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TEST 4 hem/onc/imm
NUR171
| Question | Answer |
|---|---|
| what role does iron supplements/diet play in prevention of anemia? | to provide amt of iron not rec'd by pt diet. Iron aids in RBC production. |
| compare/contrast pathogenic/opportunistic organisms. | Pathogenic can infect healthy system. Opportunistic happens with a compromised immune system. |
| MCV normal value..what does it measure.. | 80-95. size |
| MCH normal value..(MC-heavy) | 27-31. wt of hgb |
| MCHC normal value.. | 32-36. hgb concentration |
| RDW normal value.. | 11-14.5, size of rbc |
| Create diorama that depicts the immune system. Include B and T cells.. | B cells-surveillance, and produce antibodies. T cells are killer/attack cells. Cd4 are the Helper T Cell (helper & fighter), CD8 are Killers, they kill virus-infected/damaged cells |
| what disease condition will the dr. be screening for if he orders a Western Blot test | HIV |
| how would someone acquire innate immunity? | from mother at birth. "passive" comes from placenta. |
| How does adaptive immunity relate to the admin of immunizations, versus gamma gobulin? | Immunizations-take time for immunity, not immediate, but lasts longer. Gamma Globulin is immediate but short lived. |
| What is neutropenia? | decreased neutrophils. |
| What is function of neutroPhils? | Phagocytosis, ingest and kill microorganisms, aids in bacterial infections. |
| At what number do you do neutropenic precautions? | < 1000 |
| S/sx of anemia | Pallor, fatigue, SOB, beefy tongue, dizzy |
| Justify bone pain w admin of epogen.. | RBC production increases, that happens in bone marrow. Can cause bone pain. |
| In a "shift to the left", is there more segmented or band neutrophils? | Band (immature) |
| what does this shift suggest? | infection |
| Is this something you would call dr. about | yes |
| How is HIV spread | Blood, semen, breast milk, vag secretion, birth canal. (bodily fluids except saliva) |
| Lymphocyte values (hint: in %) | 20-40%. they protect immune system. |
| neutrophils % is.. | 55-70% Aid in bacterial infections |
| monocytes % is | 2-8% Clean up junk when neutrophils are done. |
| basophils % is.. | 0.5-1% will be elevated w Allergies |
| eosinophils % is.. | 1-4% will be elevated w Allergies |
| Stem cells start out as undifferentiated cells. The more they grow and divide, the more _____ they become. | differentiated |
| Are B cells humoral? | yes |
| lymphocyte ___ cells come from the thymus | T |
| Lymphocyte___cells come from bone marrow | B |
| How is CD4 count and viral load related to one another? If viral load is ____, then CD4 is ____. | Increased, decreased. |
| What are immunoglobulins? | Antibodies. |
| Identify the immunoglobulin IgG, and role. | IgG- responsible for 2* immunity. can go btwn intracellular and extracellular spaces. |
| IgA and role | lines all mucus membranes, (tears, nose) protects from invaders. |
| IgM and role | Primary immune system. confined to intravascular space. Produces antibodies |
| IgE and role | fixes to basophils and mast cells. Helps get rid of allergy causes, and parasytic infections. |
| HIV attacks CD_ cells. | CD 4 cells |
| Immunocompromised patients have to go by _____, not WBC count, to monitor infection. *definitely on test* | temperature |
| Can bone marrow be given in IV? | yes |
| what teaching is important w iron supplements | take w OJ. can cause black stools, constipation. if liquid, drink thru straw. |
| In an ELISA test, a viral load is coded as non detected instead of negative. Why? | Non detected, the virus is under control, but doesn't mean free from virus. that would be negative. |
| How would you care for a pt w thrombocytopenia | fall precautions, bleeding precautions, soft tooth brush, stool softener, electric razor, etc. |
| What is a normal CD cell count? | 600-1500 |
| what is considered a low/compromised cd count | 200-600 |
| what is dangerous? | < 200. usually AIDS |
| what assessment data suggests that person who is HIV+ has converted to AIDS | CD4 <200, and presence of one or more opportunistic infections |
| what do cephalosporins and pcn hav in common | if you are allergic to one, usually allergic to the other. |
| What normal organisms is the immune person at risk against? | themselves, their own flora. |
