CPA 1

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what you would do for an anaphylactic reaction

1. Ensure patent airway 2. Remove insect stinger 3. Establish IV access 4. Epi 5. Give high flow O2 (8-10 l/m) through mask 6. Nebulized albuterol for bronchospasm 7. Diphenhydramine IV for urticaria and itching 8. Corticosteroids

Hypotension:

1. Place recumbent and elevate legs 2. IV normal saline rapid bolus 1-2 liters 3. Maintain BP with fluids, volume expanders, vasopressors

autosomal recessive

25% have a chance of being effected and 50% chance of being carriers

What is special about stem cells

Adult stem cells can be used for skin grafting Adult stem cells are undifferentiated and can become specific cells Some embryonic stem cells are undifferentiated and can make any cells

Things to consider for genetic testing

Advocate for clients realize importance Recognize own values

A man was adopted, what health information related to his biologic parents and family will be most useful to him when he gets married

Ages of family members diagnosed with diseases Age and cause of death in deceased family members

The nurse is counseling a client on a diagnosis of a autosomal dominant disorder

All of the clients children will have a 50 chance of getting it Expressions in the past could be variable male and female will be effected equally

Which medications treat allergic rhinitis

Antihistamines Nasal Corticosteroids

The mom of a child with cystic fibrosis is asking the nurse about the impact on future children

Autosomal recessive so all children have a 50 chance of being carriers Autosomal recessive so that all children have a 25 chance of developing Autosomal so the parents may have not been effected

Which of the following is the infection that is the leading cause of death in the older adult

Bacterial Pneumonia

Transmission of HCV

Blood needles and sex

CAUTION

C - change in bowel or bladder A - any sore that does not heal U - unusual bleeding/discharge T - thickening in breast I - indigestion O- obvious change in wart N - nagging cough or hoarseness

Ribavirin

Causes birth defects - do not let a prego mother take it

Grade 4

Cells are immature and primitive (anaplasia) and undifferentiated; cell of origin is difficult to determine (high grade)

Grade 2

Cells are more abnormal (moderate dysplasia) and moderately differentiated (intermediate grade)

What is the nurses first assessment of a patient that is presenting with anaphylactic shock?

Check Airway

Carcinogens are

Chemical Viral Radiation

autosomal dominant

Children will have a 50% chance of being effected

Which transplant rejection in associated with the poorest prognosis

Chronic rejection

What is the biggest risk factor associated with pancreatic cancer

Cigarette smoking

The nurse understands that her clients acute hepatitis will effect

Coagulation Bile Production Blood glucose

Type 4 hypersensitivity

Delayed type hypersensitivity reactions. T-cell and Macrophage mediated. Ex: Tuberculosis LATEX ALLERGY CONTACT DERMITITS

Tacrolimus and cyclosporine

Do not drink grape fruit juice with this metabolizes slower and makes it stronger

24 hours post cholecystectomy. The T tube has drained 750 ml green brown drainage. What is the next best intervention

Document findings

The new parents of an infant born with down syndrome ask the nurse what happened to cause the chromosomal abnormality, what is the best response

During cell division of the reproductive cells there is an error causing abnormal number of chromosomes

Sudden change in LOC with cirrhosis

Exploded varices

Hemodialysis Patients are at the same risk for developing HBV as everyone else

False

You should wait to medicate your acute cholecystitis patient for pain until they rate the pain an 8/10

False

Acute care interventions for cholecystitis includes

Gastric decompression Assess for s/s of obstruction Turn Cough and deep breathe

GINA

Genetic Information Nondiscrimination Act

The nurse is counseling a client who ask why his warfarin dose is being decreased after undergoing genetic testing

Genetic testing shows that the client metabolized slower

Client presents to the clinic with abdominal pain what assessment finding indicate chronic pancreatitis

He reports unintended weight loss Metformin does not keep blood sugar under control Abdominal pain is not relieved

Which of the following are at high risk for latex allergy

Health Care workers Those who work in a rubber factory People who have had multiple surgeries

The nurse is counseling the mom of a child with hemophilia. The she asked how this occurred neither parent or child is effects

Hemophilia is X linked recessive so a female family member can be a carrier

Your client has undergone genetic testing for the BRCA 1 gene and express understanding test results with she says

