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nursing exam 3

questions for exam 3

QuestionAnswer
How do you distinguish healthy from non-healthy immune cells? Immune cells are the only cells capable of determining self from nonself. Self-tolerance is possible because of the different proteins present on all cell membranes.
Cardinal Signs of Inflammation Redness Warmth Swelling Pain Loss of Function
Three Stages of Inflammation 1. Vasoconstriction 2. Cellular 3. Healing
VASOCONSTRICTION: Phase of Inflammation due to trauma (vascular) Injury produces histamine and kinins Causes constriction of veins and dilates arterioles Redness and Warmth Fluid leaks out of cap into intestinal spaces of tissue Pain r/t prostaglandin release Edema protects from further i
CELLULAR: Phase of Inflammation mil-serious (dead WBCs) moderate - sangiounous/serosanguinous severe - purulent RBCs, dead and living bacteria
HEALING: Phase of Inflammation Healthy neutrophils Healing or Infection
Specific Inflammatory Response Involves antibody-mediated immune response and cell-mediated immunity Self recognize Has a memory Long lasting, generalized
Non-Specific Inflammatory Response rapid, short term, protective responses Bring fluid, dissolved substances and blood cells Occurs only in vascularized tissue helps start of the specific immune response
Which cells provide protective responses during inflammation Macrophages - protect and stimulate of longer lasting immune response
Example of non-inflammatory health condition (osteo) Auto-Immune (Lupus, RA, Psoriasis)
What is phagocytosis? Engulf and destroy invaders Rid body of debris after tissue injury MATURE NEUTRO ONLY Attraction - macros come into contact with target
Importance of Spleen in Immunity destroys old and imperfect RBCs Breaks down hemoglobin released from destroyed cells Stores platelets Filters antigens Produces Antibodies REMOVED- less able to remove disease-causing organisms
CBC Left Shift Bandemia Bands are NOT MATURE SHOULD NOT be in blood Sepsis Marrow can't produce mature neutros to keep up w/infection NEUTROPENIC REVERSE ISOLATION NEW LEFT SHIFT-TELL DR
What is Human Leukocyte Antigen Test that detects antigens on WBC- determines tissue type Used to test compatibility of donors Unique per person Not on leukocytes IN ANOTHER BODY-become antigens
Neutrophils segs/polyps-MATURE bands-IMMATURE Small energy supply Higher number - greater resistance Provide protection
Macrophages play many roles in protection Immediate inflammatory response long life and can renew energy Liver, spleen, intestinal tract
Basophils Heparin, histamine, serotonin, kinins, leukotrienes Released in blood - act on smooth muscle
Eosinophils Act against infestations of parasitic larvae Increased number circulating during an allergic response
Natural Passive Immunity antibodies passed from mother to fetus/baby
Always have what when administering vaccines? Epinephrine
Negative Antibody Titer in varicella zoster indicates what? Never had it, not immune Get a booster shot!
What type of immune protection can be transferred to another person? Natural Passive Immunity
What cells are responsible for organ transplant rejections? Natural Killer Cells Cytotoxic T cells - transplant organs
Organ Transplant Precautions Rescue Therapy - antilymphocyte globulin Alg Cycolosporins - IMURAN CellCept - Corticosteroids IV within first two hours before surgery, first few days after also
Top nursing concerns with immunosuppressed clients? RISK FOR INFECTION Imbalanced Nutrition, Skin Integrity, Ineffective Coping, Diarrhea, Pain, Injury
HIV is most commonly found with what test? And confirmed with what test? Elise Western blot antibody test
How is HIV transmitted? bodily fluids, sexual, parenteral, perinatal, needles
Who is at greater risk for HIV? Why? WOMEN. Vagina has moist mucous membrane surface areas, more non-intact skin than a penis
How to help prevent HIV? Sharing needles, abstinence, condoms
What and when to assess for opportunistic infections with HIV patients? assess for symptoms every 2-6 months based on disease progression. meningitis from cyptococcus. FEVER, HA, BLURRED VISION, N, STIFF NECK, CONFUSION, MENTAL CHANGES, MALAISE
HAART Helps raise levels of CD4 Combo of 3+ HIV drugs to reduce virus levels Start when CD4 falls below 350 Ritonavir - small doses Antiretroviral - combo is zidovudine and lamivudine
Post exposure Prophylaxis of HIV Combo of 3 approved ARVs for four weeks. PEP should be started as soon as possible after exposure!!!
