Exam 1 Study Guide Flashcards
(100 cards)
1
Q
What happens when vascular permeability is increased?
A
- Vessels become bigger, blood flows more in that area
- The stuff inside of the vessel will get out which causes the swelling
2
Q
What is the lab to determine if a patient has
progressed to AIDS?
A
Titer for CD4 T cells < 200
3
Q
P in HELPR
A
PAIN
Mediator will stimulate the nerve ending, causing pain
4
Q
2nd Stage of Wound Healing
A
- Proliferation and new tissue formation : 3 days - 2 weeks
- Granulation tissue grows (2nd step) into wound surrounding healthy tissue
- Granulation happens bc of angiogenesis (1st step); forms new capillaries
- Re-epithelialization (3rd step); skin reformation across wound bed
5
Q
Full Thickness Wound
A
- Epidermis & full dermis loss
- Involve fatty tissue, bones, muscles, or tendons
- Cannot suture
6
Q
Viral Infection : Herpes Zoster
A
- Reactivation of virus dormant within dorsal root ganglia
- Manifestations : pain & itching along 1 or more skin dermatomes, grouped vesicles/pain unilateral along ribcage
7
Q
Type II Examples
A
- Hemolytic anemia
- Grave’s disease
8
Q
What is Leukemia?
A
WBC cancer, bone marrow is overcrowded with nonfunctional WBC
9
Q
> 10,00 WBC indicates
A
- IR
- Recent surgery
10
Q
What is Polycythemia Vera?
A
- Opposite of anemia
- Cancer pluripotent cells of bone marrow increase in RBC, WBC, & platelet
11
Q
Clinical Manifestations of Leukemia
A
- Fatigue (anemia)
- Infections
- Bleeding
- Fever/night sweats
- Bone pain/tenderness
12
Q
Type IV : Cell-Mediated or Delayed
A
- Mediated by T cell lymphocytes
- Delayed hypersensitivity; 24-48hrs after exposure
- Skin reaction
- Local tissue destruction
13
Q
IR : Vascular Response
A
The mast cell is going to degranulate which causes the release of histamine
14
Q
Goals of Inflammation
A
- Limit tissue damage
- Destroy/limit microorganisms
- Initiate adaptive IR
- Begin healing
15
Q
Type I : Immediate
A
- IgE antibody sensitized to antigen (antibody becomes more sensitive to antigen)
- Mast cells release histamine bc of allergen
- Histamine release causes vasodilation, increased vascular permeability, and smooth muscle contraction
- Nausea, vomiting, & diarrhea
16
Q
What is the lab to determine if a patient has
progressed to HIV?
A
Western Blot
17
Q
Examples of Secondary Immunodeficiency Disorder
A
- Normal physiologic changes: infancy, aging, pregnancy, chronic stress
- Malnutrition: drug use, alcoholism
- Illness: HIV, cancer
- Meds: immunosuppressants, steroids, chemo
18
Q
What does Histamine cause?
A
Vasodilation
19
Q
Anaphylaxis Manifestations
A
- Skin: itch, hives, skin erythema
- Respiratory: bronchospasm, laryngeal edema, respiratory distress
- GI: N&V, diarrhea
- Cardio: hypotension, shock
20
Q
<500 WBC indicates
A
Risk for fatal infection
21
Q
Which degree of burn is the most painful?
A
2nd degree
22
Q
Types of Hypersensitivity Disorders
A
- Type I
- Type II
- Type III
- Type IV
23
Q
What are some cancers have a genetic connection?
A
- Breast
- Colon
- Prostate
24
Q
_______ tissue forms because of _________
A
GRANULATION tissue forms because of ANGIOGENESIS (process)
25
L in HELPR
LOSS OF FUNCTION
Due to swelling, can cause joints or affected area to lose their function
26
Properties of IR
- Occurs in tissue with blood supply
- Activated rapidly
- Depends on activity of both cellular & chemical components
- Nonspecific
27
1st Stage of Wound Healing
Inflammation : 1-3 days
28
What is Histamine?
A chemical that is stored and released by mast cells in the immune system in response to antibody immunoglobulin E (IgE)
29
What are the characteristics of Malignant Cell?
- Looking like a crab to infiltrate surrounding tissue
- Rapid growth; ignore signals to stop growing
- Do not die
- Cause destruction & metastasize
30
Human Immunodeficiency Virus (HIV)
Infection enters body, enters specialized T cell, slice into DNA and turn cells into virus-making factor
A virus that attacks cells that help the body fight infections
31
Type II : Cell-Specific
- Antibody-mediated (IgG or IgM), a cell specific hypersensitivity
- Activates complement system to cause specific cell destruction
32
Bacterial Infection : Cellulitis
- Infection of dermis & subcutaneous tissue; an extent of wounds or ulcers
- Clinical Manifestation : HELPR
33
What does hemoglobin measure?
