measures for reducing the risk of transmitting pathogens from both recognized and unrecognized sources of infection.

For pt known to be or suspected of being infected with highly transmissible pathogens,

It may include  isolatingthe pt

T/F?

You need to take extra percations when handeling the blood of a pt with HIV.

Fales

You should take the same precations with all blood

asume it is potentialy hazerdus

Immune System

The function

These consist of physical barriers such as the skin, mucous membranes, and cough reflex; chemical barriers such as pH of the stomach, fatty acids and proteolytic enzymes of the small intestine; and fever.

nonspecific immune cells such as phagocytes (macrophages, neutrophils, natural killer cells) and lymphocytes

a specific immunity, triggered when a person has had prior contact with a foreign agent. Upon initial contact, a chain of events leads to the activation of the humoral system

(Memory B cells)

true or fales

HIV does not cross the blood brain barrier

HIV is a self  replicating virus

T/F

Fales

the hiv virus attaches to the out side of a cell then injects

it's contents and uses teh hosts cells machinery to replicate  

pneumonystis carinii

candidiasis

TB

Herpes

Kaposi's sarcoma

through blood to blodd contact

sex, IV drug use

may/may not have fever

weight loss, diarrhea, night sweats fatigue

the pt must recive counciling the nusre can set that up

and  referr to a souport group

Acute

Chronic

when the organ is rejected in 1 week to 3 months of getting. 

The T cells and NK celss attack new organ

due to blood vessal nacrosis not aclution

general discomfort

feeling ill or an uneasiness

pain

swelling 

fever

weight change

change in heart rate

decreased urin

the segmented neutrophil (mature), which is seen at the far right of the neutrophil pathway, is no longer the most numerous type of circulating neu trophils.

the bands are high

What is heprin

100/ml 

used for?

What is 

1000u/ml

used for

10,000u/ml

is used for?

prothrombin and most of the blood clotting factors and vitamin K

wash hands

gown mask glove

antimicrob diet

poor hygen 

age (old and yung)

gender-femails strongerbut they get autoimune

nutrion-has biges impact!!!!

stress

Drugs- chemo, or recreational

Physical bariers

agenst infection

Skin

acidmantal

mucusmembrian

cillia

HCL in stomach

normal flora

Decreased bladder tone which causes urinary stasis and therefore can lead to a UTI

(ex. of a Physical Barrier that is altered)

Vascular disease

(decreased Blood Flow)

The elderly have a slower healing and ability to fight infection due to:

Decreased phagocytic activity and impaired neutrophil function

Cardiovascular

(decreased CO and increased vascular resistance)

HCl production and peristalsis

T-lymphocyte mediated
Exposure to previously sensitized antigen, T-cells release lymphokines  leading to cell lysis

Examples: TB test, contact dermatitis

infection controll

side effects of meds

s/s of rejection

report any loss of function

Monocytes-Macrophages

Leucocytes-T/B cells

Basophiles

Nutrophils

Eosiniphiles

Mast cells

T- cells

B- cells

NK cells

CD 4 helper

CD 8-  cytotoxic T cell

participate in cell-mediated immunity and are responsible for recruiting and regulating nonspecific immune cells such as phagocytes.

What is the roll of a CD- 8 T cell?

(cytotoxic T cell)

recognizes antigens on the surface of a virus-infected cell

they destroy and deactivate foreign antigens                    

To produce antibodies and are the primary defences against bacterial infections

Activated by Humoral immunity

localize damage

control spread of infection

clears area of debris so healing can occur

neutrophils

macrophages

serotonin

histamine

kines

T-cells

B-cells

varys from person to person, and may come and go. Almost everyone with SLE has joint pain and swelling,  affected joints are the fingers, hands, wrists, and knees.

Other common symptoms include: Chest pain when taking a deep breath, Fatigue, Fever with no other cause, General discomfort, uneasiness, or ill feeling (malaise), Hair loss, Mouth sores, Sensitivity to sunlight, Skin rash -- a "butterfly" rash over the cheeks and bridge of the nose affects about half of people with SLE. The rash gets worse in sunlight. The rash may also be widespread.. Swollen lymph nodes

is a AUTOIMMUNE DISORDER that affects connective tissue disease that involves changes in the skin, blood vessels, muscles, and internal organs                                                                  

A buildup of collagen in the skin and other organs ,leads to the symptoms of the disease.

affects only the skin on the hands and face. It develops slowly, and rarely, if ever, spreads throughout the body or causes serious complications.

