Exam 1 Flashcards by Katelyn Vaughn

Self markers on the surface of all cells

Human Leukocyte Antigens

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For a person to be considered immunocompetent, which three processes must be intact and functioning?

Inflammation
Cell-mediated immunity
Antibody mediated (humoral) immunity

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“natural immunity,” cannot be developed or transferred from one person to another, not an adaptive response to exposure

Innate-native immunity

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Recruitment and emigration of WBCs

Chemotaxis

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Destroys bacteria and cellular debris

Monocytes

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Weak phagocytic action; releases vasoactive amines during allergic reactions

Eosinophil

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Releases histamine and heparin in areas of tissue damage

Basophil

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Nonspecific recognition of foreign proteins and microorganisms; ingestion and phagocytosis

Macrophage

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Nonspecific ingestion and phagocytosis of microorganisms and foreign protein

Neutrophil

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Becomes sensitized to foreign cells and proteins

B-Lymphocyte

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Secretes immunoglobulins (antibodies) in response to the presence of a specific antigen

Plasma Cell

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Remains sensitized to a specific antigen and can secrete increased amounts of immunoglobulins specific to the antigen on re-exposure

Memory B Cell

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Enhances immune activity through secretion of various factors, cytokines, and lymphokines

Helper/Inducer T-cell

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Selectively attacks and destroys non-self cells, including virally infected cells, grafts, and transplanted organs

Cytotoxic/cytolytic T-cell

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Nonselectively attacks non-self cells, especially body cells that have undergone mutation and become malignant; also attacks grafts and transplanted organs

Natural Killer Cell

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Make up between 55% and 70% of the normal total WBC count

Mature Neutrophils

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WBCs that increase during an infection

Banded Neutrophils

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Increase during an allergic reaction

Eosinophils

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Vascular stage of inflammation

Momentary vasoconstriction followed by vasodilatation and capillary leakage

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Major cells of the vascular stage

Macrophages

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Provide protection after invaders, especially bacteria, enter the body

Neutrophils

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Mature neutrophils

Segmented

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Immature neutrophils

Band

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An increase in the band cells (immature neutrophils) in the white blood cell differential count; an early indication of infection

Left Shift or Bandemia

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Difference in macrophages and neutrophils

Macrophages have a longer life span, neutrophils arrive at infection site earlier, macrophage can present the antigenic fragments to t cells with MHC (Major Histocompatibility Complex) after engulfing the bacterial cells

Which cells cause the manifestations of inflammation?

Basophils

Very active against infestations of parasitic larvae and also limits inflammatory reactions

Eosinophils

Resultant formation of pus, necrotic tissue and increased edema

Cellular stage

Major cells of cellular stage, arrive first to engulf

Neutrophils

Latex allergies go along with what?

Tomatoes/bananas

Iodine allergies go along with what?

Shellfish

New blood vessel growth

Angiogenesis

When does stage 3 begin?

At the time of injury

Immunity w/out antibodies but with recognition of antigen by T cells and their destruction of cells or on the secretion by T cells that enhance the ability of phagocytes to eliminate the antigen, also involves macrophages

Cell-mediated (adaptive)

B cells produce circulating antibodies in response to the presence of a foreign substance and recognize the substance upon renewed exposure

Antibody-mediated

May be transferred to other people, "active immunity," must bind to an antigen

Antibodies

Clumping of antigen/antibody complexes

Agglutination

Overall function of T8

To suppress the immune response

Helper cells

Ratio of T4 and T8

Should be twice as many T4s

Protein hormones and thus are messengers telling cells in the immune response how and when to act

Cytokines

Include interleukins, interferons, colony stimulating factors, and tumor necrosis factor (TNF)

Cytokines

- Cytokines produced by macrophages | - Cytokines produced by T cells

- Monokines | - Lymphokines

Rejection that occurs immediately when the host has preformed antibodies to the organ

Hyperacute

Occurs within the first few months owing to vaculitis→hypoperfusion and T and NK cell activity

Acute

The donated organ is scarred and becomes non-functional

Chronic

Refers to the ability to cause disease

Pathogenicity

Addresses how frequently the organism causes disease, and refers to the severity of the disease.