The protein in RBCs that carry OXYGEN
34
Histamine Reactions
(manifestations of type 1 hypersensitivity)
1. Vasodilation : bigger vessels = redness
2. Increased vascular permeability : leaky vessels = swelling
3. Smooth muscle constriction : constrict airway
4. Itching = healing
35
What does vasodilation also increase?
Vascular permeability
36
Abnormal Inflammatory Responses
- Subacute (wks-mths)
- Chronic (autoimmune diseases, cardiovascular disease, infections)
37
Partial Thickness Wound
- Epidermis & partial dermis lost
- If left uncovered, area will bleed and form blood clot
38
What is the role of normal flora?
Prevent the colonization of pathogens, over 300 species in GI tract alone, work with immune system as part of defense
39
What are the INTRINSIC risk factors for pressure ulcers?
1. Age > 75
2. Immobility
3. Impaired sensory perception
4. Poor nutrition
5. Incontinence
40
Artificial-Active Immunity
- EX: receiving a vaccine, a deactivated virus
- Body reacts to vaccine by building (MAKING) antibodies to virus
- Measles vaccine
41
Acquired Adaptive Immunity
- Specific response, responds to antigen
- Natural : already existing
- Artificial : man-made
42
Explain the pathophysiology of sickle cell disease and the trigger for sickling phase
- Patho : decreased 02 causes distortion of RBC shape = sickle cell, clumps of crescent moon shape
- Triggers : acute infections, high altitude (low o2), cold exposure, severe physical exertion, dehydration
43
Immunodeficiency Disorders
Part of immune system not present or not working
44
What does rule of 9 do?
Divide a person's total body surface into portions of 9%, measures the % of the burn on the skin/body
45
Type IV Examples
- TB Skin test
- Poison ivy
46
What is inflammation?
A nonspecific, mediated reaction to any vascular damage
47
What is the first sign of pressure ulcer?
When the area does not blanch
48
Type I Examples
- Allergies
- Asthma
- Anaphylaxis reactions (more severe reaction)
- Eczema (atopic dermatitis)
49
Bacterial Infection : Clostridium Difficile (C. diff)
- Gram positive anaerobic bacteria
- Caregiver to patient
- Antibiotics kill normal flora of GI
50
Artificial-Passive Immunity
- Body does not make anything
- EX: injected preformed antibodies, something made in a lab that body does not have already
51
What are risk factors for cancer?
- Age
- Family hx
- Smoking
- Sun exposure
- Poor diet / Obesity
- Alcohol consumption
- Exposure to chemicals
- Sedentary Lifestyle
52
What is difference between virus and bacteria?
Bacteria are single cells that can survive on their own, inside or outside of the body. Viruses are non-living molecules that cause infections by entering and multiplying in the host's cells.
53
What is Vasodilation?
Makes vessels bigger
(vaso=vessel, dilation=larger)
54
Anaphylaxis Reaction
- Systemic life-threatening hypersensitivity to allergen
- Massive histamine release
- Vasodilation tanks pt's BP
55
What is a nursing consideration when taking care of AIDS patients when their immune system is severely compromised?
Very susceptible to infection even with ordinary viruses that are usually not that harmful
56
What is Vascular Permeability?
Vaso=vessels
Permeability=things going in & out
57
Non-Hodgkin's Lymphoma
Unpredictable spread of lymphoma in the lymph nodes anywhere in the body
58
What are the EXTRINSIC risk factors for pressure ulcer?
1. Pressure intensity & duration
2. Tissue tolerance
3. Friction
4. Shear force
5. Prolonged moisture softens skin
59
What happens smooth muscle constricts?
The airway will constrict, become smaller
60
Bacterial Infection
Replicate out of host, most not pathogenic
61
Acute Inflammatory Response
- Injury to vascularized tissue will activate IR
- EX: infection, necrosis, nutrient deprivation, genetic or immune defects, chemical injury, foreign bodies, temperature extremes, ionizing radiation
62
What is the common complication of Polycythemia Vera?
Blood clots because of increased viscosity
63
What is Friction?
- The resistance to movement between 2 forces, rubbing 2 forces against one another
- Causes damage to epidermis
- Looks like an abrasion or superficial laceration
64
Cell Mediated & Humoral Immunity has to have...
- A 2nd exposure; exposed to a pathogen/antigen and then the 2nd time with have a stronger reaction
- 1st time; spike is not very high, Ig & IgG is made
- The 2nd exposure may not cause severe S/S because of ACQUIRED immunity
65
Natural-Active Immunity
- Human body is reacting to something
- EX: building antibodies after getting cold
- Cold was already existing, but body MADE memory cells to fight off antigen
66
What are the clinical manifestations of anemia?