Pathogenic Organisms have the ability to cause disease, produce disease, caused by viral organisms, occur even in people with normal immune system
Opportunistic Organisms Does not cause disease but becomes pathogenic when body's immune system is impaired and unable to fight off infection such as AIDs, Immunocompromised
How does Chemotherapy affect Bone Marrow? Suppresses bone marrow, myelosuppression RBC, WBC, Platelets DECREASE Reduces replacement of these cells by suppressing bone marrow function Neutropenia
Non-Cancerous Tumor Characteristics Benign Continuous Ceell Division, small nucleus, diploid chromosomes
Cancerous Tumor Characteristics Rapid continuous cell division, large nucleus, adheres poorly, metastasizes, chromosomes lost/gained MALIGNANT - multiply by mitosis
What is metastasis? Cancerous ability to spread. Major Cause of Death. Common Places: lungs, lymph tissues
Normal Cell Characteristics limited cell division, apoptosis, distinct/recognizable specific response, small nucleus, well-regulated growth
What is grading? system of classifying cellular aspects of a cancerous tumor, some are more malignant than others. Find appropriate therapy.
Goals of Cancer Treatment Pain relief Prevent infection Prevent metastasis Grade 1-looks normal Grade 4-no resemblance to tissue or origin
Why would a benign tumor be removed? They can expand, but not invade. Circulation issues. Prophylactic therapy Discomfort
Theory of Carcinogenesis: Cancer Development. exposure to carcinogens, genetic predisposition, immune function, damage occurs, cancer cells reenter cell cycle quicker than normal cells.
Greatest chance for cure of cancer: SURGERY
How does Radiation Treatment work? treats cancers that are confined to one area. Prevents destruction of normal tissue. Radioactive element breaks down, radiation energy released. Purpose is to destroy cancer cells and have minimal damaging effects on normal cells.
S/S Prostate Cancer slowest growing, hesitancy, change in size or urine stream, back pain, leg, pain, history of UTI, blood in urine, swelling legs, bone pain
Leading Cause of Cancer Death in Men Lung Cancer
TNM Size of Tumor, Involvement of Nodes, Distance of Metastasis
Cancer Prevention Early detection, vaccines, smoking cessation, environmental exposure, healthy diet, changes in bowel habits, unusual bleeding, unusual discharge, difficulty swallowing
Suppressor Genes in Cancer Development tell the gene what the job is, and does it when it's supposed to Proteins that control cell division Limits cell division
What type of cancer is associated with Reed-Sternberg cells? (Hodgkins) develops from a single lymph node or chain, and spreads the adjoining nodes Involved nodes contain Reed-Sternberg cells NON HODGKINS-doesn't contain Reed-Sternberg
Most Significant factor for risk of cancer? ADVANCING AGE
Rehabilitation Surgery for Cancer increases function, enhances appearance Breast Surgery
Palliation Surgery for Cancer Improves quality of life and survival time, not focused on the cure though
Prophylactic Surgery for Cancer removal at risk tissue to prevent cancer
Curative Surgery for Cancer Removal of all cancerous tissues
Diagnostic Surgery for Cancer removal of all or part of a lesion for testing purposes Biopsy
Second Look Surgery Re-diagnosis after treatment
Cancer Control/Cytoreductive removing part of the tumor, but not all. Decrease cancer cells, increases the success of other therapies
What type of cancers are more susceptible to radiation therapy? Treats cancer that is refined to one area/tissue of the body
Radiation Principles Time, Distance, Shielding Purpose is to destroy cancer cells with minimal exposure of the normal cells to the damaging actions of radiation.
Health Problems for patients with history of radiation therapy? Infection, Fractures, Sun Problems, Fatigue, Skin Breakdown, Dry Mouth, Altered taste sensations, hair loss
What factors would prevent patients from participating in radiation therapy? Side effects, infections, immunocompromised, metastasized
What type of cancer is chemotherapy most effective in? Tumors with rapid growth. Tumors that have metastasized cancer.
What is Neumega used for? Prevention of platelet reduction, used in chemotherapy. Protein.
Why would chemo be administered intrathecal? Cancer can be undetected in the spinal cord, and can reach nervous system. Systemic, can kill bad cells.
Side Effects of Hormones for Cancer treatments? Hypercalcemia, Liver Dysphunction, Gynecomastia, Masculinizing effects in women, hormonal manipulation
Which lab result is associated with SIADH? SODIUM! Most commonly found in carcinoma of the lung, tumors also present in the brain. Hypernatremia.
What do Interleukins do? Induce fever and stimulation of prostaglandins. modify patients biological response to tumor cells. Increases growth of CD4 and T cells.