| Differentiate from Primary and 2* polycythemia vera. | Primary is from disease, 2* is from complications (hi altitude, copd, etc) |
| what clotting factor is not made in liver | platelets |
| therapeutic and dangerous aPTT values | 30-40 wnl. 50-70 therapeutic. > 70 dangerous. |
| therapeutic and dangerous PTT values | 60-70 wnl. 90-100 therapeutic. > 100 danger. |
| goal of radiation therapy? | tx localized tumor |
| How does radiation affect normal tissue? | doesn't discriminate btwn good and bad tissue |
| what lab values support the dr rx for epogen? | RBC |
| what lab values support the dr rx for neupogen | WBC |
| what lab values support the dr rx for numega | platelets |
| Name 3 functions of immune system "DSH" | Defense, Surveillance, Homeostasis. |
| What is an ESR? | Sed Rate. Indicates non specific inflammation |
| How does the role of B cells differ from the role of T cells in immunity? | B are surveillance, make antibodies. T are fighter/attack/destroy cells. |
| Why do you wash pillows in hot water, dry in hot dryer? | kill pollens and bacteria. |
| What cross sensitivity do you look for w one allergic to banana, avocado, tree nuts, tomatoes? | latex |
| differentiate btwn malignant and benign cancers | Benign- non ca, WELL differentiated. Malignant- can invade other tissue. POORLY differentiated |
| #1 priority w anaphylaxis is | airway |
| Describe the s/sx of early and late latex rx. | Early: red, itch, rash. Late: anaphylaxis. use non latex stuff. |
| if a person exposed to Hep B she receives gamma globulin instead of immunization. why? | GG- immediate protection. IMM- takes time. |
| a HIV/AIDs person says they are at greater risk from getting infection from you, then you are from them. Explain. | They are immunocompromised. |
| What info recorded on med bracelet | allergies, dx, med hx, esp blood thinner therapy |
| What is a RAST test used to dx | allergies |
| Explain patho of autoimmune disease. | Body attacks itself. |
| Explain stages of HIV. 3 | Acute-virus happens. Latent-silent. 3. AIDS |
| what is goal of anti-retroviral replication? | prevent replication of RNA (virus) |
| What is HARRT therapy for HIV | 3 drug combo for all stages of development. |
| what is health promotion for HIV+ pt? | safe sex, med compliance, manage stress, stay away from sick people. |
| reversal for heparin? | protamine sulfate |
| reversal for coumadin? | vit k |
| why do we type/cross prior to blood admin? | it will attack "bad" blood, die. |
| explain the patho of ca cells | uncontrolled growth of cells that poorly differentiate. |
| which is more dangerous, a malignant or benign brain tumor. | depends where it is, and is it treatable. |
| Is it a person's legal responsibility to disclose HIV+ dx? | No |
| what is diagnostic considered the definitive wen making a ca dx? | Bx |
| 7 warning signs of cancer. CAUTION | C-CHANGE in bladder/bowel. A-sore throat. U-UNUSUAL bleeding. T-THICKENING,lump. I-INDEGESTION. O-OBVIOUS wart/mole. N-NAGGING cough |
| List 4 CA tx used today, explain when each would be appropriate. | Radiation- localized tumor. Chemo-spread. Surgery-if it is in capsule. Biological response modifiers. |
| Describe mission of hospice. | to make time left the best it can be.. will help the person LIVE the rest of life. |
| what does TNM tell the health provider? | Tumor (size, location), Nodes involved (or not), Metastases. Tells provider how to tx. |
| why would a nurse offer anti emetic to a person receiving chemo | N/V |
| how can we best be pt advocates? | find out goals of pt, promote safety |
| What cells are hit the hardest w chemo | fastest growing ones, GI, hair. |
| how can we help the person w cancer cope | psychosocial/ support,help family, understand side effects. |
| Why isn't hospice such a bad word after all | have pallaitive care also. |
| what is the patho of anemia that makes someone sob | RBC carries O2 |
| how is tx of pain different w pt w acute, chronic, post op and terminal pt different? | Acute-push drugs, chronic-use non narc interventions also. post op- keep ahead of severe pain. terminal-keep comfortable. |
| Explain inflammatory response. | 1. Trauma 2. Vasodilation-brings phagocytes to eat bad tissue. 3.formation of exudate. |
| which wbc in charge of ATTACKING antigen? which ones are helpers? which ones form surveillance team? | Attack- T cell CD8. Helpers- CD4. Surveillance- B |
