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1. know the first line of defense and what organs it includes? Skin and mucous membrane 2. know about innate immunity and who has it & until when they have it Present at birth and is not dependent on a specific immune response or previous contact with an infectious agent. May be specific to species, race, or and individual 3. know about fungi and what they trigger Vegetable like organisms that exist by feeding on organic matter. Form spores that are resistant to many antiseptics and disinfectants 4.know about allergic reactions and which cause asthma reactions Asthma reaction- pollens, dust, molds, cigarette smoke, air pollutants, animal dander Begins with sensitization the body steps up its defense by producing large amounts of antibodies which circulate in the bloodstream and travel to the affected tissues build up triggers the release of histamine 5. know and define cortisol and when is it used A hormone produced by the adrenal cortex is an anti-inflammatory substances. Slows the release of histamine , stabilizes lysosmal membranes, and prevents the inflex of leukocytes. End result of these actions is to impeded the inflammatory process 6. know which are the antimicrobial enzymes. Lysozyme secrete by sweat glands. 7. know and define which are the abundant cells in the imflammatory response Leukocytosis, a defensive reaction that provides abundant white blood cells for the inflammatory respons. 8. know and define Cryptococcus

linton Chapter 13 Immune, Infection, inflammation

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Page 1: linton Chapter 13 Immune, Infection, inflammation

1. know the first line of defense and what organs it includes?

Skin and mucous membrane

2. know about innate immunity and who has it & until when they have it

Present at birth and is not dependent on a specific immune response or previous contact with an infectious agent. May be specific to species, race, or and individual

3. know about fungi and what they trigger

Vegetable like organisms that exist by feeding on organic matter. Form spores that are resistant to many antiseptics and disinfectants

4.know about allergic reactions and which cause asthma reactions

Asthma reaction- pollens, dust, molds, cigarette smoke, air pollutants, animal dander

Begins with sensitization the body steps up its defense by producing large amounts of antibodies which circulate in the bloodstream and travel to the affected tissues build up triggers the release of histamine

5. know and define cortisol and when is it used

A hormone produced by the adrenal cortex is an anti-inflammatory substances. Slows the release of histamine , stabilizes lysosmal membranes, and prevents the inflex of leukocytes. End result of these actions is to impeded the inflammatory process

6. know which are the antimicrobial enzymes.

Lysozyme secrete by sweat glands.

7. know and define which are the abundant cells in the imflammatory response

Leukocytosis, a defensive reaction that provides abundant white blood cells for the inflammatory respons.

8. know and define Cryptococcus

Systemic fungal infection caused by yeast and is the most common systemic fungal infection in aids patients. Symptoms appear approximately 30 days after exposure and include fever, headache, malaise, nausea, vomiting, altered mental status, and a stiff neck.

9. know and define helminthes, protozoa, rickettsia.

Helminthes- worms, found in soil and water and are generally transmitted from hand to mouth.

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Protozoa- large group of one-celled organism, often spread by food or water that is contaminated by human or animal feces.

Rickettsia- microorganisms that are between bacteria and viruses in size. Appear as rods, cocci, or pleomorphic shaped. They multiply in the cells of animal hosts. Usually transmitted to humans through bites of fleas and ticks.

10. know the difference between community acquired infections and hospital acquired infections and be able to give at least 2 examples of each.

HAIs are illness that transmitted in the hospital and may affect the patient as well as the health care worker. Community acquired infections are acquired in day to day contact with the public. Community acquired infection examples are HIV/AIDS and Hepititis. HAIs are enterococcus and MRSA.

11. Know what articles or times a patient can and cannot bring into an isolation room.

The patient can bring items in to the room but cannot

12. know atleast 3 drugs that decrease the inflammatory response.

See drug reference page 1998 cortisol, epinephrine,

13. Know what causes severe allergic reactions during pollen season and what are the treatment options.

Beings with sensitization, the body steps up its defenses by producing large amounts of antibodies which circulate in the blood stream and travel to the affected tissues. This buildup triggers the release of histamines. Antihistamines are usually given to reduce the symptoms caused by the histamine release. Other treatments include bronchiodialators, corticosteroids, topical ointments and lotions.

14. know the most common sources of Anaphylaxis reactions.

Antimicrobials, especially penicillin, other causes include medicines or serum from animal sources, insect venom(bees wasps) , iodinated radioactive contrast media, local anesthetic, and blood products.

15. know what the CDC says about the new guidelines for infection control.

16. what is the initial treatment of patient having an Anaphylactic reaction.’

Oxygen along with intravenous Epinephrine

17. Difference between surgical and medical asepsis?

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Medical asepsis: limiting the spread of microorganisms as much as possible. Known as “clean technique”

(examples) changing bed linen, sanitizing bedpans, frequent hand hygiene

Surgical Asepsis: elimination of microorganisms from any object that comes in contact with the patient.

(examples) Care techniques that prevent unsterile surfaces from coming in contact with the patient

18. know at least two antihistamines and the side effects

Diphenhydramine, side effects- drowsiness, constipation, diarrhea, dry mouth, nose, throat, headache, anorexia, nausea and vomiting, anxiety, GI upset, asthenia

Chlorpheniramine, side effects- constipation, diarrhea, dizziness, drowsiness, dry mouth/nose/throat, headache, anorexia, N&V, anxiety, GI upset, asthenia.

19. know and familiarize yourself with the reportable diseases on page 180 box 13.3: the most common.

Asthma- pollens, dusts, molds, cigarette smoke, air pollutants, animal dander

Allergic Rhinitis- pollens, dust, molds, animal dander

Anaphylaxis- antimicrobials, insect venom, blood transfusion

Urticaria- foods, drugs

Atopic dermatitis- soaps, cosmetics, chemicals, fabrics

Allergic contact dermatitis- plans (poison ivy), metals ( nickel), chemicals, cosmetics, latex gloves

Gastrointestinal allergies- foods, drugs

21. know when and in what conditions your patient would have a high Eosinophil, Basophil, or Monocyte count.

