NUR 320 Patho/Pharm 1
inflammatory basophils
contain histamine and other inflammatory mediators
Phase IV
continued evaluation after approval for marketing
Chronic course
continuous course or can present with exacerbations and remissions
Treating autoimmune disease
corticosteroids and immunosuppressive drugs, plasmapheresis
Three categories of treatment
curative control palliative
Controlled Substances Schedule
Schedule I Schedule II Schedule III Schedule IV Schedule V
competitive agonist
an agonist that "competes" for the same binding site as another substance, and produces the same effect
allspice treats
anesthetic for teeth and gums, soothes sore joints and muscles
host
any organism that can support nutritional and physical growth of another organism
Secondary actions of a drug
are effects that the drug causes in the body that are not related to the therapeutic effect.
Trousseau's sign
arm/carpal spasm associated with hypocalcemia
Malignant Neoplasms
little resemblance to normal cells, rapidly grow and can enter the circulatory and lymphatic systems
General Adaptation Syndrome (GAS)
changes the body due to a stressor
alkalosis
systemic decrease in H concentration or increase in bicarb
exogenous source of infection
when the causative organism is acquired from another person
Tertiary Disease Prevention
reduce complications, prevent further deterioration eg. support groups for alcoholics, B-blockers for those who have had a heart attack
Generic drug names
related to chemical or official name in lowercase letters required to be less expensive monitored by FDA
hypernatremia
related to sodium gain or water loss manifest-dehydration, convulsions, pulmonary edema, hypotension, tachycardia
acute course
relatively severe, but self-limiting
ANP (atrial natriuretic peptide)
release wtih increase BP - kidneys excrete more Na+ and water, thus decrease BP
Regeneration
replace with the same cell type
Resolution Stage
the interval after orgasm in which the body returns to its unaroused state, reversing the changes brought about by arousal
Cell-mediated response
the response of T-cells to antigens
How do drugs behave when loosely bound to proteins?
Loosely bound drugs act quickly, excreted quickly
What type of agents commonly trigger chronic inflammation?
Low-grade persistent infections or irritants
Hepatotoxicity
liver toxicity irritation from metabolites
T-lymphocytes
mature in thymus gland
pathogens
microorganism capable of causing disease need nutrients
monosomy
missing a chromosome
Thiazide diuretics
hydrochlorothiazide (Hydrodiuril) belong to sulfanomides, most commonly used class of diuretics, first line for BP treatment
IgA
in body secretions to protect mucous membranes
Epidemiology measures?
incidence, prevalence, morbidity, mortality
Diuretics
increase sodium excretion, if this was returned to blood would cause edema due to extra intravascular fluid leaking out
vascular stage of inflammation
increased blood flow
Ocular Damage/Toxicity from medications
inflammation and tissue damage, may lead to blindness
Phases of wound healing
inflammatory phase proliferative phase remodeling phase
Humoral response
production of antibodies by B cells
endogenous stressors
inside body (illness, infection, psychological)
patient rights of medication administration
right patient right drug right storage right route right dose right preparation right time right recording
isotonic
same tonicity as blood, normal saline, LR
BNP (brain natriuretic peptide)
secreted in response to fluid volume overload stretching heart ventricles
Epidemiology is?
the study of the incidence, distribution, and possible control of diseases
Exhaustion Stage
the third stage of the GAS, characterized by weakened resistance and possible deterioration
Distress
severe, uncontrolled situations of psychological and physical distress that are disruptive to health
Clinical Manifestations
signs and symptoms or evidence of disease some can be silent s/s may be related to primary disorder or bodies compensation to the disease
osmolarity
total concentration of all solute particles in a solution
Succimer
treats lead poisoning in children
HIV prevention
abstinence condom use avoid recreation IV drugs testing risk risk people annually
diagnosis infectious diseases
accurate documentation of all s/s, culture the microorganism
Active immunity
when host mounts an immune response through exposure or vaccine active because the hosts immune system develops the response long lasting but takes a few weeks to develop appropriate response
Histology
study of tissues
Iron Fe
10-15% absorbed in small intestine and live but not metabolized, used to tx iron deficiency take with or after meals with fluid like OJ
Category B- drug safety in pregnancy
Animal studies show no risk to fetus, no adequate studies in humans
Potassium K
3.5-5.0 mEq/L
Etiology
cause of disease
mortality
death
polysomy
extra individual chromosomes
Negative feedback system
A reaction that causes a decrease in function in response to some kind of stimulus. eg. insulin release in response to increase blood glucose
Schedule III Controlled Substances
Abuse potential leading to: - MODERATE or LOW physical dependence - HIGH psychological dependence
Pharmodynamics (how the drugs work)
1. replace or act as substitutes for missing chemicals 2. increase or stimulate cellular activity 3. depress or slow cellular activity 4. interfere with the functioning of foreign cells causing cell death
Magnesium Mg
1.8-3.0 mg/dL increases neuromuscular excitability
How is Phenylketonuria (PKU) treated?
With a special diet restricting phenylalanine intake
morbidity
functional effects of a disease
Why do loop diuretics need to be pushed slowly when administered via intravenous (IV) push? A. To prevent nephrotoxicity B. To prevent neuroplasticity C. To prevent ototoxicity D. To prevent retinopathy
C. To prevent ototoxicity
Phytonadione (Vitamin K)
fat soluble vitamin, tx bleeding disorders found in cheese, spinach, broccoli, Brussel sprouts, kale, cabbage, turnip greens, soybean oil
Vitamin D3
fat soluble, tx hypoCa, hypoparathyroidism, metabolic bone disease Found in dairy, fortified cereals, OJ, liver, fish liver, oils, saltwater fish, butter, eggs
hypotonic
fewer particles, more water than blood causes fluid to shift from ECF to ICF. Used in dehydrated patients
intracellular fluid
fluid in the cells, 40% body weight, permeable to water
IgM
forms natural antibodies ABO, prominent in early responses, clumps for lysis
How do drugs behave when tightly bound to proteins?
Tightly bound drugs have a long duration of action.
side effects of diuretics
frequent urination, hypotension, hypoNa, hypoK, hypoCl, dizziness, headache, dehydration, muscle cramps, gout, erectile dysfunction
interstitial ecf
gas, nutrients and waste between the vascular compartment and body cells.
inflammatory eosinophils
granules toxic to parasitic worms
Schedule II Controlled Substances
high potential for abuse-->severe dependence -NARCS: morphine, opium, dilaudid, Demerol, OxyContin -STIMS: Dexedrine, Adderall, Ritalin -cocaine, amobarbital
Pathogenesis
how a disease develops
onset of a drug
how fast a drug begins affecting the patient
Marfan Syndrome
Autosomal Dominant disorder of connective tissue long extremities, hyperextendable joints regularly assess at risk systems
How is Phenylketonuria (PKU) inherited?
Autosomal Recessive.
Phase I Studies
human volunteers test drug healthy volunteers with the condition must sign a consent because of risks
natural immunity
acquired as part of normal life experiences, early rapid response, skin and inflammatory process
fat soluble vitamins
A,D,E,K
seroconversion
the period of time during which HIV antibodies develop and become detectable
Convalescent Stage
the stage during which signs and symptoms of a disease fade and a person is no longer contagious
Stages of the General Adaptation Syndrome
Alarm Stage Resistance Stage Exhaustion Stage
What is Phenylketonuria (PKU)?
An inherited disorder of protein metabolism.
Schedule I Controlled Substances
High abuse potential; No accepted medical use Heroin, LSD
IgG
most abundant, can cross placenta, gives fetus passive immunity antiviral, antibacterial and antitoxin properties
Down Syndrome - Trisomy 21
a genetic disorder caused by a trisomy of the twenty-first chromosome
Pathophysiology
the study of how disease processes affect the function of the body
Types of clinical courses
acute sub-acute chronic
endogenous source of infection
internal, inside the body
Syndrome
compilation of s/s characteristic of a disease
prenatal vitamins
encouraged before, during, and after pregnancy
Blood-brain barrier
only lipid soluble drugs can pass
What are the types of neoplasms based on behavior?
