Unit 7 & 8 immunity/Cancer
When does child's igG increase until
7-8 years
What percentage of the US population is affected by autoimmune disease
8%. majority are female, and lupus are the most common
A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct? An ultrasound A biopsy A magnetic resonance imaging (MRI) A clinical breast exam
A biopsy
Live vaccines
attenuated form of the germ that causes the disease/long term immunity
disease in which a person immune system attacks the person own normal tissue
autoimmune disease
The client is scheduled for a biopsy for suspected cancer of the prostate. The nurse recognizes the purpose of this surgical procedure is: Curative Diagnostic Palliative Reparative
diagnostic
What types of cells are the primary targets of the healthy immune system?
infectious cells foreign cells cancerous cells
Which group of clients is at high risk of developing breast cancer? Women who do not consume alcohol Women who are obese Women who have sex with multiple partners Women who consume a low-fat
low-calorie diet, Women who are obese
viral vector vaccines
modified versions of different virus as a vector to deliver protection (Johnson and Johnson's -covid)
•nonspecific response to any foreign invader (inflammatory response)
natural immunity.
occurs when the person is exposed to a live pathogen, develops the disease, and becomes immune as a result of the primary immune response.
naturally acquired active immunity
Transplant reactions acute. Chronic.
occurs in weeks after transplant Chronic - occurs months after transplantation
how often is the pneumococcal vaccine administered
once
A nurse is teaching a community class about how to decrease the risk of cancer. Which food should the nurse recommend? Low-fat hot dogs Smoked ham Oranges Medium-rare steak
oranges
A patient has been taught how to perform breast self-examination. After standing in front of a mirror and checking both breasts for anything unusual, which of the following would the patient do next?
standing with arms above head looking in the mirror. looking for dimples
Naturally acquired active immunity occurs when
the person is exposed to a live pathogen, develops the disease, and becomes immune as a result of the primary immune response.
toxoid vaccines
use a toxin made by germ that causes a disease. The immune response is targeted by the toxin instead of the whole germ. use a toxin (harmful product) made by the germ that causes a disease. They create immunity to the parts of the germ that cause a disease instead of the germ itself. That means the immune response is targeted to the toxin instead of the whole germ.
Contraindications for immunizations
•Acute illness with high fever •Hypersensitivity reaction •Recent immunoglobulin therapy •Cancer treatments •Pregnancy (do not use live virus immunizations such as rubella)
Pregnancy and in utero development
•Cell-mediated immunity achieves full function early in life •Newborns most prone to infection •Ingesting human milk can provide protection
natural immunity
•nonspecific response to any foreign invader
Example of passive immunity
transfer of antibodies from mother to infant through breast feeding; receiving immune globulin through injections
Normal CD4 count
500-1500
Which substance most easily transmits the human immunodeficiency virus (HIV)? A.Blood B.Feces C.Saliva D.Urine
A.Blood HIV readily is transmitted by contact with infected blood. It exists in all body fluids but transmission through saliva, urine and feces is much less likely to occur than through blood
Signs and Symptoms of Leukemia
Anemia Low Platelet Low WBCs Infection
Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a client with leukemia? Implementing neutropenic precautions Eliminating direct contact with others who are infectious Applying prolonged pressure to needle sites or other sources of external bleeding Monitoring temperature at least once per shift
Applying prolonged pressure to needle sites or other sources of external bleeding
•Immune system loses ability to distinguish self from others •Attacks own body •Genetic component •Examples: Lupus (SLE), Rheumatoid Arthritis (RA), MS, Type 1 Diabetes
Autoimmune disease
An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors increase the risk for breast cancer? Select all that apply. Daily alcohol intake Increased age Nulliparity Obesity Silicone breast implants
Daily alcohol intake Increased age Nulliparity Obesity
Which of the following would the nurse expect to be done to assess the size of the prostate? Digital rectal examination Transillumination Pelvic examination Bladder percussion
Digital rectal examination
who can't get live vaccines
Don't give to immunocompromised, pregnant, HIV
Treatment for Anemia
EPO, Erythropoietin. Growth Factor
Cancer has many characteristics. What is one of the most discouraging characteristics of cancer? Large size tumors Carcinogenesis Metastasis Slow growth
Metastasis
The nurse recognizes the clinical assessment of a patient with acute myeloid leukemia (AML) includes observing for signs of infection early. What nursing action will most likely help prevent infection? Monitor the client's temperature every shift. Maintain contact precautions. Encourage increased fluid consumption. Practice vigilant handwashing.
