immunity and inflammation
which statements made by a patient diagnosed with <S would alert the nurse that the patient requires additional education about the disease
"avoiding high fiber foods will prevent problems with my bowels" "a hot shower everyday will help relax my muscles"
a client with viral hepatitis is having difficulty coping with the disorder. which question by the nurse is the most appropriate in identifying the clients coping problem.
"have you enjoyed having visitors"
a client with viral hepatitis is discussing with the nurse the need to avoid alcohol and states "im not sure I can avoid alcohol". what is the nurses best response
"im not sure that I understand. would you please explain?"
a client in a long term care facility is being prepared to be discharged home in 2 days. the client has been eating a regular diet for a week; however they are still receiving intermittent enteral tube feedings and will need to receive these feedings at home. the client states concern that he will not be able to continue the tube feedings at home. which nursing response is most appropriate at this time
"tell me more about your concerns with your diet after going home"
Osteoarthritis is common in SLE patients why
(bone necrosis from lack of oxygen) is often seen in those who have been treated for at least 5 years with steroids like prednisone. Chronic steroid therapy may cause the constriction of small blood vessels supplying the joint, which causes the tissue to die.
ulcerative colitis is more common in what culture
-Ashkenazki Jewish -Caucasians
during the times when a HIV/AIDs patient experiences a low WBC count, what should they do
-Avoid crowds and other large gatherings -Do not share personal toilet articles such as toothbrushes, toothpaste, washcloths, or deodorant sticks with others -bathe daily, using an antimicrobial soap. -If total bathing is not possible, wash the armpits, groin, genitals, and anal area twice a day with an antimicrobial soap -Clean your toothbrush at least weekly by either running it through the dishwasher or rinsing it in liquid laundry bleach (and then rinsing out the bleach with hot running water). -Wash your hands thoroughly with an antimicrobial soap before you eat or drink, after touching a pet, after shaking hands with anyone, as soon as you come home from any outing, and after using the toilet -Avoid eating salads; raw fruits and vegetables; undercooked meat, fish, and eggs; and pepper and paprika. -Do not reuse cups and glasses without washing -Do not change pet litter boxes. If unavoidable, use gloves and wash hands immediately -Avoid turtles and reptiles as pets.
how to prevent dumping syndrome
-Avoid sugar, salt, and milk. -Eat a high-protein, high-fat, low-carbohydrate diet. -Eat small meals and avoid consuming fluids with meals. -Lie down after meals. -Take antispasmodic medications as prescribed to delay gastric emptying.
what labs to assess in a patient with SLE
-BUN -creatinine SIGN OF RENAL IMPAIRMENT
diagnostic criteria for AIDS
-CD4+ count below 200 cells/L -presence of fungal, viral, protozoal, or bacterial infection -wasting syndrome -AIDS dementia complex
how to detect lesions with MS
-CT scan within the brains white matter -MRI used to evaluate disease progression
While assessing a patient with systemic lupus erythematosus, the nurse finds that the patient has chest pain. Which is the appropriate nursing intervention?
-Chest pain in patients with systemic lupus erythematosus occurs as a result of pericarditis, which is a cardiovascular manifestation -The nurse should immediately notify the primary health care provider if the patient complains of chest pain.
skin protection for patients with SLE
-Cleanse your skin with a mild soap such as Ivory -Dry your skin thoroughly by patting rather than rubbing -Apply lotion liberally to dry skin areas -Avoid powder and other drying agents such as rubbing alcohol -Use cosmetics that contain moisturizers -Avoid direct sunlight and any other type of ultraviolet lighting, including tanning beds -Wear a large-brimmed hat, long sleeves, and long pants when in the sun -Use a sun-blocking agent with a sun protection factor (SPF) of at least 30 -Inspect your skin daily for open areas and rashes.
diagnostic tests for MS
-EEG -lumbar puncture - ELEVATED game globulin (IgG) - normal protein level
who is at risk for hepatitis B
-IV drug users -clients undergoing long term hemodialysis -health care personal
what does mild pancreatitis treatment look like
-IV fluids -pain control -drug therapy -NPO -IV calcium/magnesium
cancers that can occur with AIDs
-Kaposis sarcoma -Hodgkins lymphoma -nonhodgkins lymphoma -invasive cervical cancer
intervention for acute pancreatitis
-NPO -administer TPN -opiates -avoid alcohol
medication classes used for HIV and AIDS
-NRTIs -NNRTIs -protease inhibitors (PIs) -fusion inhibitors
how to care for a HIV/AIDs patient in the hospital setting
-Place the patient in a private room whenever possible -Use good handwashing technique -Ensure that the patient's room and bathroom are cleaned at least once each day -Do not use supplies from common areas for neutropenic patients. For example, keep a dedicated box of disposable gloves in his or her room and do not share this box with any other patient. Provide single-use food products, individually wrapped gauze, and other individually wrapped items -Limit the number of personnel entering the patient's room -Monitor vital signs, including temperature, every 4 hours -Inspect the patient's mouth at least every 8 hours. •
how to enhance nutrition in a patient with HIV/AIDs
-Selecting foods high in calories and protein -Maintaining current weight or gaining weight -Drinking at least 2 to 3 L of fluids per day -Maintaining normal blood levels of ferritin, albumin, prealbumin, and hemoglobin
bacterial infection
-TB -MAI infection
Enfurvitide patient education (fusion inhibitor)
-Teach patients how to prepare and inject the drug subcutaneously to ensure correct dosage and effectiveness -Assess injection sites for warmth, swelling, redness, skin hardening, or bump formation because these are indications of injection site reactions -Instruct patients to report pain or numbness in the hands or feet because this drug can induce peripheral neuropathy -Teach patients to report jaundice, nausea and vomiting, or severe abdominal pain because this drug can induce liver toxicity -Teach patients to observe for and report cough, shortness of breath, fever, and purulent mucus because this drug increases the risk for severe respiratory infections, including pneumonia.
potential complications of MS
-UTI -calculi -pressure ulcers -respiratory tract infections -contractures
s/s of acute pancreatitis
-abdominal pain -mid-epigastric or LUQ pain -radiation to the back
s/s of chronic pancreatitis
-abdominal pain and tenderness -LUQ mass -steatorrhea/foul smelling stools -weight loss -muscle wasting
how does perforation pain present itself
-abdominal pain the increases with cough or movement -rebound tenderness -relieved by bending the right hip or at the knees
A client develops an anaphylactic reaction after receiving morphine. The nurse should plan to institute which actions? Select all that apply.
-administer oxygen -quickly assess the clients respiratory status -document the even interventions, clients response
a client develops an anaphylactic reaction after receiving morphine. the nurse should plan to institute which actions?
-administer oxygen -quickly assess the clients respiratory status -document the even interventions and clients response
adverse effects of zidovudine
-agranulocytopenia -anemia
what will levels of aminotransferase do in acute or fulminant cases of hepatitis
-alanine -aspartate may his into the thousands
a change in LOC could be related to what in acute pancreatitis
-alcohol withdrawal -hypoxia -impending sepsis with shock
manifestations of toxoplasmosis
-altered mental status -neurological deficits
s/s of UC
-anorexia -weight loss -malaise -abdominal tenderness -diarrhea w/ blood and mucus
what drugs are used for autoimmunity
-anti-inflammatory drugs -immunosuppressive drugs -symptomatic treatment
the nurse caring for a client diagnosed with IBD recognizes that which classifications of medications may be prescribed to treat the disease and induce remission
-antimicrobial -corticosteroid -aminosalicylate -biological therapy -immunosuppressant
what is oxybutynin
-antispasmodic -relieves symptoms of urinary urgency, frequency, nocturne, and incontinence
most common acute problems
-appendicitis -gastroenteritis -peritonitis
tenofovir patient education (nucleoside reverse transcriptase inhibitors)
-avoid fatty and fried foods with these drugs because they cause digestive upsets and may lead to pancreatitis when combined with NRTIs -Teach patients to use precautions to prevent injury because these drugs induce peripheral neuropathy -Instruct patients to avoid or severely limit alcoholic beverages to reduce the risk for liver damage while on these drugs
diet for a patient with pancreatitis
-avoid high fat -avoid alcohol -avoid spicy -avoid caffeine
the nurse is performing an assessment on a client who has been diagnosed with an allergy to latex. in determining the clients risk factors, the nurse should question the client about an allergy to which food item
-bananas -kiwi -pineapples -tropical fruits -grapes -avocados -potatoes -hazelnuts -water chestnuts
the nurse is providing instructions to a client with a colostomy about measures to reduce the odor from the colostomy. which client statement indicates that the educational session was effective
-beet greens -parsley -yogurt will help control colostomy odor
glucocorticoids are effective for patients with CD, but what can they mask
-can mask symptoms of infection -infection could be a sign of sepsis -monitor patient closely
fungal infection
-candidiases -cryptococcosis
how is HIV NOT transmitted
-casual contact -school -workplace -mosquitos -insects
which interventions does the home health nurse teach to family members to reduce confusion in a client diagnosed with AIDS related dementia
-change the decorations in the home according to the season -put bed close to the window -ask the client what time they prefer to shower or bathe -mark off the days of the calendar, leaving open the current date
other problems related to CD
-clinical depression -severe anxiety disorders
UC increases the risk for
-colon cancer -fluid and electrolyte imbalance - due to diarrhea (dehydration/hypokalemia)
where should nurses refer patients with pancreatitis who use excessive alcohol
-community resources psych as alcoholic anonymous
The nurse should incorporate which in the dietary plan to ensure optimal nutrition for the client during the acute phase of hepatitis? Select all that apply.
-consume multiple small meals throughout the day -allow the client to select foods that are most appealing -eliminate fatty foods from the meal trays until nausea subsides
the nurse should incorporate which in the dietary plan to ensure optimal nutrition for the client during the acute phase of hepatitis?
-consume multiple small meals throughout the day -allow the client to select foods that are most appealing -eliminate fatty foods from the meal trays until nausea subsides
examples of type 4 reactions
-contact dermatitis -poison ivy rashes -insect stings -tissue transplant rejections
how is toxoplasmosis encephalitis acquired
-contaminated cat feces -ingesting undercooked meat
main focus of nursing care when dealing with a patient with acute pancreatitis
-controlling pain -decrease gastrointestinal tract activity
a home care nurse is prescribing dressing supplies for a client who has an allergy to latex. which item should the nurse ask the medical supply personnel to deliver
-cotton pads -silk tape
the nurse is providing instructions to the mother of a child who has been exposed to HIV. the nurse should include notifying the HCP if which symptoms occurs in the child
-coughing -fever >101F -vomiting/diarrhea -drooling -ear pulling -drainage from the ears
who is at increased risk for hepatitis A
-crowded conditions (day care, nursing home) -exposure to poor sanitation
As the human immunodeficiency virus (HIV) infection progresses, which immunity abnormalities occur with poor CD4+ T-cell function? Select all that apply.
-decreased numbers of lymphocytes -abnormally functioning macrophages -increased production of incomplete and nonfunctional antibodies.
the nurse is caring for a client with newly diagnosed HIV. besides preventing the transmission of the disease, what are the goals of medication therapy
-decreasing the viral load -delaying the disease progression -maintaining or increasing CD4+ T cell counts -preventing HIV related symptoms and opportunistic diseases
the nurse has been assigned to care for a client with an immune disorder. in developing a plan of care for this client, the nurse incorporates knowledge that the immune system consists of specific major types of cells. which types of cells are associated with the immune system
-dendritic cells -B lymphocytes -helper T lymphocytes -cytolytic T lymphocytes
the nurse is caring for a client with AIDS who is receiving didanosine. the nurse understands that side and adverse effects associated with this medication include which findings?
-diarrhea -pancreatitis -lactic acidosis -peripheral neuropathy
treatment for type 2 cytotoxic reaction
-discontinuation of the offending drug -symptomatic treatment
Darunavir patient education (protease inhibitors)
-do not chew or crush these drugs because this action may cause the drug to be absorbed too rapidly and increase the risk for side effects -report jaundice, nausea and vomiting, or severe abdominal pain because these drugs can induce liver toxicity -keep all appointments for laboratory work because these drugs increase blood lipid levels and increase the risk for atherosclerosis and pancreatitis -avoid St. John's wort while taking these drugs because the supplement reduces the effectiveness of all PIs. **** Do not give darunavir to patients who have a known sulfa allergy because these two drugs contain sulfa. ****
Sjorgen's syndrome manifestations
-dry eyes -dry mucous membranes (nose/mouth) -vaginal dryness
manifestations of SLE
-dry scaly rash -discoid lesions -alopecia -polyarthritis -joint changes
how to care for the oral cavity when experiencing candidiasis
-eat foods that are liquid or pureed -avoid spicy foods -eliminate citrus juices -eliminate hot liquids
labs for acute pancreatitis
-elevated WBC -elevated glucose -elevated bilirubin -elevated phosphatase -increased urinary amylase levels
the nurse is caring for a hospitalized client with pancreatitis. which findings should the nurse look for and expect to note when reviewing the lab results
-elevated lipase -elevated trypsin -elevated amylase
laboratory findings for appendicitis
-elevation of WBC
emergency equipment and drugs to keep at the bedside of a patient with known severe allergies or history of anaphylaxis
-epinephrine -diphenhydramine (Benadryl) -cortisol
who is at high risk for HBV
-exposed to blood/body fluids at work -high risk sexual practices -chronic liver disease -HIV infection -correctional facility -immunosuppressant drug therapy -close contact with a HBV carrier
early clinical manifestations of RA
-fatigue -anorexia -generalized weakness -low grade fever -paresthesias
The nurse manager is providing an educational session to nursing staff members about the phases of viral hepatitis. The nurse manager tells the staff that which clinical manifestation(s) are primary characteristics of the preicteric phase?
