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module 4 meds
| Question | Answer |
|---|---|
| What are the 3 drugs of choice for Rheumatoid Arthritis? | 1. NSAIDs 2. DMARDs 3. Glucocorticoids |
| What is the 1st drug of choice for RA patients? | Methotrexate |
| Is Methotrexate a biologic or non-biologic DMARD? | Non-biologic DMARD |
| When do we use biologic DMARDs? | We use biologic DMARDS when non-biologic DMARDs are contraindicated in moderate - severe RA patients. |
| True or False: Patients taking 1-2 non-biologic DMARDs usually achieve remission of RA? | TRUE |
| What is the main difference between the 2 types of DMARDs? | Non-biologic DMARDs are drugs made of small molecules made from chemicals in a lab. Biologic DMARDs are LARGE molecules produced in living cells (antibodies) |
| What are adverse reactions for methotrexate? | - Hypersensitivity reactions, Steven Johnson Syndrome, Toxic epidermal necrolysis, GI perforation, Hepatotoxicity, Aplastic anemia, Seizures, Interstitial lung disease, and Infection |
| What are the common side effects for methotrexate? | anorexia, diarrhea, nausea, stomatitis, vomiting, nephropathy, IMMUNOSUPRESSION. |
| What are the risk factors for taking methotrexate? | Chronic liver disease, ETOH abuse, Diabetes, Obesity, and Kidney disease |
| What are the nursing considerations for methotrexate? | should not be used if pregnant and those taking have an increased risk of developing B-cell lymphomas |
| What are the drug interactions that increase methotrexate toxicity? | - ampicillin/ amoxicillin - probenecid |
| What do NSAIDS for RA patients DO and NOT do? | - They DO help with pain and inflammation due to disease - They DO NOT slow the progression of disease - They DO NOT limit joint deformation/ mobility |
| What are the nursing actions when administering an immunosuppressant? | - closely monitor temperature and WBC count - limit visitors and flowers/ plants - educate pt on important of proper hygiene / preventing infection - educate on importance of vaccinations |
| What are 5 treatment options for Rheumatoid Arthritis? | 1. Relieve symptoms 2. Maintain joint function 3. Minimize systemic involvement 4. Delay progression of disease 5. Drug and Non Drug measures |
| What are the 3 NSAIDS used in treating Rheumatoid Arthritis? | 1st generation NSAIDs - ibuprofen, naproxen 2nd generations NSAIDs - celecoxib |
| What are the non-biologic DMARDs? | methotrexate, sulfasalazine, and hydroxychloroquine |
| What are the biologic DMARDs? | etanercept, abatacept, rituximab, tocilizumab, and anakinra |
| prednisone, prednisolone are both...? | Adrenal corticosteroids (Glucocorticoids) |
| Where are Glucocorticoids produced in the body? | adrenal cortex |
| Glucocorticoids can treat _____________ insufficiency | adrenocortical |
| Glucocorticoids work primarily by suppressing _____________? | inflammation |
| Glucocorticoids may be given for what 3 common things? | 1. Asthma 2. Rheumatoid arthritis 3. Organ transplants |
| ____________ have Improved range of motion after 3 months of therapy when used for treatment of rheumatoid arthritis | DMARDs |
| ______________ slow progression of joint degeneration | DMARDs |
| What happens during stage 1 of Rheumatoid Arthritis? | The body mistakenly attacks its own joint tissue |
| What happens during stage 2 of Rheumatoid Arthritis? | The body makes the antibodies and the joints start swelling up |
| What happens during stage 3 of Rheumatoid Arthritis? | The joints start becoming bent and deformed, the fingers become crooked/ These misshapen joints can press on the nerves and can cause nerve pain as well. |
| What happens during stage 4 of Rheumatoid Arthritis? | If not treated, the disease will progress to the last stage, in which there's no joint remaining at all and the joint is essentially fused. |
| WHO AM I? The body's immune system attacks its own tissue, including joints. In severe cases, it attacks internal organs | Rheumatoid Arthritis |
| WHO AM I? A chronic inflammatory disorder affecting many joints, including those in the hands and feet. | Rheumatoid Arthritis |
| ________________ is an immunologic defense against tissue injury, infection, or allergy. | inflammation |
| What are the 3 most common types of infection control precautions? | 1. Contact Precautions 2. Droplet Precautions 3. Airborne Precautions |