Practice vigilant handwashing.
Ways to prevent transmission of HIV or STDs?
Protection. Only water based lubricant. Refer to support groups. Follow med regimen.
Consuming a diet high in which of the following has been found to increase the risk for prostate cancer? Red meats Green leafy vegetables Carbohydrates Whole grains
Red meats
Phagocytosis
The term phagocytosis comes from the ancient Greek words phagein ("to devour") and kytos ("cell"). "Osis" means process; this is the cellular process of eating.
specific immunity against a foreign antigen
acquired immunity
what is psychoneuroimmunologic?
the study of the effect of the mind on health and resistance to disease
The nurse is providing shift report related to a client newly received back to the unit from the post anesthesia care unit (PACU). The nurse is stating that the client had breast tissue removed with 7 of 14 lymph nodes the lining of the chest muscles and pectoralis major and minor muscles removed. The oncoming nurse documents which procedure completed? A segmental mastectomy A total mastectomy A modified radical mastectomy A radical mastectomy,
A radical mastectomy
AIDS is such a deadly disease because the AIDS virus attacks and destroys? A.CD4 & T cells B.B cells C.CD8 & T cells D.Macrophages E.Memory cells
A. CD4 and T cells
Which immune cell is responsible for the quickest release of histamine that causes the red itchy welts associated with allergies? A. Mast cell B. Lymphocyte C. Eosinophil D. Basophil
A. Mast cell In our skin, just outside of the capillaries, lurk the mast cells ready and waiting with allergen receptors.
gut microbiota and autoimmunity
As the gut microbiota has such profound effects on both the innate and adaptive immune system, it is not surprising that some members of the gut microbiota have been linked to autoimmune diseases. Significant attention has been focused on the role of gut microbiota in GI-related autoimmune diseases.
The nurse is evaluating bloodwork results of a client with cancer who is receiving chemotherapy. The client's platelet count is 60,000/mm3. Which is an appropriate nursing action? Taking the client's temperature rectally Providing commercial mouthwash to the client Providing a razor so the client can shave Avoiding the use of products containing aspirin,
Avoiding the use of products containing aspirin
The nurse is aware that the phagocytic immune response, one of the body's responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents? A - Neutrophils B - Macrophages
B - Macrophages
A school nurse is talking about infection with a high school health class. What would be the nurse's best explanation of the process of phagocytosis? A -Removal of bacteria and dead blood cells from circulation B- Engulfment and digestion of bacteria and foreign material
B- Engulfment and digestion of bacteria and foreign material
Diseases in which a person immune system attacks the person own normal tissue are called: A.Secondary immune diseases B.Autoimmune diseases C.Antigen shifting diseases D.Primary immune diseases E.Clonal selection diseases
B. Autoimmune disease
In HIV infection, reverse transcription describes which of the following? A. Converting viral DNA into RNA B. Converting viral RNA into DNA C. Converting proteins into viral RNA
B. Converting viral RNA into DNA Transcription is when DNA code is transcribed into RNA code. Hence, reverse transcription is when viral RNA is the template for the viral DNA produced within the host cell.
When human immunodeficiency virus (HIV) attaches to a host cell, what genetic material is released into the cell's cytoplasm? A. Chromosome B. RNA C. DNA D. Ligand
B. RNA
Which of the following statements about HIV is true? A.The disease is highly infectious B.The fatality rate is low if the disease is detected in it's early stages C.Most people who get AIDS die of pneumonia D.All of the above E.None of the above
B. The fatality rate is low if the disease is detected in its early stages
After teaching the parents of a child newly diagnosed with leukemia about the disease, which of the following descriptions given by the mother best indicates that she understands the nature of leukemia? A." The disease is an infection resulting in increased white blood cell production." B."The disease is a type of cancer characterized by an increase in immature white blood cells." C."The disease is an inflammation associated with enlargement of the lymph nodes." D."The disease is an allergic disorder involving increased circulation antibodies in the blood."