• Fingers or toes that turn blue or white in response to hot and cold temperatures (See: Raynaud's phenomenon). Hair loss. Skin hardness. Skin that is abnormally dark or light. Skin thickening, stiffness, and tightness of fingers, hands, and forearm. Small white lumps beneath the skin, sometimes oozing a white substance that looks like toothpaste. Sores (ulcers) on the fingertips or toes. Tight and mask-like skin on the face

Scleroderma

Bone and muscle symptoms may include:

• Joint pain

• Numbness and pain in the feet

• Pain, stiffness, and swelling of fingers and joints

• Wrist pain

SCLERODERMA

Breathing problems may result from scarring in the lungs and can include:

• Dry cough

• Shortness of breath

• Wheezing

SCLERODERMA

Digestive tract problems may include:

• Bloating after meals

• Constipation

• Diarrhea

• Difficulty swallowing

• Esophageal reflux or heartburn

• Problems controlling stools (fecal incontinence)

a reduction in either the n umber of RB Cs, the amount of hemoglobin, o r t he hematocrit (percentage of packed RB Cs per deciliter of blood).

Anemia

INTEGUMENTARY MANIFESTATIONS:

Pallor, especially of the ears, the nail beds, the palmar creases, the conjunctivae, and around the mouth

• Cool to the touch

 • Intolerance of cold temperatures

 • Nails become brittle and may lose the normal convex shape; over time, nails become concave and fingers assume club-like appearance

Anemia

CARDIOVASCULAR MANIFESTATIONS

• Tachycardia at basal activity levels, increasing with activity and during and immediately after meals

• Murmurs and gallops heard on auscultation when anemia is severe

• Orthostatic hypotension

Anemia

RESPIRATORY MANIFESTATIONS

• Dyspnea on exertion

• Decreased oxygen saturation levels

Anemia

NEUROLOGIC MANIFESTATIONS

Increased somnolence and fatigue

• Headache

Immunohemolytic Anemia

immune system products (e.g., antibodies) attack a person's own RB Cs for unknown reasons.

In Iron Deficiency Anemia RBCs are

(size)?

small (microcytic)

Patients with Iron Deficiency Anemia may have mild symptoms that include:

LOW

less than 10 n g/mL (normal range is 12 to 300 ng/mL).

Iron deficiency anemia  can result from:

blood loss, poor GI absorption of iron, and an inadequate diet.

Iron deficiency anemia is most common in:

Any adult with iron deficiency should ALWAYS be evaluated for:

The management of iron d efficiency anemia involves increasing the oral intake of iron from food sources such as:

red meat, organ meat, egg yolks, kidney beans, leafy green vegetables, and raisins

folic acid transport and reducing DNA synthesis in precursor cells to RBC

These precursor cells then undergo improper DNA synthesis and increase in size

Vitamin B12 Deficiency Anemia is called

(size of cells)

megaloblastic or macrocytic anemia because of the large size of these abnormal cells.

poor intake of foods containing vitamin B12. This can occur with vegetarian diets or diets lacking dairy products.

small bowel resection, diverticula, tapeworm, or overgrowth of intestinal bacteria

deficiency of intrinsic factor (a substance normally secreted by the gastric mucosa), which is needed for intestinal absorption of vitamin B12.

animal proteins, eggs, nuts, dairy products, dried beans, citrus fruit, leafy green vegetables

circulating red blood cells (RBCs)

because of failure of the b one marrow to produce these cells.

acquired aplastic anemia can be caused by:

poor oxygenation such as weakness, pallor, and petechiae or ecchymosis.

______ are the management for patients with aplastic anemia.

Blood transfusions

FYI This therapy is discontinued as soon as the bone marrow begins to produce RBCs.

Labs:      MCV                  MCH                RDW

PTs:         ↓                        ↓                      ↑

based on these values what type of anemia

does the pt have

a type of cancer with uncontrolled production of immature WB Cs (usually blast cells) in the bone marrow.

Without treatment, the patient will die of infection or hemorrhage.

is the most common form of adult-onset leukemia. Acute promyelocytic leukemia (APL) is a subtype of AML that makes up about 10% of adult-onset AML.

.

makes up about 10% of adult-onset leukemias but is most common in children.

Acute Leukemia

INTEGUMENTARY MANIFESTATIONS

Ecchymoses

Petechiae

Open infected lesions

Pallor of the conjunctiva, nail beds, palmar creases, and around the mouth

Acute Leukemia

GASTROINTESTINAL MANIFESTATIONS

Bleeding gums

• Anorexia

• Weight loss

• Enlarged liver and spleen

Acute Leukemia

RENAL MANIFESTATIONS

Acute Leukemia

MUSCULOSKELETAL MANIFESTATIONS

Bone pain

• Joint swelling and pain

Acute Leukemia

treatment

Prothrobin time (PT)

aslo INR

Coumadin

What is the Most important patient education: