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Nursing 1 EXAM 3 STUDY Guide
Terms in this set (111)
Innate immunity (immunity
that is inherent within a species and develops regardless of
AKA natural immunity, is present at birth and functions similarly regardless of the pathogen, earning it the designation nonspecific.
immunity that is not present at birth and develops either as
a result of exposure or through an external source, such as
colostrum or injection of immunoglobulin.
Adaptive immune responses
are considered either
humoral-mediated or cell-mediated.
refers to immunity that is mediated by B lymphocytes, plasma cells, and antibodies.
refers to immunity that is mediated by T lymphocytes.
What is an antigen?
any molecule that can bind with a specific antibody.
A foreign substance, such as a microorganism, which triggers the immune response
What is an immunogen?
A substance capable of inducing an immune response
WBC, originate from the bone marrow.
spend most of their time in storage, in lymphoid tissues, or dispersed throughout the host tissues.
How does leukocytes get around?
use blood mainly as a transport
system to travel to areas of the body where they are needed
Six families of leukocytes that have distinct roles inthe body's defense
dendritic cells, mast cells, granulocytes, lymphocytes, and
Monocytes (Macrophages aka EATERs)
are leukocytes found in relatively small quantities in the blood, because most of them are either in the tissues or stored in the bone marrow. Fully differentiated stage is called a macrophage
"cell eating" (ex: white blood cells and amoeba)
Affects the WAY other cells ACT (Cyto- "cell" and -kinein "move")
Attract other leukocytes to the area to battle the invaders in a process called CHEMOTAXIS
are essential in inducing and maintaining tolerance to BY PRODUCTS OF antigens, keeping the immune system from
reacting to the body's antigens
tend to live near the skin and connective of small blood vessels and contain granules with stored chemicals. When activated, they release substances within the granules (degranulate) that affect vascular permeability, particularly HISTAMINE.
A type of white blood cell that engulfs invading microbes and contributes to the nonspecific defenses of the body against disease.
Actively involved in bacterial infections
-most abundant 40-70%
-dies and turns to pus
Deficiency in neutrophils is called
- defense against parasites & other microorganisms
- role in IgE mediated allergic reactions ((redness))
are the final and most inscrutable granulocyte
- appear effective against FUNGUS
- role in inflammation
Natural Killer [NK] cells
Lymphocyte that recognizes and destroys foreign cells
- responsible for immune surveillance and detection, subsequent destruction of abnormal tissue cells by releasing cytotoxins.
[Mature in bone marrow or thymus] complete their differentiation process and
become plasma cells, releasing ANTIBODIES
[Mature in thymus]
(aka T-cells) cells that mature in the thymus and exist in four varieties, one of which kills antigen-bearing cells
Immune function of B cell
- Proteins produced by plasma cells that recognize and bind to a specific antigen
(antibodies) Y shaped with two recognition
segments and one effector segment
Clumping of (foreign) cells; induced by cross-linking of antigen-antibody complexes.
PRIMARY LYMPHOID ORGANS
Bone Marrow & Thymus
- Lymphocyte develope and mature
SECONDARY LYMPHOID TISSUE
-the spleen, lymph nodes, and epithelial lymphoid tissues. -They are strategically placed in the body so that invading pathogens will encounter them as early as possible, allowing the immune
-system to be activated before extensive damage can be done.
Innate immune system
Born with it
- mechanical factors (skin, mucous membranes, cilia, etc); lysozymes (enzymes that dissolve certain organisms); Inflammatory cells (PNMs, macrophages, mast cells, basophils); natural killer cells
(specific immunity) aquired ability to recognize and destroy a pathogen or its products. Requires exposure of the immune system to the pathogen
Cell Mediated Immunity
Involves T-CELLS!!! Attack anything it doesn't recognize (Infected cells)
is the adaptive immunity pathway
-The production of antibody molecules in response to an antigen.
The chemical components of the immune system
act as cytokines, chemokines, opsonins, and effectors.
creates memory B cells, which
will quickly produce antibodies if the body is later infected with the pathogen.
provides an infusion of antibodies that gives the body a reprieve to allow the body's own immune system a chance to activate.
Inability of the immune system to respond to an antigen. Occurs in response to disease or medications; may be intentional to prevent rejection of transplants or a side effect of some medications.