Neoplasms can be benign (non-cancerous) or malignant (cancerous).
T/F humans have normal and harmless microflora
True
What are the types of neoplasms based on structure?
Neoplasms can be solid (tumor) or hematologic (related to blood or blood-forming tissues).
Sodium Na
135-145 mEq/L
The nurse is administering an antifungal medication. What is the most relevant testing required for the client taking this medication? A.HIV testing B.Neurologic testing C.Renal testing D.Ophthalmologic testing
C.Renal testing
The innate immune system is able to recognize and identify self from nonself as well as microbial organisms. TRUE FALSE
TRUE
The innate immune system utilizes cytokines as part of its response. TRUE FALSE
TRUE
normal blood pH
7.35-7.45
pediatric body fluids
75-80% total weight, susceptible to dehydration
Calcium Ca
8.7-10.5 mg/dL
What is Turner Syndrome?
A chromosomal disorder in females where an X chromosome is missing or partially deleted. XO instead of XX
What is Klinefelter Syndrome?
A chromosomal disorder in which males have an extra X chromosome, making them XXY instead of XY.
Eustress
A positive stress that energizes a person and helps a person reach a goal
cytotoxic T cells
A type of lymphocyte that kills infected body cells and cancer cells
What is a prototype drug?
A well-understood model drug with which other drugs in a pharmacologic class may be compared.
Which factors should be assessed prior to administering a loop diuretic? Select all that apply. A. Blood pressure B. Heart rate C. Potassium level D. Sodium level E. Respiratory rate
A. Blood pressure C. Potassium level
Which are signs of metabolic alkalosis? A. Chvostek sign B. Hyperkalemia C. Cullen sign D. Hypernatremia
A. Chvostek sign
Upon assessment, a patient has Trousseau and Chvostek signs. Which electrolyte abnormality does this indicate? A. Hypocalcemia B. Hypercalcemia C. Hyperkalemia D. Hypokalemia
A. Hypocalcemia
How does the flu vaccine work to provide a person with immunity? A. It activates the formation of antibodies to the pathogen. B. It gives the client the flu and therefore allows the individual to build T-cells to fight flu infection if they are exposed. C. It usually doesn't work because there are too many varieties of the flu. D. It provides passive immunity as it transfers antibodies to the flu via the vaccine.
A. It activates the formation of antibodies to the pathogen.
A client who lives with many psychosocial and physiologic stressors is experiencing the exhaustion stage of stress. The client is likely to develop what consequence of this stage? A. Physiologic damage B. Heightened awareness C. Emotional balance D. Death
A. Physiologic damage
Which are interprofessional goals of treating sepsis? Select all that apply. A. Prevent and treat infection. B. Maintain tissue oxygenation. C. Avoid nutritional support. D. Support failing organs. E. Keep mean arterial pressure (MAP) above 65 mm Hg.
A. Prevent and treat infection. B. Maintain tissue oxygenation. D. Support failing organs. E. Keep mean arterial pressure (MAP) above 65 mm Hg.
A client in the acute stage of inflammation will experience vasodilation of the arterioles and congestion in the capillary beds. The nurse would assess the client's skin for: A. Redness B. Coolness C. Decreased sensation at the site D. Increased bacterial infection
A. Redness
Which are treatments for respiratory acidosis? Select all that apply. A. Reversing sedative medication B. Intubation or BiPAP C. Diuresis D. Sodium bicarbonate tablets E. Hydration
A. Reversing sedative medication B. Intubation or BiPAP E. Hydration
Which are involved in innate (general) immune defenses? Select all that apply. A. Skin B. Antibody response to an antigen C. Stomach acid D. Urine flow E. Maternal transfer of antibodies
A. SKIN C. STOMACH ACID D. URINE FLOW
A client with viral pneumonia asks when antibiotic medications will be prescribed. Which response will the nurse make to the client? A."Antibiotics are not used to treat viral infections." B."The medication has to be obtained from another pharmacy." C."The provider is determining which would be the best for you." D."The exact antibiotic has not yet been determined from your sputum sample."
A."Antibiotics are not used to treat viral infections."
Which clinical manifestation would lead the nurse to suspect a client has developed fluid volume excess? A. weight gain B. increased blood urea nitrogen (BUN) C. decreased blood pressure D. decreased urine output
A. weight gain
Teratogenicity
Any drug that causes harm to the developing fetus or embryo
Which statement by the client indicates that the client understands the nurse's teaching about diuretics? A."I will weigh myself daily and report significant changes." B."I will have to limit my high-sugar foods." C."If my leg becomes swollen again, I'll take an additional pill." D."I will take my medication before bedtime on an empty stomach."
A."I will weigh myself daily and report significant changes."
The nurse is preparing to administer a sulfonamide to a client when the client states, "I woke up this morning with a lot of sores in my mouth." What is the nurse's next best action? A."I'm going to contact your health care provider before I administer your medication." B."I wouldn't worry about it. It should get better in the next day or two." C."You have most likely developed these sores due to the stress of the infection." D."Take this dose of medication and I'll notify your health care provider."
A."I'm going to contact your health care provider before I administer your medication."
The faculty member is explaining homeostasis to her student. The faculty member knows the student understands the concept when he states which concept about homeostasis? A."It is a system of carefully coordinated physiologic processes that oppose change." B."It is characterized by a severe stress response secondary to experiencing previous trauma." C."An organism is able to survive as long as the composition of the external environment is compatible with the survival needs of the individual cells." D."It is a control system that monitors a function or value. When the function or value decreases below the set point of the system, the mechanism causes the function or value to increase."
A."It is a system of carefully coordinated physiologic processes that oppose change."
The nurse is caring for a client who has just been prescribed a loading dose of a drug. The nurse should explain what rationale to the client for administering a loading dose? A."We want to make sure you get the benefits of the drug as quickly as possible." B."We want to customize the dose to your body weight." C."We need to see if your body responds to the drug in the proper way." D."A loading dose will ensure that subsequent doses remain effective for as long as possible."
A."We want to make sure you get the benefits of the drug as quickly as possible."
What information should the nurse provide the pregnant client regarding specific vitamins and minerals needed to effectively manage a diagnosis of anemia? Select all that apply. A."You will need to supplement your diet daily with the prescription you've been given." B."Let's discuss foods that are rich in iron." C."Your vitamin and mineral consumption relates to how well your body produces red blood cells." D."Be sure to let your care provider know if you are more tired than usual." E."Citrus foods will be a good source of folic acid to add to your diet."
A."You will need to supplement your diet daily with the prescription you've been given." B."Let's discuss foods that are rich in iron." C."Your vitamin and mineral consumption relates to how well your body produces red blood cells." D."Be sure to let your care provider know if you are more tired than usual." E."Citrus foods will be a good source of folic acid to add to your diet."
A nurse suspects that a client with a plasma magnesium level of 1.2 mg/dL (0.60 mmol/L) may have which condition in his or her history? A.Abuse of alcohol B.Kidney failure C.Excessive intake of dairy products D.Obesity
A.Abuse of alcohol
A nurse documenting a client's health history places hypertension under which category? A.Acquired B.Congenital C.Mortality D.Complications
A.Acquired
A client's most recent laboratory results suggest the presence of metabolic alkalosis. What action by the nurse best addresses a potential cause of this acid-base imbalance? A.Administering an antiemetic to treat the client's frequent vomiting B.Repositioning the client frequently to reduce pressure on dependent skin surfaces C.Assessing the client's bowel sounds and administering scheduled stool softeners D.Assessing the client's level of consciousness using the Glasgow Coma Scale
A.Administering an antiemetic to treat the client's frequent vomiting
As a nurse prepares to change a client's dressing, the client states that she is afraid that it will be painful. Noting that the client's heart rate and respiratory rate have increased, the nurse adjusts the plan of care to reflect care for a client in which phase of Selye's general adaptation syndrome? A.Alarm B.Resistance C.Exhaustion D.Exacerbation
A.Alarm
The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys? A.Excretion is likely to take place slowly. B.The client likely has impaired drug metabolism. C.Distribution will be delayed, increasing the risk of adverse effects. D.Absorption will be increased because of fluid accumulation.
