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Exam 14 Lymph

68WM6 Phase 2 Exam 14- Blood/Lymph/Immune

QuestionAnswer
Anemia blood disorder characterized by red blood cell, hemoglobin, and hemtocrit levels below normal range
Aplasia (aplastic anemia) failure of the normal process of cell generation and development
Disseminated Intravascular Coagulation aquired hemorrhage syndrome of clotting, cascade overstimulation, and anti-clotting processes
How much blood does the average adult have? 5-6 L
Erthrocytosis abnormal increase in the number of circulating red blood cells
hemarthrosis bleeding into a joint space
Hemophilia A hereditary coagulation disorder, caused by lack of factor VIII, which is needed to convert prothrombin into thrombin through thromboplastin component
Heterozygous having two different genes
homozygous having two identical genes inherited from each parent for a given hereditary characteristic
idiopathic cause unknown
leukemia malignant disorder of the hemtopoietic system in which an excess of leukocytes accumulates in the bone marrow and lymph nodes
lymphangitis inflammation of one or more lymphatic vessels or channels that usually results from an acute staphylococcal infection in an extremity
lymphedema primary or secondary disorder characterized by the accumulation of lymph fluid in soft tissue, resulting in edema
multiple myeloma malignant neoplastic immunodeficiency disease of the bone marrow
myeloproliferative excessive bone marrow production
pancytopenic deficient condition of all three major blood elements, results from bone marrow being reduced or absent
pernicious capable of causing great injury or destruction, deadly fatal
Reed-Sternberg Cell atypical histiocytes, large abnormal, multinucleated cells in the lymphatic system, found in Hodgkin's disease
Thrombocytopenia number of platelets reduced to fewer than 150,000/mm3
Granulocytes (WBC) phagocytes- cells that surround and "eat" invaders 1. neutrophils 2. basophils 3. eusinophils
neutrophils make up 70% of wbc. initial responder to any invasion
basophils key in the inflammatory response
eusinophils key in the allergic response
Agranulocytes (WBC) 1. monocytes 2. macrophages 3. lymphocytes
Monocytes phagocytes that circulate in the blood stream and work similarly to neutrophils
macrophages mature monocytes that live in the tissue
lymphocytes T cells and B cells that directly kill invaders and produce antibodies
Functions of the lymphatic system 1. maintain fluid balance 2. produces lymphocytes 3. absorption and transportation of lipid from the intestine to the stream
What is lymph fluid? excess fluid and protein that remains in the tissues, and is trasnported back to the blood stream via lymphatic vessesl to avoid volume overload in the tissues
Lymph tissue consists of 1. lymph nodes 2. tonsils 3. spleen 4. thymus
functions of lymph nodes 1. filter impurities from the lymph 2. produce lymphocytes
functions of the tonsils 1. protect the body against invasion 2. produce lymphocytes and antibodies 3. trap bacteria and may become enlarged
functions of the spleen 1. serves as a reservoir for blood. stores 500 ml 2. matures lymphocytes, monocytes, and plasma (B)cells 3. destroys worn out RBCs 4. removes bacteria by phagocytosis 5. produces RBCs before birth
functions of the thymus 1. located between the lungs and the mediastinum 2. functions in utero and for several months after birth to develop the immune system 3. matures T cells 4. atrophies at puberty
What is Red Cell Indices measurement of the size and hemoglobin content of erythrocytes: 1. mean corpuscular volume (MCV) 2. mean corpuscular hemoglobin (MCH) 3. mean corpuscular hemoglobin concentration (MCHC)
What is Mean Corpuscular Volume (MCV)? the average volume or size of a single RBC
What is Mean Corpuscular Hemoglobin (MCH)? the average amount of (weight) hemoglobin within an RBC
What is Mean Corpuscular Hemoglobin Concentration (MCHC)? the average concentration or the percentage of hemoglobin within an RBC
Differential count actual cell count of leukocytes, identifies the number and percentage of individual SBC types
peripheral smear accompanies differential WBC count and permits examination of the size, shape and structure of individual RBCs, WBCs and platelets *most informative of all hematologic tests*
What is the Schilling test and megaloblastic anemia profile? laboratory test that identifies etiology of pernicious anemia, measures the excretion of vitamin B12 after parenteral administration
Normal findings of Schilling test and megaloblastic anemia profile excretion of 8-40% of radioactive vitamin B12 within 24 hours
gastric analysis evaluates presence of intrinsic factor, in pernicious anemia the gastric secretions are minimal and ph remains elevated, after injection of histamine