Bands vs Segs Bands - IMMATURE neutrophils Segs - MATURE neutrophils
Tumor Lysis Syndrome large number of tumor cells are destroyed rapidly resulting in intracellular contents being released into bloodstream faster than the body can eliminate them. Prevention hydration, drug therapy Pos sign that CA TX is effective Dilutes K levels DRINK
What is cytotoxic chemotherapy most effective in treating? kills specific cancer cells
Mutliple Myeloma is most common in who? BLACKS
Most common issues affecting toddlers and preschoolers? Infection/Communicable Diseases
Fifth Disease Erythema Infectiosum - Human Panovirus "slapped face" appearance, maculopapular rash on extremities in 3 days
Untreated Strep Throat can lead to what? Scarlet fever
Failure to report abuse can result in what? Prison, loss of license, civil action
End result of DIC Exhaustion of available clotting
S/S of Panic Level Anxiety Palpitations, SOB, Choking/Smothering sensation, chest pain, nausea, depersonalization, dear of dying, chills, hot flashes
Interventions for Panic Attacks stay with client, speak quietly, provide safety and comfort, relaxation techniques
Splitting From BPD- describes difficulty with the ability to hold opposing thoughts, feelings, or beliefts about oneself or others Worst person in the world, I LOVE YOU
Nursing interventions for Histrionic personality disorder emotional attention seeking behavior, the person needs to be the center of attention, often flirtatious, seductive, MAINTAIN professional boundaries and comm.
Side Effects of Electroconvulsive Therapy useful for clients with depression Alterations in bp, adverse se of anesthesia, skin burns, dental and oral trauma, pain, stroke, death
Tardive Dyskinesia in clients taking long term antipsychotics involuntary movements, tongue thrusting, repetitive chewing, MEDS-Haldol, Flunarizine If noticed within first 2 yrs, REVERSIBLE FLY CATCHING, WORM TONGUE, LIP SMACKING
Rape Trauma Syndrome Acute Phase - lasts 2 weeks after rape. Expressed -emotional outbursts, crying, laughing, anger Controlled -survivor may appear calm but confused. Difficulty making decisions, numb.
How to Avoid Reye's Syndrome? Don't give kids under 12 aspirin especially during a viral illness
Symptoms of Schizophrenia Hallucinations, Delusions, Disorganized speech, bizarre behavior, walking backwards
NOT POSITIVE SYMPTOMS OF Schizophrenia Affect-blunt or flat expression Alogia-poverty of though Avolition-lack of motivation Anhedonia-lack of pleasure/joy Anergia-lack of energy
S/S of Panic Disorder Papitations, SOB, Choking, Smothering Sensations, Chest Pain, N/ Fear of dying, chills, hot flashes
How to Combat eating problems with bipolar? Monitor fluid intake, nutrition, provide portable nutritious food
During a severe psychotic break: SEEK ADDITIONAL PERSONNEL
Abrupt Onset of Psychotic Disorder Mania, paranoid, bizarre behavior, delusion, hallucinations
Underlying factors for depressed client considering suicides? untreated depression, despair, hopelessness, changes in a job, history of suicide attempts
Seasonal affective disorder occurs during the winter months and may be treated with light therapy
S/S Depression difficulty sleeping or excessive sleeping, indecisiveness, decrease ability to concentrate, suicidal ideation, cincreased/decreased in motor activity, inability to feel pleasure, increase/decrease in weight
Interventions for major depressive disorder Safety, Milieu therapty, self care, communication, counseling, psychotherapy, antidepressants, ECT
TMS electromagnetic stimulation of the brain, exercise, St Johns Wort
Hobo Phobia fear of homeless
Athazagoraphobia fear of being ignored
Agoraphobia fear of being on open spaces impaired ability to work avoid being outside
Schizotypal odd beliefs leading to interpersonal difficulties, eccentric appearance, magical thinking that are not clear, delusions, hallucinations
Schizoid emotional detachment, disinterest in close relationships, indifference to praise or criticism, uncooperative
Antisocial disregard for others with exploitation, repeated unlawful actions, deceit, failure to accept personal responsibility
OCD Personality perfectionism with a focus on orderliness, control to the extent that the person may not be able to accomplish a given task
OCD Disorder Intruisive thoughts of unrealistic obsessions and tries to control these thoughts with compulsive behaviors, repetitive
Borderline Personality Instability of affect, identity, relationships, fear of abandonment, splitting behaviors, manipulation, impulsiveness, tries self mutilation or suicide
Avoidant social inhabitation, and avoidance of all situations that require interpersonal contact despite wanting close relationships due to extreme fear of rejections, often anxious and social situations
Histrionic emotional attention seeking behavior
Schitzoid Emotional detachment
Dependent feels the need to find another close relationship when one ends, mostly seen in personality disorders
Generalized Anxiety Disorder more than 6 months of uncontrollable excessive worry Impairment of one or more functions Fatigue, restlessness, irritability, sleep disturbances
PTSD Exposure to a traumatic event, causing flashbacks, horror, fear, impairment for longer than 1 month after the event and may last for years
Social Phobias fear of embarrassment, unable to perform in front of others, dreads social situations, believes others are judging negatively, impaired relationships
Panic recurrent panic attacks
Created by: 100000725779885