A.Excretion is likely to take place slowly.
A client is admitted after losing 44 lb (20 kg) over the past 3 months, largely due to frequent vomiting. What intervention should the nurse anticipate in the treatment of the client's resulting acid-base imbalance? A.Fluid replacement with an intravenous solution containing electrolytes as prescribed B.Administration of intravenous sodium bicarbonate as prescribed C.Supplementary oxygen using a non-rebreather mask D.Mechanical ventilation and administration of supplementary oxygen
A.Fluid replacement with an intravenous solution containing electrolytes as prescribed
Which medication, being taken regularly by a client, may create a need for oral potassium supplementation? A.Furosemide B.Diltiazem C.Loratadine D.omeprazole
A.Furosemide
Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma PCO2 levels. What is a common cause of respiratory alkalosis? A.Hyperventilation B.Hypoventilation C.Cluster breathing D.Kussmaul breathing
A.Hyperventilation
A client in cardiovascular collapse requires pharmacological interventions. What route of administration is most likely appropriate? A.Intravenous B.Oral C.Rectal D.Topical
A.Intravenous
The nurse is caring for a client with an accumulation of 2.5 cm of darkened tissue scar over the area of a 3-mm injury. How does the nurse correctly document this finding in the medical record? A.Keloid B.Thrombus C.Tumor D.Hernia
A.Keloid
Which type of immunity is achieved by an infant from its mother through antibodies transferred in utero or in breast milk? A.Naturally acquired passive immunity B.Artificially acquired active immunity C.Artificially acquired passive immunity D.Naturally acquired active immunity
A.Naturally acquired passive immunity
A child experiencing edema as a result of a congenital heart defect is prescribed a thiazide diuretic. The nurse should closely monitor which of the client's clinical characteristics? (Select all that apply.) A.Potassium level B.Daily weight C.Blood pressure D.Level of consciousness E.Appetite
A.Potassium level B.Daily weight C.Blood pressure D.Level of consciousness
The nurse is caring for a client who complains of headache and blurred vision. The nurse recognizes that these symptoms, accompanied by increased plasma partial pressure carbon dioxide (PCO2) level and decreased pH level, are consistent with which diagnosis? A.Respiratory acidosis B.Respiratory alkalosis C.Metabolic alkalosis D.Metabolic acidosis
A.Respiratory acidosis
Which assessment finding supports the diagnosis of Turner syndrome? A.Short stature B.Intellectual disability C.Enlarged breasts D.Early onset puberty
A.Short stature
The first physical line of defense in innate immunity is: A.Skin and mucous membranes B.Plasma proteins C.Specialized lymphocytes D.Neutrophils
A.Skin and mucous membranes
How can herbal therapies produce unexpected effects when taken by a consumer? A.They can interact with prescription drugs. B.They always contain known ingredients. C.They are natural so their effectiveness and toxicity cannot change. D.Their ingredients are not made in toxic amounts.
A.They can interact with prescription drugs.
Which of these are most likely to contribute to the spread of HIV infection? A.Vaginal intercourse B.Sharing of intravenous needles C.Oral sex D.Mosquitoes
A.Vaginal intercourse B.Sharing of intravenous needles C.Oral sex
A client is prescribed antibiotic therapy to treat a sexually transmitted infection. The nurse will instruct the client to do which of the following? A.complete the entire course of drug therapy. B.reduce the dosage of ciprofloxacin gradually. C.take the drug only in safe and secure home settings. D.take the drug through subcutaneous injection if it tastes bad.
A.complete the entire course of drug therapy.
The nurse administers a medication and the client has an immediate anaphylactic reaction following injection. What symptoms assessed by the nurse would indicate anaphylaxis? (Select all that apply.) A.difficulty breathing B.increased blood pressure C.Diaphoresis D.constricted pupils E.slow heart rate
A.difficulty breathing B.increased blood pressure C.Diaphoresis
A 60-year-old patient with rheumatoid arthritis visits the health care facility for a regular checkup. The patient informs the nurse that the patient has been using an over-the-counter NSAID for the last few days. Why should the nurse caution the patient against the use of NSAIDs on a long-term basis? A.increased risk of GI bleeding B.Increased risk of CNS disorders C.Increased risk of hearing impairment D.Increased risk of blindness
A.increased risk of GI bleeding
A client has been diagnosed with respiratory alkalosis. What assessment finding should the nurse anticipate? Select all that apply. A.pH above 7.45 B.PCO2- 45 mm/hg (5.99 kPa) C.HCO3- 27 mEq/L (27 mmol/L) D.PCO2 34 mm/hg (4.52 kPa) E.HCO3- 19 mEq/L (19 mmol/L)
A.pH above 7.45 D.PCO2 34 mm/hg (4.52 kPa) E.HCO3- 19 mEq/L (19 mmol/L)
What information should the nurse include when leading a discussion on alternative and complementary therapies? Select all that apply. A.the benefits of meditation B.examples of positive imagery C.demonstration relaxation techniques D.explanation of the core principles of acupuncture E.clarification of the cautions related to herbal therapy
A.the benefits of meditation B.examples of positive imagery C.demonstration relaxation techniques D.explanation of the core principles of acupuncture E.clarification of the cautions related to herbal therapy
IgD
Attached to B cells Activates B cells
Brand Name Drugs
AKA Trade name named by manufacturer presented with a capital letter may have differing levels of active ingredients
aneuploidy
Abnormal number of chromosomes.
Pharmokinetics (how medication travels through body)
Absorption Distribution Metabolism Excretion
What happens in Phenylketonuria (PKU) due to the absence of phenylalanine hydroxylase?
Toxic buildup of phenylalanine, causing intellectual disability.
Medication Metabolism
Also called biotransformation; the process of chemically converting a drug to a form that is usually more easily removed from the body in the liver
What is a neoplasm?
An abnormal mass of tissue that is not well differentiated and serves no physiological purpose.
What is the treatment for testosterone deficit in Klinefelter Syndrome?
Androgen therapy
Category C- drug safety in pregnancy
Animal studies have shown a danger to fetus, no adequate studies in humans
Autosomal chromosomes
Any chromosome that is not a sex chromosome
How long does it take NSAIDs to reach peak levels? A. 30 minutes to 1 hour B. 1 to 3 hours C. 2 to 5 hours D. 6 to 12 hours
B. 1 to 3 hours
In which patient is administering an NSAID contraindicated? A. 18-year-old with a temperature of 101.2°F being treated for an infection B. 27-year-old in the first trimester with their second child C. 48-year-old newly diagnosed with osteoarthritis D. 56-year-old with nephrolithiasis
B. 27-year-old in the first trimester with their second child
Which patient is at the highest risk for developing sepsis? A. A patient admitted for nephrolithiasis B. A patient admitted for end-stage kidney disease C. A patient admitted for vaginal delivery of a child D. A patient who is newly nothing-by-mouth (NPO) status for a procedure in the morning
B. A patient admitted for end-stage kidney disease
Which is not a potential source of an infection that could cause sepsis? A. Central venous access device B. Atherosclerosis C. COVID-19 D. Stage 4 pressure injury
B. Atherosclerosis
A woman reports to the nurse that she has developed a yeast infection. The woman does not understand how she could get a yeast infection since she has been on antibiotics for a urinary tract infection. What is the rationale for this client's complaint? A. Yeast grows well when exposed to sugar, which is found as a carrier substance in most antibiotics. B. Destroying one type of resident flora (bacteria) can allow overproliferation of another competing type (yeast). C. Yeast prefers a warm, moist, and dark environment, such as that present in the female perineum. D. Antibiotics allow yeast to access sterile environments in the body.