What is Mean Corpuscular Hemoglobin Concentration (MCHC)? radiological examination used to detect metastatic involvement of lymph nodes
Differential count actual cell count of leukocytes, identifies the number and percentage of individual SBC types
attenuated the process of weakening the degree of virulence of a diseased organism
lymphangiography radiologic examination used to detect metastatic involvement of the lymph nodes
Most commonly used site for a bone marrow aspiration iliac crest
cellular immunity the mechanism of acquired immunity characterized by the dominant role of small T cells
adaptive immunity provides a specific reaction to each invading antigen and has the unique ability to remember the antigen that cause the attack
humoral immunity one of the two forms of immunity that responds to antigens, it is mediated by B cells
allergen a substance that can produce a hypersensitive reaction in the body
immunogen any agent or substance capable of provoking an immune response or producing immunity
antigen a substance recognized by the body as foreign that can trigger an immune response
immunosuppressive the administration of agents that significantly interfere with the ability of the immune system to respond to antigenic stimulation by inhibiting cellular and humoral immunity
attenuated the process of weakening the degree of virulence of a diseased organism
autologous something that has its origin within an individual
innate immunity the body's first line of defense, provides physical and chemical barriers to invading pathogens and protects the body against the external environment
cellular immunity the mechanism of acquired immunity characterized by the dominant role of small T cells
humoral immunity one of the two forms of immunity that responds to antigens, it is mediated by B cells
immunogen any agent or substance capable of provoking an immune response or producing immunity
immunosuppressive the administration of agents that significantly interfere with the ability of the immune system to respond to antigenic stimulation by inhibiting cellular and humoral immunity
immunotherapy a special treatment of allegic responses, involves the administration of increasingly larger doses of the offending allegens to gradually develop immunity
innate immunity the body's first line of defense, provides physical and chemical barriers to invading pathogens and protects the body against the external environment
lymphokine one of the chemical factors produced and T cells that attrack microphages to the site of infection or inflammation and prepare them for attack
plasmapheresis removal of plasma that contains components causing or thought to cause disease
proliferation reproduction or multiplication of similar forms
3 functions of the immunne system 1. protect the body from invading organisms 2. maintain homeostasis 3. serve as a surveillance netowrk for recognizing and guarding against growth of abnormal cells
Body's first line of defense, provides non-specific immunity natural (innate) immunity
body's second line of defense, provides specific immunity acquired (adaptive) immunity
What does innate immunity have that azquired doesnt? physical barriers
What is humoral immunity? mediated by B cells, which produce antibodies in response to antigen change
Assist B cells to proliferate, snthesize, and secrete the appropriate antibody T-helper cells
What is cell-mediated immunity? the mechanism of acquired immunity caracterized by the dominant role of small T cells, primary defence against intracellular organisms
Characteristics of humoral immunity 1. B cells 2. antigen/antibody 3. outside cells 4. immediate 5. bacteria/viruses
Characteristics of cell-mediated immunity 1. T cells 2. natural killer cells 3. inside cells 4. delayed 5. virus, bacteria, tumor, fungus
Classifications of immunodeficiency 1. T-cell 2. combination T/B cell
Primary immunodeficiency disease 1. rare and serious 2. immunte cells are improperly developed or absent
Secondary immunodeficiency disease 1. more common, less serious 2. deficiency caused by illness or treatment
Systemic lupus erythematosus autoimmune disorder characterized by inflammation of almost any body part, chronic and incurable
clinical manifestations of lupus 1. oral ulcers 2. arthralgias or arthritis 3. vasculitis 4.rash 5. nephritis 6. pericarditis 7. peripheral neuropathies 8. anemia 9. leukopenia
most common complication of lupus anemia
How is lupus diagnosed? positive results on one or more diagnositc test along with at least 3 other criteria
criteria for diagnosing lupus 1. erythematous butterfly rash 2. photosensitivity 3. oral ulcers 4. polyarthralgias and polyarthritis 5. pleuritic pain, pleural effusion 6. pericarditis, vasculitis 7. renal disorders