I need to discuss a possible mastectomy with my husband and physician

Your seeing a client in the clinic recently diagnosed with HCV. He shows understanding of HCV when saying

I think I can get free clean needles from the clinic

which immunoglobin crosses the placenta to provide a newborn infant with innate immunity

IgG

Type 1 IgE mediated

Immediate onset (mins): ingestion, injection, or direct contact IgE formation: histamine and leukotriene release Anaphylactic reactions, allergic rhinitis, asthma, atopic dermatitis, urticaria, angioedema Antigen: pollen, food, drugs, dust Skin test: wheal and flare

innate immunity

Immunity that is present before exposure and effective from birth.

acquired immunity

Immunity that is present only after exposure and is highly specific.

Older people will have decreased cognitive function but not show a fever, what could it be

Infection

Contact precautions:

MRSA, VRSA, VRE and C DIFF. Gown and gloves

____ are more likely to develop cancer

Men

If something is carried on the X Chromosome how does it effect Men and Woman of the family

Men are more effected because they only have one X chromosome Woman have another X chromosome to compensate for the mutation

Type 2 cytotoxic and cytolytic reactions:

Min to hours Hemolytic transfusion reaction Goodpastures syndrome cell surface of RBC

The nurse is counseling twins. One of which has developed heart diseases the other did not why

Multifactorial

Interprofessional care for acute pancreatitis will include which of the following

NPO IV opioids

Does a poorly differentiated cancer cell have a really good prognosis?

No

Mycophenolate mofetil

ONLY Reconstitute in D5W DO not give as a bolus only over 2 hours

Acute Rejection

Occurs in the first 6 months due to cell immated response by lymphocytes

Which of the following clinical manifestations supports a diagnosis of acute episode of cholecystitis

Pain in the upper right quadrant after meals Fever Complaints of indigestion

Client presents to the ED with abdominal pain x 4 days which complaints below would indicate acute pancreatitis

Pain is in the upper left quadrant You notice a yellow discoloration of her sclera bruised look surrounding her umbilics

New onset nausea and vomiting in a patient with acute pancreatitis could indicate with complication

Pseudocyst

What is the first study un pancreatic cancer that reversals metastasis and vascular involvement

Spiral CT

allergy skin testing or immunotherapy

Subcutaneous immunotherapy: injection of titrated amounts of allergen extracts biweekly or weekly. Nursing management: never leave patient alone, if reaction occurs, remove patch( if they are using patch) and apply anti inflammatory cream, might need subq injection of epi, You cant do skin test on druggie patients, it suppresses the histamine response or have food Allergies Always give away from joint so you can apply a tourniquet for a sever reaction. Skin type: Scratch or prick: 5-10min Intradermal: 5-10 min Patch: 48-72 hours Usually on arms or back and you will see a flare and wheal response if positive

Chronic rejection

T-cell, antibody mediated vascular damage. Months to years after. Irreversible.

Airborne precautions:

TB, rubeola, measles, chicken pox- N95 or higher level respirators. small particles in the air

Impact of aging on immune system

Thymic shrinkage Decreased cell mediated immunity Decreased delayed hypersensitivity reactions Decreased IL1 and IL2 synthesis Decreased expression of IL2 receptors Decreased proliferative response of T and B cells Decreased primary and secondary antibody responses Increased autoantibodies

type 3 immune complex

Tissue damage in immune complex reactions occur secondary to antigen antibody complexes. Antigens combine with IgG and IgM to form complexes that are too small to be removed by mononuclear phagocyte system. They deposit in tissue or small blood vessels. Can be local or systemic and immediate or delayed. Manifestations depend on number of complexes and location in the body. Common deposit sites are kidney, skin, joints, blood vessels, and lungs. Severe type 3 reactions are associated with autoimmune disorders like systemic lupus erythematosus, acute glomerulonephritis, and rheumatic arthritis.Fi

In a type one hypersensitivity reaction the body creates antibodies that bind to mast cells and basophils

True

Malnutrition in cancer is not likely to be overcome through increased intake

True

Stage 2

Tumor limited to tissue of organ

What are the recommended measures to prevent the transmission of healthcare associated infections

Use of PPE Wash hands or use alcohol based sanitizer

Transmission of HEV

Water asia Africa Mexico developing country

Your client is a 23 yo infected with HCV and 6 months pregnant. She understands the risk to her baby when she says

When will we be able to test my baby for infection

passive acquired immunity

a form of immunity where the fetus receives antibodies made by the mother through breast milk

Antihistamines for

allergic rhinitis and urticaria (type1 )

Y linked

an affected father transmits the disorder to all his sons. Only men are affected.