B. Destroying one type of resident flora (bacteria) can allow overproliferation of another competing type (yeast).
Which condition is not an indication for a loop diuretic? A. Heart failure B. Diabetes mellitus C. Hypertension D. Fluid overload
B. Diabetes mellitus
A patient is ordered furosemide. What is a potential complication of this medication? A. Hypertension B. Hypotension C. Bradycardia D. Decreased SpO2
B. Hypotension
The course of any infectious disease progresses through several distinct stages after the pathogen enters the host. Although the duration may vary, which sign/symptom is the hallmark of the prodromal stage? A. Tissue inflammation and damage B. Initial appearance of symptoms C. Progressive pathogen elimination D. Containment of infectious pathogens
B. Initial appearance of symptoms
Which is one of the first physical lines of defense in innate immunity? A. Specialized lymphocytes B. Mucous membranes C. Neutrophils D. Plasma proteins
B. Mucous membranes
Which finding is most likely in a client in the latent period of HIV infection? A. Sores on the genitalia that drain purulent secretions B. Numerous enlarged lymph nodes in the axilla and cervical neck region for 4 months C. Excessive vomiting of blood for 2 weeks D. A chronic cough that will not go away, even after two courses of antibiotics
B. Numerous enlarged lymph nodes in the axilla and cervical neck region for 4 months
An immunocompromised client was exposed to hepatitis and will be treated with immunoglobulin G (IgG). Which mechanism of immunity will help improve this client's health? A. Active immunity B. Passive immunity C. Self-regulation of the immune system D. A way to convey life-long protection against hepatitis
B. Passive Immunity
The 'window period' of HIV infection refers to the period of time between infection and which event? A. Transmission B. Seroconversion C. Initial symptoms D. Antibody screening
B. Seroconversion
A patient is prescribed a loop diuretic. What will happen to the potassium level when this medication is administered? A. The potassium level will increase. B. The potassium level will decrease. C. The potassium level will remain unchanged. D. The potassium level will only drop if it was high prior to administration.
B. The potassium level will decrease.
A patient is ordered potassium replacement for a potassium level of 3.2 mEq/dL. What is the best way to administer this medication? A. Crushed and added to applesauce B. Whole pill by mouth C. Intravenous push D. Subcutaneous
B. Whole pill by mouth
A client has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause which? A. neutropenia or autoimmune effects. B. ototoxicity or nephrotoxicity. C. increased intracranial pressure (ICP) or changes in cognition. D. anemia or impaired erythropoiesis.
B. ototoxicity or nephrotoxicity.
A client is considering using herbal supplements and asks the nurse about them. Which response by the nurse would be most appropriate? A."Herbal supplements are safe to use because they are regulated closely." B."Herbal supplements can affect other medications so you need to consult your healthcare provider" C."Taking more than the recommended amount usually is not harmful because they are natural." D."The risk of the supplement interacting with any prescription medications is extremely low."
B."Herbal supplements can affect other medications so you need to consult your healthcare provider"
For which condition are NSAIDS recommended to alleviate symptoms? A. Gastric ulcers B. Blurred vision C. Menstrual cramps D. Cholecystitis
C. Menstrual cramps
A parent brings a 6-month-old infant to the primary care physician to treat the infant's third respiratory infection since birth. What explanation will the nurse give for the order to administer intravenous immunoglobulin (IVIg)? A."This medication helps prevent infection through the school years." B."IVIg supplements the infant's immunity to prevent recurrent infection." C."Immunosuppressive agents are needed to treat an autoimmune disorder." D."Without this drug, the infant will develop anaphylactic reactions when older."
B."IVIg supplements the infant's immunity to prevent recurrent infection."
A client asks the nurse about fat-soluble vitamins. Which statement should the nurse include when discussing fat-soluble vitamins with a client? A."Fat-soluble vitamins are only available by supplements." B."The body stores fat-soluble vitamin excess to use later." C."B1, B3, and B6 are part of the fat-soluble vitamins. D."Organic fat-soluble supplements are the best."
B."The body stores fat-soluble vitamin excess to use later."
The client is diagnosed with an influenza A infection and will be prescribed oseltamivir. What intervention should the nurse plan to implement initially to best assure safe medication theory? A.Establish client's ability to afford the anticipated medication therapy. B.Assess for known history of liver dysfunction. C.Assess bowel and bladder function to establish baseline for future evaluation. D.Establish existence of reproductive-related disorders.
B.Assess for known history of liver dysfunction.
If a client has a bacterial infection in the blood, the nurse will note which laboratory value that correlates with this? A.Increased eosinophils B.Increased neutrophils C.Severe decrease in neutrophils D.Inhibit prostaglandin release
B.Increased neutrophils
A client with renal failure and severe hyperkalemia (K+ level 7.2 mEq/L [7.2 mmol/L]) has just been admitted to the nursing unit. The nurse anticipates administering which treatment to quickly lower potassium levels? A.Lactated Ringer's solution at 150 ml/hr to maintain blood glucose levels B.Short-acting insulin with glucose given intravenously as a bolus C.Infusion of methylprednisolone to decrease irritation to intravascular system D.Hydromorphone via patient-controlled anesthesia (PCA) device to control pain
B.Short-acting insulin with glucose given intravenously as a bolus
A nurse has administered a dose of a drug that is known to be highly protein bound. What are the implications of this characteristic? A.The client must consume adequate protein in order to achieve a therapeutic effect. B.The molecules of the drug that are bound to protein are inactive and do not affect body cells. C.Increased levels of serum protein will increase the effect of the drug. D.Each molecule of the drug must bind to a protein molecule to become effective.
B.The molecules of the drug that are bound to protein are inactive and do not affect body cells.
The nurse is collaborating with the health care provider (HCP) of a client who presented with signs and symptoms of an infection. What information should the nurse prioritize so that the HCP can prescribe the proper antibiotic? A.first day of infection symptoms B.culture and sensitivity test results C.the client's intake and output for past 2 days D.results of complete blood count with differential
B.culture and sensitivity test results
Immune Suppressants
Block the normal effects of the immune system in organ transplantation and autoimmune disorders
Which type of oxygen mask may be indicated for the patient in respiratory alkalosis? A. Venturi mask B. Nasal cannula C. Non-rebreather mask D. Simple face mask
C. Non-rebreather mask
What is the maximum dose per day for ibuprofen? A. 1,200 mg B. 2,000 mg C. 3,200 mg D. 4,000 mg
C. 3,200 mg
A middle school student is scheduled to receive booster immunizations, and the parent asks the nurse why the booster is necessary. What characteristic of the adaptive immune system would inform the nurse's response? A. Some antibodies require a repeat of the primary immune response. B. Some antibodies have a duration measured in months rather than years. C. A secondary response causes a sharp rise in antibody levels. D. Antigen receptors on CD4+ cells require multiple exposures separated by time.
C. A secondary response causes a sharp rise in antibody levels.
Which statement is true regarding drawing blood cultures? A. Always draw one blood culture before administering antibiotics. B. Draw one set of blood cultures, administer antibiotics, and then draw second set of blood cultures. C. Always draw both sets of blood cultures before administering antibiotics. D. Drawing blood cultures and administering antibiotics can be done simultaneously.
C. Always draw both sets of blood cultures before administering antibiotics.
A patient has a sodium level of 124 mEq/dL. Which assessment finding is expected? A. Cardiac arrythmias B. Pressured speech C. Confusion D. Petechiae
C. Confusion
What is the difference between crystalloids and colloids? A. Crystalloids are thicker and more viscous, and colloids are clear fluids. B. Crystalloids are used to correct sodium levels, and colloids are used to correct potassium levels. C. Crystalloids are clear fluids, and colloids are thicker and more viscous. D. Crystalloids are used to correct potassium levels, and colloids are used to correct sodium levels.
