Immunity Inflammation Infection Study Guide

Question 1

1st line of defense

Answer 1

o Skin and mucous membranes
o Sweat glands secrete lysozyme, an antimicrobial enzyme

Question 2

Immunity

Answer 2

Provides resistance to invading organism’s.

Question 3

Antigens

Answer 3

-Any substance capable of stimulating a response from the immune system .
-Asthma is a common allergic response disorder.

Question 4

Antibodies

Answer 4

Also known as Immunoglobulins

Question 5

Innate (natural passive) immunity

Answer 5

-Present at birth
-Babies are born with immunoglobulin G which can cross the placenta barrier and last about 6 months .

Question 6

Acquired immunity

Answer 6

Developed after birth after being exposed to
Antigens through vaccine or living the good life.
-also know as an active immunity .

Question 7

Leukocytes (Aka white blood cells)

Answer 7

Key role in immune responses to infectious organisms and other antigens .

Question 8

Primary organs in immunity

Answer 8

Thymus
Bone marrow

Question 9

Secondary organs in immunity

Answer 9

Adenoids
Tonsils
Lymphoid
Liver
Spleen
Appendix
Gut - peyers patches (lymphoid tissue)

Question 10

2nd line of defense

Answer 10

-5 cardinal signs of inflammation : pain , heat , redness, swelling ,loss of function.
- inflammatory response : neutralize ,attract immune response, prevent spread of injury, prepare site for repair.

(Inflammation literally means the fire within)

Local Systemic
-rubor- redness. -Fever
-color -heat. -Headache
-tumor- swelling - -Muscle ache
-dolor- pain -Chills
Functionlaesa- loss of function -sweating
-leukocytosis

Question 11

Phagocytosis

Answer 11

White blood cells are able to phagocytose (ingest) bacteria.

Question 12

Anti inflammatory

Answer 12

-cortisol
-hormone produced by the adrenal cortex
-slows the release of histamine and prevents influx of the leukocytes.
- drugs such as corticosteroids mimic cortisol.
-treats inflammatory conditions

Question 13

wound healing (vitamin c)

Answer 13

Process of wound healing
-tissue repair set in motion form the beginning of inflammatory process.
-speed depends on the type of tissue injured severity , if there is infection and health of the host.
-macrophage cells clean up inflammatory debris
-fibroblasts begin repair process by laying elastin and collagen at wound edges and migrate to base of wound.
-scab is usually formed of dried blood and fibroblasts.
-epithelial cells migrate over wound and under scab.
-sometimes wound bed is too large for granulation tissue to fill.
-wound is cleaned and debrided to enhance healing.
-when infection is no longer present its sutured closed (healing by tertiary intention)

Question 14

Nursing Assessment During Antimicrobial Therapy 


Answer 14

Nausea, vomiting, diarrhea
(big 3 adverse effects)
-determine if related to antibiotic
-determine hydration status
-report diarrhea, abd pain

secondary infection
-oral infections, lesions, itching i vaginal, anal areas.
-can produce severe life threatening diarrhea.

allergies and anaphylaxis
-mild to fatal, within 30 min after administration to days after therapy
-anaphylaxis, laryngeal edema, shock, dyspnea, skin reactions

-determine if allergies (skin rash . edema , dyspnea) or gi symptoms.

Question 15

Nursing Assessment During Antimicrobial Therapy ☺
(3 of 3)

Answer 15

Nephrotoxicity: Increasing BUN/creatinine, decreasing urine output, changes in UA

Hepatotoxicity: Assess for preexisting hepatic disease, abnormal liver enzymes

***Ototoxicity: Damage to eighth cranial nerve, can lead to hearing loss. Manifested by dizziness, tinnitus, and progressive hearing loss

Blood dyscrasias

Question 16

***Ototoxicity

Answer 16

Damage to eighth cranial nerve, can lead to :
1.hearing loss
2.Manifested by dizziness
3.tinnitus
4.progressive hearing loss

Question 17

Implementation

Answer 17

-Precautions for infection transmission
-Monitor for phlebitis when given IV
-Administer on established time schedule
-Determine whether able to give with food
-Identify drug allergies

Question 18

Implementation
(2 of 3)

Answer 18

Nausea, vomiting, diarrhea: Give with food if possible, or healthcare provider can switch to parenteral

Secondary infections: Notify healthcare provider if infection develops

Allergies/anaphylaxis: Monitor patients with allergies, asthma, rhinitis, or taking multiple meds for allergic response; watch carefully for 20 to 30 minutes after administration

See treatment of allergic response

Question 19

Implementation
(3 of 3)

Answer 19

Nephrotoxicity: Monitor BUN/creatinine, I&O; report declining urine output <30 mL/hr

Hepatotoxicity: Monitor labs, observe for anorexia, nausea, vomiting, jaundice, etc.