-fatigue -anorexia -nausea
s/s of MS
-fatigue and weakness -ataxia/vertigo -tremors and spasticity of lower extremities -paresthesias -blurred vision/diplopia -nystagmus -emotional changes
how is the pain aggravated in acute pancreatitis
-fatty meak -alcohol -lying in a recumbent position
how is hepatitis A transmitted
-fecal oral route -parenteral -contaminated fruits, veggies, uncooked shelfish -contaminated water/milk -poorly washed utensils
initial obstruction for appendicitis
-fecaliths -malignant tumors -worms infection
s/s of CD
-fever -colicky pain after meals -diarrhea w/mucus and pus -abdominal distention -weight loss -anemia
symptoms associated with UC exacerbation that should be reported to the HCP
-fever (>101) -tachycardia -palpitations -increase in diarrhea -abdominal pain -nausea/vomiting
expected outcomes for MS treatment
-free of infection -maintain maximal mobility and function -maintain adequate sensory perception and cognition
what can influence the progression from HIV to AIDs
-frequency of are-exposure to HIV -presence of other STI's -nutritional status -stress
complications of hepatitis B
-fulminant hepatitis -chronic liver disease -cirrhosis -primary hepatocellular carcinoma
what foods should a patient with UC avoid
-gas forming foods -milk products -whole wheat grains -nuts -raw fruits/veggies -pepper -alcohol -caffeine -AVOID SMOKING
contact precautions for a patient with MRSA
-gloves -gown -goggles -mask/face shield
precautions for a patient with kaposis sarcoma when performing a bath
-gown -gloves
A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply.
-gray-blue color at the flank -abdominal guarding and tenderness -LUQ pain with radiation to the back
assessment findings that are consistent with acute pancreatitis
-gray-blue color at the flank -abdominal guarding and tenderness -left upper quadrant pain with radiation to the back
viral infection
-herpes simplex -cytomegalovirus retinitis
who is at high risk for AIDS
-heterosexual or homosexual contact w/ high risk individuals -IV drug users -persons receiving blood products -health care workers -babies born to infected mothers
signs of shock for a patient with acute pancreatitis
-hypotension -tachycardia -significant changes in vitals
what is effected when the liver is diseased or damaged
-immunity -cellular regulation -digestion -nutrition -metabolism
medications used to treat hepatitis B and C
-immunomodulators -----interferons, antivirals
incubation and infectious period of hepatitis A
-incubation 2-6 weeks -infectious 2-3 weeks before and 1 week after development of jaundice
the nurse is assigned to care for a child who is scheduled for an appendectomy. select the prescriptions that the nurse anticipates will be prescribed
-initiate an IV line -maintain NPO status -administer IV antibiotics -administer preoperative medications
the nurse works with high-risk clients in an urban outpatient setting. which groups should be tested for HIV
-injection drug abusers -prostitutes and their clients -people with STI's
natural resistance
-innate inherited immunity -immunity from when the persons is born -does not require previous exposure to the antigen
what is required for testing for HIV
-interpretation -counseling -confidentiality
type 4 hypersensitivity reaction
-involves T cells as the reactive cells -the sensitized cells respond to an antigen by releasing chemical mediators and triggering macrophages to destroy the antigen
why is anemia common in patients with CD
-iron deficiency -malabsorption issues
the nurse is planning discharge teaching for a client started on acetazolamide for a suprtentorial lesion. which information about the primary action of the medication should be included in the clients education
-it decreases CSF production
life threatening complications associated with acute pancreatitis
-jaundice -caclculi/pancreatic pseudocyst -hyperglycemia -left lung pleural effusion -total destruction of the pancreas = type 1 DM
The nurse is teaching the client with viral hepatitis about the stages of the disease. The nurse should explain to the client that the second stage of this disease is characterized by which specific assessment findings? Select all that apply.
-jaundice -clay colored stools -elevated bilirubin levels -dark or tea colored urine
second stage of viral hepatitis is characterized by which specific assessment findings
-jaundice -clay-colored stools -elevated bilirubin levels -dark or tea colored urine
the nurse is caring for a client with AIDS who is experiencing night fever and night sweats. which nursing interventions would be helpful in managing these symptoms
-keep liquids at bedside -place a towel over the pillowcase -make sure the pillow has a plastic cover -keep a change of bedlinen nearby in case they are needed
the patient with suspected or confirmed appendicitis should avoid
-laxatives -enemas -heat applied to the abdomen
adverse effects of pentamidine
-leukopenia -thrombocytopenia -anemia
what does the client have to do for an ERCP
-lie still -sign consent form -IV sedation to relax -anesthetic spray to prevent gagging
dietary measures for chronic pancreatitis
-limit fat and protein intake -avoid heavy meals -avoid alcohol
where are macrophages found within the body
-liver -spleen -intestinal tract
what does HIV infection lead to
-lymphocytopenia -increased production of incomplete nonfunctional antibodies -abnormally functioning macrophages
the nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. which interventions would the nurse expect to be prescribed for the client
-maintain NPO -encourage coughing and deep breathing -give hydromorphone intravenously as prescribed for pain
The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply.
-maintain NPO status -encourage coughing and deep breathing -give hydromorphone IV as prescribed for pain
s/s of AIDS
-malaise -lymphadenopathy for at least 3 months -leukopenia -diarrhea -fatigue -night sweats
focus for the nurse when caring for a patient with chronic pancreatitis
-manage pain -assist in sufficient nutritional intake -prevent recurrence
what to be alert for in a patient with CD
-manifestations of peritonitis -obstruction -nutritional and fluid imbalances
purpose of management for MS
-modify the diseases effects on the immune system -prevent exacerbations -manage symptoms -improve function -maintain quality of life
Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Which interventions should the nurse include when administering this medication? Select all that apply.
-monitor liver function studies -instruct the client to avoid alcohol -avoid exposure to the sun
the nurse is caring for a client with acute pancreatitis. which medications should the nurse expect to be prescribed for treatment of this problem
-morphine -dicyclomine -pantoprazole -acetazolamide
The nurse is caring for a client with acute pancreatitis. Which medications should the nurse expect to be prescribed for treatment of this problem? Select all that apply.
-morphine -dicyclomine (antispasmodic) -pantoprazole (proton pump inhibitor) -acetazolamide (decrease pancreatic secretions)
what does ganciclovir cause
-neutropenia -thrombocytopenia
which lab determines HIV in an infant
-p24 antigen assay -virus culture -polymerase chain reaction
s/s of appendicits
-pain in the periumbilical area -descends to the RLQ -intense pain at McBurneys point -rebound tenderness -abdominal rigidity -abdominal guarding
who is at risk for hepatitis C
-parenteral drug users -clients receiving frequent transfusions -health care personnel
tuberculosis precautions
-particulate respirator -gown -gloves -negative pressure room
if a patient has suspected or known appendicitis, which interventions should the nurse put in place
-patient remains NPO in case of surgery avoid making inflammation worse
who is at highest risk for angioedema
-patients taking an angiotensin converting enzyme inhibitor (ACEIs) -black African American patients
Who is HIV testing recommended for?
-people who have had STI's -people who have been in correctional facilities -people planning to get married -received a blood transfusion 1978-1985 -people who use injectable drugs
function of macrophages
-phagocytosis -repair -antigen presenting/processing -secretion of cytokines for immune system control
onset or exacerbation of MS can be preceded by
-physical stress -vaccination -excessive exercise -emotional stress -fatigue -infection -pregnancy -physical injury -high humidity
what to avoid when a patient has neutropenia
-place the child on a low-bacteria diet -change the dressings using sterile technique -peel fruits and veggies before allowing the child to eat them
protozoal infection
-pneumocytosis pneumonia -cryptosporidosis -toxoplasmosis -histoplasmosis
testing for hepatitis A
-presence of HAV antibodies in the blood -elevated IgM/IgG
A CD4 T-cell count is measured in a client newly diagnosed with human immunodeficiency virus (HIV). In planning care, the nurse understands that which is accurate regarding the CD4 T-cell count? Select all that apply.
-primary marker of immunocompetence -plays role in the cell mediated immune response -guides decision making regarding timing of initiation of treatment
what are CD4 cells
-primary marker of immunocompetence -plays roll in cell mediated immune response -guides decision making regarding the timing of initiation of treatment
3 main phases of specific immune response
-recognition phase -activation phase -effector phase
the nurse is conducting allergy skin testing on a client. which post procedure interventions are most appropriate
-record site, date, and time of the test -give the client a list of potential allergens if identified
where does UC begin
-rectum -spreads upward to the cecum
priorities of patient care when dealing with a patient with acute pancreatitis
-relieve symptoms -decrease inflammation -treat complications
type 3 reaction
-results from excess antigens causing immune complexes to form in the blood and lodge in small blood vessel walls
a client with a diagnosis of question of RA is admitted to the unit. which blood tests would the nurse expect to be prescribed to confirm the diagnosis
-rheumatoid factor -ANA -ESR -anti CCP (anti cyclic citrullinated peptide antibody_
what lab finding indicates chronic hepatitis
-serological marker (HBsAg) is present after 6 months
interventions to manage fatigue in SLE
-sit whenever possible -avoid long periods of rest (causes joint stiffness) -do exercises, such as walking, when not fatigued
interventions for home care measures for SLE
-sit whenever possible -eat a balanced diet -should engage in moderate low impact exercise when not tired
what do physical barriers of infection include
-skin -mucous membranes -action of Cilla lining the respiratory tract
what will XRays reveal in a patient with CD
-strictures -deep ulcerations -cobblestone appearance
as ulcerative colitis progresses, what happens to the colon
-surface becomes dark, red, and velvety -abscesses form - turn into ulcers -necrosis -scarring and thickening
the nurse is monitoring a client for the EARLY s/s of dumping syndrome. what findings indicate this occurrence
-sweating -pallor
administration considerations for sulfasalazine
-take with meals -increased sensitivity to sunlight -should be taken as prescribed
a client taking an antihistamine is scheduled for allergy skin testing and tells the nurse in the HCP office that a dose was taken this morning. the nurse interprets this to mean that which adjustment needs to be made
-the client should reschedule the appointment
nutritional interventions for patients with chronic pancreatitis
-total parenteral nutrition -collaborate with dietitian -eat foods high in carbs/proteins for healing -avoid fats -monitor nutrition indicators -prelabumin/albumin
which interventions apply in the care of a client at high risk for an allergic response to a latex allergy
-use non latex gloves -use medications from glass ampules -keep a latex safe supply cart available in the clients area -avoid the use of medication vials that have rubber stoppers
what do chemical barriers of infection include
-various acids -enzymes in body fluid
how long does active immunity last
-years -can be easily reactivated by a booster dose of antigen
what level of IgE accounts for the total antibody level
0.5%
normal beta globulin level
1.0 g/dL
The nurse is caring for a client admitted to the hospital with suspected acute appendicitis. Which laboratory result should the nurse expect to note if the client does have appendicitis?
10,000-18,000 mm3
Which statements made by a patient diagnosed with multiple sclerosis (MS) would alert the nurse that the patient requires additional education about the disease? Select all that apply.
"Avoiding high-fiber foods will prevent problems with my bowels." "A hot shower every day will help relax my muscles and relieve stress.
A patient is suffering with type I hypersensitivity. Which questions does the nurse ask during the assessment? Select all that apply.
"Do you have any food or drug allergies?" "Do you have any family members with a type I allergy?" "When did this problem begin and how long does each episode last?"
the nurse presents a seminar on HIV testing to a group of seniors and their caregivers in an assisted-living facility. which responses fit the recommendations of the CDC and prevention regarding HIV testing
"I am 78 years old and I was treated and cured of syphilis many years ago" "seven years ago I was released from a penitentiary" "at 68, I am going to get married for the fourth time"
the nurse is performing an assessment on a client with suspected acute pancreatitis. which complaint made by the client supports the diagnosis.
