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Nsg 530 / Nsg 530 Advanced Pathophysiology Exam 2. Questions And Answers.

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obstructive sleep apnea (OSA) repetitive pharyngeal collapse during sleep, which leads to absence of breathing; can produce daytime drowsiness and elevated blood pressure OSA manifestations -loud snoring -snorting -witnessed apnea -gasping during sleep -recurrent waking during sleep -choking OSA treatment 1. Weight loss and avoidance of alcohol 2. Nasal CPAP 3. Surgical widening of airway 4. Avoid use of sedatives 5. Oral appliances surfactant deficiency disorder Disorder common in premature babies in which lung inflation is very difficult ductus arteriosus a blood vessel in a fetus that bypasses pulmonary circulation by connecting the pulmonary artery directly to the ascending aorta bronchopulmonary dysplasia chronic lung condition that affect newborns on vents or preemies, had RDS, lung immaturity, severe resp/lung infections. Vent presses and damages epithelium, alveolar walls become fibrotic, lungs develop atelectasis and collapse. s/s: tachycardia, tachypnea, increased work of breathing (retractions/nasal flaring) pallor, cyanosis, restlessness. Rx: O2, diuretics, bronchodilators, anti-inflammatories, increase cal formulas and hydration. Nursing: rest periods, monitor fluid overload, pulm edema, frequent resp assessment RSV (respiratory syncytial virus) highly contagious viral respiratory infection, major cause of respiratory illness in young children Pneumonia in children - Can be viral - Streptococcus pneumoniae -Staphylococcus auresis- common complications of viral pneumonia -Mycoplasma pneumoniae common in school age children (treated with antibiotics) -Viral agents -Aspirations -Cognitive impairment- increased risk for aspiration pneumonia) cystic fibrosis autosomal recessive inherited disease A genetic disorder that is present at birth and affects both the respiratory and digestive systems. Cystic Fibrosis Treatment -no cure -largely supportive, bronchodilators, aerosol drugs to thin secretions -life expectancy is 37 yrs SIDS (sudden infant death syndrome) the sudden, unexpected death of an infant less than 1 year of age that has no identifiable cause SIDS risk factors sleeping on stomach, smoking in household and prematurity, Between 1 month and 1 year pulmonary function tests the amount of air that can be forcibly expired after a maximal inspiration. total lung capacity vital capacity + residual volume residual volume The air that remains in the lungs after maximal expiration. secondary pneumothorax caused by chest trauma Iatrogenic pneumothorax Pneumothorax that occurs as a complication of a surgery or medical procedure primary spontaneous pneumothorax Often occurs in young or middle-aged men. Predilection of taller individuals. Results from bleb or bulla rupture, usually within upper lungs. open (communicating) pneumothorax air that is drawn into the pleural space during inspiration is forced back out during expiration and only partial lung collapse results Asthma S/S Sudden dyspnea, wheezing tightness in chest, coughing, produces thick sputum, tachypnea, rapid pulse, profuse perspirations, diminished breath sounds. empyema accumulation of pus in the pleural cavity ARDS phases 1) exudative (1-3 days) -injury inflammation destruction of type I pneumocytes 2) fibroproliferative phase (3-7 days) -lung repair phase -either improve or persist 3) fibrotic phase -poor prognosis for survival Bronchial hyperresponsiveness A state characterized by easily triggered bronchospasm asthma we use inhalers to treat asthma Which hypersensitivity reaction is likely involved in asthma? type 1

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NSG 530 EXAM 2
Autoimmunity
reaction of immune response to one's own tissues


Tolerance
self-antigens not normally seen by the immune system


Most common autoimmune disease
Systemic lupus erythematosus (SLE)


Type 1 DM, MS, RA
notable autoimmune diseases


SLE
chronic autoimmune inflammatory disease that affects many body systems- more
women than men


Clinical Manifestations of SLE
- arthralgias or arthritis
- vasculitis and rash
- renal disease
- hematologic changes, especially anemia
- cardiovascular disease


SLE Positive Labs
ANA screen


Alloimmunity

,Immune reaction to tissues of another individual


x3 alloimmunity reactions
transfusion reactions, transplant reactions, fetus during pregnancy


Allo-antigens
Non-self antigens from members of the same species


Transfusion reaction
a serious, and potentially fatal, complication of a blood transfusion in which a severe
immune response occurs because the patient's blood and the donated blood do not
match


Universal donor
Type O blood


Universal recipient
type AB blood


Type A blood has ________ antibodies in the blood plasma.
B antibodies


Rh blood type
Presence or absence of Rh factor (antigen D) on erythrocytes determines if blood type
is positive or negative


Hemolitic disease of the newborn
Rh - mothers, Rh + fetuses

,Rhogram
antigen D immunoglobulin-
Rh incompatibility (necessary for Rh negative mothers who give birth to an Rh positive
baby; prevents hemolytic disease of the newborn)


D antigen expressed on RBC
Rh blood group


Transplant rejection
MHCs are a major target


Transplant Reaction Classifications
hyperacute, acute, chronic


Transplant reaction that is immediate and rare- what happens to tissue?
hyperacute, instant, graft turns white instead of pink


Transplant reactions- acute and chronic are what type of reactions?
type IV (4)


HTN and diabetes are risk factors for which transplant reactions?
chronic


Immune deficiency
the loss of the body's ability to respond to antigens and epitopes


Primary immunodeficiency
congenital; usually genetic errors

, Secondary immunodeficiency
(acquired) loss of immune functioning as a result of an illness or treatment


Immune Deficiencies
Congenital [Bruton, DiGeorge, SCID] and acquired [HIV/AIDS]


DiGeorge Syndrome
congenital- failure 3rd/4th pharyngeal pouches to develop; T cell deficiency; absent
thymus


Bare lymphocyte syndrome
1. Partial or complete deficiency in MHC I or MHC II
2. Patients have an increased susceptibility to viral and opportunistic infections
3. Symptoms: range from none to severe combined immune deficiency, depending on
number of MHC expressed


Predominantly Antibody Deficiencies
-most common immune deficiency
-defective B-cell development


Hypogammaglobulinemia
an abnormally low concentration of gamma globulin in the blood and increased risk of
infection


Agammaglobulinemia
disorder marked by an almost complete lack of immunoglobulins or antibodies


Phagocyte defects
Inadequate numbers or defects in function of phagocytes

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