Virulence

Immunity resulting from the injection of antibodies or sensitized lymphocytes from another organism or, in infants, from the transfer of antibodies through the placenta

Passive immunity

Influenza, Mycobacterium tuberculosis, and Streptococcus pneumoniae can enter how?

Respiratory Tract

Salmonella enteritiditis, Salmonella typhi, Shigella, millions of other food borne illnesses enter how?

GI Tract

Most enter via percutaneous means or broken skin. Trepoonema Pallidum enters through intact skin

Skin/mucous membranes

Requires negative pressure room and N95 or higher fitted mask (N95 means 95% of air is filtered)

Airborne (TB, chickenpox)

Do not stay suspended in air, coughs/sneezes

Droplets (Flu)

Endogenous

From the pt

Exogenous

From outside the pt

CDC recommends what for infection control?

1/100 beds and surveillance

Involves musculoskeletal system

Rheumatic Dz

Crepitus

Pieces of bones/joints that got loose. Grating upon movement

Why is smoking bad for OA?

Limits oxygen flow to your cartilage

What is the most important aspect of infection control?

Hand hygiene pre and post donning and removing gloves

Placing multiple patients with the same organism in rooms together

Cohorting, used a lot with MDROs (multi drug resistant organisms)

Airborne Precautions

- Monitored negative airflow rooms required to prevent spread of microbes - HEPA air filter - N95 mask - Limit pt movement - Pt wears N95 mask if traveling around hospital - For TB, measles, chickenpox

Droplet Precautions

- Private room preferred - Protect from droplets that may travel 3 feet but are not suspended for long periods - Wear a mask when within 3 fee of the patient - Transport with mask - For influenza, mumps, pertussis, meningitis

Contact Precautions

- For known or suspected infections transmitted by direct contact or contact with items in environment - For MRSA, VRE, pediculosis (lice), scabies, RSV, C. diff - Private room preferred - Wear gloves when entering room - Wear gown if body fluids are involved - Travel only when necessary - Have dedicated equipment

Standard Precautions

- Respiratory hygiene/cough etiquette (RH/CE) - Patient, staff, and visitor education - Posted signs - Hand hygiene - Cover nose/mouth with tissue and quickly dispose tissue - Cough into shirt sleeve rather than covering with hand - Safe injection practices - Single use sterile needle

MRSA

- Rx: Vancomycin, Linezolid - Health teaching: best way to decrease incidence - Contact precautions - Risk Factors: Older adults, Immunocompromised, Invasive lines, ICU patients

Community-associated MRSA

- Healthy non-hospitalized people infected - Health teaching best way to decrease incidence - Perform frequent hand hygiene, including use of hand sanitizers - Avoid close contact with people with infectious wounds - Avoid large crowds - Avoid contaminated surfaces

Vancomycin-resistant Enterococcus (VRE) Risk group

Abdominal surgery, long hospital stays, enteral feedings, severely ill, immunocompromised

Grows in the gut and is needed for digestion, lives for several days on objects making it easy to spread from toilet seats, door handles

Enteroccous

Complex group of microbes, “slimy,” very hard to treat

Biofilms/Glycocalyx

Frequent catheter changes are recommended for long term use what for short-term use? (3weeks)

Silver Allooy or antimicrobial covering

- Deliberate failure to take | - Accidentally not taking

- Noncompliance | - Nonadherence

Best management for biofilms/glycocalyx

Mechanical disruption

What clues can you look for with infected pts?

Incubation times

Lymphadenopathy

Swollen lymph nodes, accompany infection

Blood test that can reveal inflammatory activity in your body

ESR (>20mm/hr for infection)

NU Dx's associated with infection

- Risk for fluid volume deficit - Impaired comfort - Hyper/hypothermia - Ineffective protection

Teach patient SE after giving antipyretics

- Waves of sweating may occur, increase fluid intake | - Observe for N/V, rash

NU interventions for fevers

- Ice paks, hypothermia blankets, sponging with tepid, cool compresses to skin and pulse points - Don't use fans - Shivering can indicate they're cooling too quickly

Exam 1 Flashcards

(80 cards)