Test 3 CG Inflammation And Immunity Flashcards
(36 cards)
Urate crystals deposit in joints and other body tissues causing inflammation
Can occur from Renal insufficiency, crash diets, chemo, diuretics
Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body.
Gout
Also called gout arthritis
Drug therapy for gout
What to take and why
Colchicine and NSAIDS for acute episodes -inflammation
Allopurinol (prevents Uric acid formation)
Diet for gout ?
Low protein diet
Avoid trigger foods
Push fluids
PH increases with alkaline foods
Low purine
Most common arthritis type
•Progressive loss of cartilage & bone in joints leading to loss of joint function & deterioration
•Cartilage disintegrates; bone & cartilage “float” in joint, causing crepitus & bone spurs
•Resultant pain & stiffness leads to decreased mobility
Osteoarthritis
S/s of osteoarthritis
Physical assessment/clinical manifestations
Older than 60/ history
•Joint pain & stiffness
Joint pain in the hands, neck, lower back, knees, or hips is the most common symptom.
- Crepitus
- Heberden’s nodes
- Bouchard’s nodes
- Joint effusions
- Atrophy of skeletal muscle
Tx options for osteoarthritis
Maintain proper nutrition to prevent obesity
Avoid injuries such as contact sports
Take breaks at work to rest joints
Decrease repeatative movements
Stay active and maintain a healthy lifestyle
NSAIDs - short term use
Acetaminophen/ analgesics
Rheumatoid arthritis complications and associated syndromes
Weight loss, fever, extreme fatigue •Subcutaneous nodules-not problematic •Respiratory, cardiac inflammation •Vasculitis •Periungual lesions-due to vasculitis/ischemia •Paresthesias-decreased circulation
- Associated syndromes
- Sjögren’s syndrome
- Felty’s syndrome
- Caplan’s syndrome
Tx for RA- drug therapy
Common connective tissue disease
•Chronic, progressive, systemic inflammatory autoimmune disease; affects primarily synovial joints but any connective tissue
•Autoantibodies (rheumatoid factors) form & attack healthy tissue, causing inflammation, erosion of cartilage & bone, fibrous adhesions & ankyloses
•Remissions & exacerbations common
- DMARDs
- BRMs
- NSAIDs
- Other
- Glucocorticoids
- Immunosuppressive agents
Non Pharm tx for RA
Adequate rest •Proper positioning •Ice & heat application •Complementary & Integrative therapies •Promotion of self-management •Management of fatigue •Enhance body image
Pathophysiology of RA (cause)
The body’s immune system attacking the tissues of the joints, causing pain and inflammation.
RA can cause permanent damage to joints, especially in the early years of the disease.
- Common connective tissue disease
- Chronic, progressive, systemic inflammatory autoimmune disease; affects primarily synovial joints but any connective tissue
- Autoantibodies (rheumatoid factors) form & attack healthy tissue, causing inflammation, erosion of cartilage & bone, fibrous adhesions & ankyloses
- Remissions & exacerbations common
RA s/s
- Physical assessment
- Early—joint stiffness, swelling, pain, fatigue, generalized weakness
- Late—joints become progressively inflamed & quite painful, swollen due to effusion in joint, deformities, osteoporosis, severe fatigue, muscle atrophy-spindle like fingers, decreased ROM; vasculitis (inflammation of the blood vessels)-this leads to organ involvement
S/s of lupus
Skin involvement •Butterfly rash from UV Fever-infection Weight loss •Polyarthritis •osteonecrosis •Alopecia-hair loss •Mouth ulcers •Muscle atrophy •Fever and fatigue •Renal involvement Heart problems /inflammation / raynauds Hematologic disorders Neurological disorders Fatigue Arthritis •Symptoms are not usually fatal **CHART 18-11, pg. 326
Patho / cause of lupus
Chronic progressive inflammatory connective tissue disorder
Can cause major body organs and systems to fail
Spontaneous remission and exacerbations
Complexes tend to be attracted to glomeruli of the the kidneys (lupus nephritis-leading cause of death)
Tx for lupus
Topical cortisone drugs
Plaquenil
Tylenol
NSAIDs
Chronic steroid therapy
Immunosuppressive agents
First drug approved in 60 years- belimumab-immune modulator
Contributing factors to lupus - may make it worse
Powder /drying agents
Rubbing skin
Strong soaps
Direct sunlight, uv light
Not wearing sunscreen
Not taking rest periods/stress
Infection
Life-threatening type I hypersensitivity reaction •Rapid, systemic •Blood vessel dilation •Bronchoconstriction •Decreased CO •Can be fatal
Anaphylaxis
Tx for anaphylaxis
Assess gas exchange first!!
establish or Stabilize airway
Stay with pt
Ensure airway care is available
Epinephrine -IV (preferred) OR IM
Antihistamines
Oxygen, ABGs, suction
Beta-adrenergic agonist
Corticosteroids, oral steroids
S/s of anaphylaxis
- Feelings of uneasiness, apprehension, doom
- Generalized itching, urticaria
- Erythema, angioedema of face
- Wheals or hives
- Congestion, rhinorrhea, dyspnea, bronchoconstriction, wheezing/stridor, respiratory distress & failure due to edema, suffocation, & hypoxemia
A severe type I hypersensitivity reaction that involves the blood vessels & all layers of the skin, mucous membranes, & subcutaneous tissues in the affected area
•Most common cause from drugs is ACEI’s & NSAIDS
Angioedema
Assessment and s/s of angioedema
History •Physical assessment •Deep, firm swelling •Face, lips, tongue, and neck •Immediate intervention for inability to swallow, feeling a lump in the throat, & stridor •Psychosocial assessment
Tx for angioedema
Maintain airway
Reduce anxiety
Severe angioedema is an emergency - call 911
Patient education to prevent anaphylaxis
Avoid allergens when possible
Wear medical alert bracelet
Carry anaphylaxis kit or epinephrine injector
Make sure medical records state allergens
Precautions of drug or agent must be used despite of allergy reaction
Increased response to antigen exposure
Allergies/hypersensitivity
Most common type of allergy
May only occur in area of exposure of antigen
Caused by increased production of antibody which causes inflammation
Allergens contracted by
•Inhalation (pollens, spores, animal dander, dust, grass, ragweed)
•Ingestion (foods, food additives, drugs)
•Injection (bee venom, drugs, biologic substances)
•Contraction (latex, pollens, foods, environmental proteins)
Type 1 rapid hypersensitivity - atopic allergy