- Diminished 02
- Fatigue/Weakness
- Activity intolerance
- Pallor
- Cool extremities
- Exertion dyspnea
- Rapid HR
- Low Hgb
67
Prostaglandins
- Chemical mediator of IR
- Increases capillary permeability
- Attracts WBCs
- Cause pain (manifestation)
- Induces fever
68
Clinical Manifestations of Inflammation
HELPR
69
What is anemia?
The lack of healthy RBCs/Hgb which leads to reduced oxygen flow
70
What are the stages of Oncogenesis?
1. Initiation : normal cell DNA is damaged by carcinogens
2. Promotion : enhancement of growth of original cancer cell
3. Progression : Malignant changes; proliferation & angiogenesis takes place
71
What is the most severe complication of burns?
Bacterial infection - sepsis
72
Natural-Passive Immunity
- Not doing anything, passively receiving
- EX: if mother is sick and makes antibodies and passes antibodies to fetus in womb
- Immunity was not made in a lab, baby did nothing to receive antibodies
73
What are Hypersensitivity Disorders caused by?
Exaggerated immune responses
74
What does hematocrit measure?
- The % of packed RBCs in the total blood volume
- Determines if Hgb is high or low due to hydration status
- if Hgb is low, Hct is low
75
Why does inflammation happen?
Histamine release
76
Type III : Immune Complex-Mediated
- Mediated by IgM or IgG
- Body is making something (complex that binds antibody & antigen) that the immune system does not like
- Circulating immune complex will attach itself to areas causing destruction of tissue
77
You have exposed to someone who has the flu. Now you have the flu, after recovering you have immunity towards this type of flu. What kind of immunity do you get?
Natural-Active
78
3rd Stage of Wound Healing
- Remodeling and Maturation : 3 weeks - >6 months
- Tissue regeneration, wound contraction continue = scar tissue formation
79
Hodgkin's Lymphoma
- Arises as enlargement of single node in localized area
- Easier to treat than NHL
80
R in HELPR
REDNESS
Due to vasodilation from increased RBC blood flow
81
What is Acquired-Immunodeficiency Syndrome?
- Late stage of HIV infection
- CD4+ is <200; this is when pt is considered to have AIDS
82
What is Pernicious Anemia?
The lack of parietal cells unable to excrete intrinsic factor; failure to absorb B12
83
Primary Immunodeficiency Disorder
- Genetic cause
- EX: constantly sick babies
84
What does shock mean?
Vital organs do not get enough blood profusion
85
Type III Examples
- Systemic Lupus Erythematosus
- Rheumatoid arthitis
86
What are the warning signs for cancer?
1. Changes in bowel/bladder
2. Unusual bleeding & discharge
3. Indigestion, difficulty swallowing
4. Nagging cough/hoarseness
5. Sore that does not heal
6. Thickening or lumps
7. Changes in mole/wart
87
H in HELPR
HEAT
- Caused by vasodilation from histamine release
- Heat happens because of increased blood flow
88
A 60 yr old pt is recommended to receive a pneumonia vaccine. After receiving the vaccine, what kind of immunity does this pt get?
Artificial-Active
89
Why does histamine also cause itching?
WBC (neutrophil) will enter injured area and attach themselves to vessel walls and start healing process
90
What is Oncogenesis?
The formation or development of tumors or neoplasms; the process of tumor formation - initial formation of normal cells into cancerous cells
91
What kind of dressing would
you use to protect granulation tissue?
Moist wound bed
92
What happens because of vasodilation?
There is more blood flow in that area, which causes the redness
93
Secondary Immunodeficiency Disorder
- Depressed immune system bc of disease or medications
- Underlying cause
- Low WBC
94
E in HELPR
EDEMA
SWELLING happens bc vascular permeability increases, causing fluids to come out of the vessels and accumulate in the inflamed area
95
What is the purpose of staging cancer?
To describe the severity of the cancer, help physician plan appropriate treatment, and estimate a prognosis
96
>30,000 WBC indicates
Massive infection
97
Cell Mediated & Humoral Immunity is part of...
Acquired immunity
98
What is Shear Force?
- When unaligned forces push body in opposite directions
- Causes underlying subcutaneous tissue or muscles to rip & separate
- EX: going down a slide - skin gets dragged while body continues to move down
99
What is opportunistic infection?
- Pathogens taking the opportunity when good bacteria is taken away (defense system impaired), allows the bad bacteria to infect
- EX: Candida Albicans (yeast)
100
A newborn baby is given breast milk. The baby is getting immunity from the breast milk. What kind of immunity is this?
Natural-Passive
