NUR 152 Block 2 Final Questions With Complete Solutions
Losartan
-ARB; blocks conversion of Angiotensin II receptors, blocking
release of aldosterone and vasoconstriction
-A/E: Hyperkalemia, angioedema, dizziness, headache, syncope
Hydralazine, Nitroprusside
-vasodilators; acts directly on smooth muscle to cause
relaxation, leading to vasodilation and drop in BP
-Used for severe HTN, hypertensive emergencies
peripheral artery disease
-BLOOD DOES NOT FLOW TO FEET!
-Narrowing or blockage of arteries that supply extremities,
leading to decreased oxygenation.
-S/S: Intermittent claudication, dry/scaly skin, hair loss, skin
cool to touch. Pulse may be weak.
-The leg will feel better in idependent position
-TX: Pentoxifylline, cilostazol, aspirin, clopidogrel, statins.
Exercise, position changes
Venous Insufficiency
-BLOOD DOES NOT RETURN FROM THE FEET
,-Obstruction of venous valves in the legs or a reflux of blood
through the valves. Blood pools in the feet.
-S/S: Edema, altered pigmentation, skin may feel thick, warm,
and be brownish in color. Pulse will be normal
-Leg will feel better when raised
-TX: compression, ambulation, smoking cessation, weight loss
Raynaud's Disease
-a peripheral arterial occlusive disease in which intermittent
attacks are triggered by cold or stress
-S/S: pallor brought on by sudden vasoconstriction. Skin then
becomes cyanotic due to prolonged deoxygenation. Then
hyperemia (exaggerated reflow) occurs due to vasodilation
(White -> Blue -> Red)
-Tx: Ca+ channel blockers, avoid specific stimulus, avoid the
cold and trauma
VTE
-Venous thromboembolism includes DVT and PE.
-Prevention: early ambulation, leg exercises, compression,
SCDs, Heparin, Warfarin
Active vs Passive immunity
-Active: individual has memory cells - can make their own
antibodies & provides long term immunity
-Passive: person given antibodies, these work then die, no long
term immunity, no memory cells.
4 phases of immune response
,recognition, proliferation, response, effector
Types of T cells
-Helper T cells (CD4): Activate on recognition of antigens and
stimulate the rest of the immune response
-Suppressor T cells: suppress the immune response
-Cytotoxic T cells: lyse cells infected with a virus
-Memory T cells: remember contact with an antigen, when the
antigen is found again, they mount an immune response
WBC w/ differential normal ranges
Total WBC: 4,000-11,000
Neutrophils: 50-70%
Segments: 50-65%
Bands: 0-5% (elevated band count means bacterial infection)
Lymphocytes: 20-40%
Monocytes: 5%
Eosinophils: 1-3%
Basophils: 0.4-1.0%
Normal CD4 count
500-1500
If it's low, the patient is immunocompromised, will monitor
these levels for a patient with HIV
CD4 <200
, AIDS; severe immune system damage. At very high risk for
opportunistic infections.
Pneumocystic Pneumonia (PCP)
-pneumonia common in patients with weakened immune
systems; caused by Pneumocyctic jiroveci fungus
-S/S: progressive dyspnea, fever, nonproductive cough,
hypoxemia
TX: Trimethoprim-sulfamethoxazole (TMP-SMZ)
Mycobacterium Avian Complex (MAC)
-An opportunistic infection caused by mycobacterial organisms
that commonly causes a respiratory illness but can also infect
other body systems
-S/S: Fever, night sweats, weight loss, fatigue, diarrhea,
abdominal pain
-TX: Clarithromycin, Azithromycin
Tuberculosis (TB)
-infectious disease caused by Mycobacterium tuberculosis; lungs
usually are involved, but any organ in the body may be affected
-S/S: cough of any duration with a positive chest xray
Candidiasis
-infection of the skin, mouth, or vagina caused by the yeast-type
fungus
-S/S: painless. creamy white, plaque like lesions on buccal
surface, hard/soft palate, oropharyngeal mucosa, tongue surgace.