"I have been experiencing constant, severe abdominal pain that is unrelieved by vomiting"
The nurse teaches a patient with multiple sclerosis self-management techniques postdischarge. Which statement made by the patient indicates the need for further teaching?
"I will regularly have sauna and steam baths as instructed by the physical therapist." -avoidance of extreme temperatures because the patient may have a decreased sensation of temperature -The patient should avoid hot tubs, sauna baths, and steam baths because the patient may suffer from a heat injury.
WBC for a patient experiencing peritonitis
20,000 with a high neutrophil count
when to apply ice packs to the abdomen with appendecitis
20-30 minutes every hour IF prescribe
common age for MS
20-40 years
after completing an assessment and reviewing the lab test results of a client admitted to the hospital with acute abdominal pain, the nurse should take action for which noted serum amylase level
200 somogyi units
erythrocyte sedimentation rate normal
22mm/hr
high amylase level that indicates pancreatitis
4 - 6 times higher than normal
normal amylase level
40-140
The nurse is planning care for the client with a neurogenic bladder caused by multiple sclerosis. The nurse plans for fluid administration of at least 2000 mL/day. Which plan would be most helpful to this client?
400 - 500 mL with each meal and 200-250 mL at midmorning, mid afternoon, and late afternoon
incubation period of hepatitis C
5-10 weeks
incubation period of hepatitis B
6-24 weeks
total serum complement normal
75 units/mL
The number of CD4+ T-cells is reduced in human immunodeficiency virus (HIV) disease. How many CD4+ T-cells are usually present in a cubic millimeter (mm 3) of a healthy adult's blood?
800-1000
A diagnosis of acquired immunodeficiency syndrome (AIDS) requires the patient to meet which criteria? Select all that apply.
A diagnosis of AIDS requires the patient have a CD4+ T-cell count less than 14%, diagnosis of an opportunistic infection, and/or a CD4+ T-cell count less than 200 cells/mm 3 (0.2 × 109/L).
Why does anal intercourse have the highest risk of human immunodeficiency virus (HIV) transmission?
Anal intercourse allows seminal fluid to make contact with rectal mucous membranes and also tears the mucous membranes, making infection more likely.
Which hypersensitivity reaction is characterized by the antigen-antibody complex formation that gives rise to an inflammatory response? Select all that apply.
Anaphylaxis serum sickness rheumatoid arthritis hemolytic anemia ----triggering inflammation that results in tissue or vessel damage.
A middle-aged patient, who is alert, is admitted to the emergency department (ED) with wheezing, difficulty breathing, angioedema, blood pressure (BP) of 70/52 mm Hg, and apical pulse of 122 and irregular. The nurse makes an immediate assessment using the "ABCs" for any patient experiencing anaphylaxis. What nursing intervention is the immediate priority?
Apply oxygen using a high-flow non-rebreather mask at 90% to 100%.
the nurse overhears the HCP tell a client with RA that the condition needs to be treated with gold therapy. the nurse interprets that the HCP is referring to which medication
Auranofin -used when patients have an insufficient therapeutic response to NSAIDs
a client with AIDS has been started on therapy with zidovudine. the nurse should monitor the results of which lab blood study for adverse effects of therapy
CBC
labs for crohns disease and ulcerative colitis
CBC - infection, anemia albumin - nutrition statues ESR- inflammation CRP - inflammation stool specimen electrolyte levels/hydration GLUCOSE LEVEL - if on TPN
in HIV infections, more virus particles are created when the virus enters what type of host cell
CD4+ T cell (Hijacking these cells)
In human immunodeficiency virus (HIV) infections, more virus particles are created when the virus enters which type of host cell?
CD4+ T-cell
A client is receiving zalcitabine. The nurse should monitor the results of which study to determine the effectiveness of this medication?
CD4+ cell count
a client is receiving zalcitabine. the nurse should monitor the results of which study to determine the effectiveness of this medication
CD4+ cell count
the nurse is caring for a client with AIDS who has begun to experience multiple opportunistic infections. which lab test would be most helpful in assessing the clients need for reassessment of treatment
CD4+ cell or T lymphocyte count
reliable image for pancreatitis
CT
The nurse provides care for a patient admitted with multiple sclerosis (MS). Which medications does the nurse expect will be ordered for the patient? Select all that apply.
Cholinergics Stool softeners Muscle relaxants Glucocorticoids
What medications are given in combination with immunosuppressive therapy to stabilize the disease process and decrease inflammation in patients diagnosed with multiple sclerosis? Select all that apply.
Cyclophosphamide methylprednisolone adrenocorticotropic hormone (ACTH)
The nurse assesses a patient with multiple sclerosis (MS) for motor, sensory, cerebellar, and emotional manifestations. Which are motor manifestations of MS? Select all that apply.
Diplopia scanning speech spasticity of muscles weakness or paralysis of limbs, trunk, and head
integumentary signs and symptoms of AIDs
Dry skin Poor wound healing Skin lesions Night sweats
What cerebellar findings are consistent with a diagnosis of multiple sclerosis? Select all that apply.
Dysmetria intention tremor dysdiadochokinesia
tests used to diagnose HIV
ELISA western blot
HIV antibodies can be measured by
ELISA (enzyme linked immunosorbent assay) western blot analysis
if patient receives a positive ELISA test but a negative western blot test what is your thought process?
ELISA test was a false positive
if pancreatitis is caused by gallstones, what will be performed
ERCP with sphincterotomy
fulminant hepatitis
Failure of liver cells to regenerate, progression of the necrotic process
a client recently diagnosed with HIV is being treated for candidiasis. which medication does the nurse anticipate the HCP will prescribe for this client
Fluconazole (Diflucan) -fungal infection
medication prescribed for fungal infection (such as candidiasis)
Fluconazole (diflucan)
Which features of the human immunodeficiency virus (HIV) virus assist the viral particle in finding a host?
Gp41 and gp120 docking proteins
the student nurse is presenting a clinical conference regarding HIV in children. which information should the student include
HIV cannot be spread by hugging, holding, or touching other people
When the human immunodeficiency virus (HIV) virus enters the patient's CD4+ T-cell, what is the new role served by the immune cell?
HIV factory
you should be tested for HIV if?
Have a sexually transmitted infection Use injection drugs Consider yourself at risk Are a woman of childbearing age with identifiable risks Received a transfusion between 1978 and 1985 Plan to get married Are undergoing medical evaluation or treatment for symptoms that may be HIV related Are in correctional institutions such as jails and prisons Are a sex worker or have had sex with a sex worker
The nurse is reviewing discharge teaching with a patient who suffered an anaphylactic reaction to a bee sting. Which statement by the patient indicates the need for further teaching?
I am immune to bee stings now
the HCP has determined that client has contracted HAV based on flulike symptoms and jaundice. which statement made by the client supports this medical diagnosis.
I ate shellfish about 2 weeks ago at a local restaurant
a sexually active young adult client has developed viral hepatitis. which client statement indicates the need for further teaching
I can go back to work right away
The nurse has given instructions to a client with hepatitis about postdischarge management during convalescence. The nurse determines that further teaching is needed if the client makes which statement?
I can resume full activity level in 1 week
the nurse provides home care instructions to the parent of a child with AIDS. which statement by the parent indicates a need for further teaching
I can send my child to daycare even if he has a fever, as long as it is low-grade
a 6 year old child with HIV has been admitted to the hospital for pain management. the child asks the nurse if the pain will ever go away. what is the nurses best response
I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less
the nurse is conducting a health assessment interview with a client diagnosed with HIV. which statement by the client does the nurse immediately address?
I remember to take my antiretroviral drugs ALMOST every day CLIENTS MUST TAKE DRUGS CONSISTENTLY
The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction?
I should increase the fiber in my diet
the nurse provides home care instructions to a client with SLE and tells the client about methods to manage fatigue. which statement by the client indicates a need for further teaching
I should take hot baths because they are relaxing
the nurse teaches a patient with MS self management techniques post discharge. which statement made by the patient indicates the need for further teaching
I will regularly have sauna and steam baths as instructed by the PT
which statement of the student nurse indicates inadequate understanding about precautionary measures to take while treating a patient with a history of allergic reaction during an emergency situation
IV fluid administration is avoided in the patient
what medications are started immediately after the diagnosis of appendicitis
IV fluids broad-spectrum antibiotic
A patient is diagnosed with a type I hypersensitivity. Which antibody level increases during this type of allergy?
IgE
A patient is scheduled to undergo desensitization therapy during which a very dilute solution of allergen (1:100,000) is injected. This process induces the formation of antibodies against the allergen. Which antibody is produced during this process?
IgG
what is the major serum antibody
IgG -consists about 70% of the total circulating antibodies -antiviral -antibacterial -effective against toxins
what is the first antibody produced
IgM -response to antigen -makes up 7% of total circulating antibodies
the nursing instructor is evaluating a nursing student for knowledge of antibody classes. which statement by the nursing student indicates that teaching has been effective
IgM is the first antibody produced in response to antigen
immunological signs and symptoms of AIDs
Low white blood cell counts CD4+/CD8+ ratio <2 CD4+ count <200/mm3 (0.2 × 109/L) Hypergammaglobulinemia Opportunistic infections Lymphadenopathy Fatigue
Which immunologic signs and symptoms may occur in a patient with acquired immunodeficiency syndrome (AIDS)? Select all that apply.
Lymphadenopathy hypergammaglobulinemia
when providing teaching to a patient newly diagnosed with MS, the nurse informs the patient that the confirmation of the diagnosis is based on what finding
MRI
how to determine if someone has MS
MRI -detects plaques
What chemotherapy drug has been shown to effectively reduce neurologic disability in patients with multiple sclerosis?
Mitoxantrone
patients with severe UC and are hospitalized should have what intervention in place
NPO to ensure bowel rest
what is an opportunistic BACTERIAL infection that may occur in patients with AIDs
Nocardiosis
Which bacterial infections may occur as opportunistic infections in patients with AIDS? Select all that apply.
Nocardiosis and tuberculosis are bacterial infections that may occur as opportunistic infections in patients with AIDS
immune complex disorders caused by type 3 reactions
RA SLE
where is a stoma located
RLQ
medication prescribed for treatment of TB
Rifampin (Rifadin)
a client seen in an ambulatory client has a facial rash that is present on both cheeks and across the bridge of the nose. the nurse interprets that this finding is consistent with manifestations of which disorder
SLE
the nurse is reviewing the diagnostic test prescribed for a client and notes that an LE cell prep has been prescribed. which immune disorder should the nurse anticipate
SLE
Which diseases can be categorized as autoimmune diseases? Select all that apply.
Scleroderma rheumatic fever Goodpasture's syndrome
what is serositis
Serositis is an inflammation of the inner lining of the peritoneum, which causes abdominal pain in patients with systemic lupus erythematosus.
a patient has developed a type 4 hypersensitivity reaction. which immune cells or components are involved in this type of reaction
T cells
A patient has developed a type IV hypersensitivity reaction. Which immune cells or components are involved in this type of reaction?
T-cells
What defines the concept known as treatment as prevention (TAP) of human immunodeficiency virus (HIV)?
The use of combination antiretroviral therapy (cART) reduces the viral load to undetectable levels, thereby reducing the risk of HIV transmission.
Which instruction would the nurse give to a patient who has had an allergic reaction to environmental airborne allergens?
Thoroughly clean cloth drapes, carpeting, and upholstered furniture.
medication prescribed for bacterial infections (such as UTI)
Trimethoprim/sulfamethoxazole
two most common IBDs that affect adults
Ulcerative Colitis Crohns Disease
what is vasculitis
Vasculitis is the inflammation of the lining of blood vessels, which causes disruption of blood flow and leads to organ failure.
early phases for HIV
Virion, fusion, and uncoating phases
The nurse is caring for a patient who recently had a first positive human immunodeficiency virus (HIV) test result within six months after a negative HIV test result. According to the Centers for Disease Control and Prevention (CDC) classifications, when should the patient's status be changed from stage 0 to stage 1, 2, or 3?