Ototoxicity: Report hearing impairment, dizziness, or tinnitus

Blood dyscrasias: Monitor and report sore throat, fatigue, elevated temperature, skin hemorrhages, and bruises

Photosensitivity: Wear sunscreen, avoid ultraviolet light

Question 20

Drug Class: Aminoglycosides ☺

Answer 20

Action: Inhibit protein synthesis

Use: Effective against gram-negative organisms that cause urinary infections, meningitis, wound infections, septicemia

**Serious adverse effects: Ototoxicity (damage to the 8th cranial nerve manifested by hearing loss); nephrotoxicity (damaging or destructive to the kidneys)

Do not give within 72 hours of skeletal muscle relaxants used with anesthesia

Question 21

Drug Class: Glycopeptides ☺

Answer 21

Action: Prevent synthesis of bacterial cell walls

Uses
Dalbavancin is used in treatment of adult patients with acute bacterial skin and skin structure infections
Oritavancin, telavancin, *vancomycin

Serious adverse effects: Ototoxicity (notify for any changes in hearing) , nephrotoxicity, Q-T interval prolongation, coagulation, hepatic effects, secondary infections

Table 45.4 Glycopeptides

Question 22

Drug Class: Penicillins ☺

Answer 22

Action: Inhibit cell wall synthesis, penicillinase-resistant penicillins

Uses: Treat middle ear infections, pneumonia, meningitis, urinary tract infections, syphilis, gonorrhea, and as prophylactic antibiotic

Common adverse effects: Diarrhea, electrolyte imbalance

Serious adverse effects: Hepatotoxicity, nephrotoxicity, hyperkalemia, or hypernatremia

Table 45.6 Penicillins
e.g. ***amoxicillin-clavulanate – take with food

Question 23

Drug Class: Antitubercular Agents ☺
(1 of 4)

Drug: Ethambutol (Myambutol)

Answer 23

Action: Alters cellular RNA synthesis and phosphate metabolism

Use: Treatment of tuberculosis

Common adverse effects: Nausea, vomiting, anorexia, abdominal cramps

Serious adverse effects: Confusion, hallucination, blurred vision, red-green vision changes

Question 24

Drug Class: Antitubercular Agents ☺ 
(2 of 4)

Drug: Isoniazid (INH, Nydrazid)

Answer 24

Action: Disrupts the cell wall and inhibits replication of tuberculosis bacteria

Use: Treats and prevents tuberculosis

Common adverse effects: Nausea, vomiting

Serious adverse effects: Hepatotoxicity, tingling, numbness of hands and feet, dizziness, ataxia

Question 25

Drug Class: Antitubercular Agents 
(3 of 4) Drug: Pyrazinamide (Tebrazid)

Answer 25

Action: Lowers the pH of environment Use: Treatment of tuberculosis; in combination with antitubercular agents Common adverse effects: Nausea, vomiting, anorexia, arthralgia, myalgia Serious adverse effect: Hepatotoxicity

Question 26

Drug Class: Antitubercular Agents ☺ 
(4 of 4) Drug: Rifampin (Rifadin)

Answer 26

Action: Prevents RNA synthesis by inhibiting DNA-dependent RNA polymerase Use: Eliminates meningococci and H. influenzae type b (Hib) from asymptomatic carriers **Common adverse effect: Reddish-orange secretions Serious adverse effects: Nausea, vomiting, anorexia, abdominal cramps What important information does a nurse provide to a patient prescribed rifampin (Rifadin) to treat tuberculosis? A. “Medication should be taken with food to reduce irritation to the stomach.” B.“Oral contraceptives are not affected by the drug.” C.“This medication will turn body secretions a reddish-orange color.” D.“Any nausea and vomiting must be reported to your healthcare provider immediately.”

Question 27

A large, heavy, and older adult patient has a stroke and develops an infected decubitis ulcer on the sacrum during the hospital stay. Approximately 2 weeks after the patient has gone home, the patient returns to the hospital with pneumonia. What is the distinction between these 2 infections?