C. Crystalloids are clear fluids, and colloids are thicker and more viscous.
Which aspect of pathogen recognition in the innate immune system explains why the immune system does not attack all the body's cells in an autoimmune disease? A. Normal host cells excrete inhibitory proteins that are detected by natural killer cells. B. Intraepithelial lymphocytes and natural killer cells possess specific highly diverse receptors. C. Pattern recognition receptors (PRRs) ensure cells are correctly identified. D. Leukocytes possess pathogen-associated molecular patterns (PAMPs).
C. Pattern recognition receptors (PRRs) ensure cells are correctly identified.
Which cells are primarily programmed to remove the invading organisms and remember the antigen in order to respond rapidly in response to a future exposure? A. CD4 and CD8 cells B. Natural killer (NK) cells and macrophages C. T and B lymphocytes D. White blood cells and platelets
C. T and B lymphocytes
Which description best characterizes sepsis? A. A localized infection B. An infection that spread from the skin to the lymph nodes C. The body's exaggerated response to infection D. An infection that develops postoperatively
C. The body's exaggerated response to infection
Why does knowing what causes acid-base imbalances and what is happening in the body important? A. To encourage similar behavior B. To train the body to live in a different state C. To guide treatment and prevention efforts D. To educate families on their risk of inheriting these disorders
C. To guide treatment and prevention efforts
A 15-year-old female client is receiving tetracycline for the treatment of severe acne. Which statement would the nurse make when teaching the client about this drug? A."A change in diet is a better treatment for acne than medication." B."Tetracycline can only be administered here in the hospital." C."When taking tetracycline, wear extra sunblock and watch for discoloration of your teeth." D."You need to have lab work done daily to ensure the proper dose of this medication."
C."When taking tetracycline, wear extra sunblock and watch for discoloration of your teeth."
The nurse is assigned to care for four clients. Which of these individuals should the nurse carefully monitor for signs and symptoms of hyperkalemia? A.A client who is taking furosemide for hypertension B.A client who has been admitted for pneumonia taking antibiotics C.A client who is taking spironolactone for lower extremity edema D.A client with a seizure disorder who is taking phenytoin
C.A client who is taking spironolactone for lower extremity edema
A parent has brought a 6-year-old child to the clinic. The child has a fever of 102.8°F (39.3°C) and is subsequently diagnosed with the flu. What medication best balances risks and benefits for treating this client's fever? A.Etanercept B.Penicillamine C.Acetaminophen D.aspirin
C.Acetaminophen
A nurse is preparing a teaching plan for a client with edema who is prescribed a diuretic. Which teaching should the nurse prioritize? A.Decrease fluid intake. B.Gradually increase the dosage. C.Administer early in the day. D.Encourage exercise.
C.Administer early in the day.
A nurse gives a client 0.25 mg of digoxin instead of the prescribed dose of 0.125 mg. What should the nurse do next? A.Give another 0.125 mg as soon as possible. B.Nothing; the dose will not make a significant difference. C.Assess the client and notify the client's health care provider. D.Hold the next dose to make sure the total amount balances.
C.Assess the client and notify the client's health care provider.
A client with an upper respiratory tract infection has been prescribed an antibiotic that the nurse is not familiar with. What should the nurse caring for the client do if not familiar with the new medication? A.Avoid administering the prescribed medication to the client. B.Administer an antibiotic with which the nurse is familiar. C.Collect information about the new medication. D.Administer the antibiotic as per the prescription provided.
C.Collect information about the new medication.
What do morbidity and mortality statistics refer to? A.Long-term consequences and recovery rates of a disease B.Cause of death and impact on the family because of a disease C.Functional effects and death-producing characteristics of a disease D.Effects a disease has on a person's life and treatment
C.Functional effects and death-producing characteristics of a disease
It is well known that cancer is not a single disease. It follows then that cancer does not have a single cause. It seems more likely that the occurrence of cancer is triggered by the interactions of multiple risk factors. What are some identified risk factors for cancer? A.Body type, age, and heredity B.Radiation, cancer-causing viruses, and color of skin C.Hormonal factors, chemicals, and immunologic mechanisms D.Immunologic mechanisms, cancer-causing viruses, and color of skin
C.Hormonal factors, chemicals, and immunologic mechanisms
Potassium: 2.5 mEq/L (2.5 mmol/L)Sodium: 136 mEq/L (136 mmol/L)Calcium: 9.2 mg/dL (2.3 mmol/L)Magnesium: 2.02 mEq/L (1.01 mmol/L)How should the nurse best respond to these values? A.Document the fact that the laboratory results were reviewed and noted to be within reference ranges. B.Obtain a prescription for evaluation of the client's chloride level. C.Inform the health care provider and monitor the client's cardiac status. D.Ensure IV access and administer calcium gluconate as prescribed.
C.Inform the health care provider and monitor the client's cardiac status.
The nurse is educating a couple about the recommended immunization plan for their infant. What should the nurse teach these new parents? A.Whenever possible, avoid having the child receive more than one vaccine at a time. B.Stop the immunizations after 2 years of age, provided the program has been adhered to up to that age. C.Keep a written record of the child's immunizations. D.The child's risk factors for autism will be assessed before any immunizations are given.
C.Keep a written record of the child's immunizations.
The nurse is caring for a client who is experiencing elevated intracranial pressure following neurosurgery. The health care provider orders an osmotic diuretic to reduce pressure. Which medication would the nurse expect to be ordered? A.Spironolactone B.Bumetanide C.Mannitol D.Ethacrynic acid
C.Mannitol
The nurse is administering a unit of packed red blood cells to a client and piggybacks the unit of blood through a solution of 0.9% NaCl. Blood cells placed in a solution of 0.9% saline will do which of the following? A.Shrink B.Swell C.Neither shrink nor swell D.Rupture
C.Neither shrink nor swell
What are the treatment options for Turner Syndrome?
Treatment includes growth hormone and estrogen therapy.
A nurse educator is explaining how the HIV virus is responsible for AIDS and AIDS syndromes. The educator should explain that replication involves the killing of: A.The CD8+ T cell and the release of HIV copies into the bloodstream. B.Macrophages and the release of HIV copies into the bloodstream. C.The CD4+ T cell and the release of HIV copies into the bloodstream. D.Plasma cells and their eventual replacement with HIV cells.
C.The CD4+ T cell and the release of HIV copies into the bloodstream.
A 22-year-old woman has received an organ transplant and is on immunosuppressive therapy. She is prescribed cyclosporin. The nurse will encourage her to avoid crowds and limit social activities while on the medication due to: A.increased sedation. B.episodes of extreme dizziness. C.increased risk of infections. D.frequent migraine headaches.
C.increased risk of infections.
A client states, "I take acetaminophen four to five times daily when I'm at home.." Which laboratory test is a relevant response to best evaluate the client for any adverse effects? A.cardiac enzymes B.peak and trough C.liver enzymes D.white blood cell count
C.liver enzymes
The nurse is caring for a client undergoing gastric suctioning. Which arterial blood gas results will the nurse interpret as confirming the client is experiencing metabolic alkalosis? A.pH of 7.42 and HCO3 of 20 mEq/l (20 mmol/l) B.pH of 7.25 and HCO3 of 18 mEq/l (18 mmol/l) C.pH of 7.45 and HCO3 of 30 mEq/l (30 mmol/l) D.pH of 7.35 and HCO3 of 22 mEq/l (22 mmol/l)
C.pH of 7.45 and HCO3 of 30 mEq/l (30 mmol/l)
HIV attaches to?