When six months have elapsed and the conditions for another stage are met
the nurse is assigned to care for four clients. which client does the nurse assess first?
a client with a history of liver transplantation who is currently taking cyclosporine and has an elevated temperature ---indicates infection is occuring
Which patient condition would necessitate the nurse to wear latex-free gloves when providing care?
a client with spina bifida
a client reports to the health care clinic for testing for HIV immediately after being exposed to HIV. the test results are negative, and the client expresses relief about not contracting HIV. what should the nurse emphasize when explaining the test results to the client
a negative HIV test result is not considered accurate immediately after exposure
what is the process of phagocytosis
a particle is ingested and digested by a cell
Raynaud's phenomenon
a peripheral arterial occlusive disease in which intermittent attacks are triggered by cold or stress
the nurse is caring for a client after abdominal surgery and creation of a colostomy. the nurse is assessing the client for a prolapsed stoma and should expect to note which observation if this is present
a stoma that is elongated with a swollen appearance
a client has requested and undergone testing for HIV. the client asked what will be done next because the result of the ELISA test has been positive. which diagnostic study should the nurse be aware of before responding to the client
a western blot will be done to confirm these findings
What is the gastrointestinal sign of systemic lupus erythematosus?
abdominal pain
cardinal sign of peritonitis
abdominal pain tenderness
what will the bowel sounds be like in a patient with acute pancreatitis
absent or decreased bowel sounds
A client seen in the ambulatory care clinic has ascites and slight jaundice. The nurse should assess the client for a history of chronic use of which medication?
acetaminophen -potentially hepatotoxic medication
the nurse is developing a teaching plan for a client with viral hepatitis. the nurse should plan to include which information in the teaching session
activity should be limited to prevent fatigue
what should be gradually increased in a patient with hepatitis
activity to prevent fatigue
what does viral load testing measure
actual amount of HIV viral RNA particles present in 1 mL of blood An uninfected adult has no viral load for HIV A POSITIVE viral load test can measure as few as 40 particles/mL High viral loads can be greater than 80,000 HIV particles/mL The HIGHER the viral load the BIGGER risk for transmission
what is appendicitis
acute inflammation of the vermiform appendix -leads to infection as bacteria invades the walls of the appendix
a client arrives at the ED complaining of acute RLQ pain and appendicitis is suspected. lab tests are performed and the nurse notes that the clients WBC count is elevated. on the basis of these findings the nurse should question which HCP prescription
administer 30 mL of milk of magnesia (MOM)
What should be the first intervention for a patient with systemic lupus erythematosus (SLE) when there is severe renal involvement?
administer immunosuppresents and steroids
what should a nurse do for any patient going through anaphylaxis
administer oxygen
before administering prednisone IV push to a middle-aged adult with RA, the nurse notes that the clients random blood glucose level is 139 mg/dl. which action is the most important for the nurse to take
administer the prescribed prednisone on schedule blood sugar is only slightly elevated
In North America, the highest rates of new human immunodeficiency virus (HIV) infections occur among which population?
african american hispanic adults
A client with ulcerative colitis has a prescription to begin a salicylate compound medication to reduce inflammation. What instruction should the nurse give the client regarding when to take this medication?
after meals
a client with UC has a prescription to begin a salicylate compound medication to reduce inflammation. what instruction should the nurse give the client regarding when to take this medication?
after meals with a full glass of water this reduces GI irritation
a client with AIDS has started therapy with zidovudine. the nurse assess the CBC, knowing which is an adverse effect of this medication
agranulocytosis
The nurse has taught the client with chronic pancreatitis about risk factor modification to reduce the incidence of recurrences. The nurse determines that teaching was effective if the client states that it will be necessary to control which factor?
alcohol intake
the nurse plans to assess a patient with type 1 hypersensitivity for which clinical manifestation
allergic asthma
when preparing a client newly diagnosed with HIV and the significant other for discharge, which explanation by the nurse accurately describes proper condom use
always position the condom with a space at the tip of an erect penis
drug therapy for UC
aminosalicylates glucocorticoids antidiarrheal drugs immunomodulators
A client with acquired immunodeficiency syndrome (AIDS) is receiving didanosine. When the nurse reviews the client's laboratory test results, which result should be most closely monitored?
amylase
a client with AIDS is receiving didanosine. when the nurse reviews the clients lab test results. which result should be closely monitored
amylase
highest risk for infecting with someone with HIV is when
an infected male injects seminal fluid into the rectum of an uninfected person
why does anal intercourse have the highest risk of HIV transmission
anal intercourse allows seminal fluid to make contact with rectal mucous membranes and also tears the mucous membranes making infection more likely
which sexual act carries the highest risk for the transmission of HIV
anal sex
which hypersensitivity reaction is characterized by the antigen-antibody complex formation that gives rise to an inflammatory response?
anaphylaxis serum sickness rheumatoid arthritis immune hemolytic anemia
Which is an example of a type I hypersensitivity reaction?
angioedema
the nurse is reviewing the health care record of a client with RA. the nurse understands that which is an early clinical manifestation of RA
anorexia
a patient has developed serum sickness. what is the most likely cause
antibiotic therapy caused by penicillin
interventions to prevent VTE
anticoagulants exercises sequential compression devices ted hose
drug therapy used for angioedema
antihistamine corticosteroids epinephrine
parents bring their child to the ED and tell the nurse that the child has been complaining of colicky abdominal pain located in the RLQ of the abdomen. the nurse suspects that the child has which disorder?
appendicitis
a client with acute UC requests a snack. which is the most appropriate snack for this client
applesauce and a graham cracker
what to avoid with a patient with appendicitis
application of heat to the abdomen -can cause rupture of the appendix -this leads to peritonitis
The nurse is caring for a patient experiencing an anaphylactic reaction to an intravenous (IV) drug. Which nursing intervention is priority for this patient?
apply oxygen using a high flow, non-rebreather mask at 90% to 100%
The home health nurse is visiting a client with a diagnosis of multiple sclerosis. The client has been taking oxybutynin. The nurse evaluates the effectiveness of the medication by asking the client which assessment question?
are you getting up at night to urinate
what should nurses be aware of in RA
arthritis often accompanies other diseases -psoriasis -CD -hemophilia
a client calls the nurse in the ED and states that he was just stung by a bee while gardening. the client is afraid of a severe reaction because the clients neighbor experience such a reaction just 1 week ago. which action should the nurse take
ask the client if they have ever sustained a bee sting in the past
a client with a history of asthma comes to the ED complaining of itchy skin and SOB after starting a new antibiotic. what is the first action the nurse should take
assess for anaphylaxis and prepare for emergency treatment
what to immediately assess in a patient who is suffering from an allergic reaction
assess respiratory status and airway immediately remove and IV drug/antibiotic
a patient with anaphylaxis is admitted to the ED. order of interventions for the nurse to perform
assess the respiratory status of the patient stabilize the airway immediately tracheostomy equipment should be available initiate supplemental oxygen epinephrine - IM
A patient is experiencing reduced chest movement and impaired airflow, hypotension, and a rapid, weak, irregular pulse. What should be the nurse's first priority?
assessing gas exchange
a patient is experiencing reduced chest movement and impaired airflow hypotension, and a rapid, weak, irregular pulse. what should be the nurses first priority
assessing gas exchange respiratory management is critical during an anaphylactic reaction
which intervention should the nurse implement prior to administering TPN
assist the HCP with a subclavian line insertion
a client with viral hepatitis states "I am so yellow". what is the most appropriate nursing action
assist the client in expressing feelings
amount of fluids per day for patients with viral hepatitis
at least 4000mL/day
the nurse is caring for a patient admitted with complications of MS. the nurse assesses the patient for which cerebellar manifestations of MS
ataxia dysphagia dysarthria nystagmus
What is Sjorgren's syndrome caused by
autoimmune destruction of the lacrimal, salivary, and vaginal mucous-producing glands
goodpastures syndrome
autoimmune disorder antibodies are made against the glomerular basement membrane and neutrophils
a patient has developed a type 2 hypersensitivity reaction. which condition is associated with this type of hypersensitivity
autoimmune hemolytic anemia
The nurse is performing discharge teaching for a client with chronic pancreatitis. Which information should the nurse include?
avoid caffeine because it may aggravate symptoms
what teaching is important to give a patient receiving interferon beta -1b?
avoid crowds rotate the injection site
After assessing the laboratory reports of a patient, the nurse concludes the patient's immunity is compromised. Which instructions will the nurse give to the patient? Select all that apply.
avoid digging in the garden Wash your genitals twice a day with antimicrobial soap if total bathing is not possible
what to remind RA patients of
avoid large crowds other possible sources of infection
education to avoid sunlight for SLE patients
avoid prolonged exposure to sunlight and other forms of ultraviolet lighting including certain types of fluorescent light. wear long sleeves and a large brimmed hat when outdoors sun protection factor (SPF) of 30 or higher on exposed skin surfaces.
a patient with a type 1 a;;edgy is treated with antihistamine and corticosteroids. what other measure can help the patient to prevent future recurrence of allergies
avoidance therapy
what to educate patients on who are taking steroids or immunosuppressants
avoiding large crowds avoid people who are ill report early signs of infection to HCP take medication early in the morning before breakfast
what can make CD worse
bacterial infections
BRAT diet
bananas, rice, applesauce, toast
a client diagnosed with HIV is concerned about getting opportunistic infections and asks the nurse how to prevent them. which interventions does the nurse recommend to the client?
bathe daily using an antimicrobial soap
why should a patient with SLE take the corticosteroid early in the morning before breakfast
because that is the time when the body's natural corticosteroid level is the lowest.
first drug approved for SLE
belimumab Belimumab is an IV human monoclonal antibody (mAb) that prevents B-lymphocyte stimulator protein from binding to B-cell receptor sites It is given with other drugs to treat SLE. Like for other biologics, teach patients that the drug increases their risk for serious infections. Teach them not to receive live vaccines for 30 days before treatment.
A patient presents with severe angioedema of the lips, face, and tongue. Which medication is most likely to have caused this hypersensitivity reaction?
benanzepril
teaching for arthritic patients
benefits of exercise joint protection techniques energy conservation guidelines
a patient presents with severe angioedema of the lips, face, and tongue. which medication is most likely to have caused this hypersensitivity reaction
benzapril (lotensin)
the nurse is assigned to care for a client with AIDS that is suspected of having Kaposis sarcoma. the nurse should prepare the client for which test
biopsy
which medication is contraindicated for a client with an ileostomy
biscodyl
highest risk of concentrations in a infected patient
blood semen vaginal secretions breast milk
where is HIV located in a infected patient
blood semen vaginal secretions breast milk amniotic fluid urine feces saliva tears cerebrospinal fluid lymph nodes cervical cells corneal tissue brain tissue
a client diagnosed with HIV is prescribed Zidovudine (Retrovir), efavirenz, lamivudine, and enfurvirtide. the client asks the nurse what will happen if the prescriptions are not refilled on time or if a few doses of one of the medications are missed. what is the nurses best response
blood concentration will be decreased, which will lead to increased viral replication
turners sign
bluish discoloration of the flank
which factors are possible transmission routes for HIV
breast feeding anal intercourse oral sex
what does bloody stool look like in a patient with UC
bright red (frank) black and tarry (melena)
What phase of the human immunodeficiency virus (HIV) life cycle involves separating from the infected cell's membrane to search for another CD4+ T-cell to infect?
budding
major skin manifestation of SLE
butterfly rash dry, scaly raised rash
how is hepatitis confirmed
by acute elevations of liver enzymes -indicates liver cellular damage -bilirubin -liver biopsy -aminotransferase
ulcerative colitis labs
c reactive protein essay ESR platelet leukocyte serum albumin
what to avoid with UC
caffeine alcohol (increase diarrhea and cramping)
pancytopenia
can be seen in a CBC - decrease of all cell types
if a patient becomes HIV positive as a result of a single sexual encounter, how long is the progression to AIDs
can be up to 10 years
NRTI lamivudine/zidovudine
can cause -anemia -neutropenia -lactic acidosis
NRTI emtricitabine
can cause -headache -diarrhea -nausea -rash -hyperpigmentation of palms and soles
NRTI tenofovir
can cause -nausea -vomiting
NNRTI Efavirenz
can cause -rash -dizziness -confusion -difficulty concentrating -dreams
Fusion Inhibitor: Enfuvirtide
can cause -skin irritation at injection site -fatigue -nausea -insomnia -peripheral neuropathy
NNRTI: Etravirine
can cause: -rash -GI upset -headache -hypertension -peripheral neuropathy
A patient's serum contains a highly elevated level of immunoglobulin E (IgE) antibodies (140 IU/mL). What could be the possible effects of this elevated IgE? Select all that apply.
capillary leak pruritus and inflammation excessive release of histamine
the location of the appendix is attached to which part of the GI system?
cecum
Which statement describes systemic lupus erythematosus (SLE)?
characterized by intermittent remissions and exacerbations
a client who has undergone gastric surgery has an NG tube connected to low intermittent suction that is not draining properly. which action should the nurse take initially
check the suction device to make sure it is working
A client with Crohn's disease is scheduled to receive an infusion of infliximab. What intervention by the nurse will determine the effectiveness of treatment?
checking frequency and consistency of bowel movements
The nurse is providing dietary instructions to a client hospitalized for pancreatitis. Which food should the nurse instruct the client to avoid?
chili
if a HIV/AIDs patient has an opportunistic infection, how will it present
chills, fever, or temperature instability purulent drainage or sputum diarrhea chest x-ray infiltration (WBC) count out of the patient's normal range
the nurse provides care for a patient admitted with MS. which medications does the nurse expect will be ordered for the patient?
cholinergic - bladder dysfunction stool softeners - bowel dysfunction muscle relaxants - reduce stiffness glucocorticoids - treat relapses
what is SLE
chronic progressive inflammatory CTD that can cause major body organs and systems to fail
multiple sclerosis
chronic autoimmune disease the affects the myelin sheath and conduction pathway of the central nervous system
crohns disease
chronic, inflammatory disease of the small intestine, and the colon. it presents as inflammation that causes a thickened bowel wall -slowly progressive and unpredictable
systematic lupus erythematosus (SLE)
chronic, progressive, inflammatory connective tissue disorder that can cause major body organs and systems to fail.