TX: Antifungals
Losartan
-ARB; blocks conversion of Angiotensin II receptors, blocking
release of aldosterone and vasoconstriction
-A/E: Hyperkalemia, angioedema, dizziness, headache, syncope
Hydralazine, Nitroprusside
-vasodilators; acts directly on smooth muscle to cause
relaxation, leading to vasodilation and drop in BP
-Used for severe HTN, hypertensive emergencies
peripheral artery disease
-BLOOD DOES NOT FLOW TO FEET!
-Narrowing or blockage of arteries that supply extremities,
leading to decreased oxygenation.
-S/S: Intermittent claudication, dry/scaly skin, hair loss, skin
cool to touch. Pulse may be weak.
-The leg will feel better in idependent position
-TX: Pentoxifylline, cilostazol, aspirin, clopidogrel, statins.
Exercise, position changes
Venous Insufficiency
-BLOOD DOES NOT RETURN FROM THE FEET
,-Obstruction of venous valves in the legs or a reflux of blood
through the valves. Blood pools in the feet.
-S/S: Edema, altered pigmentation, skin may feel thick, warm,
and be brownish in color. Pulse will be normal
-Leg will feel better when raised
-TX: compression, ambulation, smoking cessation, weight loss
Raynaud's Disease
-a peripheral arterial occlusive disease in which intermittent
attacks are triggered by cold or stress
-S/S: pallor brought on by sudden vasoconstriction. Skin then
becomes cyanotic due to prolonged deoxygenation. Then
hyperemia (exaggerated reflow) occurs due to vasodilation
(White -> Blue -> Red)
-Tx: Ca+ channel blockers, avoid specific stimulus, avoid the
cold and trauma
VTE
-Venous thromboembolism includes DVT and PE.
-Prevention: early ambulation, leg exercises, compression,
SCDs, Heparin, Warfarin
Active vs Passive immunity
-Active: individual has memory cells - can make their own
antibodies & provides long term immunity
-Passive: person given antibodies, these work then die, no long
term immunity, no memory cells.
4 phases of immune response
,recognition, proliferation, response, effector
Types of T cells
-Helper T cells (CD4): Activate on recognition of antigens and
stimulate the rest of the immune response
-Suppressor T cells: suppress the immune response
-Cytotoxic T cells: lyse cells infected with a virus
-Memory T cells: remember contact with an antigen, when the
antigen is found again, they mount an immune response
WBC w/ differential normal ranges
Total WBC: 4,000-11,000
Neutrophils: 50-70%
Segments: 50-65%
Bands: 0-5% (elevated band count means bacterial infection)
Lymphocytes: 20-40%
Monocytes: 5%
Eosinophils: 1-3%
Basophils: 0.4-1.0%
Normal CD4 count
500-1500
If it's low, the patient is immunocompromised, will monitor
these levels for a patient with HIV
CD4 <200
, AIDS; severe immune system damage. At very high risk for
opportunistic infections.
Pneumocystic Pneumonia (PCP)
-pneumonia common in patients with weakened immune
systems; caused by Pneumocyctic jiroveci fungus
-S/S: progressive dyspnea, fever, nonproductive cough,
hypoxemia
TX: Trimethoprim-sulfamethoxazole (TMP-SMZ)
Mycobacterium Avian Complex (MAC)
-An opportunistic infection caused by mycobacterial organisms
that commonly causes a respiratory illness but can also infect
other body systems
-S/S: Fever, night sweats, weight loss, fatigue, diarrhea,
abdominal pain
-TX: Clarithromycin, Azithromycin
Tuberculosis (TB)
-infectious disease caused by Mycobacterium tuberculosis; lungs
usually are involved, but any organ in the body may be affected
-S/S: cough of any duration with a positive chest xray
Candidiasis
-infection of the skin, mouth, or vagina caused by the yeast-type
fungus
-S/S: painless. creamy white, plaque like lesions on buccal
surface, hard/soft palate, oropharyngeal mucosa, tongue surgace.
TX: Antifungals
