Exam 2
which white blood cell is the first to arrive at the site of inflammation
neutrophils
which sequence is the correct pathway for blood flow thru the heart
right atrium-tricuspid valve-right ventricle-pulmonary artery-lungs-pulmonary vein-left atrium-mitral valve-left ventricle-aorta
A client has prominent jugular veins. What type of medical problem is associated with prominent jugular veins
right-sided heart failure
headache in fever is the result of
cerebral vasodilation
in which stage of fever do piloerection and an urge to curl up under blankets occur
chill stage
passive immunity
transferred from one source to another infant receives from mother in utero and breast milk passive can also be artificially provided by the transfer of antibodies produced by other people or animals
which blood vessel layer is made primarily of muscle
tunica media
adaptive immunity
specific or acquired immunity develops during an individuals lifetime, distinguished self from nonself, and responds specifically to different pathogens and foreign molecules these cells incluse the T lymphocytes which participate in cell-mediated immunity and the B lymphocytes which participate in humoral immunity attacks specific microbes
prions
small modified infectious host protein without a genome. extremely resistant transmissible neurodegenerative diseases because they lack reproductive and metabolic functions, current antimicrobials are useless
the life span of the neutrophil in the tissues is approximately
10 to 12 hours
a client is lying in a recumbent position. in this client, approximately house much total blood volume is in the central circulation
25-30%
the most abundant humorally circulating immunoglobulin is
IgG
which immunoglobulins protect newborns by passing thru the placenta
IgG
immunoglobulins
IgG, IgA, IgM, IgD, IgE
the development of memory loss, difficulty concentrating, euphoria, and lethargy suggests
AIDS dementia complex
the immunoglobulins are produced by
B cells; plasma cells
which type of lymphocyte participates in the development of humoral immunity thru the production of antibodies
B lymphocytes
immune cells
CD4+ helper T cell serves as a master switch for the immune system the human immunodeficiency virus (HIV) that causes acquired immunodeficiency syndrome (AIDS) infects and destroys the CD4+ helper T cell
Which cell in the immune system is considered the "master switch"?
CD4+ helper T cells
the HIV virus directly infects the
CD4+ lymphocytes
AIDS is caused by
HIV
which immunoglobulins protect moist mucous membranes in the body as a first line of defense against infection
IgA
which one of the following types of immunoglobulins is involved in allergic and hypersensitivity responses
IgE
type 1
IgE mediated
opportunistic infections are
Infections involving usually harmless microorganisms that develop in a person who is immunocompromised
natural killer cells
NK cell is programmed to automatically kill foreign cells. CD+8 must be activated to become cytotoxic
the nurse assesses the electrocardiogram for depolarization of the atria. that portion of the ECG will the nurse be assessing
P wave above the baseline
which of the following is called the pacemaker of the heart
SA node
if a client experiences sympathetic nervous stimulation of heart, the nurse will observe which changes in manifestations
increased heart rate and increased contractility
HIV type 2
is endemic in many countries in West Africa but rarer in other parts of the world
a number of clients on an acute cardiac care unit of a hospital have dx of impaired cardiac conduction. which client is most deserving of immediate attention
a 69 year old woman who has entered ventricular fibrilation
a client is admitted to the cardiac unit with a diagnosis of pericarditis. the nurse is teaching the client about the anatomical location of the infection. the nurse evaluates the effectiveness of the teaching when the client correctly identifies which of the following as the location of the pericardium
a membranous sac that encloses the heart
a positive antibody test in an infant indicates
a perinatally exposed infant with maternal antibodies
causes of fever in infants and small children can reflect
a vaccine reaction overbundling serious infections that can progress to bacteremia and meningitis minor infection
the nurse is assessing a client said to be in sinus rhythm. what does the nurse expect to find when evaluating the electrocardiogram
absence of T waves irregular rhythm
active immunity
achieved through exposure to a specific antigen acquired through immunization or actually having a disease long lasting but requires a few days to weeks to develop
colonization
act of establishing a presence, a step required in the multifaceted process of infection. the organisms are simply hanging out
virulence factors are substances or products generated by infectious agents that enhance their ability to cause disease. endotoxins are complex molecules found in the cell wall of gram-negative bacteria that are responsible for