What is rheumatoid arthritis?
chronic, progressive, systemic inflammatory autoimmune disease process that affects primarily the synovial joints
what can chronic hepatitis lead to
cirrhosis liver cancer
education for skin washing for SLE patients
clean the skin with mild soap (ivory) avoid hard perfumed washes apply lotion after showering mild protein shampoos (alopecia is common)
definitive test for UC
colonoscopy
assessment findings reveal that a patient admitted to the hospital has a contact type 1 hypersensitivity to latex. which preventive nursing intervention is best in planning care for this patient
communicate the need for avoidance therapy to the health care team
what does a pale pink stoma indicate
compromised circulation -LOW HEMO/HEMA
what does a purple/black stoma indicate
compromised circulation -contact HCP immediately
central nervous system signs and symptoms of AIDs
confusion dementia personality changes
the nurse is providing dietary instructions to a client with a diagnosis of IBS. the nurse determines that education was effective if the client states the need to avoid which food
corn
in most cases the treatment of choice for SLE is
corticosteroids
an infant of a mother with HIV is seen in the clinic each month and is being monitored for symptoms. with knowledge of the most common opportunistic infection of children infected with HIV, the nurse assesses the infant for which signs
cough
the nurse is caring for a client with AIDS and detects early infection with pneumocystis jiroveci by monitoring the client for which clinical manifestation
cough
respiratory signs and symptoms of AIDs
cough shortness of breath
Which are required elements of the human immunodeficiency virus (HIV) testing process? Select all that apply.
counseling interpretation confidentiality
intervention to use for a patient with a latex allergy and using crutches
cover the crutch pads with cloth
medications used to decrease inflammation and stabilize the disease process of MS
cyclophosphamide methylprednisone adrenocorticotropic hormone (ACTH)
what medications are given in combination with immunosuppressive therapy to stabilize the disease process and decrease inflammation in patients diagnosed with MS
cyclophosphamide methylprednisone adrenocorticotropic hormone (ACTH)
the nurse is caring for a patient with AIDs who is experiencing impaired vision, fever, and malaise. the nurses physical assessment finds swollen lymph nodes. what opportunistic infection is the most likely diagnosis
cytomegalovirus CMV
what is a type three reaction
cytotoxin reaction autoimmune hemolytic anemia goodpastures syndrome
the nurse inspects the color of the drainage from a NG tube 24 hours after gastric surgery. which finding indicates the need to notify the HCP
dark red drainage
which outcome should the nurse expect to observe in the client who is recovering from viral hepatitis without complications
decrease in aspartate aminotransferase (AST)
diphenoxylate hydrochloride with atropine sulfate is prescribed for a client with UC. the nurse should monitor for which therapeutic effect of this medication
decreased diarrhea
The nurse is caring for a client with ulcerative colitis. Which finding does the nurse determine is consistent with this diagnosis?
decreased hemoglobin
the nurse is caring for a client with UC. which finding does the nurse determine is consistent with the diagnosis
decreased hemoglobin -due to 10-20 bloody stools per day
a CBC is performed in a client with SLE. the nurse would suspect which finding will be noted
decreased number of all cell types
a CBC is performed on a client with SLE. the nurse suspects that which finding will be reported
decreased numbers of all cell types
major factor in fatal outcomes for anaphylaxis
delay in the administration of epinephrine
the nurse is caring for a patient with poison ivy skin rash. what type of hypersensitive reaction is the patient experiencing
delayed reaction - reactive cell is T cell
GI signs and symptoms of AIDs
diarrhea weight loss nausea and vomiting
necrotizing hemorrhagic pancreatitis (NHP) characteristics
diffusely bleeding pancreatic tissue with fibrosis and tissue death
antidiarrheals used for UC and crohns
diphenoxylate loperamide
the nurse assess a patient with MS for motor, sensory, cerebellar, and emotional manifestations. which are motor manifestations of MS?
diplopia scanning speech spasticity of muscles weakness or paralysis of limbs, trunk, and head
cullens sign
discoloration of the abdomen and periumbilical area
A patient who is receiving an intravenous antibiotic begins to cough and states, "My throat feels like it is swelling." Which action will the nurse take next?
discontinue infusing the antibiotic
a patient who is receiving an IV antibiotic begins to cough and states "my throat feels like it is swelling" which action will the nurse take next?
discontinue infusing the antibiotic
Which factor indicates to the nurse the only similarity between discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE)?
disfiguring and embarrassing rash
what do avoid when experiencing candidiasis
do not use commercial mouth wash, cannot tolerate the alcohol
the nurse reviews the medication HX of a client and notes that the client is taking leflunomide. during assessment of the client the nurse should ask which question to determine the effectiveness of this medication
do you have any joint pain?
the nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital. which assessment question would most specifically elicit information regarding the pain that is associated with acute pancreatitis
does the pain in your stomach radiate to your back
education for belimumab
drug increases risk for serious infection do not receive a live vaccine 30 days before treatment
while caring for patients diagnosed with MS, the nurse should see the patient with which symptoms first
dysphasia at risk for aspirating
the nurse who is working for a home care agency assesses a patient with MS. the patient is experiencing cognitive impairment. which intervention is appropriate for this patient?
educating the patient to keep medications in a familiar place
most important aspect for prevention of HIV
education
the nurse is caring for a client with pancreatitis. which finding should the nurse expect to note when reviewing the clients lab results
elevated level of amylase
how is pancreatitis diagnosed
elevated lipase/amylase -clinical presentation (LUQ/mid epigastric pain)
The nurse is reviewing the results of serum laboratory studies for a client admitted for suspected hepatitis. Which laboratory finding is most associated with hepatitis, requiring the nurse to contact the health care provider?
elevated serum bilirubin level
The nurse is caring for a client with acute pancreatitis. Which finding should the nurse expect to note when reviewing the laboratory results?
elevated serum lipase
the nurse is caring for a client with acute pancreatitis. which finding should the nurse expect to note when reviewing the laboratory results
elevated serum lipase levels
laboratory findings that indicate perforation of the appendix
elevation of WBC greater than 20,000
A client with acquired immunodeficiency syndrome (AIDS) is receiving ganciclovir. The nurse should take which priority action in caring for this client?
ensure that the client uses an electric razor
a client with AIDS is receiving ganciclovir. the nurse should take which priority action in caring for this client
ensure that the client uses an electric razor for shaving
what class of drugs for HIV prevents viral binding
entry inhibitors
first sign of acute pancreatitis
epigastric pain centered close to the umbilicus radiates between the 10th thoracic and 6th lumbar vertebrae and is unrelieved by vomiting
the nurse is assessing a patient with MS is aware that although patients with this condition can expect a normal lifespan, they can develop a variety of complications. which complications should the nurse evaluate the patient?
epilepsy muscle stiffness/spasms paralysis, typically in legs problems with bladder, bowel, or sexual functioning
multiple sclerosis is characterized by
episodes of remission and exacerbation of an inflammatory response that results in demyelinization
The nurse is preparing to administer an intermittent enteral feeding though a nasogastric (NG) tube. Which priority assessment should the nurse perform?
evaluate absorption of the last feeding
how often should the patient taking tenofovir/emtricitabine for PrEP should be tested for HIV?
every three months
fever is the classic sign of what in SLE
exacerbation or flare up
what is a type 3 reaction
excess antigens cause the formation of immune complexes in the blood:
interventions for diplopia
eye patch
the nurse is performing an assessment on a female client who complains of fatigue, weakness, muscle and joint pain, anorexia, and photosensitivity. SLE is suspected. what should the nurse further assess for that also is indicative of SLE
facial rash
which risk factors would the nurse educate a patient about in regards for MS
family history age 20-50 history of Epstein Barr virus caucasian
the nurse is providing instructions to the mother of a child with HIV regarding immunizations. which statement by the mother indicates an understanding of the schedule
family members in the household need to receive the influenza vaccine
A client with chronic pancreatitis needs information on dietary modification to manage the health problem. Which item in the diet should the nurse teach the client to limit?
fat
A client is admitted to the hospital with acute viral hepatitis. Which sign or symptom should the nurse expect to note based on this diagnosis?
fatigue
what is an immunological manifestations of AIDs
fatigue
most disabling manifestations of MS
fatigue -associated with continuous sensitivity to temperature
What are the clinical signs and symptoms of adrenal insufficiency associated with acquired immune deficiency syndrome (AIDS)? Select all that apply.
fatigue nausea electrolyte disturbances
most comfortable position for patients with acute pancreatitis
fetal position sitting upright and bending forward
Some adults develop an acute infection within four weeks of first being infected with human immunodeficiency virus (HIV). What symptoms may indicate this acute HIV infection? Select all that apply.
fever night sweats muscle aches
oral immunomodulator for MS
fingolimod (Gilenya)
preicteric stage of hepatitis
first stage -jaundice -malaise -fatigue -anorexia -GI upset -ELEVATED bilirubin/enzymes
what is a common complication of CD but not of UC
fistulas
A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery?
fluid and electrolyte imbalance
a client has just had surgery to create an ileostomy. the nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery
fluid and electrolyte imbalance
education for hydroxychloroquine
frequent eye examinations before starting the drug and q 6 months after
how can someone be infected with HIV perinatally
from the placenta from contact with maternal blood and body fluids during birth breast milk from infected mother to child
The nurse is reviewing the health care provider's prescriptions written for a client admitted to the hospital with acute pancreatitis. Which prescription requires follow-up by the nurse?
full liquid diet
which factor relates most directly to a diagnosis of primary immune deficiency
full term infant surfactant deficiency -genetic mutation
what type of infection is pneumonocystis kiroveci pneumonia
fungal infection
complications of peritonitis
gangrene perforation
what causes CD
genetic immune environmental
what causes MS
genetic predisposition
how can someone be infected with HIV sexually
genital, anal, or oral sexual contact with exposure of mucous membranes to infected semen or vaginal secretions
the nurse is conducting a physical assessment for visual acuity, visual fields, and pupils in a patient diagnosed with MS. which clinical finding is not a complication of MS
glaucoma
a client is diagnosed with good-assures syndrome. the nurse determines that this clients renal disease is caused by a type 2 hypersensitivity response. which lab result would be most important for the nurse to evaluate
glomerular filtration rate (GFR)
what laboratory result would indicate a perforated appendix
greater than 20,000 mm3
common symptoms of lupus erythematosus
hair loss swelling and redness of the knees inflammation in 5+ joints
the community health nurse is conducting a research study and is identifying clients in the community at risk for latex allergy. which client population is most at risk for developing this type of allergy
hairdressers, health care workers, people that work in rubber factories
standard precautions for patients with HIV
handwashing gown gloves
The nurse is caring for a patient who is being admitted for muscle weakness, fatigue, and vertigo. The patient reports feeling some numbness and tingling in the legs. What question by the nurse is most appropriate?
have you ever experienced anything like this before
the nurse is caring for a patient who is being admitted for muscle weakness, fatigue, and vertigo. the patient reports feeling some numbness and tingling in the legs. what question by the nurse is most appropriate?
have you ever experienced anything like this before
in discharging a client diagnosed with AIDS, which statement by the nurse uses a nonjudgemental approach in discussing sexual practices and behaviors?
have you had sex with men or women or both?
a client has been ordered norepinephrine for treatment of severe hypotension. the nurse plans to monitor the client for which adverse effects
headache -vassopresser
what can occur with high doses of sulfasalazine
hemolytic anemia hepatitis male infertility agranulocytosis
if a patients immunity is compromised, which hepatitis are they more likely to contract
hepatitis B (HBV)
chronic hepatitis usually occurs as a result of
hepatitis B AND C
what cases need to be reported to the local health department and the CDC
hepatitis cases
the nurse is caring for a patient with AIDs who has painful genital lesions, fever, and malaise. the nurses physical assessment finds swollen lymph nodes. what opportunistic infection is the most likely diagnosis
herpes simplex virus
Which minority group shows an increasing trend in human immunodeficiency virus (HIV) infection?
hispanics
if a patient develops angioedema what should the nurse do
hold the dose of any prescribed drug
a client asks the nurse about obtaining a home test kit for HIV status. what should the nurse tell the client
home test kits may not be as reliable as lab blood tests
what should patients with MS avoid
hot showers at risk for burns due to peripheral neuropathy
when do type 4 reactions occur
hours to days after exposure -causes -edema -induration -ischemia -tissue damage at site
What medication used in the treatment of lupus erythematosus decreases the risk for skin lesions?