CD4 T cells, glycoproteins enters host through fusion RNA is then transcribed into DNA
Chvostek's sign
Cheek, facial spasm when Cheek is tapped associates with hypocalcemia
What distinguishes chronic inflammation from acute inflammation in terms of duration?
Chronic inflammation may last for years
The opportunistic organisms that produce infections in a client with HIV are able to do so because the immune system of the individual is compromised. TRUE FALSE
TRUE
Which intravenous (IV) solution is expected for a patient with cerebral edema? A. Normal saline B. ½ normal saline C. D5 normal saline D. 3% saline
D. 3% saline
A person who was diagnosed with HIV infection 12 years ago and still has a CD4+ cell count of 800 cells/µL and a low viral load is considered be clinically what? A. Rapid progressor B. Typical progressor C. Slow progressor D. Long-term nonprogressor
D. Long-term nonprogressor
How do NSAIDs work? A. They elevate the body's pain threshold and remove excess heat. B. They bind to opioid receptors. C. They block beta receptors in the heart. D. They block prostaglandin synthesis.
D. They block prostaglandin synthesis.
Which is not a cause of metabolic acidosis? A. Diarrhea B. Diuretics C. Kidney failure D. Vomiting
D. Vomiting
The nurse is teaching an older adult about adapting to age-related physiologic changes. Which statement by the client prompts the nurse to provide additional teaching? A."I will use a moisturizing lotion after my bath." B."I will ensure to keep rooms well lit in my home." C."I will change positions from lying to standing slowly." D."I will reduce my total daily fluid intake."
D."I will reduce my total daily fluid intake."
A client is ordered to receive vancomycin IV. When administering the drug, the nurse would infuse the drug over which time frame? A.15 minutes B.30 minutes C.45 minutes D.60 minutes
D.60 minutes
When providing medication teaching to a client who has been prescribed spironolactone, what foods should the nurse instruct the client to avoid? A.Fish B.Apples C.Crackers D.Bananas
D.Bananas
A pregnant client has just undergone cytogenetic studies to determine fetal karyotyping. She learns that her fetus has trisomy 21. Which of the following is a manifestation of this condition? A.Tall stature B.Testicular agenesis C.Gynecomastia D.Epicanthal eye folds
D.Epicanthal eye folds
Which condition is a cause of osmotic edema? A.Varicose veins B.Local injury and inflammation C.Congestive heart failure D.Low blood levels of albumin
D.Low blood levels of albumin
Which condition is characterized by a deficiency of the liver enzyme phenylalanine hydroxylase? A.Cystic fibrosis B.Tay-Sachs disease C.Cri du Chat D.Phenylketonuria
D.Phenylketonuria
What is true concerning medication errors? A.The nurse is not responsible for preventing medication errors. B.Most medication errors are committed by physicians. C.Most medication errors are committed by pharmacists. D.The nurse is responsible for ensuring medication safety.
D.The nurse is responsible for ensuring medication safety.
The nurse is performing an assessment for a client who had a left mastectomy 3 months ago and demonstrates significant swelling of the extremity. What assessment data indicates that the client has lymphedema and not another form of edema? A.The swelling in the arm is pitting. B.The arm is reddened as well as edematous. C.The arm is weeping serous fluid. D.The skin of the arm has a honeycomb appearance.
D.The skin of the arm has a honeycomb appearance.
A client with a large decubitus ulcer asks the nurse, "How it is possible for a wound this deep to ever fully heal?" What is the nurse's best response? A.Deep wounds like this require surgical intervention and skin grafting before they will be healed. B.It will be difficult, but you have many experts planning your care so the chances of healing are good. C.Once the first layer of new granulation tissue is formed, the speed of the repair will increase greatly. D.With adequate resources, the body is capable of regenerating tissue and blood flow to the area over time.
D.With adequate resources, the body is capable of regenerating tissue and blood flow to the area over time.
A client has been prescribed an oral drug that is known to have a high first-pass effect. Which measure has the potential to increase the amount of the free drug that is available to body cells? A.giving the drug with food in order to delay absorption B.administering the drug in small, frequent doses C.limiting the client's protein intake and encouraging fluids D.administering the drug intravenously rather than orally
D.administering the drug intravenously rather than orally
Which combination of supplements should the nurse discuss with a client at risk for developing osteoporosis? A.phosphorus and vitamin D B.vitamin D and magnesium C.potassium and calcium D.calcium and vitamin D
D.calcium and vitamin D
While reviewing a newly admitted client's previous health records, the nurse notes that the client is currently prescribed acyclovir. The nurse should assess the client for signs and symptoms associated with what medical diagnosis? A.human immunodeficiency virus (HIV) B.hepatitis A C.hepatitis B D.herpes simplex virus
D.herpes simplex virus
A client's tissue biopsy reveals the presence of cells that appear to have abnormalities in shape and size. Carcinoma is suspected because these cells possess the characteristics of: A.cohesiveness and adhesion. B.cell density-dependent inhibition. C.angiogenesis. D.loss of differentiation.
D.loss of differentiation.
Agents to treat hyperK
Na Bicarb-controls acidosis Ca gluconate- decrease cardio toxic effect of K Glucose & insulin: cause K to move into cells
All vaccines used to immunize children against childhood diseases are made of live viruses. TRUE FALSE
FALSE
Components of the innate immune system can be physical, chemical, lymphocytes, and/or antibodies. TRUE FALSE
FALSE
Humoral- and cell-mediated immunity are types of innate immunity. TRUE FALSE
FALSE
Once a client is exposed to the HIV, they will develop AIDS immediately. TRUE FALSE
FALSE
True or false: Passive immunity is achieved through immunization. TRUE FALSE
FALSE
What are some possible physical characteristics of individuals with Klinefelter Syndrome?
Female characteristics, feminine voice, lack of facial hair, breast enlargement
Give examples of systemic manifestations.
Fever, lethargy, generalized body aching, high blood pressure, etc.
diuretics can treat?
HF, acute pulmonary edema, liver disease, renal disease, HTN, increased IOP, hyperkalemia
Secondary Immune response
Immune response after the body has already been exposed to a specific antigen. Response is faster, of greater magnitude, and more prolonged.
Primary immune response
Immune response the first time the body is exposed to a particular antigen. Does not peak until 10-17 days after exposure.
Stages of Disease
Incubation Period Prodromal Stage Acute Stage Convalescent Stage Resolution Stage
Prodromal Stage
Initial appearance of symptoms, can be vague
What is Medication Distribution?
It is the movement of a drug into body tissues.
Osmotic diuretics
Mannitol (osmitrol), pull water into renal tubule without Na loss used for diabetics
Acute Stage
Maximum impact and expression of the infection. More severe and specific S&S
What is the characteristic infiltration in chronic inflammation?
Mononuclear cells and lymphocytes instead of neutrophils
Phase II Studies
More patients are treated performed across the country may be removed if adverse side effects
Can you provide an example of off-label medication use?
Ozempic being used for weight loss
What enzyme is absent in Phenylketonuria (PKU)?
Phenylalanine hydroxylase.
Stages of FDA drug approval process
Pre-Clinical Trials Phase I Studies Phase II Studies Phase III studies FDA Approval Phase IV
What is the significance of protein bonding in medication distribution?
Proteins in the blood can bind to drugs, allowing them to be carried into circulation.
Adaptive Immune System
Respond to specific antigens; Responds by remembering signature molecules, called antigens, from pathogens to which the body has previously been exposed
Critical Concentration
The amount of a drug that is needed to cause a therapeutic effect
Potassium-sparing diuretics
Spironolactone (Aldactone)loss of Na while promoting K retention, may cause hyperkalemia, only diuretic recommended for children
Chronic Asymptomatic or Latency Phase
Still Asymptomatic CD4 starts to decline- than 200 CD4 chronic swollen lymph nodes
Schedule IV Controlled Substances
Substances in this schedule have a low potential for abuse relative to substances in Schedule III. Examples of Schedule IV substances include: alprazolam (Xanax), carisoprodol (Soma), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), and triazolam (Halcion).