activation of regulatory systems that may induce hypotension, fever, bleeding
cell mediated immunity
adaptive response against microbes where they cannot be destroyed by antibodies helper T cells-CD4+
microflora serve as useful function for their host. these include
aiding in the digestion of food producing vitamins such as vitamin K protecting host from colonization with pathogenic microbes
class 1 MHC antigens are found on
all nucleated cells of the body; allows them to alert immune system of any changes
type 2
antibody mediated disorders
the lymph nodes
assist in removing foreign materials from the lymph channels and are centers for immune cell proliferation
chemotaxis involves the
attraction of leukocytes to a chemical signal
T and B lymphocytes have all of the following properties except
automaticity
A client's echocardiogram identified a narrowed valve that has resulted in a decreased blood flow between the left atria and left ventricle. The nurse would interpret this as the
biscuspid valve
IgG
remains elevated after the acute phase
universal precautions are designed to prevent exposure to infectious agents that are present in
blood, semen, and vaginal secretions
HIV is spread thru
blood, sexual contact, maternal placental circulation and breast milk
secondary immune repsonse
booster shots cause a secondary immune response so antibody levels will be high before the disease is encountered
a prolonged fever for which the cause is difficult to ascertain is
called an FUO 9; fever of unknown origin
T lymphocytes
cell mediated function in the activation of other T cells and B cells, control of viral infections, rejection of foreign tissue grafts and delayed hypersensitivity reactions CD+4 helper T cells CD8+ molecules
type 4
cell mediated hypersensitivity reactions
adaptive or specific immune mechanisms include protection afforded by
cell mediated immunity
the immune responses related to T cells function are called
cellular immunity
the distensibility of the blood vessel is the major factor in which of the vessels characteristics
compliance
the controls the direction of blood flow. what is the role of the aortic valve
controls the direction of blood flow from the left side of the heart to the systemic circulation
diagnostic methods
culture serology DNA and RNA sequencing-increased sensitivity and decreased time
infection
describes the presence and multiplication within another living organism with subsequent injury to the host
toxins
destroy or alter normal cell function; trait chiefly monopolized by bacteria
a fever (pyrexia) that is not accompanied by the normally expected increase in heart rate is associated with
drug fever and legionnaires disease
which of the following statements is true as it related to fever in the elderly
elderly persons have a lower basal temperature than younger persons; serious infections can occur without marked elevations in temperature
the macrophages
engulf and digest antigens that come into contact with their cell membrane
the school nurse is doing a health class on the functional organization of the circulatory system. what is the function of the capillaries in the circulatory system
exchange gases, nutrients, and wastes
HIV is not transmitted from an infected mother to her baby by
genetic transmission at conception
type 1 hypersensitivity immune responses include
hay fever and bronchial asthma
a prion is
host protein lacking a genome that causes neurodegenerative disease
why should you understand MHC
human MHC proteins are called human leukocytes antigens (HLA) because they were first detected on WBC
the cell surface antigen that determines whether transplanted tissue is recognized as foreign are the MHC antigens. these are specifically called
human leukocytes antigens
the nurse is assisting a client who had a myocardial infarction 2 days ago during a bath. the client suddenly loss consciousness and the nurse was unable to feel a pulse. cardiopulmonary resuscitation was begun and the client was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. what is a priority intervention at this time
immediate fibrilation
type 3
immune complex mediated disorders
the "window period" of HIV infection refers to the period of time between
infection and detectable antibody levels
HIV
infects by the attachment of a surface protein on the viral envelope of HIV to a special CD4+ T cell receptor
the phases of wound healing include
inflammatory, proliferative, remodeling
HIV is transmitted by all of the following except
insect vectors in crowded living conditions in which people have HIV
cytokines can be described as
intercellular protein messenger molecules that regulate the movement, proliferation, and differentiation of immune and other cells
which of the following is true regarding pulmonary circulation
it is a low pressure system that allows for improved gas exchange
endotoxins
large amounts released in septic shock, DIC, and acute respiratory distress syndrome
the heart is a four-chambered pump. which chamber of the heart pumps blood into the systemic circulation
left ventricle