A condition that occurs when pathogens enter the body, multiply, and cause harm
A white blood cell (WBC) count of 18,000
An irritation of a tissue caused by infection or injury. Inflammation is characterized by four cardinal symptoms; redness, swelling, heat, and pain.
Rules of infection/inflammation
- Infection w/Inflammation
- Inflammation not always with infection
Cold and Hot Therapy
- The use of cold is recommended to reduce swelling and pain.
- Later, the use of heat is recommended to increase circulation to the area;
providing increased nutrients and oxygen to promote healing.
sprains and strains
RICE [Rest, Ice, Compress, Elevate]
Body's first line of defense
The skin and mucous membranes lining, the respiratory, digestive, and genitourinary tracts.
Chemically, electrolytes are substances that become ions in solution and acquire the capacity to conduct electricity. Electrolytes are present in the human body, and the balance of the electrolytes in our bodies is essential for normal function of our cells and our organs.
Isotonic IV fluids:
maintain vascular volume, or if run fast will increase vascular volume
Use Isotonic fluids for:
Dehydration, hypovolemia (bleeding, etc)
include NS 0.9% NaCl and LR
Hypotonic IV fluid:
decrease intravascular volume and will incresase intracellar volume
Use hypotonic fluids for
Celluar dehydration (normal BP but concentrated urine or high HCT)
develops about 72-96 hours after infection, lasts about 28 days. IgM develops FIRST.
second most common
(external secretions / tears, saliva) provides passive immunity for breastfed infants / found in all mucous membrane secretions.
MOST common Ig or most abundant >75% of immunoglobulins will be IgG
Least common, present in allergic reactions and parasitic infections
Medications causing metabolic acidosis:
Live virus vaccine
MMR, varicella, nasal spray version of flu vaccine, oral polio vaccine, rotavirus
= live virus
= dead virus
ROME is my best place to yell (Live Viruses)
Rubella, oral polio, measles, epidemic typhus, influenza, mumps, BCG (TB), plague, typhoid, yellow fever.
Too little or too much of any electrolyte is called _______ and will affect most body systems.
Sodium Normal(more neurologic)
is 135 to 145
fatigue, muscle spasm, h/a, irritability
S/S of hyponatremia
Symptoms of dehydration, BP LOW, pulse rate increased, weak palpable pulses.
(much less common) fluid retention, lethargy or weakness that can progress to seizures coma and death
primarily a neurological symptoms, fluid follows sodium: hypernatremia= edema, intravascular fluid excess, hypervolemia, INCREASED BP, bounding pulse
Potassium (K+) (looking at cardiac things)
normal is 3.5 to 5.5
heart rhythm disturbances, which mimic MI (no enzyme changes)
Normal 8.5 to 10.5 [My bones became strong when I was about 8 to 10 (8.5-10.5) years old]
is a carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes. hypocalcemia, hypoparathyroidism
twitching of the lip at the corner of the mouth or spasm of all facial muscles depending on the severity of hypocalcemia
moans, stones, & groans, Kidney stones, depression, abd pain
Muscle cramps, Confusion/forgetfulness, tingling in lips & fingers, hypoparathyroidism
Normal is 1.6 to 2.6
muscle weakness, jerky movements, coordination issues loss
heaviness of the limbs, extreme fatigue, decreased DTRs (deep tendon reflex) potentially can lead to respiratory arrest
Magnesium containing Meds
What does Lasix do to electrolytes balance?
Excrete K+ and retain Na+
What does steroids do to electrolyte balance?
increase sodium levels (sodium retention) and excrete potassium (K+)
Normal is 95-105
prolonged vomiting, diarrhea, weakness, respiratory distress
Kussmaul's breathing, intense thirst (r/t hypernatremia)
Chloride levels >108 mEq/L.
-Result of underlying condition, not just bc of increased chloride.
-Diag: blood chem, ABGs.
-Treatment: Diuretics to help eliminate Na+ will help eliminate chloride, bicarbonate (basic) neutralizes the acidosis if present.
Normal levels are 3.0 to 4.5
-Loss of appetite, anxiety, bone pain, stiffness, fatigue, irritability
-correct underlying cause and administer oral replacements with vitamin D
results from renal failure, DKA, regular heart rate, muscle weakness, N/V
Presence of pathological microorganisms or their toxins in the blood
An acute infection, usually systemic, that overwhelms the body (toxic shock symdrome). Poisonous substances accumulate in bloodstream and blood pressure decreases, impairing blood flow to cells, tissues, and organs.
