Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Complex Nursing 1
Immune/HIV/transplants/ABGs/respiratory
| Question | Answer |
|---|---|
| Tonsils and adenoids (immune) | prevents infections of the throat when you are young, but not very beneficial when older. |
| Where do T-cells mature | Thymus |
| Where do B-cells mature | Bone Marrow |
| Self-tolerance (immune) | the ability of the immune system to distinguish host cells from foreign cells |
| 3 types of T-cells | T-helpers (activate B-cells), T-cytotoxic (phagocytosis), T-memory (acquired immune response for future infections) |
| 2 types of B-cells | B-plasma (produce antibodies to fight antigen), B-memory (acquired immune response for future infection) |
| NK cells | Natural Killers. Part of the innate immune response. Non-specific phagocytosis. |
| Neutrophils | Innate immune response; phagocytosis; first-responders to most infections |
| Eosinophils | parasitic infections and allergy response |
| Basophils | release chemotaxis to attract other WBC |
| Monocytes | innate immune response, phagocytosis, and antigen presenting cell to activate T-cells. |
| Human Leukocyte Antigens | cluster of 6 genetic markers used to identify which patients are good organ transplant matches |
| Stages of the innate immune response (non-specific response) | 1. Vascular response: blood vessels constrict to stop bleeding, then dilate to allow excess fluid to enter area and causes inflammation 2. Cellular response: blood thickens WBC enter the area and begin phagocytosis 3. Tissue Repair and Resolution |
| Adaptive: Antibody Mediated (Specific response) | B-cells come into contact with antigen and produce plasma and memory cells. Plasma cells produce antibodies to fight the antigen and memory cells create acquire immunity |
| Adaptive: Cell Mediated (Specific response) | T-cells come into contact with sleeper cell antigens and produce cytotoxic cells, T-helpers, and memory cells. Cytotoxic cells destroy the sleeper cells, helper cells stimulate the production of more T and B cells, memory cells produce acquired immunity |
| Type 1 immunoglobulin (IgE) | allergic reactions (peanut allergy), allergies (hay fever), anaphylaxis |
| Type 2 immunoglobulin (IgG/IgM) | Cytotoxic response attacks self-cells that have foreign proteins attached to them. Examples: hemolytic anemia (RBC destroyed too early), transfusion reactions, good pastures syndrome (attacks collagen in kidneys and lungs), thrombocytopenic purpura |
| Type 3 immunoglobulin (IgG/IgM) | trigger inflammation responses in kidneys, skin, joint, small vessels. Examples: rheumatoid arthritis, lupus, serum sickness |
| Type 4 immunoglobulin (T-cell mediated) | Delayed hypersensitivity reactions. Examples: latex allergies, poison ivy, TB skin test |
| Types of Immunoglobulin | immunoglobulin are antibodies that are produced by the B-plasma cells |
| Active Immunity | acquired through the disease or vaccinations |
| Natural immunity | acquired through getting the disease, placental, breast milk |
| Passive immunity | passed through breast milk or placental/ injection of antibodies |
| Artificial Immunity | passed through vaccinations |
| Anaphylaxis | Histamines causes vasodilation and increased capillary permeability, third spacing of fluid, and hypovolemic shock. |
| Autograph transplant | Transplant of your own tissues |
| Isograft transplant | Transplant between identical twins |
| Allograft transplant | Transplant between the same species |
| Xenograpft transplant | Transplant between different species |
| HLA histocompatibility test | Based on 6 genetic markers that determine transplant compatibility |
| Hyperacute tissue rejection | Occurs immediately-3 days after transplantation. More likely in patients with past transplants. Organ will be become soft and cyanotic due to decreased blood perfusion (Triggered by pre-formed antibodies) |
| Acute tissue rejection | Most common type. Occurs 4 day to 3 months after transplantation. Results in red and tenderness at site, fever, and organ failure. (Triggered by Cellular immune response) |
| Chronic tissue rejection | Occurs 4 months to years after transplantation. Results in slow progressive organ failure. (Triggered by the Antibody mediated immune response) |
| Graft versus host disease | Most commonly occurs with bone marrow transplant. Cell-mediated immune reaction where the body attacks its own host cells. |
| Symptoms of graft versus host disease | Bright red rash on palms of hands and soles of feet, bloody diarrhea, and abdominal pain. |
