2024 LATEST High Acuity NURSING Finals

hypersensitivities type I-IV (examples or tx) -A: anaphylactic/allergic; tx with epi -C: cytotoxic/hemolytic; ex: blood transfusion, Rh incompatability -I: immune complexes; ex: SLE, vasculitis, graft rejection -D: delayed, ex: GVHD, +TB test, poison ivy; T-cell mediated DIC (what, most common cause, tx) -abnormal bleeding and clotting (bleeding times prolonged) -sepsis is the most common cause -tx: FFP if platelets < 50,000, cryprecipitates platelets normal range 150,000-400,000 PT normal range 10-13 seconds PTT normal range 60-70 seconds most accurate measure of total number of neutrophils ANC (absolute neutrophil count) calculating ANC total # WBC x (segs + bands/100) ANC level (agranulocytosis? neutropenia?) -ANC < 100: agranulocytosis -ANC < 500: neutropenia (normal s/s of infection are blunted, fever may be only remaining sign of infection) tumor lysis syndrome (+ electrolytes) -metabolites from destroyed cells spill into circulation -elevated uricemia, phosphatemia, kalemia -hypocalcemia pancytopenia -low levels of all blood cell types -malignant cells crowd out normal blood cells systemic lupus erythematosus (SLE) (what, s/s, triggers, tx) -strong type III hypersensitivity rxn -tissue ischemia, attacks cardio, vascular, renal systems -butterfly rash, fatigue, fever, joint pain -triggers: sunlight, meds, genetics -tx: NSAIDs, immunosuppressants HIV (CD4 count, dx, tx, AIDS) -CD4 < 500 -dx: 2 +ELISA, then Western blot test -AIDS: CD4 < 200, presence of at least 1 AIDS defining illness P wave atrial depolarization PR interval (what it depicts) conduction from SA to AV to ventricles QRS complex ventricular depolarization & atrial repolarization ST segment completion of ventricular depolarization & beginning of repolarization T wave repolarization of ventricles atrial fibrillation -NO p-waves! -normal QRS with irregular intervals -fibrillatory waves (dissimilar, some pointy, etc)