Signs of septic shock
TADDLE -Tachycardia, Altered LOC, Decreased BP, Delayed cap refill, Light colored (pallor), Extremities are cold
Steps for inflammation
3 major events: 1) vasodilation 2) increased permeability of capillaries 3) escaped of leukocytes from the capillaries
Treatment for Inflammation
reduce blood flow, reduce swelling, and block the actions of the chemical mediators with anti-inflammatory drugs, steroids.
Treatment for infections
-palliative therapy - via NSAIDS and NON-ASPIRIN ANTI-PYRETICS (b/c bleeding don't want to use aspirin) -corticosteroids if airway obstruction due to lymphadenopathy is a concern
-A form of arthritus in which an autoimmune response leads to inflammation of connective tissue, particularly the membranes that line the joints, resulting in overall stiffness, inflammation, aching, deformed joints, and a serious loss of mobility.
-Most common in women and can occur at any age.
-A type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms.
-causes abdominal pain, diarrhea (which may be bloody if inflammation is at its worst), vomiting (can be continuous), or weight loss, but may also cause complications outside the gastrointestinal tract such as skin rashes, arthritis, inflammation of the eye, tiredness, and lack of concentration.
SLE [systemic lupus erythematosus]
-chronic autoimmune inflammatory disease of collagen of the skin, of joints and of internal organs
-Inflammation of almost any body part, chronic, multisystem inflammatory disorder that occurs when the body produces antibodies against its own cells.
Treatment for Auto Immune Diseases
eat a balanced and healthy diet
get plenty of rest
take vitamin supplements
take hormone replacement, if necessary
get blood transfusions, if blood is affected
take anti-inflammatory medication, if joints are affected
take pain medication
take immunosuppressive medication
get physical therapy
limit sun exposure
Addison's Disease "Add some more cortisol"
Reduced secretion of hormones of the ADRENAL cortex, characterized by low blood pressure, dehydration, muscle weakness, and mental lethargy.
Cushing's Disease "too much Cush (cortisol)"
Adrenal cortex hypersecretion, persistent hyperglycemia, protein loss, water and salt retention, moon face, buffalo hump, bird legs
Decreased circulatory blood volume resulting from extracellular fluid losses. [Na+ deficit]
An abnormal increase in blood volume or, strictly speaking, an abnormal increase in the volume of blood plasma.
S&S: bounding increased pulse / increased BP / distended neck and hand veins / dysrhthmias/ Weight gain
-An infectious disease that may affect almost all tissues of the body, especially the lungs
-Acid fast, transmitted via droplet nuclei, difficult to eradicate.
-s/s: fatigue, weight loss, anorexia, night sweats, productive cough with purulent sputum.
-Administered by means of an intradermal needle and syringe.
Exposure and infected with TB; Access for reaction in 48-72 hours; induration of 10mm or more is positive (+) unless HIV then 5mm induration
excreted by living bacteria from cell wall, causes strong immune response.
-Bad, highly toxic, fatal
comes from lysed gram negative bacteria (dead bacteria), causes weak immune response; fever, diarrhea, vomitting
stimulate or depress the desire for a person to drink
A neural structure lying below the thalamus; directs eating, drinking, body temperature; helps govern the endocrine system via the pituitary gland, and is linked to emotion
Accumulation of an excessive amount of fluids in cells, tissues, or serous cavities; usually results in a swelling of the tissues.
- Dehydration occurs when a person loses more fluids than he/she takes in
- Lab tests: HCT, Hbg
- deceased pulse
- increase HR
- weak pulse, fatique
-Addison's/ DM increase UO
Attempts to prevent the onset of the disorder (i.e., vaccinations).
-Identifying a health problem and its intervention
-Screenings / Monitoring
focuses on stopping disease progression & returning the individual to pre-illness state, or learn to live with disease
Chain of infection
Infectious agent, reservoir, portal of exit, means of transmission, portal of entry and susceptible host.
Classification of infection
Location (local or systemic), Primary, Secondary, Exogeneous (someone else), Endogeneous (within body),
- Acute, chronic, latent [duration]
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