| Acute GVHD | Resolves within first 100 days |
| Chronic GVHD | Resolves after 100 days |
| Pre-transplantation medications | Antiviral and Antibiotic medications to prevent secondary infections |
| Post-transplantation medications | Corticosteroids, T-cell suppressors, Cytotoxic agents, and antilymphocyte globulin |
| Corticosteroid considerations (post-transplant) | Slow wound healing, hyperglycemia, mood changes, immune suppression, fluid retention |
| T-cell suppressing agent considerations (post-transplant) | Monitor BUN/Creatinine levels. This drug is renal toxic |
| Cytotoxic Agent considerations (post-transplant) | Monitor I&Os closely, risk for bleeding, and pulmonary fibrosis. This drug affects liver and kidneys |
| Antilymphocyte globulins considerations (post-transplant) | Given via IV through a central line or port immediately after a transplant. Pre-treat with Tylenol and Benadryl to reduce risk of serum sickness |
| HIV virus attacks which cells | CD4 T-cells |
| HIV is fought by which cells | B-plasma antibodies |
| HIV Acute Retroviral Syndrome | First 2-4 weeks after contracting HIV. Patient may present with flu-like symptoms and general malaise, but the viral antibodies are still undetectable by HIV tests |
| HIV diagnostic tests | ELISA (fast and cheap), Western Blot (more specific), Viral load test (looks at CD4 counts and progression of the disease) |
| HIV Seroconversion | Time at 5-6 weeks when the HIV antibodies are detectable by tests |
| Early Asymptomatic HIV infection | Patient may be asymptomatic or have vague symptoms, middle interval before HIV symptoms appear. CD4 counts are still above 500. |
| Early Symptomatic HIV Infection | Symptoms: herpes zoster, yeast infection, kaposis sarcoma, persistent lymphadenopathy (swollen lymph nodes) |
| Normal CD4 counts | Greater than 500 |
| CD4 count for AIDS diagnoses | Less than 200 with opportunistic infections |
| What is the Ryan White Bill for HIV? | A federal fund to help HIV patients pay for treatment |
| HIV Treatment: Transcriptase Inhibitors | Interrupts DNA synthesis |
| HIV Treatment: Protease Inhibitors | Blocks movement of HIV virus. Side effects include HTN, insulin resistance, obesity, and skeletal wasting |
| HIV Treatment: Reverse Transcriptase Inhibitors | Interrupts RNA to DNA synthesis |
| HIV Treatment: Entry Inhibitors | Blocks entry of HIV virus into healthy cells |
| HIV Treatment: HAART Therapy | Combination anti-retroviral therapy that is highly active |
| Side effects of HIV HAART therapy | Atrophy if fat and muscle stores in the body, insulin resistance, changes in extremities, muscle wasting, HTN, and hyperlipidemia |
| How do hypotonic fluids affect cells | hypotonic fluids move fluid into the cells to make them bigger |
| How do hypertonic fluids affect cells | Hypertonic fluids move fluid out of the cells to make them shrink |
| Symptoms of fluid deficit | v blood pressure, ^ HR, v skin turgor, v urine output, edema |
| Symptoms of fluid excess | ^ BP, ^ HR, ^ respiratory effort, crackles, edema, normal urine output, weight gain |
| Normal Sodium | 135-145 (regulated by kidneys, helps control BP and muscle contraction) |
| Normal Potassium | 3.5-5.0 (regulates cardiac contraction) |
| normal Calcium | 8.5-10 (regulated by the parathyroid and dependent on albumin) |
| Normal Magnesium | 1.6-2.6 |
| normal Phosphate | 2.5-4.5 |
| Hyponatremia symptoms | Na+ <135; muscle cramps, weakness, fatigue, N/V/D, headache, depression, lethargy, changes in reflexes, dulled senses, and irritability |
| Hypernatremia symptoms | Na+ >145; extreme thirst, lethargy, weakness, irritability, seizures, coma, death. Flushing, restless, increased BP, edema, decreased urine output, low grade fever |
| Hypokalemia symptoms | K+ <3. 5; confusion, depression, changes in nerve impulse transmission, respiratory arrest, muscle cramps, paralysis, fatigue, polyuria, polydipsia, severe heart arrhythmias (U wave with ^ risk of V-tach/V-fib) |
| Treating hypokalemia | Administer oral or IV potassium chloride with magnesium (Mg helps with K+ absorption) |
| Hyperkalemia symptoms | Muscle cramps, bradycardia, weakness, tremors, peaked T-wave with widening QRS complex which can lead to CARDIAC STANDSTILL |
| Treating hyperkalemia | Kayexalate enema/oral K+ laxative, insulin/glucose tx, hemodialysis, stop K+ supple |
| Hypocalcemia symptoms | Tetany (muscle stuck), Chvostek's sign (cheek twitching), Trousseau's sign (BP cuff causes arm to contract), lung stridor, convulsion, seizures |