B."The disease is a type of cancer characterized by an increase in immature white blood cells."
Laboratory findings indicate that a child with leukemia is also anemic. The nurse interprets this finding as most likely resulting from which of the following? A.Inadequate dietary folic acid intake. B.Decreased red blood cell production. C.Increased destruction of red blood cells by lymphocytes. D.Progressive replacement of bone marrow with scar tissue.
B.Decreased red blood cell production.
Which of these cell types play a primary role in attacking and killing cancer cells? A. Red blood cell B. Cytotoxic T cell C. Platelet D. Mast cell
Cytotoxic T Cell
Cytotoxic T Cell
Cytotoxic T lymphocytes (CTLs) recognize surface markers on target cells in the body. Target cells may be cancer or infected cells.
A declining AIDS patients significant other is tearful over the client's condition and lack of improvement. He says he feels powerless and unable to help his friend. Which response by the nurse is the best? A.Agree with the person B.Tell him there's nothing he can do C.State she understands how he must feel D.Ask if he would like to help with some comfort measures (there there)
D. Ask if he would like to help with some comfort measures The significant other expresses a need to help and the nurse can encourage him to do whatever he feels comfortable with, such as putting lubricant on lips, moist cloth on the forehead, or lotion on skin. The nurse may not understand his situation and agreeing with a person doesn't diminish powerlessness. There are many ways the significant other can help if he wants to.
Which of the following statements would the nurse use to describe to the parents why their child with leukemia is at risk for infections? A."Play activities are too strenuous." B."Vitamin C intake is reduced over a period for time." C."The number of red blood cells in inadequate for carrying oxygen." D."Immature white blood cells are incapable of handling an infectious process.
D."Immature white blood cells are incapable of handling an infectious process.
The nurse is assessing a 73-year-old client who was diagnosed with metastatic prostate cancer. The nurse notes that the client is exhibiting signs of loss grief, and intense sadness. Based on this assessment data, the nurse will document that the client is most likely in what stage of death and dying? Depression Denial Anger Resignation,
Depression
Which of the following are autoimmune diseases? A.Heart disease B.Hashimoto's thyroiditis C.Erythroblastosis fetalis D.Systemic lupus erythematosus E.B & D
E. B & D
Protection for leukemia
Handwashing No sick people visiting No fresh flowers/fruits
Where does IgA present in
breast milk and in colostrum
While completing an admission assessment the client reports a family history of breast cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology? Inherited gene mutation Smoking and tobacco use Exposure to chemicals and spermicides Increased tumor suppressor genes,
Inherited gene mutation
live vaccines examples
MMR Intranasal flu, Rotavirus Small pox Yellow fever Chicken pox (varicella)
•Prevalence of rejection hard to determine •Medications to suppress immune system •Increased risk of serious infections, malignancies •Drugs discontinued → risk of organ rejection •Secondary immune deficiencies more prevalent than primary (secondary is meds, diet)
Organ and tissue transplants and effect on the immune system
what is pcp (pneumocystis carininii pneumonia?
P.carinii is a fungus normally found in the human lung. It does not cause disease in healthy individuals; the disease develops when the host's immune systems are critically impaired.
Name the process a cell, such as a neutrophil or a macrophage, uses to ingest (eat) its prey: A. Halitosis B. Chemotaxis C. Botulism D. Phagocytosis
Phagocytosis
Question 46 of 51 Which laboratory test results indicate to the nurse that the client is experiencing symptoms of acute lymphocytic leukemia (ALL)? Select all that apply. Platelet count of 20,000 Blastocyte count 94 Hemoglobin 16 Erythocyte count 2.5 Granulocyte count 0.8
Platelet count of 20,000 Erythocyte count 2.5 Granulocyte count 0.8
A nurse is caring for a client with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this client the nurse should assign the highest priority to which nursing diagnosis? Activity intolerance Risk for infection Acute confusion Risk for spiritual distress,
Risk for infection
A client asks a nurse, "What can I use to decrease my risk of exposure to HIV?" What will the nurse include as effective in reducing the risk of HIV exposure? Select all that apply. Lambskin condoms Sexual abstinence Latex male condoms Polyurethane female condoms Dental dams
Sexual abstinence Latex male condoms Polyurethane female condoms Dental dams
The public health nurse is presenting a health promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America? Monthly self-breast exams Smoking cessation Annual colonoscopies Monthly testicular exams
Smoking cessation
What precautions are needed for HIV/AIDS?