How long before administration should blood be refridgerated? 1/2 hours before administration
Within what time frame must blood be administered after refridgeration? 4 hours
Within what time frame must blood components be administered after refridgeration? 6 hours
Only compatible solution with blood products 0.9% NS
Acquired Immunodeficiency Syndrome (AIDS) aquired condition that impairs the body's ability to fight disease, it's the end stage of a continuum of HIV infection
Adherence maintaining a prescribed regimen
CD4+Lymphocyte these cells pay a pivotal role in ability of the immune system to recognize and defend against foreign invaders
Enzyme-linked Immunoabsorbent Assay (ELISA) a rapid enzyme immunochemical assay method to detect certain bacterial antigens and antibodies
Kaposi's sarcoma a rare cancer of the skin and mucous membranes characterized by blue red or purple lesions
opportunistic caused by normally nonpathogenic organisms in a host whose resistance has been decreased by such disorders as HIV illness
Pneumocystitis Carinii Pneumonia an unusual pulmonary disease caused by a fungus and primarily associated with people who have suppressed immune systems
retrovirus a virus taht carries its genetic material in RNA rather than DNA and it replicates by converting RNA into DNA
Seroconversion a person is said to have seroconverted when there is development of a detectable level of HIV antibodies found in the blood
Seronegative means there is not a detectable lvel of HIV antibodies found in the blood
Vertical transmission can occur during pregnancy, delivery, or through postpartum breastfeeding
viral load amount of measurable HIV virions
virulent toxic
western blot technique for analyzing small amounts of antibodies
HIV-1 found worldwide but more prevalent in the US and Europe
HIV-2 prevalent in Western Africa and countries with historical and commerical ties to that region. appears to be less virulent
Opportunistic infections resulting from HIV: 1. Pneumocystitis Carnii Pneumonia 2. Kaposi's sarcoma
Acute retroviral syndrome acute infection period in which viral replication occurs
when does seroconversion occur? 1. 5 days-3 months after exposure, generally within 1-3 weeks. 2. process accompanied by flu or mononucleosis-like syndromes
early infection median time between HIV infection and development of end-stage HIV disease or AIDS (in an untreated individual, generally 10-14 years)
early symptomatic disease AIDS-related complex (ARC) only appiles if CD4+ cell count is above 500 cells/ml
AIDS end-stage or terminal phase of HIV infection
transmission of HIV 1. sexual practice 2. IV drug use with shared needles of HIV infected 3. infected blood 4. ceriovaginal secretions 5. breast milk
1. persistent unexplained fever 2. night sweats 3. weight loss 4. fatigue 5. lymphadenopathy 6. s/s may not occur until 10-14 yrs after infection HIV disease
1. acute illness w/flu-like symptoms, develop antibodies in 1-12 weeks 2. can be asymptomatic 3. infectious but no sign of illness except for HIV antibodies test HIV infection
1. advanced HIV disease 2. chronic illness in development of opportunistic infections after immune suppression AIDS
HIV blood and plasma manifestations 1. CD4+ count decreases 2. HIV viral RNA in peripheral circulation increases
respiratory manifestations of HIV 1. non-productive cough 2. progressive SOB 3. pneumonia 4. vesicular eruptions on mucosa
integumentary manifestations of HIV 1. vesicular eruptions on mouth and perineum 2. shingles 3. rash 4. pruritis 5. lesions of retina
GI manifestations of HIV 1. watery diarrhea 2. abd. pain 3. weight loss 4. nausea 5. gastritis
Neuro manifestations of HIV 1. cognitive dysfunction 2. motor impairment 3. decreased LOC
Diagnositic tests for HIV/AIDS 1. ELISA 2. enzyme immunoassay 3. viral load 4. CD4+ count 5. CDC
4 steps of hemostasis 1. vessel spasm 2. platelet plug 3. clotting cascade 4. fibrinolysis
1. contraction of blood vessel immediately after damage to control blood loss 2. effect lasts 30 minutes vessel spasm- step 1
1. platelets become activated 2. controls blood loss if vessel break small platelet plug- step 2
1. dependent on clotting factors and calcium 2. intrinsic and extrinisc pathways both end with prothrombin 3. prothrombin converts to thrombin 4. thrombin degrades fibrinogen into fibrin, which is relatively insoluble and maintains stability of clot clotting cascade- step 3
1. process of breaking down a clot 2. tissue plasminogen activator (t-PA) released after clot formation 3. turns plasminogen into plasmin, which dissolves fibrin, and clot is dissolved fibrinolysis- step 4.