| Tetany | Muscle stuck in contraction (r/t hypocalcemia) |
| Chvostek's sign | Cheek muscles twitch when flicked (r/t hypokalemia) |
| Hypercalcemia symptoms | Weakness, fatigue, kidney stones, cardiac arrest, confusion, lethargy, polyuria, shorten QT complex, heart arrhythmias *potentiates the effects of Digoxin (causes bradycardia HR <60) |
| Treating hypercalcemia | IV hydration, Calcitonin (combats calcium), non-thiazide diuretics |
| Hypomagnesium symptoms | Changes in personality, nystagmus (eyes twitch), Babinski's sign, ^BP/HR, arrhythmia |
| Hypermagnesium symptoms | Confusion, lethargy, v BP, coma, cardiac arrest, arrhythmia |
| Hypophosphate symptoms | Tremors, bone pain, joint stiffness, bleeding disorders, seizures |
| Hyperphosphate symptoms | Weakness, N/V, dysphagia, tetany, v BP |
| Trousseau's sign | BP cuff on arm and arm will start to contract |
| Normal blood pH | 7.35 - 7.45 |
| Normal paCO2 | 35-45 (regulated by lungs) Respiratory system |
| Normal paHCO3 | 22-26 (regulated by kidneys) Metabolic system |
| Metabolic Acidosis symptoms | Weakness, fatigue, LOC changes, bradycardia, arrhythmia, hyperkalemia, stupor, coma, *Kussmaul's respiration (rapid deep breathing to get rid of excess CO2) |
| Metabolic Alkalosis symptoms | Confusion, *hyperreflexia, tetany, dysarrhythmias, seizures, reps failure, hypokalemia |
| Respiratory Acidosis symptoms | Acute: Flushed skin, blurry vision, v LOC Chronic: weakness, impaired memory, sleep disturbances, dull headache |
| Respiratory Alkalosis symptoms | Dizziness, palpations, dyspnea, chest tightness, anxiety, panic, tremors, tetany, seizures, loss of consciousness |
| Causes of Metabolic acidosis | DKA, renal failure, diarrhea (excess gastric acid) |
| Causes of Metabolic alkalosis | Excessive vomiting, GI suctioning, or too much bicarb (loss of gastric acid) |
| Causes of Respiratory acidosis | COPD, near drowning, suffocation, respiratory failure, lung diseases (retaining too much CO2) |
| Causes of respiratory alkalosis | Hyperventilation, anxiety (breathing off too much CO2) |
| Tidal Volume | The amount of air moved in and out of the lungs in one normal breath |
| Inspiratory volume | The amount of air that can forcibly be inhaled over tidal volume |
| Expiratory volume | The amount of air that can be exhaled forcibly over tidal volume |
| Residual volume | The value of air left in the lungs after a forced exhale |
| Vital capacity | The sum of TD, IV, and EV (about 4500mL) |
| WBC count that signals infection is present | >11,000 |
| Normal pulse ox and COPD pulse ox | >90% and >88% |
| Pulmonary angiogram | Checks circulation pattern through lungs |
| Pulmonary V/Q scan | Injected dye/inhaled gasses to check ventilation and perfusion |
| Thoracentesis | Drains fluid from the pleural space to increase comfort |
| Pleuritis | Inflammation of the plural sac secondary to a lung infection or trauma |
| Plural effusion | Collection of fluid in the plural space. Dx with x ray, lungs sound diminished; tx underlying cause |
| Pneumothorax | Collection of air in the plural space., can be spontaneous (primary or secondary cause), Traumatic (open/closed/latrogenic), or Tension. Dx with chest x ray. Tx with chest tube |
| Symptoms of spontaneous/traumatic pneumothorax | Chest pain, dyspnea, SOB, tachypnea, tachycardia, diminished/absent lung sounds |
| Symptoms of tension pneumothorax | Life threatening: hypotension, shock, distended jugular veins, severe dyspnea, tachypnea, tachycardia, absent breath sounds, tracheal deviation |
| Hemothorax | Collection of blood in the plural space |
| Flail chest | 2 or more consecutive rib breaks result in free floating portions of rib. Tx with pain control |
| Inhalation injuries | Smoke (fire/chemical burns results in airway damage) and Near-drowning (asphyxiation/aspiration injuries) |
| Pulmonary Embolism prevention | teds, SCDs, heparin, Lovenox, mobility |
| Manifestations of pulmonary embolism | Sudden onset: dyspnea, SOB, chest pain, anxiety, cough, tachycardia, crackle, low-grade fever |
| Acute respiratory failure | Lungs are unable to meet demands of body (obstruction, COPD, PE, trauma, et.) |
| Symptoms of hypercapnia | dyspnea, respiratory depression, swelling of optic disc, tachycardia, DROWSINESS, respiratory acidosis |
| Symptoms of hypoxemia | dyspnea, tachypnea, RESTLESSNESS, tachycardia, metabolic acidosis |
Created by:
jperrault9941
Popular Nursing sets