| What are 5 risk factors for C. diff | 1. Abx Resistance 2. Older age 3. Recent hospital stay 4. Weakened immune system 5. Previous Hx of C.Diff |
| ____._________ spores are known to remain viable on surfaces for weeks to months. | C. difficile |
| _______________________ ________________is one of the most common preventable causes of nosocomial infections | MRSA |
| What are the most common causes of nosocomial infections? (6 things) | 1. Antibiotics 2. CAUTI 3. CLABSI 4. Ventilators 5. Surgical procedures 6. FAILURE TO FOLLOW STANDARD PRECAUTIONS! |
| What are 5 risk factors for infection? | 1. Age (very young, very old) 2. Lower socioeconomic class 3. Uninsured 4. Geographical residence 5. Chronic conditions |
| In the immunocompromised individual they can result in infections that lead to death | fungal cells |
| Require a host for a suitable environment for multiplication | bacterial cells |
| What are the steps in the chain of infection? | 1. Pathogen 2. Susceptible Host 3. reservoir 4. Portal of exit 5. Mode of transmission 6. Portal of entry |
| Having ____________increases your risk for many types of infection. | neutropenia |
| ______________ is a blood condition characterized by low levels of neutrophils, which are white blood cells that protect your body from infections | neutropenia |
| Primary immunodeficiency is ____________ | genetic (autoimmune disorders) |
| Secondary immunodeficiency is ...... | caused by another illness (cancer, AIDS) |
| __________ ___________ _____________is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs. | Systemic lupus erythematosus (SLE) |
| ____________ _____________ _____________ is when an infection triggers your immune system to flood your bloodstream with inflammatory proteins called cytokines. They can kill tissue and damage your organs. | cytokine release syndrome |
| Many COVID-19 complications may be caused by a condition known as _________ ____________ _____________ | cytokine release syndrome |
| During anaphylaxis, The head of the bed should be ____________ if the client's BP is hypotensive | Trendelenburg position (head down and feet elevated) |
| During anaphylaxis, The head of the bed should be ____________ if the client's BP is NML | elevated |
| The nurse is caring for a client who is experiencing anaphylaxis, what 3 things would the nurse anticipate the HCP to order? | 1. Oxygen 2. Epinephrin 3. IV of NML saline |
| "Cytokine" is a hormone of the ________ _________ | immune system |
| During anaphylaxis, ___________ reactions may occur so these clients must be observed carefully! | REBOUND |
| During an anaphylactic reaction, the patient may experience... (7 things) | 1. hypotension 2. difficulty in breathing or hypoxia 3. circulatory failure (distributive shock). 4. pruritus 5. erythema 6. nasal mucus secretions 7. conjunctival mucus secretion. |
| Type I, II and III hypersensitivity reactions are known as _____________ hypersensitivity reactions because they occur within 24 hours of exposure to the antigen or allergen. | immediate |
| Basophils, eosinophils, neutrophils, mast cells, natural killer cells, macrophages, and dendritic cells mediate the ____________ immunity. | Innate Immunity |
| ______________ is "borrowed" from another source and it lasts for a short time. For example, antibodies in a mother's breast milk give a baby temporary immunity to diseases the mother has been exposed to. | passive acquired immunity |
| What type of immunity is this? Vaccine-induced immunity is acquired through the introduction of a killed or weakened form of the disease organism through vaccination. | active immunity z |
| What are the 3 3rd lines of defense in adaptive immunity? | 1. Lymphocytes 2. Antibodies 3. Memory cells |
| What are the 4 2nd lines of defense in innate immunity? | 1. Phagocytic leukocytes 2. Antimicrobial proteins 3. Inflammatory response 4. Fever |
| What are the 3 first lines of defense in innate immunity? | 1. Skin 2. Mucous membranes 3. Secretions of skin |
| WHO AM I? when a large part of the population of an area is immune to a specific disease. | Herd Immunity |
| ______________ immunity is also called antibody-mediated immunity. | Humoral |
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nnonno
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