NRS3015 Midterm Exam With Complete Solution

NRS3 015 Mi dterm Exam W ith Compl ete Solution What is HLA - ANSWER Human Leukocyte Antigen. It's what helps recognize self from non-self. Associated with blood transfusion reactions. Important supplement during methotrexate therapy - ANSWER folate Myasthenia Gravis - ANSWER Autoimmune mediated blockade of neuromsucular trasnmission Weakness is worse with activity - more need for ACTH Occular symptoms often the first sign Exacerbations causes by stressors, medications Myasthenic criss is a medical emergency Tensilon improves Allergic blood transfusion reaction signs - ANSWER tachycardia, itching, hives, redness of skin, bronchospasm Hemolytic blood transfusion reaction - ANSWER lower back pain, tachycardia, headache, red-tinged urine, fever, chills, hypotension (later), a nd chest pain What can an elevation in WBC indicate? - ANSWER Inflammation, infection, some malignancies, trauma, dehydration, stress, steroid use, and thyroid storm. Someone who has had a splenectomy can have a persistently increased WBC count. What are the WBCs involved in inflammation? - ANSWER neutrophils, macrophages, eosinophils, monocytes, and basophils What does a decrease in WBC indicate? - ANSWER drug toxicity, autoimmune disease, bone marrow failure, and some overwhelming infections Neutropenic Precautions - ANSWER Restricting visitors, Prohibiting visits by people who have an infection, Restricting exposure to live (cut or potted) plants, Restricting ingestion of fresh fruits and vegetables, Avoiding contamination from the client's own bacterial flora by avoiding the measurement of rectal temperature and administering IM injections. Splenectomy - ANSWER ability to produce antibodies is decreased Five cardinal manifestations of inflammation - ANSWER Warmth, Redness, Swelling, Pain, Decreased function Stages of inflammatory response - ANSWER -Stage I (vascular) - Change in blood vessels Phase I - Constriction stop bleeding and prevent further pathogens from entering the area Phase II - Hyperemia and edema, edema is caused by capillary permeability so WBCs can rush to the area -Stage II (cellular exudate) - Neutrophilia, pus -Stage III (tissue repair and replacement) - WBCs trigger new blood vessel and growth (angiogenesis) and scar tissue formation Immunizations aren't helpful if CD4 counts aren't above ______. - ANSWER 200 When and why is the TDAP booster given to pregnant moms? - ANSWER between 27 and 36 weeks to protect the fetus from pertussis MMR vaccine facts - ANSWER shouldn't receive if pregnant or have had anaphylactic reaction to gelatin or neomycin. Precaution in simultaneous tubuculin skin testing. Varicella vaccine facts - ANSWER contraindicated for pregnancy, some cancers, hypersensitivity to gelatin and neomycin. Not recommended in HIV, congential immune deficiencies, immunosuppresive medications Pneumococcal vaccine facts - ANSWER given to people 65 and older Hepatitis A vaccine facts - ANSWER contraindicated in severe allergy to latex and a precaution is pregnancy Hepatitis B vaccine facts - ANSWER contraindicated in severe allergy to yeast HPV vaccine facts - ANSWER contraindicated in pregnancy and severe allergy to yeast Influenza vaccine facts - ANSWER Inactivated influenza vaccine (IIV) is approved for pregancy. Recombinant influenza vaccine is approved for adults 18 years and older. Live attenuated (nasal spray) only for ages 2-49 that aren't pregnant or immune compromised. Contraindicated in chicken egg allergy and previous guillain-Barre syndrome. What do you document with administration of vaccine? - ANSWER Document administration of vaccines including date, route, site, type, manufacturer, lot number, and expiration date. Also document the client's name, address, and signature. Include the name, title of the person administering the vaccine, and the address of the facility where the permanent record is located.