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115 LEC > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Which nerve is implicated in the Chvostek’s sign?

A

Facial

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2
Q

What is the function of the immune system?

A

to remove foreign antigens such as viruses and bacteria to maintain homeostasis

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3
Q

What 2 labs are specific to measuring an inflammatory response?

A

WBC
CRP or ESR - markers for inflammation

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4
Q

Natural immunity

A

NONSPECIFIC RESPONSE TO FOREIGN INVADERS
WBC - release cell mediators such as histamine, bradykinin and prostaglandins and engulf foreign substances

inflammatory response

Physical barriers

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5
Q

Acquired immunity

A

Results of prior exposure to an antigen
active or passive

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6
Q

Active immunity is

A

Immunologic defenses developed by persons own body

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6
Q

Active immunity is

A

Immunologic defenses developed by persons own body

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7
Q

Passive immunity

A

Temporary
Results from a transfer of a source outside of the body
Ex. transfer of antibodies from mother to infant, injections

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8
Q

What leukocytes are assoc with inflammation?

A

Neutrophils

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9
Q

What are the 4 stages of immune response?

A

-Recognition - Lymph for surveillance/Macrophages
-Proliferation - Lympho stims T and B and they enlarge, divide and turn into cytotoxic or antibodies
-Response -
-Effector -

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10
Q

HUmoral immunity

A

Interplay of antibodies

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11
Q

Cellular immunity

A

cytotoxic T cells

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12
Q

Research shows that stem cells can

A

Restore an immune system that has been destroyed

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13
Q

Immune deficiency is acquired in what 2 ways?

A

-Due to medical treatment such as chemotherapy
-Infection from agents such as HIV

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14
Q

HIV-1 is transmitted through what body fluids?

A

Blood & Blood products
Seminal fluid
Vaginal secretions
Mother-to-child: amniotic fluid, breast milk

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15
Q

What is the prevention education for HIV & AIDS

A

-Behavioral interventions
-HIV testing
-Linkage to treatment and care

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16
Q

What is reproduction education for HIV?

A

Artificial insemination
ART -
Refrain from breastfeeding

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17
Q

What is the confirmatory testing for HIV

A

Western blot test

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18
Q

What precautions are used with HIV patients?

A

Standard precautions

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19
Q

HIV is in the subfamily of lentiviruses and is a ——– virus?

A

Retrovirus bc it carries genetic material in the form of RNA rather than DNA

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20
Q

HIV targets cells with

A

CD4+ receptors - which are expressed on the surface of T lymphocytes, monocytes, dendritic cells and brain microglia

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21
Q

What are the steps in HIV life cycle?

A

Attachment
Uncoating/fusion
DNA synthesis
Integration
transcription
translation
Cleavage
Budding

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22
Q

What is Stage 0

A

Early HIV, inferred from lab testing

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23
Q

What is Stage 1 HIV

A

–The period from infection with HIV to the development of HIV-specific antibodies
-Dramatic drops in CD4 T cell counts normally 500 to 1500 cells/mm3 of blood