signs indicating a serious fever in an infant or small child include
lethargy poor feeding signs of impaired tissue perfusion cyanosis
the acute phase response in inflammation includes all of the following changes except
leukopenia
which cells differentiate to form antibody-producing plasma cells and cell mediated immunity cells
lymphocytes
which cells in the body are activated to engulf and digest foreign particles and are involved early in the host response to ensure amplification of inflammation and initiation of specific immunity
macrophages
which statement is false concerning monocytes and macrophages
macrophages engulf and digest foreign particles in a process called autolysis
what are the self components that the immune system uses to distinguish self from nonself
major histocompatibility molecules
the mediators involved in allergic responses are released from
mast cells or basophils
developmental aspects of the immune system
maternal IgG effective against bacteria and viruses largest amount crosses placenta during last weeks of pregnancy therefore premature infants will be deficient cord blood does not normally contain IgM or IgA
innate immunity
nonspecific can distinguish self from non-self but does not distinguish one type of pathogen from another microorganisms encounter first line of resistance on exposure to epithelial layers of our skin and mucous membranes that line respiratory, GI, and urogenital tracts second line involves chemical signals, antimicrobial substances, phagocytic and natural killer cells as well as fever associated with the inflammatory response always present; generic
complement system
primary mediator of both innate and adaptive immunity that enables the body to localize and destroy infective agents when an antibody attaches to an antigen, the resulting immune complex can activate complement
vaccination
produces a primary immune response provides active immunity; long lasting
the group of inflammatory mediators that contributes to swelling, redness, tissue warmth, and pain is the
prostaglandins
which one of the following is an example of active immunity
protection afforded by the flu vaccine
The heart is a four-chambered pump. What is the function of the right ventricle
pumps blood to the lungs
the electrical activity of the heart is recorded on the ECG. what does the T wave on the ECG represent
repolarization of the ventricles
antipyretic drygs such as aspirin and acetaminophen act by
resetting the hypothalamic temperature control center as a means of initiating heat reducing behaviors
a client has has an acute myocardial infarction. the brother of the client has a history of angina. the client asks how he will if his brothers pain is angina or if the brother is actually having an MI. which statement is correct
rest and intake of nitroglycerin relieve cheat pain with angina; they do not relieve chest pain with an MI
the white blood cell differential count includes all but which one of the following
reticulocytes
IgM
rises during the acute phase, then falls
what is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction
sa node-av node-bundle of His-bundle branches-purkinje fibers
a thin and watery exudate that contains red blood cells is called a
serosanguinous exudate
Major Histocompatibility Complex (MHC)
serves as a peptide display molecule for recognition by T lymphocytes; needed for induction and regulation of immune response response is very specific and targeted MHC 1 proteins tell T cytotoxic cells to kill the infected cell before it can infect other cells
the health care provider is concerned that a client has developed a decreased in cardiac output. cardiac output may be calculated as
stroke volume x heart rate
autoimmune diseases such as food poisoning and toxic shock syndrome after a strep or staph infection as caused by
superantigens
anaphylaxis
systemic response to the inflammatory mediators released in type 1 hypersensitivity histamine, acetylcholine, kinins, leukotrienes, and prostaglandins all cause vasodilation
the immune system consists of
the bone marrow, thymus gland, lymphoid organs, spleen, and T and B lymphocytes
the circulatory system is a closed system that is divided into two parts. which statement is correct about the closed system
the low pressure pulmonary circulation links circulation and gas exchange in the lungs
IgG
the most abundant of the circulating immunoglobulins and is present in body fluids and readily enters the tissue only one to cross placenta and can transfer immunity from mother to fetus passive-immunity; short acting protects against bacteria/viruses, toxins. and activates the complement system circulates in body fluids, attacking antigens
the polymerase chain reaction is used to detect
the presence of HIV DNA
the granulocytes are characterized by
the presence of granules in their cytoplasm distinctive multilobular nuclei phagocytuc properties
fever differs from hyperthermia in terms of
the upward displacement of hypothalamic set point for temperature control
differentiation of T lymphocytes occurs in the