Standard precautions for blood and body fluids
Male circumcision can reduce heterosexually HIV infection in males by approximately 60%. T/F
T
Which of the following is the single largest preventable cause of cancer? Tobacco Pesticides Arsenic Asbestos
Tabacco
Can I get HIV from body piercing, ear piercing, or tattoo needles? A.Yes B.No
Technically yes, but no recorded cases
The nurse at a genetics clinic is reviewing the health and genetic history of a woman whose mother died of breast cancer. Which of the following is the most important factor documented in the client's genetic history? Three generations of information about the family Current medications taken Health problems present in the woman's children Immunizations received for the past three generations
Three generations of information about the family
Autoimmune disorders are more common in women than men. T/F
True Women are less susceptible to infectious diseases than men, but are more often prone to autoimmune diseases. This higher prevalence is partly attributable to the X chromosome, which has many genes relating to the immune system. It is advantageous for women to have two X chromosomes, but the price is a greater tendency to develop autoimmunity.
Breast cancers are usually found in which area of the breast? Upper outer quadrant Lower inner quadrant Middle Posterior
Upper outer quadrant
Sub unit, recombinant, polysaccharides, conjugate vaccines examples
Very strong immune response that targeted to key parts of the germ. Hib HPV, pneumococcal, meningococcal, singles Hep B Pertussis (whooping cough)
Could you get HIV from kissing? A.Yes B.No
Yes/ very weak yes
what does a phagocytic cell function test immune function?
how well is our body working
igG pediatirc
immunoglobin that crosses the placenta
Where is bone marrow aspirated from
posterior iliac crest of the pelvis. Back of hipbone
What prevents immune disorders
vaccines!!
How long does passive immunity last
weeks to months, temporary
A nurse is caring for a recently married, 29-year-old female client, who was diagnosed with acute lymphocytic leukemia. The client is preparing for an allogeneic bone marrow transplant. Which statement by the client demonstrates she understands the informed consent she gave about the diagnosis and treatment? "I should be able to finally start a family after I'm finished with the chemo." "I always had a good appetite. Even with chemo I shouldn't have to make any changes to my diet." "I'll have to remain in the hospital for about 3 months after my transplant." "I'll only need chemotherapy treatment before receiving my bone marrow transplant."
"I'll only need chemotherapy treatment before receiving my bone marrow transplant."
A client recovering from the removal of a gastric tumor asks why radiation therapy is needed. Which response will the nurse provide? "It is to heal the wound faster." "It is to kill any remaining cancer cells." "It is to reduce your need for medication." "It is to prevent the development of a wound infection."
"It is to kill any remaining cancer cells."
The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis? "Once the colon tumor is removed I will be fine." "I will be happy once all the cancer is cut out." "How could I be so unlucky to get cancer twice?" "My cancer has now spread to my liver."
"My cancer has now spread to my liver."
A patient with an advanced laryngeal tumor is to have radiation therapy. The patient tells the nurse "If I am going to have radiation, I won't need surgery." What is the best response by the nurse? "That is correct. The radiation will eradicate the tumor and you won't have to have further treatment." "Radiation is used to shrink the tumor size and is an adjunct to surgery." "All patients have to have radiation before they have surgery. It is protocol." "You really don't have to have radiation but you won't have to have such invasive surgery if you have the radiation first.",
"Radiation is used to shrink the tumor size and is an adjunct to surgery."
A client with cancer has just been told that the disease is now terminal. The client tearfully states "I can't believe I am going to die. Why me?" What is the nurse's best response to elicit more information from the client? "I know how you are feeling." "You have lived a long life." "Tell me more about how you feel about this news." "Life can be so unfair.",
"Tell me more about how you feel about this news."
A nurse is providing teaching to a client who will undergo chemotherapy and radiation prior to hematopoietic stem cell transplantation (HSCT) for acute myeloid leukemia (AML). What statement will the nurse use to describe the purpose of the chemotherapy and radiation? "These therapies shrink your tumor to ensure the stem cell transplant is more effective." "These therapies destroy the ability of your body to produce blood cells inside your bone marrow." "These therapies destroy the bone marrow in an effort to shrink it and decrease your pain." "These therapies decrease your immune system to decrease the risk of allergic reaction."