Answer 27

The decubitis ulcer is termed a 'health-care associated' infection, and pneumonia is termed a 'community-acquired' infection

Question 28

A school nurse hosted a clean up campaign at a local elementary school, in effort to combat allergens. What is the most common allergic response disorder?

Answer 28

asthma

Question 29

Miscellaneous Antibiotics

Answer 29

Aztreonam (Azactam): Inhibits cell wall synthesis, monobactams Clindamycin (Cleocin): Inhibits protein synthesis Daptomycin (Cubicin) Cyclic lipopeptide, binds to bacterial membranes and causes rapid depolarization Serious adverse effects: diarrhea, muscle pain

Question 30

Which medication is in a class of antibiotics known as cyclic lipopeptide antibiotics?

Answer 30

Metronidazole (Flagyl) Clindamycin (Cleocin) Chloramphenicol (Chloromycetin) Daptomycin (Cubicin)

Question 31

Miscellaneous Antibiotics
(2 of 2)

Answer 31

Metronidazole (Flagyl): Bactericidal, trichomonacidal, and protozoacidal Tinidazole (Tindamax) Similar to metronidazole Primary therapeutic outcome: elimination of parasitic infection

Question 32

Corticosteroids

Answer 32

Corticosteroids are hormones Two categories: mineralocorticoids and glucocorticoids The primary mineralocorticoid is aldosterone Fludrocortisone is the only commercially available mineralocorticoid Glucocorticoids (e.g. cortisone, hydrocortisone, prednisone) regulate carbohydrate, protein, and fat metabolism. Used to treat variety of disorder because of its potent anti-flammatory, antiallergenic, and immunosuppressant activity

Question 33

Nursing Implications For Corticosteroid Therapy

Answer 33

Assessment: Baseline weight Blood pressure Results of electrolyte and glucose studies Medication use

Question 34

Nursing Implications For Corticosteroid Therapy

Answer 34

Neurologic Mental status Check for orientation to date, time, and place Assess for level of confusion, restlessness, or irritability Status of hydration Dehydration Skin turgor Oral mucous membrane Laboratory changes Overhydration Edema

Question 35

Nursing Implications For Corticosteroid Therapy ☺

Answer 35

Assessment: -Presence of ulcer disease **-Laboratory tests – monitor the serum potassium, PT/INR, and blood sugar if patient is taking furosemide, warfarin, and metformin. -Nutrition -Hyperglycemia -Activity and exercise

Question 36

Drug Class: Glucocorticoids ☺

Answer 36

Actions: the major glucocorticoid is cortisol. -Uses: usually given because of their anti-inflammatory and antiallergenic properties. They do not cure disease, but they relieve symptoms of tissue inflammation. -When used to control rheumatoid arthritis, symptom relief is noted. Joint and muscle stiffness, muscle tenderness and weakness, joint swelling, and soreness are slightly reduced. *-Glucocorticoids are also effective for immunosuppression in the treatment of cancers, organ transplantation, autoimmune diseases *(rheumatoid arthritis), relief of allergic manifestation, and treatment of shock. Also treat nausea and vomiting secondary to chemotherapy. **-E.g. A patient with rheumatoid arthritis is taking glucocorticoid (prednisone) will experience an improve range of motion.

Question 37

Drug Class: Glucocorticoids ☺

Answer 37

**Examples of drugs that reduce inflammation and hinder body’s immune response are bronchodilators and corticosteroids -Therapeutic outcomes: Reduced pain and inflammation Minimized shock and faster recovery Reduced nausea and vomiting associated with chemotherapy

Question 38

Table 37.1 Topical and Systemic Corticosteroid Preparation

Question 39

A nurse explains that a medication, hydro-cortisone is given to a patient with severe inflammatory response mimics a hormone secreted by the adrenal cortex. To what hormone is the nurse referring?

Answer 39

cortisol

Question 40

A nurse is discussing the body's first and second lines of defense against infection with a community group. What does the body's first line of defense include?

Answer 40

sweat

Question 41

With the exposure to an antigen, a nurse explains that the initiator of the inflammatory response is the presence of histamine. What is responsible for releasing histamine?

Answer 41

Basophils- Basophils are a type of white blood cell that works closely with your immune system to defend your body from allergens, pathogens and parasites. Basophils release enzymes to improve blood flow and prevent blood clots.