Emerging infection:

an infectious disease that has recently increased in incidence or that threatens to increase the immediate future. Example: H. pylori, Hep C and E, zika virus, west nile virus

Latex food:

banana, avocado, chestnut, kiwi, tomato, water chestnut, guava, hazelnut, potato, peach, grape and apricot.

Which of the following allergens can cause anaphylactic shock

bee stings nuts penicillin

Transplant rejection the

body attacks the organ

Which of the following is a teaching related to epinephrine injectors

can be injected through clothing Hold in place 2-3 seconds Inject at a 90 degree angle

Initiation: :

cancer cells arise from normal cells because of changes in genes. This involves a mutation in the cells genetic structure.

Stage 0

cancer in situ

Grade 3

cells are very abnormal (severe dysplasia) and poorly differentiated (high grade)

Grade 5

cells cannot be assessed

grade 1

cells differ slightly from normal cells and are well differentiated (mild dysphagia)

Transmission of HAV

contaminated food / water, fecal oral / Gay Men

active acquired immunity

develops following direct exposure to the pathogenic agent, VACCINE

Anaplaxis reaction needs what kind of medication

epi

Stage 3

extensive local and regional spread

Graft vs host the

graft attacks the host

Reemerging infection:

illnesses like measles and pertussis have had sporadic recurrences. Example: diptheria, pertussis, TB, measles

Hyperacute rejection

immediately after transplantation due to preexisting antibodies against the transplanted organ

Droplet precautions:

influezna, pertussis, bacterial meningitis surgical mask

Progression:

last stage in the natural history of a cancer. This is characterized by increased growth rate of the tumor, increased invasiveness, and metastasis.

Pharmacogenomics:

looks at how drugs affect and interact with the genome and output expression. It allows for the identifications of variations in multiple genes that affect drug response. helping develop personalized medicine based on genetics (warfarin dosing - some are most sensitive/ less sensitive to it which was discovered through genetic testing)

Stage 4

metastasized

Why should you not take leftover antibiotics

not enough may not have bacteria may not be appropriate antibiotics lose potency over time

If they have Huntington's recommend

recommend genetic testing, maybe recommend not to have kids.

Promotion:

reversable proliferations of the altered cells. An increase in alter cell population further increases the likelihood for more mutations. The activity of the promotors are reversible. This includes dietary fat, obesity, cigarette smoking, and alcohol use. Changing ur lifestyle can help reduce the risk of cancer development.

Cholecystitis

risk, manifestations, what you do - know that surgery is an option ^ pain meds, anticholinergics, antispasmodics, we would cut down on fat they consume so maybe cut down fat soluble vitamins, bile salts, smaller more frequent meals low in fat high in fiber and calcium, how do you take care of them in acute care setting

Transmission of HDV

same as HBV

Transmission of HBV

sex, perinatal contaminated blood, shared needles, Healthcare workers at risk. Carrier for life

Single Gene Disorders:

single gene mutation. Ex: cystic fibrosis, sickle cell, etc. Can be autosomal dominant, recessive, or x linked.

What are some examples of promotion in the development of cancer

smokes cigarettes A diet high in fat 3 glasses of wine at dinner

Antibiotics are effective against

strep

A Whipple procedure

the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. The remaining organs are reattached to allow you to digest food normally after surgery

Pharmacogenetics:

the study of variable drug responses including adverse events from differences in inheritable genes.

Antipruritic drugs:

topically applied for relief from itching when skin is intact (calamine lotion)

Stage 1

tumor limited to the tissue of origin; localized tumor growth

The nurse suspects cancer of the pancreatic head with the client presents with

unintentional weight loss abdominal pain jaundice


Conjuntos de estudio relacionados

module four - cellular structure: biology 1308 (textbook)

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