"These therapies destroy the ability of your body to produce blood cells inside your bone marrow."
A client with the diagnosis of ovarian cancer confides in the nurse that they practice holistic medicine. The client believes a cure exists through a macrobiotic diet rather than what surgery or medical treatment can achieve. Which statement by the nurse is most appropriate? "I wouldn't bet my life on a diet treatment plan." "We can talk to your provider about adding this diet as a complementary therapy." "You should listen to your provider, who is the expert on this condition." "Alternative treatments do not have good outcomes for this type of cancer.",
"We can talk to your provider about adding this diet as a complementary therapy."
A 50-year-old is diagnosed with stage II prostate cancer. The client is upset and verbalizes that he would rather die than have any surgery. Which is the best response by the nurse? "What concerns you most about having surgery?" "Your surgeon has performed this surgery many times." "How does your family feel about this decision?" "This surgery can cure you of cancer."
"What concerns you most about having surgery?"
A nurse is caring for a client who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the client's sacral area and petechiae on the forearms. In addition to informing the client's primary care provider, the nurse should perform what action? Initiate measures to prevent venous thromboembolism (VTE). Check the client's most recent platelet level. Place the client on protective isolation. Ambulate the client to promote circulatory function.
, Check the client's most recent platelet level.
What percentage of Worldwide population is affected by autoimmune disease
5% worldwide
when does maternal IgG disapear
6-8 months
A gardener sustained a deep laceration while working and requires sutures. The date of the client's last tetanus shot was over 10 years ago. Based on this information, the client will receive a tetanus immunization, which will allow for the release of which type of substance? A - Antibodies B - Antigens
A - Antibodies
The nurse is teaching the client with HIV about therapy. Which elements are essential for the nurse to include in the teaching plan? Select all that apply. A - CD4 count is the major indicator of immune function and guides therapy. B - Antiretroviral therapy targets different stages of the HIV life cycle. C - The goal of antiretroviral therapy is to prevent opportunistic infections. D - Medication therapy is rarely effective. E - Clients rarely respond to medication therapy.
A - CD4 count is the major indicator of immune function and guides therapy. B - Antiretroviral therapy targets different stages of the HIV life cycle.
A client has been brought to the emergency department by the parents after falling through the glass of a patio door, sustaining a laceration. The nurse caring for this client knows that the site of the injury will have an invasion of which type of cell? A - Phagocytic cells B - Interferons
A - Phagocytic cells
A nurse caring for a client with acquired immunodeficiency syndrome is working with a nursing student. She notes the student doesn't attempt to suction or assist with care of the client. Which action is appropriate? A.Talk to the student B.Talk to the charge nurse C.Address a coworker with the concerns D.Seek advice from the students instructor
A.Talk to the student The nurse should approach the student to determine her feeling and experience in caring for this client. The charge nurse and coworkers aren't familiar with the student's abilities but the instructor may be approached if the nurse can't communicate with the student
Kaposi's Sarcoma
AIDS defining illness, Affected areas - lesions. Life threatening when lesions are in lungs, liver, or digestive tract
A client is undergoing chemotherapy treatment for prostate cancer and has lost considerable weight due to nausea and vomiting. Which nursing intervention is appropriate for the client? Decreasing dietary fluids 2 days before chemotherapy Adjusting the client's meal plan before and after chemotherapy Increasing fresh fruits in the client's diet Administering beta-blockers as ordered by the physician
Adjusting the client's meal plan before and after chemotherapy
An adult client with leukemia will soon begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy? Administer an antiemetic. Administer an antimetabolite. Administer a tumor antibiotic. Administer an anticoagulant.
Administer an antiemetic.
•WBC count and differential •Bone marrow biopsy •Humoral and cellular immunity tests (wbc) •Phagocytic cell function test (how well is our body working) •Complement component tests •Hypersensitivity tests •Specific antigen-antibody tests •HIV infection tests •Enzyme immunoassay •Polymerase chain reaction •Rapid HIV tests •Radioallergosorbent test •Skin reactions •Western blot test
All test to evaluate immune function
What lab values will be monitored for HIV/AIDS?
