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365 Exam 2
365 CH Immunity & Transplant
| Term | Definition |
|---|---|
| response to transplant | immune response to foreign tissue |
| rejection prevention | qualification for organ transplantation, do they have comorbidities; blood type and HLA tissue typing |
| hyperacute rejection | occurs within first 24 hours; no cure organ must be removed, avoid by crossmatching |
| acute rejection | occurs in the first 6 months after transplant; treat with immunosuppressants |
| chronic rejection | occurs over months or years; irreversible, treatment is supprotive |
| general manifestations of rejection | fever, chills, tenderness over transplanted area; flu like symptoms |
| kidney rejection | edema of hands or legs, oliguria and anuria, weight gain of 1 - 2 kg |
| pancreas rejection | increase blood glucose, decreased energy |
| liver rejection | abdominal pain and tenderness, jaundice, itching, ascites and abdominal edema |
| heart rejection | decreased energy and activity tolerance, irregular pulse, lower extremity edema, SOB, hypotension, weight gain of 1kg/ day or more |
| lung rejection | chest pain or tenderness, SOB, dry cough, decreased energy and activity, decreased appetite, decreased spirometry levels |
| immunosuppressive therapy | suppress natural immune response to foreign tissue; prevents and treats rejection |
| calcineurin inhibitors | inhibits proliferation of T and B cells; tacrolimus |
| corticosteroids | suppress inflammatory response, T cell activation and proliferation; prednisone |
| cytotoxic drugs | suppress proliferation of T and B cells; mycophenalate |
| hyperacute rejection prevention | cross matching |
| allergic reactions management | recognition and control, skin tests, elimination diet; immunotherapy |
| steroids | given to suppress an immune response |
| pharmacologic management of allergies | antihistamines, sympathomimetic drugs and decongestants, corticosteroids, antipruritic agents, leukotriene receptor antagonists |
| systemic lupus erythematosus | autoimmune disease, attacks own body |
| lupus manifestations | malar/ butterfly rash, hematologic disorders, photosensitivity, positive ANA titer, oral ulcers, non erosive arthritis, pleuritis or pericarditis, seizures, proteinuria |
| lupus pericarditis | fluid around the heart; chest tube can drain fluid and antibiotics treat infection |
| pharmacologic management of lupus | NSAIDs, steroids sparing immunosuppressants, antimalarials, corticosteroids, immunosuppressants |
| lupus treatment | plasmapheresis; cleans the blood |
| gout | flare up and remission, uric acid build up in joints |
| manifestations of gout | pain, inflammation and swelling, tophi |
| treatment of acute gout attack | colchicine |
| chronic gout treatment | allopurinol |
| foods to avoid gout | organ meats, wine and beer, sardines and shellfish |
| HIV | asymptomatic CD4 count over 500; enough to fight infection |
| AIDS | CD4 count less than 200; presence of an opportunistic condition |
| pneumocytisis pneumonia (PCP) | fever and chills, nonproductive cough, dyspnea |
| tuberculosis | high fever, lymphadenopathy, night sweats |
| candidiasis (thrush) | creamy white patches on oral mucosa, difficult and painful swallowing |
| cytomegalovirus | causes retinitis, visual deficits such as floaters, blindness |
| wasting syndrome | involuntary weight loss exceeding 10% of body weight, chronic diarrhea for over 30 days |
| kaposi sarcoma | skin lesions of various shapes and shades on mucous membranes and organs, pain |
| lymphomas | CNS, Burkitt's, immunoblastic |
| HIV encephalopathy (AIDS dementia complex) | progressive decline in cognitive, behavioral and motor function; memory loss, ataxia progresses to weakness and paralysis of lower extremities, hallucinations, tremors |
| priorities for immunocompromised patients | monitor and prevent opportunistic infections; respiratory changes, neuro changes, inspect mouth and throat; low grade fever |
| antiretroviral therapy (ART) | goal of treatment to make patient more comfortable |
| pre exposure prophyalxis (PrEP) | tenofivir and emtrictabine (truvada) |
| minimizing HIV progression | eliminate drug and alcohol use, vaccinations, nutritional supprot, adequate rest and exercise, reduce stress |
| systemic infection | do not see, bloodstream infection; more life threatening, often affects more than one part of the body |
| managing an infection | cultures and sensitivity, evaluate labs; WBC, UA, Xray |
| contact precautions | private room, gown and gloves, masks if respiratory |
| central line associated bloodstream infections CLABSI | redness at site, pain, drainage, fever and chills; only access central line when needed |
| surgical site infections | yellow and green smelly drainage; keep dressing clean; prophylactic antibiotic |
| c diff | liquid stool can hold the shape of container; easily transmitted |
| catheter associated UTI | burning upon urination, fever and pain; remove catheter as soon as possible |
| ventilator associated pneumonia | respiratory distress, purulent secretions; HOB 45 prevent aspiration and suctioning |
| preventing HCAI | hand hygiene, aseptic technique, identify clients at risk, isolation precaution |
| antimicrobial resistant infections | MRSA, VRE |
| contact precautions | infections spread skin to skin or contact with surfaces; gloves and gown |
| droplet precautions | infections spread through large droplets by coughing, talking or sneezing; gloves, gown, mask, eye cover |
| airborne precautions | infections spread through large particles in the air; negative pressure airflow room, keep door closed; gown, gloves, N95 |
| contact infections | MRSA, VRE, CDIFF |
| airborne infections | measles, TB, coronavirus |
| droplet | flu, RSV, bacterial meningitis, COVID |
| immune system lab study | CBC with differential |
| decreased WBC | indicates immunodeficiency or suppression |
| culture | used to identify the presence of microorganisims in blood, body fluid and tissue |
| urinalysis | identify a UTI |
| infection markers of a UA | nitrites, leukocyte esterase or WBC |
Created by:
ahommel
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