| do ca cells grow faster than normal cells? explain | No. they just don't die like a normal cell. |
| How do BRM (biological response modifiers) work in tx of ca? | Intereferes w cancer growth. |
| Explaine protective isolation practices for immune compromised pt | neutropenic precautions |
| example of neutropenic precaution | bottled water only, no fresh fruit/veggies. avoid sick people, no mani/pedi, no hand washed dishes. |
| what is patho of jaundice | breakdown of bilirubin. |
| what is patho of 2* polycythemia vera? | Hypoxia driven- hypoxia stimulate EPO production in kidney,so increase RBCs. Hypoxia independent- produced by malignant tumor or benign tumor, or altitude |
| what is therapeutic phlebotomy? | take out 500ml blood, dilute w saline. |
| what is pancytopenia? what is most common cause? | Decreased rbc, wbc, platelets. Common cause is aplastic anemia, and ca tx |
| why are terms leukopenia and neutropenia often used interchangeably | neutrophils are leukocytes |
| what organism often cause of infection for immunocompromised pt | opportunistic staph and strep, and persons own flora |
| explain plasmapharesis. when is it used in pt care | take blood out, go thru plasma, filter out immune complexes that may cause exacerbation |
| what role do glucocorticoids play in the care of a person w autoimmune disease | decrease inflammatory response, suppresses immune response. |
| what does + ANA (anti nuclear antibodies) indicate | Lupus |
| explain patho of autoimmune disease | Sees its own cells as invaders. |
| Exacerbation/remission is seen in.. | autoimmune disease. |
| why is someone with SLE at risk for glomerulonephritis and CRF? | Immune complex gets clogged in kidneys. |
| **compare various types of immunity. what immunity are babies born with? | active and passive. babies born w passive, it comes from placenta. active is when you come in contact with it. Active are immunizations, unless GG..then it is passive. |
| B-12 can't be activiated without _____ _____. (hint: made in stomach) | intrinsic factor. |
| B-12 converts folic acid (inactive) into ______ (active). | folate |
| which type of anemia causes numbness/tingling of fingers and lips? They will be on B12 supplements for rest of life. | Pernicious |
| We need _____ ____ for building nervous system and aid in RBC production | folic acid |
| normocytic, normochromic is.. | normal size/color |
| macrocytic, normochromic is.. | large size, normal color |
| microcytic, hypocromic is... | small size, pale color |
| what is aplastic anemia? | Aplastic anemia develops when damage occurs to your bone marrow, slowing or shutting down the production of new blood cells. |
| what is a common condition that manifests from aplastic anemia? | pancytopenia. (decreased wbc, rbc, platelets) |
| Why would you give Fe supplements w meals? | prevent GI upset. |
| Examples of high iron diet include.. | red meat, organ meat, whole wheat products, spinach. |
| What foods high in folic acid? | citrus fruits, green veggie, liver |
| what foods high in vit B-12 | milk, cheese, yeast, green leafy veggies. |
| to determine neutropenia, we multiply total ___ by % of _______ | WBC x % of NEUTROPHILS |
| what is the single most important preventative measure in neutropenic pt? | hand washing. |
| in neurtopenic pt, what is more accurate in determining infection, WBC count, or temperature? | Temperature. Because WBC's main component is pus, in a neutropenic pt, pus formation is absent. |
| Leukopenia is.. | decreased WBC count. |
| What is antibiotics are commonly rx'd for neutropenic pt? | cephalosporins/aminoglycosides |
| common side effect of aminoglycosides | nephrotoxicity, ototoxicity. |
| common side effect of cephalosporins | pruritis, rash. |
| the longer the neutropenia, the greater the risk of _____ infection | fungal |
| what do biologic response modifiers do? | stimulate bone marrow to make more cells. |
| Grade I (histolic classification) means.. | cells differ SLIGHTLY from normal cell. WELL DIFFERENTIATED |
| Grade II class histo means.. | cells more abn. MODERATELY differentiated. |
| Grade III class histo means | cells VERY abn. POORLY differentiated. |
| Grade IV class histo means.. | immature cells, difficult to determine. Bad bad bad |
| Stage 0 ca disease class means | Cancer in situ. no ca yet |
| Stage IV ca means | metastasis. :( |
Created by:
scynba36
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