CD4, B&T cells+helper. Cell suppressor ratios. Viral load. Body function: CBC, platelets, lymphocytes, chemistries and other comorbidities.
What lab values would determine medication regimen for HIV/AIDS
CD4, Viral Load , Liver and Kidney function
mRNA vaccines/ viral vector vaccines
COVID 19
What is the term used to describe white blood cells migrating toward bacteria? A. Zeiosis B. Phagocytosis C. Chemotaxis D. Phototaxis
Chemotaxis
Chemotaxis is
Chemotaxis is the movement of a cell or organism in response to a chemical stimulus. "taxi itself on over"
Which nursing intervention(s) are related to a client with breast cancer? Select all that apply. Client education and preparation for treatment Promotion of positive body image Relieving fear Prevention of social isolation Management of complications
Client education and preparation for treatment Promotion of positive body image Relieving fear Management of complications
A client is not dealing well with the diagnosis of cancer. She feels she is "so alone." Which intervention would be most appropriate for this client? Offer advice on how to deal with the stress of cancer. Refer the client to hospice as she will need future care. Teach the client relaxation techniques to deal the future of cancer. Educate the client on the availability of support groups for clients with cancer.
Educate the client on the availability of support groups for clients with cancer.
A client receiving treatment for leukemia is experiencing stomatitis. Which interventions will the nurse implement to improve the client's nutritional status? Select all that apply. Encourage small frequent meals. Suggest foods that are soft in texture. Provide foods that are hot in temperature. Administer pain medication before meals. Provide mouth care before and after meals.
Encourage small frequent meals. Suggest foods that are soft in texture. Administer pain medication before meals. Provide mouth care before and after meals.
A client with leukemia has developed a cough and increased fatigue. What is the primary nursing intervention? Evaluate the client for potential infection. Administer an antitussive. Place a cooling blanket on the client. Medicate the client to relieve pain.
Evaluate the client for potential infection.
After a breast biopsy a client is diagnosed with lobular carcinoma in situ. Which information about treatment will the nurse prepare for this client? Select all that apply. Use of antibiotics Frequency of mammograms Chemoprevention strategies Radical mastectomy Application of heat to the area,
Frequency of mammograms Chemoprevention strategies
Which component of client teaching helps the nurse assist a client following treatment for cancer of the prostate gland to manage and minimize the possibility of a recurrence of the primary cancer or metastasis? Have regular prostate-specific antigen (PSA) levels tested and repeat lymph node biopsies. Avoid sexual intercourse for at least 2 years. Undertake pelvic floor retraining exercises. Avoid strenuous exercises especially lifting
Have regular prostate-specific antigen (PSA) levels tested and repeat lymph node biopsies.
The health care provider recommends that parents have their daughter vaccinated with HPV vaccine. What is this vaccine for? Help prevent lung cancer Help prevent breast cancer Help prevent cervical cancer Help prevent leukemia,
Help prevent cervical cancer
A client diagnosed with acute myeloid leukemia has just been admitted to the oncology unit. When writing this client's care plan which potential complication should the nurse address? Pancreatitis Hemorrhage Arteritis Liver dysfunction,
Hemorrhage
inactivated vaccine examples
Hep A Flu IM - everyone over 6m should get a flu vaccines Polio shot Rabies (post prophylactic)
A client with chronic lymphocytic leukemia (CLL) wants to have treatment for the condition. Which medication will the nurse question for this client? Heparin Ipilimumab Dexamethasone Vincristine
Heparin
Do not give live vaccines to those who are?
Immunocompromised. immunizations be delayed for 3 months after the immunosuppressive drugs have been discontinued.
A patient with acute myeloid leukemia (AML) has a neutrophil count that persists at less than 100/mm3. What should the nurse cautiously monitor this patient for? Abdominal cramps Hypotension Seizure activity Infection
Infection
A nurse is caring for a client who has a diagnosis of acute myelocytic leukemia (AML). Assessment of which factor most directly addresses the most common cause of death among clients with leukemia? Infection status Nutritional status Electrolyte levels Liver function
Infection status
What is? •Response to injury or invading organisms •Chemical mediators minimize blood loss, wall off invading organisms, activate phagocytes, promote formation of scar tissue and regeneration of injured tissue
Inflammatory response
The following lesions found on an AIDS patient would be linked to what condition: A.Kaposi's Sarcoma B.Herpes Simplex C.Varicella D.ITP
Kaposi's Sarcoma
What are purplish spots on someone with AIDS?