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24
What is the CD4 T cell count determinant for AIDS?
Below 200
25
What is Stage 2 HIV?
Occurs when T lymphocytes are between 200-499 cells/mm3
26
What is Stage 3 HIV?
When CD4 T cell count drops below 200 *AIDS
27
What is the main symptom for later stages HIV/AIDs
Respiratory manifestions SOB, dyspnea, cough, chest pain --Pneumocystis pneumonia TB
28
What are the GI manifestions of HIV
Loss of appetite Oral candidiasis diarrhea wasting syndrome
29
What are oncologic manifestations of HIV?
Kaposi sarcoma Aids related lymphomas
30
What are the neurologic manifestations of HIV
Effects on cognition, motor function, attention, visual, memory Peripheral neuropathy HIV encephalopathy Fungal infections - cryptococcus neoformans Depression and apathy
31
What are the integumentary manifestations of HIV?
Herpes zpster Seborrheic dermatitis
32
What are the gynecologic manifestations of HIV?
Genital ulcers Persistent, recurrent vaginal candidiasis Pelvic inflammatory disease Menstrual abnormalities
33
What is Antiretroviral therapy?
-Goal to suppress HIV replications -Reduce HIV associated morbidity and prolong duration and quality of life -Restore and preserve immunologic function -Prevent transmission
34
What are the problems/potential complications of patients with HIV?
Development of HAND - Body images change Adverse effects of meds
35
What is HIV encephalopathy?
Formerly AIDS dementia complex Progressive decline in cognitive, behavioral and motor functions as a direct results of HIV
36
What is the chain of infection?
Susceptible host Causative organism A reservoir of available organisms a portal of exit a mode of transmission a mode of entry to a susceptible host
37
What is a person who provides living conditions to support a microorganism called?
a HOST
38
What is a person who carries an organism without apparent signs and is able to transmit to others?
A carrier
39
What is colonization?
Microorganisms present without host inference or interaction
40
Define infection
Indicates host interaction with organism
41
Define infectious disease.
The infected host displays a decline in wellness caused by infection
42
What are the standard precautions to prevent the transmission of microorganisms?
Used for all patients Primary strategy for preventing health care associated infection
43
What are transmission-based precautions?
for patients with known infectious disease spread by airborne, droplet, or contact
44
For airborne precautions -What diseases -what are the precautions
TB, varicella -Hospitalized patient should be in a negative pressure room with door closed; healthcare should wear an N-95
45
DROPLET PRECAUTIONS -Diseases -Precautions
-Used for organisms transmitted by close contact with respiratory or pharyngeal secretions, flu, meningococcus -Face mask/door may remain open/transmission is limited to close contact
46
CONTACT PRECAUTIONS -Diseases -Precautions
-Organisms spread skin-to-skin contact, antibiotic-resistant organisms or Cdiff Use of barriers to prevent transmission Masks not needed
47
What are organisms with HAI potential? 5
C diff MRSA VRE MDROS - multidrug resistant organism CLABSI - health care assoc bloodstream infections
48
What medication is assoc with C Diff besides antibiotics
stomach med - PPI's
49
What are the 5 P's?
Partners Prevention of pregnancy Protection from STI Practices Past history of STI
50
Diarrheal diseases - port of entry - Causes
port of entry is oral ingestion Caused by: *Bacterial; campylobacter, salmonella, shigella & E coli *Viral; rotavirus, callicvirus *Parasitic; giardia, cryptosporidium, entamoeba histolytica
51
What are the clinical manifestations of pts with infectious diarrhea?
Thirst Dry mucous membranes weak pulse loss of skin turgor sunken eyes I&O
52
MILD DEHYDRATION Signs Rehydration goal
Dry oral mucous membranes & increased thirst 50mL/kg per 1 kg ORS over 4 hrs
53
MODERATE DEHYDRATION signs rehydration goals
SUnken eyes, loss of skin turgor, increased thirst, dry oral 100mL/kg of ORS over 4 hrs
54
SEVERE DEHYDRATION signs rehydration goals
Signs of shock (rapid thready pulse, cyanosis, cold extremities, rapid breathing, lethargy, coma) IV replacment until normal than treat with ORS
55
what is the preoperative phase?
Begins when decision to proceed with surgical interventions and ends with transfer of patient to OR -preop testing **used to identify any risks!!
56
What is the intraoperative phase?
begins when pt is transferred to the OR bed and ends with admission to PACU (postanesthesia care unit) **Focus on SAFETY
57
What is postoperative phase?
Begins with admission to PACU and ends iwth follow up eval in clincal setting or home
58
What is the pre-intra-post operative called?
Perioperative
59
What is palliative surgery?
Ex. cancer is not curable but the surgery can give better quality of life = less pain
60
What is preadmission testing?
Initiates nursing process Admin data: demographics, health history, other info Verifies completion of preop testing Begins discharge planning (transportation & care)
61
Whats included in preop health assessment?
Health history & physcial exam Meds and allergies Nutritional and fluid status Drug/alcohol abuse Respiratory & cardio status Hepatic & renal function Dentition - any teeth that are loose? teeth rotting?
62
What are some meds that can affect surgery?
Corticosteriods Diuretics - cause a circulatory collapse/electrolyte disorders Phenothiazines - hypersensitivity Tranquilizers - withdrawl Insulin - Antibiotics - on a reg basis? Anticoagulants - affect clotting Opioids Herbal/supplements Anticonvulsant - LOC and respiratory Thyroid hormone - affect hr and metabolism
63
What are special considerations during pre-op period?
Obesity Diabilities Undergoing ambulatory surgery - dont drive after surgery! Undergoing emergency surgery
64
What is informed consent?
Should be in writing before nonemergent surgery legal Surgeon must explain procedure, benefits, risks, complications Nurse clarifies and witnesses Consent is valid only before giving meds that alter mind consent goes with pt to OR
65
Preop nursing interventions
Pt changes into gown, hair back, mouth inspected, jewerly removed admin preanesthetic meds Maintain preop record Transport to presurgical area attending family needs
66
What is the role of -Circulating nurse -Scrub nurse -Surgeon
-Circulating nurse - double checks everything Checks consent/labs/etc -Scrub nurse - monitors everyone to make sure sticking to aseptic technique -Surgeon
67
What is the role of RN first assist Anesthetist
RNFA - skin closures, harvest veins, etc Anesthetist - puts patient to sleep/controls life functions
68
What cells increase during allergic or stress response?
Eosinophils and basophils
69
What is C difficle
spore-forming bacterium Releases toxins into lumen of bowel Bleach based cleaning products
70
What is MRSA?
S. aures resistant to methicillin, oxacillin, nafcillin Skin colonization
71
What is multidrug resistant enterobacteriaceae?
gram negative organsims, associated with GI colonolization E.coli and Klebsiellla
72
What is candida auris?
multi-drug resistant fungus
73
What is VRE
Vancomycin resistant enterococcu blood, wouds and uti
74
What is an ambulatory surgery
surgery that does not require a hospital stay
75
What is an emergent surgery
without delay Pt requires immediate attention/life threatening
76
What is a required surgery
planned w/in a few weeks or months
77
What is an urgent surgery
within 24-30 hours closed fractures, infected wounds,
78
What is an elective surgery
failure to have surgery not catastropic repair of scars, simple hernia, vaginal repair
79
What is optional surgery
Personal preference cosmetic
80
What are the responsibilities of the circulating nurse?
Manages OR Verify consent ensures cleanliness, temp, lighting, avail of supplies Monitors aseptic & "time-out"
81
What are the responsibilities of the scrub nurse
Hand hygeine setting up sterile field preparing equipment anticipating instruments needed counting needles, spounges

115 LEC (5 decks)

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