coagulopathies condition in which a component that is nessary to control bleeding is missing or inadequate 1. thrombocytopenia 2. heomphilia 3. disseminate intravascular coagulation (DIC)
causes of thrombocytopenia 1. decreased platelet production (aplastic anemia, leukemia, tumors and chemo) 2. decreased platelet survival (antibody destruction, infection) 3. altered platelet function 4. platelet sequestration
manifestations of thrombocytopenia 1. petechiae 2. ecchymoses 3. severity of s/s corretlates w/ platelet count
platelet count < 20,000/mm3 significant bleeding
platelet count < 5,000/mm3 spontaneous bleeding
a decrease in the formation of prothrombin activators occurs as a result of decreased clotting factors hemophilia
manifestations of hemophilia 1. internal or external hemorrhage w/large ecchymosis into tissues 2. deformed muscles and immobile joints 3. hemarthrosis 4. pain, erythema and fever 5. excessive bleeding
grave coaguloathy resulting from the over-stimulation of clotting and anticlotting processes in response to disease or injury. mortality reaches 80-90% disseminated intravascular coagulation
causes of DIC 1. obstetrical 2. neoplastic 3. trauma
major manifestation of DIC bleeding noted from 3 unrelated sites
diagnostic results for DIC 1. prolonged PT/PTT 2. positive D-dimer 3. decreased fibrinogen 4. decreased clotting factors
treatment of DIC 1. crystalloids 2. transfusion 3. vitamin K 4. heparin therapy
1. aspirin 2. dig 3. furosemide 4. NSAIDS 5. oral hypoglycemics 6. penicillins 7. quinidine 8. sulfonamides 9. thiazides 10. ranitidine medications that have a thrombocytopenic effect
usually idiopathic thrombocytopenia
X-linked heredity trait hemophilia
secondary process with massive over-stimulation of the clotting cascade DIC
1. inherited bleeding disorder 2. abnormally slow coagulation of blood 3. spontaneous episodes of GI bleeding, epitaxis, and gingival bleeding 4. mild deficiency of factor VIII Von Willibrand's disease
agranulocytosis 1. severe reduction in the number of granulocytes 2. characterized by low white blood count, bone marrow suppression, fatality from severe bacterial infections
clinical manifestations of agranulocytosis 1. fever and chills 2. headache and fatigue 3. ulcerations of mucous membranes 4. bronchial pneumonia 5. UTI in later stages
assessment of agranulocytosis 1. subjective- fever and extreme fatigue 2. objective- fever over 100.6, erythema and pain from ulcerations, crackles and rhonchi
precautions for agranulocytosis neutropenic precautions
diet for agranulocytosis high protein, high calorie
leukemia 1. malignant disorderof hematopoietic system 2. excess of leukocytes accumulate in bone marrow and lymph nodes 3. white cells replace bone marrow 4. immature cells in circulation infiltrate lymph nodes, spleen and liver, causing damage
manifestations of leukemia 1. anemia 2. thrombocytopenia 3. leukopenia 4. enlarged lymph nodes and painless splenomegaly
acute leukemia treated with complex combination of chemotherapeutic drugs and total body radiation
chronic leukemia drug therapy is palliative, not curative
1. Chlorambucil 2. Hydrocyurea 3. Corticosteroids drugs for leukemia
1. untreated patients 4-6 month prognosis 2. 50% of kids can be cured Acute Lymphocytic Leukemia (ALL)
1. remission w/75% of cases 2. 20-25% of adults experience 5 year remission Acute Myelogenous Leukemia (AML)
1. survival rate variable 2. early stage survival is 10-12 years 3. late stage survival rate 18 months Chronic Lymphocytic Leukemia
Multiple myeloma 1. malignant neoplastic immunodeficiency disease of the bone marrow 2. tumor destroys osseous tissue 3. plasma cells proliferate, destroys bone by crowding bone marrow 4. abnormal antibody formation- prone to infection