Question 42

Physical and chemical barriers :)

Answer 42

Skin and mucous membranes are the first line of defense. Sweat is included as the first line of defense * Sweat glands secrete lysozome -antimicrobial enzyme * Sebaceous glands secrete sebum – has antimicrobial and antifungal properties. Second line of defense is the phagocytosis and the inflammatory response *** White blood cells – count increases during infection * Reticuloendothelial cells are found in the blood and connective tissue **** Organs involve in immunity are liver, spleen,tonsils, bone marrow, and lymph nodes

Question 43

A nurse is bathing a patient who is immunodeficient and has a cryptococcus infestation. What is the classification of this organism?

Answer 43

Fungus

Question 44

A mosquito or a fly carries an organism that infects another living organism. What is this mode of transportation of infection?

Answer 44

vector

Question 45

An air conditioner duct cleaning is recommended by a home health nurse. What should this precaution prevent the spread of in the parent's home?

Answer 45

fungi

Question 46

A school nurse cautions a group of parents about children playing barefoot on dirt. To what infectious agents can this action expose the children?

Answer 46

Helminthes

Question 47

A community picnic is held. A number of the attendees become ill with GI symptoms after the picnic. How was the pathogen acquired?

Answer 47

common vehicle

Question 48

A nurse caring for a patient who is immuno-suppressed is diligent about protecting the patient from infection. When visitors come in, in addition to having them put on isolation attire, what should the nurse also prohibit?

Answer 48

potted plants (flowers etc)

Question 49

A patient who is receiving daily steroids for the control of a condition calls the nurse to ask advice whether a small child who has been exposed to influenza should come and visit because she has not had any symptoms. What is the most appropriate response by the office nurse?

Answer 49

"No, the child should not visit. Infectious diseases are often most communicable in the short period before signs and symptoms appear"

Question 50

A patient with the diagnosis of Clostidium difficile infection asks what has caused the diarrhea. What is the best response by the nurse?

Answer 50

a long term of antibiotic therapy

Question 51

A patient receiving a large intramuscular dose of antibiotic was asked to please wait 20-30 minutes before checking out. What is the reason for this request?

Answer 51

Antibiotics are a common source of severe allergic reactions within the first few minutes after an injection

Question 52

After receiving an injection of penicillin, a patient undergoes an anaphylactic reaction. What should the nurse do first?

Answer 52

administer oxygen

Question 53

The organs involved in immunity include the tonsils, spleen, and lymph nodes. What other organ is involved in immunity?

Answer 53

liver

Question 54

What occurrences of disease is the school nurse required to report to the health department? (SATA-3)

Answer 54

1. rubella 2. lyme disesae 3. salmonella

Question 55

The nurse is discharging a client who has been taking prednisone 30 mg/day for the last 14 days and is going home with an order for a taper of the medication. What is the priority client teaching that the nurse needs to cover?

Answer 55

The client should never stop the medication abruptly; he should follow the prescribed taper regimen to prevent adrenal insufficiency Tapering means to reduce opioid dosage over time. Opioids can be an important part of treatment for your pain management, but they come with serious. side effects and risks. If your healthcare provider thinks the risks of opioids outweigh the benefits, they may recommend tapering.

Question 56

Medications which are used to stop the growth and development of susceptible bacteria are classified as which one of the following

Answer 56

Antibiotics

Question 57

Clients taking aminoglycosides should have the functioning of their _____ tested before and after treatment

Answer 57

Hearing

Question 58

A client has been diagnoses with tuberculosis and has been started on rifampin along with other antitubercular medications. The nurse should notify the client to expect which common adverse effect?

Answer 58

All body fluids will turn reddish orange

Question 59

Ketoconazole is used to treat which type of infection?

Answer 59

fungi

Question 60

The client has been diagnosed with herpes simplex virus. The nurse expects that the medication most likely to be prescribed is acyclovir if:

Answer 60

the client has normal kidney function

Question 61

High dose or long-term use of aspirin (ASA) can produce a variety of adverse effects that include; (SATA-3)

Answer 61

1. gastric ulceration 2. hemorrhage 3. tinnitus

Question 62

To decrease the risk of gastrointestinal upset when taking nonsteroidal anti-inflammatory agents, the nurse advises the client to take the medication

Answer 62

with food or milk

Question 63

White blood cells called Granulocytes

Answer 63

neutrophils, eosinophils and basophils

Question 64

White blood cells (leukocytes)

Answer 64

colorless blood cells that have the ability to phagocytose (ingest) bacteria that can cause infection when they invade the body.