hydroxychloroquine
the nurse is reviewing the medical record of a patient who is prescribed a decongestant. the nurse plants to contact the patients HCP if the patient has which condition
hypertension
The nurse is reviewing the medical record of a patient who is prescribed a decongestant. The nurse plans to contact the patient's health care provider if the patient has which condition?
hypertension decongestants can cause vasoconstriction which will increase BP
pain relief for patients with arthritis
ice/heat rest positioning complementary/alternative therapies medication
what is a type 1 reaction
immediate hypersensitive reaction: hay feber allergic asthma anaphylaxis
Abnormal functioning of which body system is responsible for the signs and symptoms of human immunodeficiency virus (HIV) disease?
immune
what are the main factors that cause damage to patients with RA
immunity and inflammatory factors cause cartilage damage
the nurse is assisting in administering immunizations as well as providing education. which statement by a client indicates that the teaching was successful
immunizations are a way to acquire immunity to a specific disease
which drug type does the nurse expect to administer as a part of the treatment plan for a patient with relapsing MS?
immunomodulator interferon-beta -1b
what is the purpose of drug therapy for RA
improve comfort by reducing pain and secondary joint inflammation
what is the purpose of managing MS
improve function manage symptoms prevent exacerbations
what does dalfampridine do for patients with multiple sclerosis
improve the patients ability to walk
an HIV positive client with AIDs is seen in the clinic for reevaluation of the immune systems response to prescribed medication. which test result does the nurse convey to the HCP?
improved CD4+ T-cell count and reduced viral load
Dysmetria
inability to control the distance, power, and speed of a muscular action
The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which piece of assessment data should alert the nurse to this occurrence?
inability to pass flatus
paralytic ileus
inability to pass flatus
the nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. which piece of assessment data should alert the nurse of this occurrence
inability to pass flatus
dysdiadochokinesia
inability to perform rapid alternating movements
aquired immunity
includes all antigen specific immunities that a person develops in a lifetime
a client is diagnosed with viral hepatitis complaining of no appetite and losing a taste for food. what instruction should the nurse give the client to provide adequate nutrition
increase intake of fluid, including juices
what amylase level can signify pancreatitis in patients with AIDS
increased by 1.5 - 2.0 times than normal
The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine. The nurse interprets that the client may have the medication discontinued by the health care provider if which elevated result is noted?
increased serum amylase
a newborn infant of a mother who has HIV is tested for the presence of HIV antibodies. an ELISA test is performed and the results are positive. which is the correct interpretation of these results
indicates the presence of maternal infection
the nurse is reviewing the diagnostic tests performed on an adult with a CTD. the ESR is reported as 35 mm/hr. how should the nurse interpret this finding
indicating mild inflammation
what is the priority concern for a client with immunodeficiency
infection
A client who has been receiving pentamidine intravenously now has a fever with a temperature of 102°F (38.9°C). Keeping in mind that the client has a diagnosis of acquired immunodeficiency syndrome (AIDS) and Pneumocystis jirovecipneumonia, the nurse should interpret that this fever is most associated with which condition?
infection caused by leukopenic effects of the medication
a client who has been receiving pentamidine intravenously now has a fever of 102F. keeping in mind that the client has a diagnosis of AIDS and pneumonocystis jiroveci pneumonia, the nurse should interpret that this fever is most associated with which condition
infection caused by leukopenic effects of the medication
clinical manifestations of SLE
inflamed red rash discoid lesions nephritis pericarditis raynauds phenomenon plural effusion joint inflammation (poly arthritis) abdominal pain fever Fatigue Anorexia Weight loss Generalized weakness Vasculitis
what contributes to pancreatic insufficiency/diminished function of the organ
inflammation and fibrosis of the tissue
urge all patients who are HIV positive to what?
inform their sexual partners of their HIV status
A client is admitted with an exacerbation of multiple sclerosis. The nurse is assessing the client for possible precipitating risk factors. Which factor, if reported by the client, should the nurse identify as being unrelated to the exacerbation?
ingestion of increased fruits and vegetables
NRTIs and NNRTIs work by
inhibiting the activity of reverse transcriptase
fusion inhibitors work by
inhibiting the binding of HIV to cells
what does antiretroviral therapy do
inhibits viral replication DOES NOT KILL THE VIRUS
The home health nurse has been discussing interventions to prevent constipation in a client with multiple sclerosis. The nurse determines that the client is using the information most effectively if the client reports which action?
initiating a bowel movement every other day -45 minutes after the largest meal of the day
What class of drugs for human immunodeficiency virus (HIV) infection prevents the virus from inserting its DNA into the host's DNA?
integrase inhibitors
PIs work by
interfering with the activity of the enzyme protease
medication that reduces progression in MS
interferon beta-1a/1b
what immunomodulator is used in the treatment of MS?
interferon beta-1b
A client with multiple sclerosis is experiencing muscle weakness, spasticity, and an ataxic gait. On the basis of this information, the nurse should include which client problem in the plan of care?
interruption in physical mobility
what is cryptosporidiosis
intestinal infection
primary progressive MS
involves a steady, gradual neurologic deterioration with plaques on the brain and spinal cord
majority of deaths in patients with acute pancreatitis are caused by
irreversible shock
the home health nurse is making an initial home visit to a client currently living with family members after being hospitalized with pneumonia and newly diagnosed with AIDs. which statement by the nurse best acknowledges the clients fear of discovery of his AIDs by his family
is there somewhere private in the home where we can go and talk
an ESR determination is prescribed for a client with a CTD. the client asks the nurse about the purpose of the test. how should the nurse respond
it confirms the presence of inflammation or infection in the body
a CD4+ lymphocyte count is performed in a client with HIV. when providing education about the testing, what should the nurse tell the client
it establishes the stage of HIV infection
How does the assessment of the financial resources of the patient with AIDS help the nurse?
it helps in assessing the nutritional status of the patient
the nursing instructor asks a nursing student to identify the components of natural resistance as it relates to the immune system. which statement by the nursing student indicates a need for further research
it includes all antigen specific immunities a person develops during a lifetime
The client with a small bowel obstruction asks the nurse to explain the purpose of the nasogastric tube attached to continuous gastric suction. The nurse determines that teaching has been effective if the client makes which statement?
it will help to remove gas and fluids from my stomach and intestine
The nurse is caring for a patient with acquired immunodeficiency syndrome (AIDS) who has small, purplish brown, raised lesions on the skin. The patient denies itching or discomfort at the site of the lesions. What is the most likely diagnosis?
kaposi's sarcoma
Which methods are useful in decreasing fatigue in a patient with multiple sclerosis (MS)?
keeping frequently used items easily accessible
postiteric stage of hepatitis
last stage of hepatitis -jaundice decreases -color of urine/stool return back to normal -energy increases -bilirubin/enzyme levels return to normal
the nurse is caring for a client admitted to the Hospital with a suspected diagnosis of acute appendicitis, which lab finding should the nurse expect
leukocytosis with a shift to the left
The nurse is assisting a client with Crohn's disease to ambulate to the bathroom. After the client has a bowel movement, the nurse should assess the stool for which characteristic that is expected with this disease?
loose, watery stool
the nurse is giving dietary instructions to a client who has a new colostomy. the nurse should encourage the client to eat foods representing which diet for the first 4-6 weeks postop
low fiber
A patient reports hair loss, swelling, and redness of knees to the nurse. The test reports of the patient reveal inflammation of five joints. Which condition does the nurse suspect in the patient?
lupus erythematosus
While reviewing the laboratory test reports of a patient, the nurse finds a false-positive venereal disease research laboratory (VDRL) syphilis test. Which condition does the nurse suspect in the patient?
lupus erythematosus (SLE)
A client with acute pancreatitis is experiencing severe pain from the disorder. The nurse determines that education about positioning to reduce pain was effective if the client avoids which action?
lying flat
What are B lymphocytes responsible for?
making antibodies and mediating humoral immunity
a client has developed HAV after eating contaminated oysters. the nurse assesses the client for which expected assessment finding
malaise
the nurse is assessing a patient with suspected serum sickness. which symptoms are consistent with serum sickness/
malaise arthralgia lymphadenopathy
kaposis sarcoma
marked by small, purplish brown, raised lesions on skin - mucous membranes that are usually not painful or itchy
AIDs cases usually occur in North America among
men who have had sex with other men
PrEP is for who?
men who have sex with men heterosexually active men and women injecting drug users serodiscordant relationship (one partner positive, other negative)
AIDs is most common in
men who have sex with men (MSM) adults of either gender who have used injection drugs black/African American hispanic
the nurse is assigned to care for a client with HIV. the nurse reviews the clients health care record and notes documentation of toxoplasmosis encephalitis. on the basis of this information, the nurse would assess for which manifestation
mental status changes
medication to reduce CNS inflammation
methylprednisone
medication for patients with fistulas
metronidazole (Flagyl)
A client with viral hepatitis has no appetite, and food makes the client nauseated. Which nursing intervention is appropriate?
monitor fluid and electrolyte imbalance
a client with viral hepatitis has no appetite and food makes the client nauseated. which nursing intervention is appropriate
monitor for fluid and electrolyte imbalance
how to prioritize care for patients with SLE
monitor for life threatening conditions -renal failure -pericarditis
a patient with MS will begin therapy with fingolimod. which instruction does the nurse give to the patient about this drug
monitor pulse daily can cause bradycardia especially within the first 6 hours of administration
side effects of steroids
mood changes weight gain - causes patient to hold onto water, can also make patient very hungry hyperglycemia - watch glucose levels (if DM) bone loss - risk of osteoporosis hypertension
the mother with HIV brings her 10 month old to the clinic for a routine checkup. the HCP has documented that the infant is asymptomatic for HIV. after the checkup the mother tells the nurse that she is so pleased that the infant will not get HIV. the nurse should make which most appropriate response to the mother
most children infected with HIV develop symptoms within the first 9 months of life. and some become symptomatic sometime before they are 3 years old
viral hepatitis
most common type of hepatitis and can be either acute or chronic
Type 1 hypersensitivity/rapid
most common type of hypersensitivity -results from increased production of IgE
where does CD effect someone
mouth to the anus -most common TERMINAL ILEUM
Which gastrointestinal (GI) signs and symptoms may occur in a patient with acquired immunodeficiency syndrome (AIDS)? Select all that apply.
nausea diarrhea
which gastrointestinal signs and symptoms may occur in a patient with AIDs
nausea diarrhea
multi organ system failure may be caused by what in acute pancreatitis
necrotizing hemorrhagic pancreatitis (NHP)
main reason for occupation-related HIV infection
needle sticks "sharp" injuries
what is an integumentary manifestation of AIDs
night sweats
what symptoms are seen in patients with primary progressive multiple sclerosis
no acute attacks steady neurologic deterioration
Consensual and nonconsensual sexual exposures involving insertive and receptive types of sex with oral, vaginal, or anal contact are considered which type of exposure to human immunodeficiency virus (HIV)?
non-occupational
what should the nurse put in place for precautionary measures while treating a patient with a history of allergic reactions
normal saline administration
the nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. the client begins to complain of increased abdominal pain and begins to vomit. on assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. which Is the most appropriate nursing intervention
notify the HCP
What class of drugs for human immunodeficiency virus (HIV) infection reduces how well HIV genetic material can be converted into human genetic material?
nucleoside reverse transcriptase inhibitors (NRTIs)
which factor distinguishes a diagnosis of HIV and AIDs
number of CD4+ T cells
who should not provide care to a patient with HIV?
nurses with weeping dermatitis
Which food items may cause anaphylaxis in some individuals? Select all that apply.
nuts eggs peanuts shellfish
signs and symptoms of MS
nystragmus diplopia blurred vision dysarthria dysphasia urinary retention spastic bladder constipation ataxia vertigo
a client with multiple sclerosis tells a home health care nurse that she is having increasing difficulty in transferring from the bed to a chair. What is the initial nursing action?
observe the client demonstrating the transfer technique
What teaching is priority for a patient taking dalfampridine?
observing for seizure activity
a patient has been ordered by the HCP to carry a bee stink kit at all times. what does the nurse teach the patient about the care and use of the device
obtain a replacement device if the drug is discolored
education for allergy kit/epi pen
obtain a replacement device is the drug is discolored (drug must be clear) -keep at least two drug filled devices on hand -the drug is injected into the thigh -patient most go to the nearest hospital for observation for at least 4-6 hours after the device is used
a client who is HIV positive has a CD4+ count of 15 has just been admitted with a fever and abdominal pain. which HCP request does the nurse implement first
obtain blood cultures from two sites -antibiotics should be given once the cultures return
type 2 cytotoxic reaction
occurs when the body makes special autoantibodies directed against self-cells that have some form of foreign protein attached to them
steatorrhea
oily stools fat in the feces common in CD
what will stool look like in a patient with pancreatitis
oily, fatty frothy pale less dense
which age group is perforation more likely in
older adult
recommendation for HIV screening
one-time screen for all adults between the ages of 15 and 65 annual screening of those who are at heightened risk for HIV infection routine prenatal screening frequent testing in adults with repeated high-risk exposures.