Kaposi's Sarcoma (KS) Cancerous condition on skin. When its on the internal organs can be life threatening
A client seeks medical attention for a painless lump located in the upper right area of the right breast. Which additional finding indicates to the nurse that the client has advanced breast disease? Select all that apply. Tissue dimpling Nipple retraction Unequal breast size Occasional breast pain Breast tenderness with menstruation
Tissue dimpling Nipple retraction
Leukemia
a disorder of the blood forming tissue; proliferation of immature WBCs.
what variables effect the immune system function?
age and gender, nutrition, gut microbes •History of infection or immunization •Allergies (autoimmune) •Presence of conditions or disorders: autoimmune disorders, cancer or neoplasm, chronic illness, surgery or trauma •Medications and transfusions •Lifestyle: Sleep/ exercise etc.• Psychoneuroimmunologic factors
Which options are available to women who have an increased risk of developing breast cancer? Select all that apply. annual mammogram and MRI bilateral prophylactic mastectomy chemoprevention with tamoxifen preventive radiation,
annual mammogram and MRI bilateral prophylactic mastectomy chemoprevention with tamoxifen
immunity can be induced by a vaccine, a substance that contains the antigen.
artificially acquired immunity
The anemia seen in children with leukemia is
caused by the bone marrow's overproduction of immature white blood cells at the expense of producing red blood cells and platelets.
Treatment for Leukemia
chemotherapy
toxoid vaccines example
diphtheria, tetanus
Influenza vaccine should not be given to those with an allergy to? Timing?
eggs yearly
What is the difference between HIV and AIDS
either their CD4 counts are 200/cmm or less and/or they have developed an AIDS defining condition
ELISA test
enzyme-linked immunosorbent assay
Which is the primary preventable cause of skin cancer? Fair skin Excess melanin Exposure to UV radiation Skin disease
exposure to UV radiation
What is given for hep A outbreak
gamma globulin shot
A nurse is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination: at the end of her menstrual cycle. on the same day each month. on the first day of the menstrual cycle. immediately after her menses.
immediately after her menses
Artificially acquired active immunity can be
induced by a vaccine, a substance that contains the antigen
What are physical barriers
intact skin, chemical barriers, and acidic gastric secretions or enzymes in tears and saliva
Immunizations Inactivated vaccines -
killed version of the germ that causes a disease
How long does active immunity last
lasts many years, may last a lifetime
Local responses to vaccines
mild: pain, swelling, redness
effects of chemotherapy
myelosuppression, gatigue, exertional dyspnea, pain, tachycardia, diarrhea, nervous system effects, renal dysfunction, nutritional deplettion
Leukemia is a __________, or cancerous, disorder of blood forming tissues characterized by a proliferation of __________ white blood cells. Leukemia is not an infection, inflammation or allergic disorder.
neoplastic immature
A nurse is caring for a client with prostate cancer and assesses bleeding gums and hematuria. What serum indicator should the nurse relate the bleeding? lymphocyte count of 30% platelet count of 60,000/mm3 neutrophil count of 40% reticulocyte count of 1%,
platelet count of 60,000/mm3
A client asks the nurse what PSA is. The nurse should reply that it stands for: prostate-specific antigen which is used to screen for prostate cancer. protein serum antigen, which is used to determine protein levels. pneumococcal strep antigen, which is a bacteria that causes pneumonia. Papanicolaou-specific antigen, which is used to screen for cervical cancer.
prostate-specific antigen, which is used to screen for prostate cancer.
When is revaccination recommended
recommended in persons with renal failure, those who have had splenectomies, those with malignancies, and those with HIV/AIDS.
