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NUR 2349 / NUR2349 Professional Nursing I Exam 3 Study Guide Latest 2022.

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NUR 2349 / NUR2349 Professional Nursing I Exam 3 Study Guide Latest 2022. Inflammation and Immunity  Allergies  True allergic reaction vs. side effects:  A true allergic reaction occurs when your body sees something as harmful and rejects it.  You can have pruritis, urticaria, redness, rhinorrhea, sneezing, itchy and watery eyes, crackles, wheezes, hoarseness, stridor, blood vessel dilation, decreased cardiac output, bronchoconstriction, and anaphylaxis.  Adverse reaction.  A side effect is a sensitivity and is not life-threating.  It can include nausea, decreased energy, muscle aches, coughing, constipation, diarrhea, easy bruising, ringing in the ears, or stuffy nose.  Angioedema may occur which is edema in lips, face, tongue, larynx, neck. Generally caused by ACE inhibitors or NSAIDs.  Something that isn’t detrimental.  Anaphylactic shock (definition, care, etc.):  Anaphylaxis is life-threatening reaction to a Type 1 hypersensitivity reaction which occurs rapidly and systemically.  Common causes are drugs, dyes, food, and insects.  Nursing interventions include maintaining the airway, administering epinephrine, and education on avoiding of allergen exposure and use of epinephrine.  The patient may need more than one shot of epinephrine.  Remove and prevent allergen exposure if possible.  Pharmacologic:  Diphenhydramine/Benadryl  Corticosteroids  Epinephrine  Antihistamines  Leukotriene inhibitors  Mast cell stabilizers  Decongestants  Allergy Shots  Inflammation  Pathophysiological process: (Cause of tissue damage.) Exam 3 Study Guide  Stage 1: Vascular response with blood vessel changes. Constriction of small veins and dilation of arterioles. Redness and warmth. Increased blood flow to the affected area which leads to edema and capillary leak. Macrophage is the major cell type involved and releases cytokines that stimulate more WBC production.  Stage 2: Cellular exudate. Exudate (pus) forms which contains dead WBCs, necrotic tissue, and fluids. Neutrophils secondary to cytokines from macrophages. Basophils and mast cells sustain and continue initial responses. This stage may occur for several days.  Stage 3: Tissue repair and replacement. WBCs induce the remaining healthy cells to divide. Scar tissue is formed. Blood vessels grow.  Signs and Symptoms (localized and systemic):  Localized inflammation symptoms are pain, redness, warmth, decreased function, and welling.  System symptoms are fever, increased WBC count (normal WBC values are 4,500-10,000).  Nursing care:  When wrapping the affected extremity, start distal and work proximal to promote return towards the heart. Never wrap down because it will inhibit venous return.  Medical treatment (medications, procedures, etc.):  RICE – Rest, Ice, Compression, Elevated.  Treatment includes resting the affected extremity.  Applying cold/ice for 15-20 minutes every 2-3 hours.  Utilizing compression devices to limit harmful swelling and promote blood return to the heart.  Elevating the affected extremity to promote blood and fluid return to the heart.  Immunity  Types of immunity (acquired, innate, passive, etc.):  Active immunity occurs when antigens enter a human and he/she responds by making antibodies.  Natural – Antibody formation without human assistance. o Example would be contracting a disease.  Artificial – Antibody formation with vaccination or immunization. o Example would be receiving a vaccination.  Passive immunity is the transfer of antibodies to another human from human or an animal.  Natural – Passage from mother to fetus/infant via the placenta or breast milk. o Example would be breast milk.  Artificial – Used for exposure to rabies, tetanus, or poisonous snake bites to prevent disease or death. o Example would be rabies.  Acquired immunity is an adaptive protection that results in longterm resistance to the effects of invading microorganisms. The responses are not automatic. The body has to learn to generate specific immune responses when it is infected or exposed to specific organisms. o Example would be  Innate immunity is something already in the body. o Example would be WBC fighting bacteria.  Adaptive immunity is created in response to exposure to a foreign substance. o Example would be the Varicella vaccination to prevent chickenpox. The adaptive immunity system has remembered the foreign body.  Persons at risk for compromised immunity:  Patients with an autoimmune disease, cancer patients, renal patients, HIV/AIDs patients, infants, geriatric patients, long-term steroid use, disease, injury, surgery, and immunosuppressants.  Age-related changes in immunity:  Changes in normal flora.  Lower WBC count.  Altered nutritional intake and absorption.  Decreased infection response (less fever).  Lower T-cell and B-cell function.  Need for repeat vaccinations.  Increased risk for autoimmune disease (decreased self vs. non-selfrecognition).

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