what is histoplasmosis
opportunistic infection that effects the lungs
Which term describes infections caused by organisms that are present as part of the body's microbiome and usually are kept in check by normal immunity but may cause infection in patients with acquired immunodeficiency syndrome (AIDS)?
opportunistic infections
patients with low CD4+ Cell counts are at risk for what conditions caused by organisms that are present as a part of the body microbiome and usually kept in check by normal immunity
opportunistic infections
The nurse is caring for a client experiencing an exacerbation of Crohn's disease. Which intervention should the nurse anticipate the health care provider prescribing?
oral corticosteroids (treat inflammation)
opportunistic infections are caused by what
organisms that are present as a part of the body microbiome and usually are kept in check with normal immunity
herpes simplex virus
painful lesions fever pain bleeding enlarged lymph nodes headache myalgia malaise
the nurse is teaching a patient newly diagnosed with MS. which statement by the patient indicates a correct understanding of the pathophysiology of the disease
parts of my nervous system have plaques
manifestations of peritonitis
patient appears -acutely ill -lying still -knees flexed -abdominal pain -tenderness -distention
As a CD4+ T-cell level drops, what occurs?
patient is at risk for bacterial, fungal, and viral infections as well as opportunistic cancers
Stage 0 of HIV
patient who develops a first positive HIV test result within 6 months after a negative HIV test result.
stage 2 of HIV
patient with a CD4+ T-cell count between 200 and 499 cells/mm3 and a percentage between 14% and 28%. An adult at this stage has no AIDS-defining illnesses.
stage 1 of HIV
patient with a CD4+ T-cell count of greater than 500 cells/mm3 or a percentage of 29% or greater. An adult at this stage has no AIDS-defining illnesses.
stage 3 of HIV
patient with a CD4+ T-cell count of less than 200 cells/mm3 or a percentage of less than 14%. An adult who has higher CD4+ T-cell counts or percentages but who also has an AIDS-defining illness
most common anaphylaxis agent
penicillin
The nurse is teaching a patient about multiple sclerosis. What statement by the patient indicates a need for further teaching?
people with Asian ancestry are more likely to get multiple sclerosis
the nurse is caring for a child who was brought to the clinic complaining of severe abdominal pain and is suspected of having acute appendicitis. the child is lying on the examining table with the knees pulled up toward the chest. what is the priority nursing concern
perform a pain assessment using the FACES scale
A patient diagnosed with multiple sclerosis is having difficulty managing her activities of daily living (ADLs) due to weakness, fatigue, and loss of balance. What is recommended for this patient?
perform regular exercise
a client is admitted to the hospital with a diagnosis of pericarditis. the nurse should assess the client for which manifestation that differentiates pericarditis from other cardiopulmonary problems.
pericardial friction rub
What are the cardiovascular manifestations of systemic lupus erythematosus (SLE)?
pericarditis raynauds phenomenon
the nurse is assessing a client with liver disease for s/s of low albumin. which s/s should the nurse expect to note
peripheral edema
perforation of the appendix results in
peritonitis -TEMP will increase 101 -PULSE will increase
a patient has developed a type 2 hypersensitivity. which mechanism is involved in this type of allergic reaction
phagocytes of self cells
what do neutrophils do
phagocytize any potentially harmful agents
A 12 year old girl is admitted to the hospital with suspected appendicitis. what nursing interventions should be implemented preoperatively
placing the adolescent in a fetal position -side lying with legs drawn up to the chest
a client has symptoms of RA. which laboratory finding indicates to the nurse the the client may have RA?
positive antinuclear antibody (ANA) elevation of ANA is common in SLE, RA, & SSc
the client with AIDS is diagnosed with cutaneous Kaposis sarcoma. based on this diagnosis, the nurse understands that this has been confirmed by which finding
positive punch biopsy of the cutaneous lesions
in planning care for a client with an acquired secondary immune deficiency with Candida albicans, which problem has the highest priority
potential for infection transmission related to recurring opportunistic infections
stages of hepatitis
preicteric icteric posticteric
what is pancreatitis caused by
premature activation of excessive pancreatic enzymes that destroy pancreatic tissue, resulting in auto digestion and fibrosis of the pancreas
which laboratory findings may support a diagnosis of MS
presence of myelin proteins in the CSF presence of increased protein levels in the CSF presence of increased IgG antibodies in the CSF
A patient with systemic lupus erythematosus reports abdominal pain to the nurse. What could be a possible cause for this condition?
presence of serositis
a rheumatoid factor assay is performed in a client with suspected diagnosis of RA. which lab results should the nurse anticipate
presence of unusual antibodies of the IgG and IgM types
Higher incidences of which conditions occur among pregnant women with human immunodeficiency virus (HIV)? Select all that apply.
preterm delivery low birth weight vertical transmission (mother to infant)
Which rationale is accurate regarding the use of interferon beta-1b for patients with multiple sclerosis (MS)? Select all that apply.
prevention of relapse modification of disease progression
which rationale is accurate regarding the use of interferon beta-1b for patients with MS
prevention of relapse modification of disease progression
which type of MS involves steady and gradual neurological deterioration without temporary diminution of the symptoms
primary progressive MS
the patient reports progressive fatigue, muscle weakness, and diplopia that has worsened during the past six months. the MRI reveals the presence of plaques on the brain and spinal cord. what diagnosis does the nurse anticipate
primary progressive multiple sclerosis
ileostomy
procedure where the loop of the ileum is placed through the abdominal wall for drainage of fecal material into a pouching system
what is phagocytosis
process of ingesting and destroying any potentially foreign material, such as germs
chronic pancreatitis
progressive, destructive disease that has remissions and exacerbations. develops after repeated episodes of alcohol induced acute pancreatitis OR chronic obstruction of the common bile duct
a client diagnosed with an exacerbation of systemic sclerosis asks the nurse why a foot board and a bed cradle have been places on the bed. the nurse explains that they are used for what purpose?
promote comfort from Raynauds phenomenon
what treatments can provide relief from tremors in a patient with MS
propranolol thalamotomy
What class of drugs for human immunodeficiency virus (HIV) infection prevents new virus particles from splitting into functional pieces?
protease inhibitors
what class of drugs for HIV prevents new virus particles from splitting into functional pieces
protease inhibitors
the nurse is assisting in planning care for a client with a diagnosis of HIV and should incorporate which action as a PRIORITY in the plan
protecting the client from infection
opportunistic infections for patients with HIV/AIDs
protozoan, fungal, bacterial, or viral. More than one infection may be present at the same time. The presence of opportunistic infections may represent disease progression or a temporary further reduction of immunity.
what should a healthy stoma look like
protrude from the abdominal wall pinkish/cherry red
a client who is HIV positive is experiencing anorexia and diarrhea. which nursing actions does the nurse delegate to a nursing assistant?
provide oral care to the client before meals to enhance appetite
the nurse is providing care for a client with a recent transverse colostomy. which observation requires immediate notification of the HCP
purple discoloration of the stoma
Which type of hypersensitivity is anaphylaxis?
rapid hypersensitivity
which type of sensitivity is anaphylaxis
rapid hypersensitivity anaphylaxis
The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, should the nurse report to the health care provider (HCP)?
rebound tenderness
the nurse is caring for a hospitalized client with a diagnosis of UC. which finding if noted on assessment of the client, should the nurse report to the HCP
rebound tenderness
a patient is undergoing a skin test for allergies. which symptoms are associated with an anaphylactic reaction
red blotches itching and urticaria erythema angioedema - vasodilation is occurring and blood is lost from the vascular system
What is the role of decongestants in the treatment of a type I hypersensitivity?
reduce edema Decongestants usually contain ephedrine, phenylephrine, or pseudoephedrine.
what is the role of decongestants in the treatment of a type 1 hypersensitivity
reduce edema cause vasoconstriction to reduce edema
why is activity restricted in patients with UC
reduce intestinal activity promote comfort and healing
what are muscle relaxants used for in a patient with MS
reduce muscle stiffness or spasms
A client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?
reduction of steatorrhea medication used for pancreatitis
manifestations of CD
remissions and exacerbations severe diarrhea abdominal pain low grade fever malabsorption of vital nutrients weight loss anemia
what is an appendectomy
removal of the appendix
a client with AIDS is experiencing nausea and vomiting. the nurse should include which measures in the dietary plan
remove dairy products and red meat from the meal
how to determine which hygiene or beauty products are responsible for a persons contact dermatitis
repeat open application testing (ROAT)
if a patients stoma presents pale, blueish, or dark what should the nurse do
report the findings to the HCP immediately
education for sulfasalazine
report: nausea vomiting anorexia rash headache
what recommendations should the nurse give to a patient diagnosed with MS who is trying to manage fatigue
rest periods amantadine aerobic exercises
Which features of the human immunodeficiency virus (HIV) virus convert HIV's RNA into DNA and insert it into the host's DNA?
reverse transcriptase and integrase inhibitors
a patient recently admitted tot he hospital is to receive an antibiotic IV for the first time for a UTI. before checking the five rights before administration. what is the nurses first action?
review the clinical records and ask the patient about any known allergies
labs for SLE
rheumatoid factor ANA (antinuclear antibody) erythrocyte sedimentation rate (ESR) serum complement (c3 and c4) anti-SS-a (Ro) anti-SS-b (La) anti-smith anti-DNA CBC - pancytopenia (decrease of all cell types)
The clinic nurse is performing an abdominal assessment on a client and preparing to auscultate bowel sounds. The nurse should place the stethoscope in which quadrant first? Click on the image to indicate your answer.
right lower quadrant RLQ
signs and symptoms of appendicitis
right lower quadrant (RLQ) pain in young adults
what position should the patient with appendicitis be in
right side lying or low to semi fowlers position
the nurse is preparing to care for a client with immunodeficiency. the nurse should plan to address which problem as the priority
risk for infection
The nurse is assessing a patient with allergic rhinitis. What assessment finding does the nurse anticipate?
runny nose with itchy watery eyes
what foods should a patient with AIDS avoid
salty foods
The nurse recognizes that which patient condition or disorder is an example of a type IV hypersensitivity reaction? Select all that apply.
sarcoidosis poison ivy skin rash
the nurse recognizes that which patient condition or disorder is an example of a type 4 hypersensitivity reaction
sarcoidosis poison ivy skin rashes DELAYED
what is specific immunity
second line of defense against an infection
icteric stage of hepatitis
second stage -elevated bilirubin -dark/tea colored urine -clay colored stools -pruritus
most frequent mental health disorder associated with patients who have MS
secondary depression
AIDs is the most common
secondary immune deficiency disease
acute pancreatitis
serious/life threatening inflammation of the pancreas
a patient presents with fever, arthralgia, rash, malaise, lymphadenopathy, nephritis, and poly arthritis. the patient has been admitted to the hospital several times in the past month and was last discharged one week ago. what does the nurse suspect the patient is experiencing?
serum sickness patient would have received antibiotics or serums during their previous visits
Which are common means of human immunodeficiency virus (HIV) transmission? Select all that apply.
sexual perinatal parenteral
how can someone be infected with HIV parenterally
sharing of needles or equipment contaminated with infected blood or receiving contaminated blood products
varicella zoster virus
shingles pain and burning along sensory nerve tracts headache low grade fever fluid filled blister with or without crust
what medication may be used in a patient with MS who is experiencing erectile dysfunction
sildenafil prostaglandin - 5 inhibitor
a client with AIDS is experiencing fatigue. the nurse should plan to teach the client which strategy to conserve energy once at home
sit for as many activities as possible
While assessing a patient, the nurse notes that the patient's vagina and buccal and nasal mucous membranes are dry. The laboratory reports indicate the presence of elevated levels of IgM rheumatoid factor. The nurse suspects what syndrome?
sjögrens syndrome
a client is suspected of having SLE. on reviewing the clients record, the nurse should expect to note documentation of which characteristic sign of SLE
skin lesions
what to assess in a patient with AIDS-related diarrhea
skin of the perianal region after every bowel movement
what do DMARDs do
slow the progression of CTDs (SLE/RA)
the nurse is caring for a group of clients on the surgical nursing unit. the nurse anticipates the client who underwent which procedure is most likely to have some long term residual difficulty with absorption of nutrients
small bowel resection
diet for patient with hepatitis
small frequent meals of high carb foods avoid alcohol and other medications
The nurse is caring for a patient admitted with an exacerbation of multiple sclerosis (MS). The patient reports urinary incontinence. Which primary urinary bladder alteration related to MS is most likely the cause?