Schedule V Controlled Substances
Substances in this schedule have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics. Examples of Schedule V substances include: cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC®, Phenergan with Codeine®), and ezogabine.
What are systemic manifestations?
Symptoms present throughout the body and not confined to one area.
Overt Aids Phase
TH cell count less than 200 cells/mL or AIDS-defining illness with no antiretroviral therapy death occurs in 2-3 years
The innate immune system is a quickly reacting system. TRUE FALSE
TRUE
Mechanisms of autoimmune disease
The body makes antibodies against itself - does not recognize some tissues as belonging to the body.
Alarm Stage
The first stage of the general adaptation syndrome, in which the person experiences a burst of energy that aids in dealing with the stressful situation. (fight or flight)
Morphologic changes
The gross anatomic and microscopic changes that are characteristic of a disease
First pass-effect
The initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream.
oncotic pressure
The osmotic pressure in the blood vessels due only to plasma proteins (primarily albumin) --> causes water to rush back into capillaries at end.
Resistance Stage
The second stage of the general adaptation syndrome, when there are intense physiological efforts to either resist or adapt to the stressor. (body attempts to return to normal)
Metastasis
The spread of cancer cells to locations distant from their original site.
Why are prototype drugs important?
They are often the first drug developed in a pharmacologic class.
What does 'off-label' use of medications mean?
Using a prescribed medication for a reason besides its intended use
Neuroleptic malignant syndrome
a potentially fatal hyperpyrexia with temp of over 104, looks like EPS except for temp
prognosis
a prediction of the course of a disease chance of full recovery <50%
Autsomal recessive
a way of inheriting genes where both parents must pass on a recessive gene for their child to express the trait or condition with an early onset
Which individual situation best exemplifies the processes of innate immunity? a. A child who has experienced heat and swelling of a skinned knuckle b. An adult who complains of itching and sneezing due to an allergy to pollen c. A client whose blood work indicates increased antibody titers during an acute illness d. A client who has experienced rejection of a donor liver after transplantation
a. A child who has experienced heat and swelling of a skinned knuckle
major concerns of herbal and dietary supplements
active ingredients and effects are unknown supplements may prevent people from seeking care may interact with prescribed meds most not studied to evaluate safety and efficacy many patients dont tell their providers
Complications
adverse extensions of a disease or outcomes of Tx
CNS toxicity effects
alterations in electrolyte and glucose levels
alfalfa treats
arthritis, hot flashes, increase strength, reduce cholesterol
immunization
artificially stimulating active immunity by exposing the body to weakened or less-toxic proteins, goal is to cause immune response without suffering the whole disease course
IgE
binds to mast cells and basophils. involved in allergic reactions by releasing histamine
vascular ecf
blood, electrolytes, gases, nutrients, waste
Dendritic cells (innate immunity)
bridge between innate and adaptive, transports pathogens to secondary lymph tissues
Loop diuretics
bumetanide (Bumex), Furosemide (lasix), exerts main effect on loop of Henle, high-ceiling diuretics because they can cause greater degree of diuresis, used with Pulmonary edema monitor K levels
hyperkalemia
cause-increase intake, shift of K from ICF to ECF, renal excretion, insulin deficiency manifest-numbness, tingling, weakness
hypokalemia
cause-reduce K intake, loss of K, entry of K into the cells. increased loss of K manifest-decrease in neuromuscular excitability, skeletal muscle weakness, cardiac dysrhythmias, tingling of lips, leg cramps
cellular stage of inflammation
causes migration of leukocytes
hypercalcemia
causes- hyperparathyroidism, sarcoidosis, excess vit D Effects- fatigue, weakness, lethargy, anorexia, nausea, constipation, impaired renal function, kidney stones, dysrhythmias, bradycardia, cardiac arrest, bone pain, osteoporosis
hypermagnesium
causes- usually renal insufficiency or failure, excessive Mg-containing antacids (TUMS), adrenal insufficiency Effects- skeletal smooth muscle contraction, excess nerve function, loss of deep tendon reflex, nausea, vomiting, muscle weakness, hypotension, bradycardia, respiratory distress
hypocalcemia
causes-ineadequate intestinal absorption, decreases in PTH and vit D, nutritional deficiencies effects-increased neuromuscular excitability, tingling, spasms, convulsions, prolonged QT interval, cardiac arrest Chvosteks sign and Trousseau's sign are true indicators
hypomagnesium
causes-malnutrition, malabsorption, alcoholism effects- behavioral changes, irritability, increased reflexes, muscle cramps, ataxia, nystagmus, tetany, convulsions, tachycardia, hypotension
hyponatremia
causes-sodium loss, low intake Manifest-lethargy, confusion, decreased reflexes, seizures, coma
renin
hormone secreted by the kidney; it raises blood pressure by influencing vasoconstriction (narrowing of blood vessels)
two types of adaptive immunity
humoral and cell mediated
Nephrotoxicity
damage to the kidneys by a toxic substance decreased urine output
antibiotics
decrease the population of invading bacteria, use can result in superinfection, bactericidal kills bacteria
aging population body fluids
decreased total water mass percentage, increased adipose, decrease thirst, renal decline
metabolic acidosis
depression of HCO3 or an increase in noncarbonic acids excessive H accumulation from renal failure, DKA, starvation, drug use or loss of buffers in diarrhea or intestinal malabsorption Metabolic acidosis 3 D's-DKA, diarrhea, dialysis
respiratory alkalosis
depression of pCO2 as a result of alveolar hyperventilation caused by altered ventilation anxiety, fear, pain, fever, sepsis, ASA overdose, hyperthyroidism
To diagnose you....
designate the cause of a health problem through history review, exams and diagnostics. You must weigh all competing possibilities
Extrapyramidal Symptoms of medication toxicity
dopamine levels affected side effects such as restlessness, involuntary movements, and muscular tension produced by antipsychotic medications
herbal therapy issues
dose isnt precise ingredients are not precise may interact with medication not regulated by FDA
Noncompetitive agonist
drug combines with different parts of the receptor and inactivates it; agonist then has no effect
immune stimulant
drug used to energize the immune system when it is exhausted from fighting prolonged invasion or needs help fighting a specific pathogen or cancer cell
Receptor site agonist
drugs that interact directly with receptor sites to cause the same activity that natural chemicals would cause at that site -insulin causes movement of glucose into the cell
Anticholinergic effects of medication toxicity
dry mouth constipation photophobia blurred vision Tachycardia
Secondary Disease Prevention
early detection and treatment eg. pap smear, colonoscopy
Neutrophils (innate immunity)
early responder, dormant until needed, migrate through the body
metabolic alkalosis
elevation of HCO3 usually caused by an excessive loss of metabolic acids excess intake of bicarbs in antacids like tums or loss of acid through vomiting, NGT suction, diuretic use
respiratory acidosis
elevation of pCO2 as a result of ventilation depression caused by altered ventilation, CNS depression Symptoms: headache, blurred vision, muscle twitching pneumothorax, massive PE, pneumonia, severe pulmonary infections, pulmonary edema, COPD, heart failure
Macrophages (innate immunity)
engulf and digest microbes
acute inflammation phagocytic leukocytes
enzymes destroy microbes neutrophil count rises monocytes and macrophages produce vasoactive mediators
colonization
establishing a presence, host not being harmed
Category D- drug safety in pregnancy
evidence of fetal risk but the benefits from taking the drug may be worth the risk
Medication Excretion
excreted through kidneys, monitored through BUN and creatinine levels
natriuresis
excretion of a large amount of both sodium and water by the kidneys in response to excess ECF volume
Primary actions of a drug
extension of a drug's desired effect
Factors Influencing Drug Effects
interactions of multiple substances taken together stagger administration as necessary improve any levels of discomfort eg. weight, age, sex, physiological factors, genetics, environmental, drug tolerance
sub-acute course
intermediate, between acute and chronic. Not as severe, not as prolonged
HIV Tx
interrupt HIV replication through antiretroviral therapy-3-4 antiviral agents
Hepatic Enzyme System
intracellular-structures of hepatic (liver) cells are lined with enzyme-systems drugs increase or decrease CYP-450 and enzyme in the liver
acute inflammation platelets
involved in hemostasis release inflammatory mediators
Selective Toxicity
killing harmful microbes without damaging the host
Phase III studies
larger population sample determine and minot side effects patients keep journals to record symptoms
Half-Life
length of time required for half of the radioactive atoms in a sample to decay
Sequelae
lesions or impairments that are caused by a disease
penicillimine
main use is removal of copper is Wilsons disease, makes copper excretable
CD4 helper T cells
master regulator, influence function of all other immune cells
B-lymphocytes
mature in bone marrow
regulatory T cells
moderate immune response
diffusion
molecules passively spread from high concentration to low
nursing implications for diuretic use
monitor pt response to therapy by weight and BP and UO and edema, monitor for electrolyte imbalances, evaluate patient understanding monitor patient compliance to therapy
hypertonic
more particles, less water than blood, causes cells to shrink like in cellular edema and cerebral edema, mannitol, 3% saline
vitamins
must be partially obtained through diet, function as coenzymes that activate protein and catalize biochemical activity, can be water or fat soluble, used to build bones, make hormones, regulate fluid volume, generate nerve action potentials and produce RBC
ginger treats
nausea and vomitings
Pre-clinical trials
no human use determine if drug has the effect on living tissue evaluate adverse effects
Category A- drug safety in pregnancy
no risk to fetus in any studies
blood can only be ran with?