Question 65

There are five types of leukocytes:

Answer 65

neutrophils, monocytes, eosinophils, basophils, and lymphocytes.

Question 66

Neutrophils

Answer 66

are the first to respond to infection. Neutrophils phagocytise (eat) bacteria and also destroy bacterial toxins in body fluids. They primarily destroy dissolved toxins that bacterial secretes (produce and discharge) into your body's fluids. Neutrophils' contain a nuclear that has 2 to 6 lobes. Neutrophils are the white blood cells that contribute to immunity. Neutrophils contribute to immunity by engulfing (completely covering) bacteria and foreign bodies (thorns, dirt, etc) a process called phagocytosis.

Question 67

WBCs (neutrophils, eosinophils and basophils)

Answer 67

release the contents of their lysosomes onto the invader, dissolving it. When a bacterium has a capsule, it makes it hard to phagocytise, so the neutrophil requires opsonization by antibodies.

Question 68

Bacteria without capsule

Answer 68

can be destroyed without opsonization. Antibodies can destroy the bacterium itself by popping the cell membrane. When a capsule is present, the neutrophil and antibody work best together. Neutrophils are also considered leukocytes.

Question 69

Patient teaching for antibiotics

Answer 69

Rest, nutrition, and hydration Infection prevention Personal hygiene Refrain from sexual intercourse during therapy for STIs Common adverse effects and what to report to prescriber Take entire course of antimicrobials t

Question 70

Personal measures to control the spread of communicable diseases

Answer 70

proper hygiene HAND WASHING use of personal barriers such condoms stay home when you have symptoms of an infectious disease so you can break the chain of infection

Question 71

On a visit to administer the fifth in a series of 10 antibiotic doses, a home health nurse is told that the patient is now complaining about a bothersome vaginal discharge. The nurse communicates the problem and arranges for medication. What is the most likely cause of the vaginal discharge?

Answer 71

A 'superinfection', which is an acquired response, caused by taking antibiotic medication

Question 72

know nursing interventions for anaphylactic reactions

Answer 72

Patients who are at risk for life-threatening (anaphylactic) reactions should wear a medical alert bracelet that identifies their allergy. *Individuals with insect sting allergies should obtain an emergency sting kit and be taught how to self-inject epinephrine. Cause and risk factors Life-threatening; can quickly deteriorate into shock, coma, and death Histamine released causes bronchospasm, vasodilation, and increased capillary permeability, which causes fluid to leave the circulation and enter the tissues, causing shock from hypovolemia Signs and symptoms of anaphylaxis include anxiety, wheezing and difficulty breathing, cyanosis, hives, facial edema, and hypotension Anaphylaxis is an emergency situation, and the patient's life depends on rapid intervention

Question 73

know nursing interventions for anaphylactic reactions -medical treatment

Answer 73

Medical treatment Oxygen, intravenous epinephrine, aminophylline, diphenhydramine, and corticosteroids Dopamine to raise blood pressure; nebulized bronchodilator to relax bronchi and improve ventilation Nursing care Administer prescribed drugs, including oxygen, and monitor intravenous fluids Monitor respirations, color, heart rate, and oxygen saturation until the patient is fully recovered The best care is to prevent anaphylaxis whenever possible by obtaining a history of allergies and taking precautions to protect the patient from substances (often drugs) that may trigger this reaction. -Common that nitrile gloves replaced latex. Allergic reactions to antiobiotics - rash or hives, which typically occur during the first days of therapy. If the reaction is severe, the client may exerpience swelling of the airway, wheezing and difficulty breathing, also known as anaphlactic reaction.

Question 74

organs involved in immunity

Answer 74

thymus and bone marrow Participate in the formation and maturation of immune system cells Lymph nodes Attack antigens and debris in the interstitial fluid and produce and circulate lymphocytes Spleen Filter dead cells, debris, and foreign molecules from blood Liver Filters blood and plays a part in the production of specific immunoglobulins and other chemicals involved in the immune response

Question 75

Know what organs are involved in immunity ..