thymus
central lymphoid organs
thymus generates mature immuno-competent T lymphocytes; fully developed at birth but regresses and replaced by adipose tissue at puberty; some tissue persists at old age mature immuno-competent T cells leave the thymus in 2 to 3 days and enter peripheral lymphoid tissues
the heart consists of four valves. which are the hearts atrioventricular valves
tricuspid mitral
which dysrhythmia is considered to be the most fatal and requires immediate treatment
ventricular fibrillation
acquired immunodeficiency syndrome (AIDS)
HIV infected person can transmit when no symptoms are present; seroconversion occurs from 1 to 3 months but may take up to 6 months
which one of the following classes of immunoglobulins cross the placenta
IgG
if the donor and recipient are related or unrelated but share similar HLA types, the transplant tissue is categorized as
allogenic
the absence of an immune response directed against a person's own antigens is called
anergy
antigens
antigens are also called immunogens and are substances foreign to the host that can stimulate an immune response
when explaining to a client why there was only minimal muscle damage following 99% occlusion of the left anterior descending artery, the nurse will explain that is primarily due to
development of collateral circulation that build channels between some of the smaller arteries, usually when the flow is decreased gradually
the transudation of fluid that occurs at the site of an acute inflammatory response is of benefit to the host because it
dilutes the noxious agent
type 1 IgE mediated disorders
immediate reactions triggered by binding of an allergen to a specific IgE that is found on the surface of most cells or basophils systemic anaphylactic reactions localized atopic disorders; allergic rhinitis and food allergies
autoimmune diseases
immune system attacks self-antigens immune system destroys body tissues
the complement system could best be described as a system of
inactive circulating precursor proteins that function as a mediator of both innate and adaptive immunity; produces inflammation and increases phagocytosis
AIDS manifestations
opportunistic infections wasting syndrome
when the immune system reaches a point of being severely compromised by HIV
opportunistic infections occur malignancies appear persons with a history of a positive tuberculin test are likely to develop tuberculosis
antigen example
penicillin has a mass of 350 daltons and is incapable of causing an immune response if chemically combines with body proteins to form larger complex that can generate an immune response to the penicillin epitope
cultures are serology are the conventional tests for infectious disease. methods for identifying infectious agents thru DNA or RNA detection are increasingly used. a sensitive method of DNA detection that is useful in HIV diagnosis is
polymerase chain reaction
neutrophils are also called
polymorphonuclear leukocytes
immunity
protection from disease
exotoxins
proteins secreted by certain bacteria and other organisms
the heart consists of four valves. which are the semilunar valves
pulmonary aortic
clusters of differentiation
serves to define functionally distinct subsets of cells such as CD4+ helper T cells and CD8+ cytotoxic T cells
when trying to explain to a client on dialysis the movement of substances through the capillary pores, the nurse will explain that in the kidneys, the glomerular capillaries ha
small openings that allow large amounts of smaller molecular substances to filter through the glomeruli
myeloid lineage
monocytes and macrophages are key members of the phagocytic system that engulf and digest microbes and foreign substances
immature white blood cells are released during leukocytosis. these immature cells are called
myeloblasts
the white blood cell that has the greatest rate of increase during a bacterial infection is the
neutrophil
cytokines and the immune response
cytokines are low molecular weight proteins made by cells that affect the behavior of other cells excess can have serious adverse effects associated with septic shock, food poisoning and cancer
the local heat that occurs during an inflammatory response in the result of
increased blood flow
the acute primary infection or primary phase of HIV
is a mononucleosis-like syndrome with fever, myalgias, malaise, sore throat, nausea, lymphadenopathy, night sweats, and rash
B lymphocytes
mature B lymphocytes leave bone marrow and enter circulation and migrate to peripheral lymphoid tissues where they are stimulated to respond to a specific antigen activated B cell differentiates into a plasma cell which can produce thousands of antibodies
peripheral lymphoid immune structures
spleen filters antigens and involved in immune response can live without but require vaccinations to provide protection red pulp destroys senescent and injured RBC, white pulp contains concentrated areas of B and T lymphocytes
the nurse identifies the blood vessel layer that constricts to regulate and control diameter as
tunica intima
