NURS 5220 Test 1 Exam Latest Updated 2023 And Detailed Solutions

Lymphatic System • Inspect the visible nodes and surrounding area for the following characteristics: o Edema o Erythema o Red streaks • Palpate the superficial lymph nodes and compare side to side for the following: o Size o Consistency o Mobility o Discrete borders or matting o Tenderness o Warmth • Anatomy and Physiology o Lymphatic system consists of: ▪ Lymph fluid/collecting ducts ▪ Lymph nodes ▪ Spleen ▪ Thymus ▪ Tonsils and adenoids ▪ Peyer patches o Lymph tissue located in multiple body systems, including the mucosa of the stomach, appendix, bone marrow, and lungs • Immune System o Function ▪ Protects body from antigenic substances ▪ Removes damaged cells ▪ Partial barrier to malignant cell maturation o When it functions well, the individual is immunocompetent ▪ Tissue rejection of transplanted organs o When it fails, immunoincompetence can lead to a variety of illnesses ▪ Allergic ▪ Immunodeficient ▪ Autoimmune • Immunologic and Metabolic Processes o Movement of lymph fluid within cardiovascular system o Filtration of fluid o Production of lymphocytes o Production of antibodies o Phagocytosis o Absorption of fat and fat-soluble substances o Pathway for spread of malignancy • Lymph o Composition ▪ Clear fluid ▪ Mostly white blood cells (WBCs) • Mostly lymphocytes ▪ Occasional red blood cells (RBCs) ▪ Proteins o Drainage ▪ Moves from bloodstream to interstitial spaces • No built-in pumping mechanism ▪ Collected by tubules/ducts ▪ Carried to lymph nodes ▪ Moved to venous system • Subclavian veins ▪ Closed but porous circulation • Lymph Nodes o Discrete structures surrounded by a capsule composed of connective tissue and a few elastic fibrils o Usually occur in groups o Located superficially and deep in body o Superficial nodes accessible to inspection and palpation • Lymphocytes o Central to body response to antigens. o B lymphocytes produce antibodies. o T lymphocytes have important role in controlling immune responses brought about by B lymphocytes. o Increased presence in blood indicates systemic response to most viral and some bacterial infections. • Thymus • Located in the superior mediastinum, extending upward into the lower neck • Primary function in infancy and childhood o Little or no demonstrated function in adulthood • Essential to the development of the protective immune function • Site for T-cell production • Spleen, Tonsils, and Adenoids • Spleen o Highly vascular organ composed of white and red pulps o Destroys old red blood cells, produces antibodies, stores red blood cells, filters microorganisms from blood • Tonsils o Composed of lymphoid tissue • Adenoids • Pharyngeal tonsils • Tonsils and adenoids defend against inhaled and intranasal antigens • Peyer Patches o Small, raised areas of lymph tissue on the mucosa of the small intestine o Consist of many clustered lymphoid nodules o Immune surveillance of the intestinal tract o Facilitate immune response when pathogenic microorganisms are detected • Infants and Children o Antibody production is immature at birth. o Thymus is at its largest relative to the rest of the body shortly after birth and persists through the first year. o Tonsils are larger in early childhood. o Lymph node distribution is same as in adults. o Lymphatic tissue is normally very reactive in childhood leading to shotty lymph nodes, big tonsils, and adenoids. o Lymphatic system gradually reaches adult competency after the age 7 to 9 years. • Pregnant Patients and Older Adults o Pregnant patients ▪ Pregnancy is a state of altered immune function ▪ Pregnancy can lead to temporary remission of autoimmune/inflammatory diseases o Older adults ▪ Number of lymph nodes may diminish ▪ Size of lymph nodes may decrease ▪ Some of the lymphoid structures are lost ▪ Nodes of older patients are more likely to be fibrotic and fatty • Impaired ability to resist infection • History of Present Illness o Enlarged node(s) ▪ Character (should be firm and mobile) ▪ Associated local symptoms ▪ Associated systemic symptoms ▪ Predisposing factors ▪ Medications o Swelling of extremity ▪ Unilateral or bilateral, intermittent or constant, duration ▪ Predisposing factors ▪ Associated symptoms ▪ Efforts at treatment and effect • Past Medical History o Blood transfusions, use of blood products o Chronic illness o Surgery o Recurrent infections o Autoimmune disorders o Allergies • Family o Malignancy o Anemia o Recent infectious diseases o Tuberculosis o Immune disorders o Hemophilia • Personal and social history