Answer 75

Primary lymphoid organs: These organs include the bone marrow and the thymus. They create special immune system cells called lymphocytes. Secondary lymphoid organs: These organs include the lymph nodes, the spleen, the tonsils and certain tissue in various mucous membrane layers in the body (for instance in the bowel)

Question 76

The big 3 as it relates to antimicrobial agents

Answer 76

Nausea, vomiting, diarrhea: "Big three" Determine if related to antibiotic Determine hydration status Report diarrhea, abdominal pain

Question 77

Nursing Assessment During Antimicrobial Therapy 
(1 of 3)

Answer 77

Nausea, vomiting, diarrhea: “Big three” adverse effects Determine if related to antibiotic Determine hydration status Report diarrhea, abdominal pain Secondary infection Oral infections, lesions, or itching in vaginal, anal areas Can produce severe life-threatening diarrhea

Question 78

Nursing Assessment During Antimicrobial Therapy 
(2 of 3)

Answer 78

Allergies and anaphylaxis Mild to fatal, within 30 minutes after administration to days after therapy Anaphylaxis, laryngeal edema, shock, dyspnea, skin reactions Determine if allergies (skin rash, edema, dyspnea) or GI symptoms

Question 79

Nursing Assessment During Antimicrobial Therapy ☺
(3 of 3)

Answer 79

Nephrotoxicity: Increasing BUN/creatinine, decreasing urine output, changes in UA Hepatotoxicity: Assess for preexisting hepatic disease, abnormal liver enzymes Ototoxicity: Damage to eighth cranial nerve, can lead to hearing loss. Manifested by dizziness, tinnitus, and progressive hearing loss Blood dyscrasias

Question 80

Antimicrobial therapy implementation 1 of 3

Answer 80

Precautions for infection transmission Monitor for phlebitis when given IV Administer on established time schedule Determine whether able to give with food Identify drug allergies

Question 81

Antimicrobial therapy implementation 2 of 3

Answer 81

Nausea, vomiting, diarrhea: Give with food if possible, or healthcare provider can switch to parenteral Secondary infections: Notify healthcare provider if infection develops Allergies/anaphylaxis: Monitor patients with allergies, asthma, rhinitis, or taking multiple meds for allergic response; watch carefully for 20 to 30 minutes after administration See treatment of allergic response

Question 82

Antimicrobial therapy implementation 3 of 3

Answer 82

Nephrotoxicity: Monitor BUN/creatinine, I&O; report declining urine output <30 mL/hr Hepatotoxicity: Monitor labs, observe for anorexia, nausea, vomiting, jaundice, etc. Ototoxicity: Report hearing impairment, dizziness, or tinnitus Blood dyscrasias: Monitor and report sore throat, fatigue, elevated temperature, skin hemorrhages, and bruises Photosensitivity: Wear sunscreen, avoid ultraviolet light

Question 83

Examples of drugs that reduce inflammation and hinder body’s immune response are ?

Answer 83

bronchodilators and corticosteroids

Question 84

RIFAMPIN

Answer 84

Rifampin Antitubercula agent Actions ◦Prevents RNA synthesis by inhibiting DNA-dependent RNA polymerase Uses ◦Eliminate meningococci and H. influenzae type b, (Hib) from asymptomatic carriers Common adverse effects ◦Reddish-orange secretions Serious adverse effects ◦Nausea, vomiting, anorexia, abdominal cramps

Question 85

which drugs are used to treat anaphylaxis diphenhydramine corticosteroids epinephrine

Answer 85

which drugs are used to treat anaphylaxis diphenhydramine corticosteroids epinephrine

Question 86

which illnesses require the use of airborne precautions

Answer 86

measles tuberculosis varicella

Question 87

any items that have bee touched or cross-contaiminated by the host, such as bed linens or side rails are

Answer 87

Fomites

Question 88

soiled hands are the main transmitter of

Answer 88

nosocomial infection

Question 89

Localized infections

Answer 89

redness swelling pain warmth pus

Question 90

An anti-inflammatory hormone produced by the adrenal cortex is called:

Answer 90

Cortisol

Question 91

Three common sites for nosocomial infections include surgical wounds, the respiratory tract, and the:

Answer 91

Urinary tract

Question 92

Isonaizid

Answer 92

Isoniazid - antitubercula agent Drug: isoniazid (INH, Nydrazid) Actions ◦Disrupts the cell wall and inhibit replication of tuberculosis bacteria Uses ◦Treat and prevent tuberculosis Common adverse effects ◦Nausea, vomiting Serious adverse effects ◦Hepatotoxicity, tingling, numbness of hands and feet, dizziness, ataxia

