N320 Unit 2 - exemplars

influenza transmission

droplet

3 major strains of influenza

A,B,C

what is the goal of influenza antibiotics

the antibodies build to prevent severity

allergic reactions to flu vaccine

egg allergy

flu s/s

muscle weakness, stuffy nose, N/V, diarrhea, fatigue, and chills

adults are contagious - flu

24 hours before symptoms and 5 days after they start

what are you checking in the CBC for influenza

lymphocytes

medications for influenza

antivirals, antipyretics, antitussives, antihistimines, and analgesics

does influenza or a common cold run a higher fever

influenza

how is MRSA developed

due to antibiotics being given at higher doses and for longer period of time than were necessary

why is MRSA difficult to treat

antibiotic therapy may increase the growth of microbes within biofilms

what patients are most at risk for developing MRSA

long history of antibiotics, invasive tubes/lines(biofilms), and immunocompromised

how is MRSA transmitted

contact

is MRSA curable

once you get it you always have it

treatment for health care associated MRSA

vancomycin, linezolid, and IV ceftaroline

health care associated MRSA

patients and health care staff may be colonized, invades through tubes/lines, can quickly lead to sepsis

community associated MRSA

infections in healthy people, can cause serious skin and soft-tissue infections

meds to treat community associated MRSA

minocycline and doxycycline

what is cellulitis

localized area of inflammation, may spread rapidly if not treated

what can cause cellulitis

minor skin trauma that doesn’t heal right

how can cellulitis spread

scratching

s/s cellulitis

redness, warmth, edema, tenderness, and pain

risk factors of cellulitis

injury, weak immune, skin conditions (secondary infections), chronic swelling (skin may crack), history, and obesity

TB transmission

airborne

what is TB

bacteria multiplies in bronchi or alveoli, when you cough it spreads

TB s/s - adults

fatigue, lethargy, nausea, anorexia, weight loss, fever, night sweats, cough with blood, and chest tightness

TB s/s - infants

persistant cough, weight loss, failure to gain weight, and low grade fever

TB s/s - children

fatigue, cough, low appetite, weight loss/growth delays, night sweats, chills, fever, and enlarged lymph notes

immunization for TB

not as effective in adults, BCG vaccine

TB screening

Mantoux (PPD), must be checked 48-72 hours after

what is a positive finding on the PPD test

greater than 15mm (general), greater than 10mm (LTC), greater than 5mm (HIV)

other TB screenings

sputum test, QuantiFERON (24hrs), and chest x-ray

abnormal electrolytes with TB

ABG and PFT

first line TB treatment

isoniazid and rifampen

additional TB meds

ethambutol and pyrazinamide

most common lab technique for TB

acid staining

what does a positive mantoux test show

contact with the bacteria, not active tb

SIRS

systemic inflammatory response syndrome

SIRS patho

body’s response to critical illness that results in a whole body inflammatory process

what infections lead to sepsis

almost any infection can lead to sepsis

SIRS criteria - 2 or more with s/s

temp above 100.4 or below 96.8, heart rate above 90, respirations above 20, abnormal WBCs (4,000-12,000)

SIRS s/s

hypotension, low UO, decreased cap refil, hyperglycemia, mental status change, and rising creatinine

sepsis complications

ARDS, acute renal failure, DIC, MODS, and GI complications

sepsis vitals

low BP, high heart rate, low O2, low LOC, decreased kidney function, and BUN

hallmark sign of sepsis

lactate level above 4

sepsis 1 hour bundle

draw lactic acid, collect culture, broad spectrum antibiotics, fluids, and vasopressors (keep MAP greater than 65, raise BP)

equation for MAP

(diastolic x 2) + systolic / 3

sepsis 24 hour bundle

must be started at same time as 6hr bundle, assess for recombinant APC, low dose steroids, glycemic control, and low tidal volume vent

homeostasis

the constant movement of fluids and electrolytes to maintain a balance in the body

degree of concentration

osmolality

solvent

the water portion of fluids

solute

the particles dissolved in the water

hydrostatic pressure

pushes water back and fourth for equilibrium, water moves through membrane from high pressure to low pressure

diffusion

solute from high concentration to low

osmosis

water molecules move through membrane unti equilibrium is established

active transport

solutes from low to high, goes against gradient

filtration

movement across membrane by pressure from high to low