primary marker of multiple myeloma Bence Jones protein- monoclonal protein found in blood or urine
Dx of multiple myeloma 1. CBC (pancytopenia) 2. radiographic studies- demineralization of bones 3. bone marrow biopsy- large amt of immature plasma cell 4. blood and urine, plasme electrophorses- Bence jones protein
graft vs host. cells from the transplanted tissue of a donor initiate an immunologic attack on the cells and tissue of the recipient
lymphangitis inflammation of one or more lymphatic vessels or channels caused y acute strep/staph infection in an extremity
manifestations of lymphangitis 1. fine red streaks from affected area in groin or axilla 2. diffuse edema 3. chills, fever, and local pain 4. swollen lymph nodes 5. septicemia
dx of lymphangitis made via inspection and palpation
lymphedema primary or secondary disorder characterized by the accumulation of lymph in soft tissue and edema
if lymph drainage is disturbed... an inflammatory process may result.
manifestation of lymphedema massive edema and tightness cause pressure and pain in the affected extremeties
used to differentiate lymphedema from venous disorders lymphangiography
diet restrictions for lymphedema 1. limit sodium 2. avoid spicy foods or anything that precipitate thirst
1. neoplastic disorder of lymphoid tissue 2. cause unknown- viral suspected 3. includes non-Hodgkin's lymphoma malignant lymphoma
manifestations of malignant lymphoma 1. painless lymphadenopathy in cervical area 2. fever 3. weight loss 4. anemia 5. pruritis 6. susceptibility to infections 7. GI malabsorption 8. bone lesions
dx for malignant lymphoma 1. bone scan 2. CBC 3. Coombs' test 4. radiographic studies
1. cyclophosphamide 2. vincristine 3. prednisone 4. doxorubicin 5. bleomycin 6. methotrexate chemotherapy agents used in lymphomas
where is radiation often recieved in radiation of lymphomas? 1. chest wall 2. mediastinum 3. axillae 4.neck
Rituximab (rituxan) 1. monoclonal antibody therapy 2. immunotherapy to eliminate malignant cells and induce remission 3. cancer cells injected into mice 4. mice create antibodies 5. antibody cells cloned and administered to patient
carry risk of infection with development of graft v. host disease allogenic grafts
have higher incidence of recurrence than allogenic autologous grafts
Hodgkin's Disease 1. malignant disorder 2. painless, progressive enlargement of lumphoid tissue 3. cause unknown but thought to be an immune disorder 4. characterized by Reed-Sternberg cells
manifestations of Hodgkin's disease 1. anorexia 2. weight loss 3. malaise 4. extreme pruritus 5. low-grade fever 6. night sweats 7. anemia, leukocytosis followed by respiratory infections
stages of Hodgkin's treated with radiation Stages I and II
stages of Hodgkin's treated with chemo/radiation Stages III and IV
traditional chemo regimen for Hodgkin's MOPP: 1. mustargen 2. oncovin 3. procarbazine 4. prednisone
alternative reginmen to MOPP ABVD: 1. Adriamycin 2. Blenoxane 3. Velban 4. dacerbazine
Why are oncologists switching from MOPP to ABVD? Mustargen was causing secondary leukemia
1. abnormal or single lymph nodes 2. regional or single extranodal site Stage I Hodgkin's
1. two or more lymph nodes on same side of diaphragm 2. localized involvement of extranodal site and one or more lymph node regions Stage II Hodgkin's
1. abnormal lymph node regions on both sides of diaphragm 2. possible spleen involvement Stage III Hodgkin's
1. diffuse and disseminated involvement of one or more extralymphatic tissue and/or organs w/out lymph node involvement Stage IV Hodgkin's
Clincal manifestations of anemia 1. anorexia 2. cardiac dilation 3. disorientation 4. dizziness 5. dyspnea 6. fatigue 7. insomnia 8. paloor 9. SOB 10. tachycardia 11. vertigo