Question 93

Nursing care of patients with infections

Answer 93

Urge the patient to consume adequate fluids Encourage to consume high-protein, high-vitamin diet Isolation, if required Laboratory tests White blood cell count with differential; erythrocyte sedimentation rate; iron level; cultures of urine, blood, wound, sputum, and throat Administer antibiotic drug therapy Hyperbaric oxygen therap

Question 94

CDC’s Nationally Notifiable and Reportable Diseases

Answer 94

Influenza, Lyme disease, Rubella, Salmonellosis

Question 95

MRS

Answer 95

infections become resistant to high doses of antibiotics

Question 96

transmission based isolation precaution

Answer 96

***Airborne infection isolation precautions * Used with diseases that are spread through the air **(TB, varicella (chicken pox,) rubeola (measles), SARS) * Fitted high efficiency particulate absorption (HEPA) filter respirators or N95 respirators * Droplet precautions – p. 72 * Used with infections that are spread by droplets or dust particles containing the infectious agent (Flu, Bacterial Meningitis, Mumps, Rubellla) ** Contact precautions – p. 72 * Used when caring for patients who are infected by microorganisms that are transmitted by direct (skin-to-skin) or indirect contact with contaminated equipment (MRSA, C-diff, VRE) ** Dedicate the use of equipment to a single patient

Question 97

Reportable to the health department by a school nurse:

Answer 97

* Rubella * Lyme disease * Salmonella

Question 98

nursing care for an immunosuppressed patient

Answer 98

Prevent infection * Proper hand hygiene * Vital signs – small increase in the body temperature is significant * Adequate nutrition * Flowers or plants may be prohibited * Patient education * A patient with neutropenia should be assign to a private room

Question 99

hypersensitivity and allergen

Answer 99

Causes and Risk Factors * Allergy (or hypersensitivity) describes an atypical immune response that is activated by a foreign substance that normally is inoffensive * An antigen that causes a hypersensitive reaction is called an allergen. Any substance can act as an allergen to a susceptible person, but some of the more common ones are house dust, animal dander, pollens,molds, foods, *pharmacologic agents (antibiotics are a common source of allergic reactions w/n the first few minutes after injection), cigarette smoke,feathers, and insect venoms.

Question 100

hypersensitivity and allergen

Answer 100

**Asthma is the most common allergic response disorder * Local manifestations of allergic reactions include urticaria, pruritus, conjunctivitis, rhinitis, laryngeal edema, bronchospasm, dysrhythmia, gastrointestinal cramps and malabsorption, and angioedema. Medical Treatment * Antihistamines, bronchodilators, corticosteroids, topical lotions, and ointments * Antihistamines sometimes cause confusion in older adults. * Testing to determine specific allergens * Desensitization * Aimed at increasing tolerance to the offending agent and decreasing the severity of the allergicresponse

Question 101

anaphylaxis

Answer 101

Cause and risk factors * Life-threatening; can quickly deteriorate into shock, coma, and death * Histamine released causes bronchospasm, vasodilation, and increased capillary permeability, which causes fluid to leave the circulation and enter the tissues, causing shock from hypovolemia * Signs and symptoms of anaphylaxis include anxiety, **wheezing and difficulty breathing, cyanosis, hives, facial edema, arthralgia, and hypotension *** Antimicrobials (Ex. Penicillin) – the most common cause of Anaphylaxis *(Administer oxygen) *** Cephalexin should be avoided if the individual is allergic to penicillin due to cross-sensitivity. Request the physician to prescribe a different antibiotic Medical treatment * Oxygen, intravenous epinephrine, aminophylline, diphenhydramine, and corticosteroids * Dopamine to raise blood pressure; nebulized bronchodilator to relax bronchi and improve ventilation * Nursing care of the patient with allergies p. 77-78 * Administer prescribed drugs, including oxygen, and monitor intravenous fluids * Monitor respirations, color, heart rate, and oxygen saturation until the patient is fully recovered *** A patient who is allergic to shellfish should not receive drugs containing iodine because an anaphylactic reaction may result

Question 102

Laboratory tests

Answer 102

monitor the serum potassium, PT/INR, and blood sugar if patient is taking furosemide, warfarin, and metformin

Question 103

Glucocorticoids are also effective for immunosuppression in the treatment of?

Answer 103

cancers, organ transplantation, autoimmune diseases **(rheumatoid arthritis), relief of allergic manifestation, and treatment of shock. Also treat nausea and vomiting secondary to chemotherapy. **E.g. A patient with rheumatoid arthritis is taking glucocorticoid (prednisone) will experience an improve range of motion.