abnormally high temperature?
> 100.4 degrees F or 38 degrees C
What is considered hyperpyrexia?
> 105.8 degrees F
What is considered hypothermia?
<95 degrees F
What is the most accurate location for a pulse?
Apical Pulse
What is the most common location for a pulse?
Radial Pulse
What is the average adult pulse?
60-100 bpm
What is bradycardia?
pulse rate < 60bpm
What is tachycardia?
pulse rate >100bpm
What are some factors that affect pulse rate?
age, disease, medications, fever, food, blood loss, gender, stress, and position change.
What occurs during respirations?
The exchange of O2 and CO2.
What causes breathing?
the build up of CO2.
What is inspiration?
negative pressure, bringng air into the lungs
What is expiration?
positive pressure, pushing air out of the lungs.
What is the acceptable range for respirations?
12-20 breaths per minute
What is apnea?
lack of breathing
What is bradypnea?
slow breathing, <12 breaths per minute
What is tachypnea?
fast breathing, >20 breaths per minute
What is hyperventilation?
rapid, deep breathing resulting in excess loss of CO2.
What is hypoventilation?
slow, shallow breathing
What are the tools to measure oxygenation?
Arterial Blood Gases and Pulse Ox
What is pulse ox?
noninvasive, photosensor placed on finger. measures respiratory status and oxygen saturation.
What is the optimal range for a Pulse Ox reading?
95-100%
What is measured with a blood pressure?
the blood forced against the arterial walls.
systolic pressure- ventricles contract
diastolic pressure- heart is at rest
What is the blood pressure measured in?
millimeters of mercury
What is the ideal patient position for an accurate blood pressure reading?
seated, arm at heart level, uncrossed legs
What happens if your BP cuff is too small?
you’ll get a high reading
What happens if your BP cuff is too big?
you’ll get a low reading
What is the ideal BP ?
120/80
How do you get pulse pressure?
systolic - diastolic = pulse pressure
What is hypotension?
systolic <100
What is hypertension?
BP reading > 150/90
What is orthostatic hypotension?
also known as postural hypotension, sudden drop on BP due to change in position. ex sitting to standing.
When are weights taken?
upon admission, daily after 1st urine. calculated in kg.
What are rules on weight taking?
weigh on empty bladder, same clothing, same time of day, and use same scale.
What is the importance of weights?
used for medication dosage