dx tests for anemia 1. CBC 2. iron 3. reticulocyte 4. bone marror biopsy 5. peripheral blood smears 6. vitamin b12 level
In anemia you want to avoid ______ ___________ as much as possible blood transfusions
1. decreased RBC, HGB, HCT resulting from hemorrhage hypovolemic anemia
how much blood loss can be tolerated in an adult? <500 ml
blood loss of _____ or more in an adult can be severe 1000 ml
clinical manifestations of hypovolemic anemia depend on what? severity and speed of blood loss
what will be found in an assessment of a client with hypovolemic anemia? 1. thirst 2. weakness 3. irritability 4. restlessness 5. hypotension 6. rapid, weak, thready pulse 7. cool clammy skin with pallor 8. oliguria
1. autoimmune disorder resulting from the destruction of parietal cell and eventual gastric mucosa atrophy 2. parietal cell damage 3. decreased intrinsic factor production pernicious anemia
1. glycoprotein produced by parietal cells 2. necessary for absorption of vitamin b12 intrinsic factor
what will vitamin b12 deficiency cause? 1. erythrocyte membranes fragile and easy to rupture 2. progressive demyelination and degeneration of nerves and white matter
manifestations of pernicious anemia 1. fever 2. extreme weakness 3. dyspnea 4. hypoxia 5. slight jaundiced 6. edema of legs 7. constipation or diarrhea
1. vitamin b12 2. folic acid 3. iron drug therapy for pernicious anemia
diet for pernicious anemia high protein, vitamin, and mineral
1. congenital-chromosomal alterations 2. hematopoietic tissue replaced by fatty tissue 3. depression of erythrocyte production 4. pancytopenic aplastic anemia
manifestations of aplastic anemia 1. repeated infections w/high fever 2. weakness 3. fatigue 4. bleeding tendencies 5. high mortality w/complications of infection and hemorrhage
medical management of aplastic anemia 1. identify cause and remove 2. if possible, avoid blood transfusion 3. possible splenectomy 4. drug therapy 5. bone marrow transplant
aplastic anemia, also known as bone marrow failure
1. body's demands for iron exceed its absorption 2. malabsorption caused by celiac disease and sprue, subtotal gastrectomy or poor dietary intake iron deficiency anemia
s/s of iron deficiency anemia 1. pallor 2. fatigue, weakness 3. glossitis 4. pagophagia 4. s/s of angina and heart failure may occur
Clinical manifestations of sickle cell anemia 1. asymptomatic for first 10-12 weeks of life 2. loss of appetite and irritability 3. abdominal enlargement 4. jaundice 5. joint and back pain 6. edema 7. multi-system failure
1.myeloproliferative disorder w/hyperplasia of bone marrow 2. increased RBCs, WBCs and platelets 3. stem cell abnormailty of unknown cause polycythemia vera (primary polycythemia)
1. caused by hypoxia rather than defect in RBC evolution 2. usually results from high altitude, pulmonary disease, CV disease, or tissue hypoxia 3. physiologic, not pathologic secondary polycythemia
1. mainly effects middle age-men 2. gradual onset 3. venous distention and platelet dysfunction 4. esophageal varices, epitaxis, GI bleeding 5. hepatomegaly and splenomegaly manifestations of polycythemia
assessment findings in polycythemia 1. hot/cold sensitivity 2. pruritis 3. headaches, vertigo, tinnitus, blurred vision 4. eczema 5. hypertension
Medical management of polycythemia includes repleated phlebotomy to maintain HCT between _________ 45-48%
nursing interventions for secondary polycythemia 1. maintain adequate oxygenation 2. control pulmonary disease 3. avoid altitude
major complication with polycythemia thrombosis due to the abnormal increased number of circulatings RBCs and platelets