normal saline
exogenous stressors
outside body (hot/cold environment, abusive relationships, poor work conditions, nursing school)
extracellular fluid
outside the cells, 20% body weight, contains electrolytes, oxygen, glucose, cellular waste
Systemic Inflammatory Response Syndrome (SIRS)
overwhelming inflammatory response in the absence of infection causing relative hypovolemia and decreased tissue perfusion
ABG values pH, pCO2, PaO2, HCO-3, SaO2
pH-7.35-7.45 pCO2-35-45 mmHg PaO2-75-100 mmHg HCO-3-22-26 mEq/L SaO2-94-100%
Incubation period
pathogen is replicating without symptoms
Modes of Transmission
penetration, direct contact, ingestion, inhalation
infection
presence and multiplication within a host with no injury to the host
osmotic pressure
pressure that must be applied to prevent osmotic movement across a selectively permeable membrane
3 Types of disease prevention
primary secondary tertiary
Stages of HIV infection
primary infection phase chronic asymptomatic or latency phase Overt AIDS Phase
Exudates
produced during the inflammatory response. composed of: degraded WBC Proteins Tissue Debris
Therapeutic Index
ratio of toxic dose to therapeutic dose
inflammation
reaction of vascularized tissue to injury localizes and eliminates microbes and foreign particles can be acute or chronic
cardinal signs of inflammation
redness, swelling, heat, pain, loss of function
primary disease prevention
removing risk factors eg. immunizations, healthy lifestyles
renin-angiotensin-aldosterone system (RAAS)
renin leaves kidney and enters bloodstream, converts angiotensin to angiotensin I angiotensin I rapidly converts to angiotensin II by angiotensin-converting enzyme (ACE) in small vessels in the lungs angiotensin II acts on renal tubules to increase Na reabsorption decreasing GFR angiotensin II is a powerful regulator of aldosterone and increases K elimination and Na reabsorption
replacement
replace cells with connective tissue aka a scar
Primary infection phase
signs of systemic infection- fever, fatigue, myalgias, sore throat, night sweats, GI issues, rash, headache Seroconversion: immune system responds and antibodies against HIV appear (1-6months)
natural killer cells (innate immunity)
spontaneously kill target organisms
Positive feedback system
strengthens or reinforces a change in one of the body's controlled conditions eg. labor contractions
nonsteroidal anti-inflammatory drugs (NSAIDs)
strong anti-inflammatory and analgesic effects, cardiovascular and GI risks, choice depends on preference and patient response, Tylenol is NOT an NSAID
Category X- drug safety in pregnancy
studies in animals or humans demonstrated abnormalities or adverse reactions
Pharmacology
study of drugs and their effects on the body
Natural History
studying patterns of disease over a period of time to determine disease outcome, establish priorities, determine effects of screenings and compare new treatment results.
acidosis
systemic increase in H concentration or decrease in bicarb
tonicity
the ability of a surrounding solution to cause a cell to gain or lose water
osmolality
the concentration of solutes in body fluids
osmosis
the movement of only water molecules to reach equally concentrated gradients
Neoplasia
the new and abnormal development of cells that may be benign or malignant
Autosomal dominant disorders
the parent has a 50% chance to pass the disorder to the offspring with a delayed onset
hydrostatic pressure
the pressure within a blood vessel that tends to push water out of the vessel
heredity
the transmission of traits from one generation to the next
window period
time from infection with HIV until seroconversion detected on HIV antibody test
Medication Absorption
time from when drug is introduced to the body until it reaches circulating fluids. IV fastest, PO non-invasive and cheap absorption through: GI tract, mucous membranes, skin, lungs, muscle
Auditory Damage/Toxicity from medications
tinnitus antibiotics can cause progressive hearing loss
passive immunity
transferred from another source mother to fetus via placenta, breast milk short term lasts weeks to months
allograft
transplantation of healthy tissue from one person to another person; also called homograft
autograft
transplantation of healthy tissue from one site to another site in the same individual
Deferoxamine and Deferasirox
treats iron overdose from those requiring frequent blood transfusions
Acetaminophen (Tylenol)
treats mild pain and fever, liver toxicity at high doses, max dose 4G daily.
acute inflammation
triggered by infection, trauma, tissue necrosis two major components- vascular stage and cellular stage
Anaphylaxis
type I hypersensitivity widespread release of histamine
Hypersensitivity disorder
type I-IV
Adverse Effects
unintended and usually undesired effects that may occur with use of the drug
Loading Dose
use of a higher dose than what is usually used for treatment to allow the drug to reach the critical concentration sooner
Pharmacotherapy
use of drugs to prevent, diagnose, or treat signs, symptoms, and disease processes
RAAS summed up
used to replenish blood volume, sodium and water goal to raise BP RAAS driven by hydrostatic pressure
Pharmacotherapeutics
using drugs to prevent, diagnose, or treat symptoms and disease processes
toxoids
vaccines from toxins produced by a microorganism
retrovirus
virus that contains RNA as its genetic information
hypovolemia
water deficit, caused by burns and dehydration, fever, causes tachycardia, weak pulses, hypotension, headache, thirst, dry skin
hypervolemia
water excess, causes heart failure and decrease urine formation, comes with cerebral edema, weakness, muscle twitches, nausea, headache, weight gain
Cyanocobalamin (Vitamin B12)
water soluble, IM or oral, tx folic acid deficiency and anemia Found in liver, kidney, shellfish, poultry, fish, eggs, milk, blue cheese, fortified cereals
Folate/Folic Acid (vitamin B9)
water soluble, tx RBC formation and cell growth, deficiency during pregnancy can result in neural tube defects Found in liver, kidney beans, fresh green vegetables, fortified grains easy to lose in excretion, ensure all pregnant woman take it
Ascorbic Acid (vitamin C)
water soluble, tx scurvy and enhance wound/burn healing. found in broccoli, green peppers, spinach, brussel sprouts, citrus, fruits, tomatoes, potatoes, strawberry, cabbage, liver
Benign Neoplasm
well-differentiated clustered slow growths and resemble normal cells