Eosinophil-High numbers of eosinophils (eosinophilia) are usually associated with allergic diseases and

infections from parasites such as worms. A high eosinophil count may be due to:

Asthma

Autoimmune diseases

Eczema

Hay fever

Leukemia

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Basophil-A high basophil count can indicate a problem with the production and growth of blood cells in the bone narrow.

Monocyte-A high monocyte count generally means there is an infection somewhere in your body. If it is not very high it means that the infection is mild. If it is really high it means there is a severe infection

22. know some guidelines patient must know prior to getting into a hyperbaric chamber.

Do not smoke for several hours before or after treatment to decrease lung irritation.

You can prevent pressure buildup in the ears by swallowing

You must wear 100% cotton clothing in the hyperbaric oxygen chamber to prevent static electricity

23. know which diseases, or conditions (microorganisms), patients with HIV are at increased risk of getting.

Bacillary Angiomatosis, Mycobacterium Avium complex, Tuberculosis

24. know what diet and what vitamins, patients with would infections should be on.

Diet high in protein and with vitamins C, zinc, and other important vitamins and minerals.

31. Know the effects of Antibiotic use in the female, older adult, or child.

Antibiotics may have side effects. Some of the more common side effects may include:

Soft stools or diarrhea Mild stomach upset

You should notify your doctor if you have any of the following side effects:

Vomiting Severe watery diarrhea and abdominal cramps Allergic reaction (shortness of breath, hives, swelling of lips, face, or tongue, fainting) Rash Vaginal itching or discharge White patches on the tongue

Events in an antibody- mediated immunity response and their order of occurrence

First line of defense involves B lymphocytes and the production of antibodies in response to specific antigens

* Humeral immune response is imitated when an antigen binds to a special receptor on a B lymphocyte. This binding results in production of antibodies that

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seek out and “ sticktd” combination forms antigen - antibody complexes, targeted for clean up by neutrophills and macrophages which intensifies T-lymphocyte activity

* Antibodies (immunoglobulin (Ig)) divided into 5 classes IgG, IgM,IgA, IgE,IgD, IgG most abundant immunologic, cross the placenta to provide passive immunity newborn IgE important allergic reactions in parasitic infections

Know when to provide hand washing After a nurse passes medications and asked by a patient with pulmonary

secretions to hand her box of tissue, or has her hand soiled

Why do we practice hand washing Prevent cross contamination

Know organs of immunity and what they do -Leukocytes(WBC) key role in immune responses to infectious organisms and

other antigens -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 acts as filter remove dead cells debris and foreign molecules from the

blood -Liver filters the blood plays part in production of specify immunologist and

other chemicals When and what to present if your patients care on daily corticosteroids

Know and define clostridium difficle and who can get it? Clostridium difficle= bowel infection after treatment with oral broad- spectrum

antimicrobials resides in GI tract Patients with compromised immune system are more susceptible, patients with

aids and with cancer

Know and define Iatrogenic infections and Hospital Acquried infections give 2 examples

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HAI: nosocomial infections , are more important cause of increased morbidity, prolonged hospitalization and higher cost affect both nurses and patient sites

most common: surgical wounds, urinary tract, respiratory tract 1.) Hep B, for example transmitted through needle punctures 2.) Small, open wounds on the upper extremities may come in contact with

resistant strains of staphylococcus or pseudomonas and become infected Iatrogenic infection caused by the treatment given to the patient For example may be caused by giving immunosuppressive drugs to prevent

rejection of transplanted organ, resulting in infection Caused by the treatment of a primary infection Define vector, bacteria, virus ,fungi, protozoa, helminthes Bacteria: one celled microorganism capable of multiplying rapidly within

susceptible host Round-cocci, Rod shaped- Bacilli Aerobes grow in oxygen Anaerobes- do not need oxygen to grow Virus: small microorganisms cause significant morbidity disease in humans Depend on host to replicate (common cold, measles ,chicken pox) Fungi: vegetable like organisms that exist by feeding on organic matter.

Mushrooms Cryptococcus and aspergillums life threatening Protozoa: one cell organisms produce plasmodium( malaria) Pheumocytis jiroveci- protozoal infection onset of the HIV/ acquired

immunodeficiency syndrome(AIDS) Helminthes: worms Pinworms more common in children, tapeworms found in GI tract Vector: object living or nonliving transfer pathogens from one organism to

another

Transmission of infection occurs Causative Agent: are the microorganisms Reservoir: area which organisms pool and reproduce “host” Portal of exit: route which infections agent leaves one host and travels to

another. Common route is GI tract Nose and Mouth common portal of exit

Mode of transfer: microorganism is transported to a host Person to person- direct spread through sexually transmitted, and

indirect spread through droplets during sneeze and cough

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Common vehicle transmission is through water, food, blood or air currents contaminated or shared by people

Vector transmission transmitted into a host by a living organism such as a fly or mosquito

Formites- cross contamination such as bed linen, side rails ect Portal of entry: pathways into the host Influenza and cold virus enter the body through nose and mouth Susceptible host: produce tissue damage

Signs and symptoms of infection and inflammation Localized infection: redness, pain, warmth, and swelling. Pus may form Generalized infection: redness, pain, swelling Swelling in liver cause dull ache Little swelling in appendix cause severe discomfort Malalse, anorexia, and prostraction Local inflammation: heat, swelling, redness and pain which result in loss of

fraction Systemic inflammation: swelling, redness and local warmth fever is common sign Signs headache. Muscle aches, chills, sweating