What do wbcs do in natural immunity
release cell mediators such as histamine, bradykinin, and prostaglandins and engulf (phagocytize) foreign substances
After being stuck with a needle what should you do?
report and needle stick; start treatment within 24 hrs) preventive antiretroviral treatment
Which gender have a higher incidence of autoimmune disease
women
How do antiretroviral drugs work?
work by stopping the HIV from making copies of itself. Protects the immune system. Prevents HIV from advancing to AIDS Reduces the risk of HIV
life threatening allergic reactions to vaccines
•Anaphylaxis- Hives, swelling mouth/throat, difficulty breathing, low blood pressure, shock
Andrew has been seropositive for several years, yet he has been asymptomatic for AIDS. What factors may have influenced his development of PCP?
•Pressure and stress at work (long hours working); not eating well; "co-factors " may have triggered activation of the virus-producing immunodeficiency and allowed opportunity for P.carinii to cause illness.
Warnings signs of Cancer CAUTION
⋆Change in bowel or bladder function ⋆A sore that does not heal ⋆Unusual discharge or abnormal bleeding ⋆Thickening or lump in the breast or other tissue ⋆Indigestion or difficulty swallowing ⋆Obvious change in a wart or a mole ⋆Nagging cough or hoarseness •Unexplained weight loss • (10 # or more) pancreas/ esophagus & stomach, lung •Fever (more common if it has spread) •Leukemia/ lymphoma •Fatigue: Leukemia, colon, stomach •Pain: Colon, bone, testicular, brain
An elderly client is hospitalized for treatment related to leukemia. Family members want to visit with a toddler who has a cold. It would be best for the nurse to Instruct the family to remove the toddler from the room for the protection of the client. Ask the family to leave the client's room. Inform the family to either wash their hands or use the hand sanitizer. Allow the toddler to remain in the room if a family member wipes the toddler's nose.
Instruct the family to remove the toddler from the room for the protection of the client.
Which nursing interventions related to a client with breast cancer are appropriate for a nurse working in a community-based setting and a hospital-based nurse? Select all that apply. Patient education Promotion of a positive body image Intravenous (IV) therapy Incision care Prevention of social isolation
Patient Education Promotion of a positive body image Intravenous (IV) therapy Incision care
Immunization education
parent education and informed consent. discuss risks and benefits of vaccines.
Sub unit, recombinant, polysaccharides, conjugate vaccines
the specific pieces of the germ - like protein, sugar, or capsid. Because these vaccines use only specific pieces of the germ, they give a very strong immune response that's targeted to key parts of the germ. They can also be used on almost everyone who needs them, including people with weakened immune systems and long-term health problems.
systematic reaction to vaccines
•Fever, malaise, muscle pain, H/A/ loss of appetite ( more common with live vaccines)- ( similar to a mild form of the natural disease)
(3) What is the human body constantly threatened by
•Foreign substances •Infectious agents •Abnormal cells
What are non modifiable risk factors for immunity
•Gender •Many conditions more prevalent in female •Age •Race •African Americans •Higher rates of transplant rejection •Increased prevalence of autoimmune diseases •Genetics key component in immune disorders, deficiencies •Children at greater risk of allergies if parents have allergies •Predisposition to autoimmune diseases in presence of environmental trigger
Normal immune changes with aging
•Immune function declines •External factors •Nutrition •Effects of exposure to toxins
Active immunity
•Immunologic defenses developed by person's own body
Modifiable risk factors
•Nutrition •Weight •Stress •Alcohol, drug and cigarette use •Intravenous drug use •Risky sexual behaviors (STDs/HIVs)
Transplant reactions -hyperacute reactions
•Occurs minutes, hours after transplantation
What is the function of the immune system?(3)
•Protect body from foreign antigens •Identify, destroy potentially harmful cells *Remove cellular debris
What can stem cells
•Research shows that stem cells can restore an immune system that has been destroyed •Clinical trials using stem cells are under way in patients with a variety of disorders having an autoimmune component, including systemic lupus erythematosus, rheumatoid arthritis, scleroderma, and multiple sclerosis •Along with these remarkable opportunities, many ethical challenges arise
What is Passive immunity
•Results from transfer of a source outside of the body that has developed immunity through previous disease or immunization
What top 4 tests evaluate immune function?
•WBC count and differential •Bone marrow biopsy •Humoral and cellular immunity tests (wbc) •Phagocytic cell function test (how well is our body working)
Phagocytosis
•monocytes responsible for engulfing and destroying foreign bodies and toxins