Jehovah's witness opposed to ___________ blood transfusions, but may agree to certain types of ________ blood transfusions. homologous, autologous
artificially aquired active immunity occurs when an individual is given a killed or weakened antigen, which stimulates the formation of antibodies against the antigen
naturally acquired active immunity person is exposed to a disease, experiences it, and the body manufactures antibodies to provide future immunity to said disease
passive immunity ready-made antibody from another human or animal source. provides immediate immunity to invading antigen, but is temporary
provide passive immunization to infectious diseases by providing antibodies immune globulins
1. administered to rho(D) neg patients who have been exposed to rho(D) pos blood 2. management of immune thrombocytopenic purpura RHO(D) immune globulin
1. prevention of sytomegalovirus disease associated with transplant of kidney, lung, liver, pancrease, or heart cytomegalovirus immune globulin
prevention of hepatitis B virus in exposed patients heptitis B immune globulin
contraindications for DTaP diphtheria pertussis vaccine 1. actue febrile infection 2. immunosuppressive therapy 3. previous CNS damage 4. convulsions
contraindications for hemophilus b conjugate vaccine 1. febrile illness 2. active infection
contraindications for hepatitis b vaccine anaphylactic allergy to yeast
flu vaccine contraindications 1. allergy to eggs 2. acute neurologic compromise 3. FluMist to be avoided in patients using salicylates
contraindications for MMR II vaccine 1. active infection 2. immunosuppression 3. pregnancy 4. avoid becoming pregnant for 4 weeks
pneumococcal 7-valent vaccine contraindications thrombocytopenia or coagulation disorder
pneumococcal vaccine polyvalent contraindications 1. Hodgkin's disease 2. ARDs
polio vaccine contraindications 1. active infection 2. allergy to neomycin/streptomycin 3. immunosuppression 4. vomiting, diarrhea
varicella vaccine contraindications 1. allergy to gelatin/neomycin 2. active infection 3. immunosuppression 4. pregnancy 5. blood/blood products
1. azathioprine 2. cyclosporine 3. mycophenolate immunosuppressants used with corticosteroids for the prevention of transplantation rejection reactions
1.basiliximab 2. daclizumab 3. sirolimus immunosuppressants used to prevent acute organ rejection (renal), used with corticosteroids and cyclosporine
Muromonab-CD3 manages rejections not controlled by other agents
tacrolimus prevention of organ rejection (liver), used with corticosteroids
1. azathrioprine 2. cyclophsphamide 3. methotrexate management of selecter autoimmne diseases (nephrotic syndrome, severe rheumatoid arthritis)
side effects of immunosuppressants 1. increased risk of infection 2. trembling or shaking of hands 3. anorexia 4. n/v 5. megalopblastic anemia 6. leukopenia 7. pancytopenia 8. thrombocytopenia
normal values for neutrophils 3000-7000 mm3
neutropenia <1000 mm3
severe neutropenia <500 mm3
nursing implications for Muromonab-CD3 1. assess fluid overload 2.chest x-ray nefpre therapy 3. vs
Cytokine Release Syndrome (CRS). systemic inflammatory response caused by release of cytokine from T cells.
1. used in treatment of solid tumors, lymphomas, and leukemias 2. used in some autoimmune disorders 3. used in combinations to minimize individual toxicities antineoplastics
methotrexate toxicity is increased by ________ or large doses of __________ or ___________ nephrotoxic drugs, aspirin, NSAIDS
nursing implications for antineoplastics 1. monitor for bone marrow depression 2.assess for bleeding 3 assess for signs of infection/neutropenia 4. monitor for gout 5. monitor for fatigue, dyspnea, and orthostatic hypertension
Created by: hegaub