spastic bladder
the nurse is caring for a patient admitted with an exacerbation of MS. the patient reports urinary incontinence. which primary urinary bladder alteration related to MS is most likely the cause
spastic bladder small capacity for urine
what is SLE characterized by
spontaneous remissions and exacerbations
a client with HIV has a fever and histoplasmosis is suspected.the nurse should prepare the client for which diagnostic test to confirm the presence of histoplasmosis
sputum culture
the nurse is caring for a client with HIV and notes a diagnosis of cryptococcosis in the clients chart. the nurse understands that this opportunistic infection was diagnosed with which test
sputum culture
According to the Centers for Disease Control and Prevention (CDC) classifications, what stage of human immunodeficiency virus (HIV) is marked by CD4+ T-cell count greater than 500 cells/mm 3 (0.5 × 109/L) or 29% or greater?
stage 1
According to the Centers for Disease Control and Prevention (CDC) classifications, what stage of human immunodeficiency virus (HIV) is marked by CD4+ T-cell count less than 200 cells/mm 3 (0.2 × 109/L) or less than 14%?
stage 3
epinephrine administration is essential during anaphylaxis. what is the mechanism of action of this drug?
stimulates the alpha- and beta- adrenergic receptors
A client with human immunodeficiency virus infection has signs and symptoms of cryptosporidiosis. The nurse should prepare the client for which test that will assist in confirming the diagnosis?
stool culture
a client with HIV has signs and symptoms of cryptosporidiosis. the nurse should prepare the client for which test
stool culture
precautions to take for patients taking oral opioid analgesics for any length of time (oxycodone/acetaminophen)
stool softener such as decussate sodium (Colace, Regulex)
key to preventing all forms of hepatitis A,B,C
strict and frequent hand washing
A patient in the allergy clinic develops all of these clinical manifestations after receiving an intradermal injection of an allergen. Which symptom requires the most immediate action by the nurse?
stridor ABC's
what is rhinorrhea manifested as
stuffy nose itchy, watery eyes
aminosalicylate medication
sulfasalazine
why is appendicitis more difficult to diagnose in the older adult
symptoms of pain and tenderness may not be as pronounced in this age group
a client calls the ED and tells the nurse that he came directly into contact with poison ivy shrubs. the client tells the nurse that he cannot see anything on the skin and asks the nurse what to do. the nurse should make which response
take a shower immediately, lathering and rinsing several times
a patient with MS and receiving drug therapy develops severe disability. a CSF examination and MRI indicate progressive multifocal leukoencephalopathy. what should be the immediate nursing intervention
terminating natalizumab intravenous administration
A diagnosis of AIDs requires what?
the adult is HIV positive CD4+ T-cell count LESS than 200 cells/mm3 less than 14% opportunistic infection
a client with CD is experiencing acute pain, and the nurse provides information about measures to alleviate the pain. which statement by the client indicates the need for further teaching
the best position for me is to lie supine with my legs straight - this adds pressure to abdominal muscles and increases pain
occurrence of any type of hepatitis effects which body system
the body immunity and ability to protect itself
the nurse is reviewing the immunization schedule for a child with HIV. which instruction should the nurse provide to the mother
the child and the siblings will need to receive inactivate polio vaccine
a client with AIDS has a concurrent diagnosis of histoplasmosis. during the assessment, the nurse notes that the client has enlarged lymph nodes. how should the nurse interpret the findings
the client has disseminated histoplasmosis infection
a client with AIDS has a respiratory infection from pneumocystis jiroveci and has been experiencing difficulty breathing and resultant problems with gas exchange. which finding indicates that the expected outcome of care has yet to be achieved
the client limits fluid intake
which member of the health care team demonstrates reducing the risk for infection for a client with AIDS
the dietary worker hands the disposable meal trays to the LPN assigned to the client
SLE complexes are most attracted to?
the glomeruli of the kidneys - causes lupus nephritis = LEADING CAUSE OF DEATH IN SLE pts
the nurse is instructing the parent of a child with HIV regarding immunizations. the nurse should provide which instruction
the inactivated influenza vaccine will be given yearly
the nurse is caring for an older client. the nurse should anticipate that medication dosages will be further adjusted if the client has dysfunction of which organ
the liver
which organ holds Kupffer cells
the liver
what occurs as hepatitis progresses
the livers normal lobular pattern becomes distorted as cellular regulation is compromised
sulfasalazine is prescribed for a client with a diagnosis of UC, and the nurse instructs the client about the medication. which statement requires a need for further education
the medication will cause constipation
the nurse is reviewing the lab results of a 4 month old and notes that the HIV antibody test is positive. how should the nurse interpret this test result
the mother is infected with HIV virus
which statement made to the nurse by a health care worker assigned to care for a client with HIV indicates a breach of confidentiality and requires further education by the nurse
the other health care worker and I were out in the hallway discussing our concern about getting the HIV infection from our client
A client is admitted to the hospital with a diagnosis of acute pancreatitis. Which would the nurse expect the client to report about the pain?
the pain usually increases after vomiting
A patient who experienced an anaphylactic reaction is hypotensive and has a rapid, weak, and irregular pulse. What is the priority nursing intervention?
the priority nursing intervention in this situation is to elevate the legs and feet, leaving the head of the bed elevated to about 10 degrees.
the nursing instructor asks the student nurse to explain a type 4 hypersensitivity reaction. which statement by the student best describes type 4 hypersensitivity
the reaction of sensitized T cells with antigen and release of lymphokines activate macrophages and induce inflammation
a client is tested for HIV with the ELISA test. the result is positive, what should the nurse tell the client
the test will need to be confirmed with a western blot test
Pre-exposure prophylaxis (PrEP)
the use of HIV -specific anti-retroviral drugs in an HIV- uninfected adult for the purpose of preventing HIV DRUGS: "Truvada" TENOFOVIR 300mg/EMTRICITABINE 300mg
the clinic nurse is providing home care instructions to a client who has been diagnosed with a latex allergy. the nurse most appropriately instructs the client to avoid which activity
the use of latex condoms
the nursing instructor is reviewing the plan of care with a nursing student who is caring for a client with an altered immune system and the role of interferons is discussed. which statement by the nursing student indicates a need for further teaching
they are effective against a wide variety of bacteria
patients should be educated that even with low viral levels
they can still transmit the disease to others
what is the primary purpose of neutrophils
they engulf any potential foreign materials
the nursing student conducted a clinical conference on the role of B lymphocytes in the immune system. which statement by a fellow nursing student indicates successful teaching
they produce antibodies
A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?
this is a normal, expected event
a client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. what is the correct interpretation by the nurse
this is a normal, expected event
a CD4+ count has been prescribed for a child with HIV. the nurse has explained to the mother the purpose of the blood test. which comment by the mother indicates the need for further teaching
this test identifies the specific diagnosis of HIV infection
a TB patient asks the nurse when it is permissible to return to work. which factor should the nurse include when responding to the client
three sputum cultures are negative
why do severally ill patients with pancreatitis have a NG tube
to prevent gastric juices from going into the duodenum
medications used for SLE
topical cortisone - fading of skin lesions acetaminophen/NSAIDs - treat join, muscle pain, and inflammation anti-malarial (HYDROXYCHLOROQUINE) - decreased absorption of UV light by the skin, decreases risk for lesions chronic steroid therapy immunosuppressive agent - methotrexate
complications of UC
toxic megacolon hemmorhage dysplastic biopsy colon cancer
pyrimethamine has been added to the medication regimen for a client with AIDs. on review of the clients record, the nurse notes this new prescription and plans care knowing that it has been prescribed to treat which condition
toxoplasmosis
the nurse is providing care to a client with impaired oxygenation related to anemia. which nursing intervention has the nighest priority
transfuse ordered packed RBCs -increase hemoglobin molecules
AIDs often develops quickly in patients who have been?
transfused with HIV contaminated blood
what are cholinergic used for in a patient with MS
treat bladder dysfunction
what are stool softeners used for in a patient with MS
treat bowel dysfunction
The nurse has been exposed to the blood of a patient who is human immunodeficiency virus (HIV) positive. What is the window of opportunity to begin postexposure prophylaxis (PEP) for the best possible outcome in preventing HIV infection?
two hours
a 2 year old with pneumocystis jiroveci is to begin treatment with highly active antiretroviral therapy. the nurse anticipates that the health care provider will prescribe which combination
two nucleoside analogues and one protease inhibitor
Which type of hypersensitivity may be associated with rhinorrhea?
type 1 hypersensitivity
which type of hypersensitivity may be associated with rhinorrhea
type 1 hypersensitivity
angioedema
type 1 hypersensitivity -involves blood vessels and all layers of the skin -mucous membranes -subq tissue -potential airway obstruction
what do UC stools look like
typically contain blood mucous tenesmus (urgent sensation to defecate) lower abdominal colicky pain
a test for the presence of rheumatoid factor is performed in a client with a diagnosis of RA. which result should the nurse anticipate?
unusual antibodies of the IgG and IgM type
tenesmus
urgent sensation to defecate
the nurse is preparing to teach a client with a new colostomy about how to perform a colostomy irrigation. which information should the nurse include in the teaching plan
use 500-1000mL of warm tap water
The nurse is obtaining a health history for a client with chronic pancreatitis. The health history is most likely to include which as a most common causative factor in this client's disorder?
use of alcohol
Which patient action reflects appropriate self-management of lupus erythematosus?
use sun blocking agent with a sun protection factor of 30 SPF or higher
education for patients with SLE
use sunscreen with 30 SPF+ avoid sunlight = causes exacerbations
what are glucocorticoids used for in a patient with MS
used to treat relapses of MS
which instructions for joint protection does the nurse recommend for a client with a connective tissue disease?
using long handled devices - reacher use adaptive devices such as velcro closures
first sign of HIV in women
vaginal candidates pelvic inflammatory disease STI's genital herpes
What complication in patients with lupus erythematosus causes organ failure?
vasculitis
fecaliths
very hard pieces of stool
The nurse is assigned to care for a client with human immunodeficiency virus (HIV) infection. The nurse notes recent documentation of herpes simplex in the client's medical record. On assessment, the nurse would expect to note which type of lesion?
vesicular lesions that rupture
the nurse is assigned to care for a client with HIV. the nurse notes recent documentation of herpes simplex in the clients chart. on assessment the nurse would expect to note which type of lesion
vesicular lesions that rupture -occurs in the perirectal, oral, and genital area
a client with HIV is diagnosed with HSV. the nurse should prepare the client for which diagnostic test to determine the presence of herpesvirus
viral culture
questions to ask for patients with potential MS
vision history mobility sensory perception CHANGES
medications to take to improve bone strength
vitamin D mineral - calcium
the nurse is interacting a UAP on the care of a client with HIV who also has active genital herpes. which statement by the health care worker indicates effective teaching of Standard Precautions
washing my hands and putting on a gown and gloves is what I must do before starting care
education for patient taking anticoagulants
watch for bleeding use care when using a straight razor
after performing an initial abdominal assessment on a client with nausea and vomiting, the nurse should expect to note which finding
waves of loud gurgles auscultated in all 4 quadrants
The nurse is caring for a patient with lupus erythematosus. What does the nurse teach the patient about skin protection?
wear a large brimmed hat in the sun
late clinical manifestation of RA
weight loss
A patient is experiencing a severe type I hypersensitivity reaction resulting in angioedema. What is the nurse's priority action?
what medications is the patient taking
when is hepatitis considered chronic
when liver inflammation lasts longer than several months (6+)
The nurse teaches a preoperative client about the use of a nasogastric (NG) tube for the planned surgery. Which statement indicates to the nurse that the client understands when the tube can be removed in the postoperative period?
when my bowels begin to function again and I begin to pass gas
when do discoid lesions occur in SLE
when patient is exposed to sunlight or UV light
what lab value should be assessed in patients taking oral immunomodulating drugs
white blood cells these medications can cause a decrease in WBC which increases risk of infection
what is interferon effective against
wide variety of viruses -it works on the host cells to induce protection
hepatitis
widespread inflammation of liver cells
where in the body does UC effect
widespread inflammation, mainly in the RECTUM and RECTOSIGMOID colon -associated with periodic remissions and exacerbations
a client is receiving highly active antiretroviral therapy (HAART), which statement by the client indicates a need for further teaching by the nurse
with this treatment, I probably cannot spread this virus to others
when do neutrophils appear in the area of injury
within 30-60 minutes
who does lupus effect
women POC childbearing ages (20-40) could have genetic predisposition
the nurse reviews the record of a client with AIDS and notes that the client has a diagnosis of candida. when performing history taking and assessment, which finding should the nurse anticipate
yellowish-white curdle patches in the oral cavity
who is more at risk for RA
younger patients
Signs of Bowel Perforation and Peritonitis
▪ Guarding of the abdomen ▪ Increased temperature and chills ▪ Pallor ▪ Progressive abdominal distention and abdominal pain ▪ Restlessness ▪ Tachycardia and tachypnea
