Test 2 Patho

resident flora

microorganisms that live on or within the body - skin, mucous membranes, bowel, vagina

what may kill the helpful resident flora bacteria?

prescribed antibiotics (could end up causing yeast infections, diarrhea)

virulence

potency/strength of pathogen (more virulent→more people affected)

aerobic

likes water

anaerobic

doesn’t like water

exotoxins (neuro, hepato, nephron, entero)

target tissue

neuro

head

hepato

liver

nephron

kidneys

entero

intestines

what will happen whenever something is wrong with a part of the body?

it will release a signal or some type of substance to let the body know something’s wrong

opportunistic

cause disease in host with compromised immune system (yeast, aids), (immunosuppression drugs, steroids)

communicable

spread from person to person

universal precautions

PPE - all are potentially infected

modes of transmission: direct

physical touch

modes of transmission: droplet

(large) coughing, sneezing - wear masks, leave distance

modes of transmission: airborne

(small) your breath (ex: TB, varicella - chicken pox)

modes of transmission: vector

vehicle harbors the pathogen (ex: insects, food)

portals of entry and exit

respiratory tract, GI (gastrointestinal), skin, blood, GU (genitourinary), mucous membranes

phases of infection

exposure/incubation/prodrome/acute/convalescence

exposure

contact

incubation

from exposure to onset of symptoms

prodrome

onset of vague, nonspecific, signs and symptoms - feeling under the weather

acute

manifestations of signs and symptoms

convolescence

decreasing clinical manifestations all the way to full recovery

complications

bacteremia, sepsis, septicemia

when is a culture done?

FIRST THING to collect bacteria

how long does it take a culture to grow?

3 days

while waiting for culture results to come back what should you do?

start a BROAD antibiotic for the patient

after you get the culture results back, what should you do?

NARROW the antibiotic prescribed down to fit the exact target of the problem

what does an R beside a patient’s antibiotic mean?

resistant (antibiotic not working for patient)

what does an I beside a patient’s antibiotic mean?

i don’t know/indeterminant (don’t know if the antibiotic is working for the patient yet so keep watching their signs and symptoms as they take the antibiotic)

what does an S beside a patient’s antibiotic mean?

susceptible (this antibiotic is working positively for the patient)

what does R, I, S, stand for?

resistant, i don’t know/indeterminant, susceptible

what is the responsibility of the nurse when evaluating how a patient is responding to their antibiotic?

interpret the results and notify the provider if you receive an R and an I (ONLY if the patient is not doing better)

Which of the following may make a person more susceptible to getting an infection?
a. Age between 6 and 46 years
b. Experiencing a surgery that is healing by primary intention
c. Final exams week
d. A functioning immune system

c. Final exams week (the stress causes lowered immune function)

The feeling that “something is not quite right” is considered which stage in infection?
a. Point of infection with pathogen
b. Incubation
c. Prodrome
d. Acute symptoms

c. Prodrome

plasma

liquid protein (yellow) - contains albumin that keeps electrolytes and fluid within vessel

erythro

red

normal RBC range

4.8 - 5.4 mil

leuko

white

normal WBC range

5000-10,000 cells/mL

what do RBCs contain

hemoglobin that binds to O2 - gives blood its color (the darker the color of blood, the more O2 and higher hemoglobin count)

hematocrit

how much volume is in erythrocytes

thrombocytes (platelets)

controls blood clotting

normal range for thrombocytes (platelets)

150,000 - 400,000

thrombocytopenia

low platelet count - cause easy bleeding

thrombocytosis

high platelet count

bleeding precautions for pts. with thrombocytopenia

no flossing, no sports, etc. anything that could cause blood loss

normal hemoglobin counts in women

11.5 - 14

normal hemoglobin counts in men

12 - 16 (higher in men)

if Hgb is 5, what is the Hct?

15

if Hgb is 15, what is the Hct?

45

if Hct is 27, what is the Hgb?

9

how do you find the Hct?

multiply the Hgb by 3

how do you find the Hgb?

divide the Hct by 3

what does CBC stand for?

complete blood count

hematopoiesis

process of blood formation

when does erythrocyte production happen?

with hypoxia and blood loss

when does leukocyte production happen?

with infection and inflammation

hemastasis

stops bleeding

stages of wound healing

vasospasm/constriction→platelet plug→coagulation

vasospasm/constriction

blood vessels narrow

platelet plug

barrier to blood flowing out of vessel

coagulation

change blood from liquid to gel; fibrin acts like glue to hold the platelet plug together

WBC diseases

neutropenia, mono, leukemia, multiple myeloma

neutropenia

less than 1500 cells/mL

neutrophils are first response and destroy microorganisms to prevent from spreading; the infected cells die - yellow wound drainage and pus

you have a decreased ability to fight infection

what are neutropenic precautions?

same as leukopenic precautions - no fresh fruits, no flowers, no sick or ppl under 16 yrs in pts room

mono

acquired from person to person by saliva, coughing, sneezing (kissing disease) - caused by EBV (epstein-barr virus), human herpes virus

incubation period: 4-6 weeks, pt can transmit virus for a few weeks

which immunoglobulin would be released for acute mono (first time)

IgM - bc it is the first to be released when exposed to a new virus

which immunoglobulin would be released for chronic mono (had it before)

IgG - bc it is released when a virus becomes chronic, 2nd released

what is the treatment for mono?

avoid contact sports (possible splenic rupture - storehouse for RBCs), could cause splenomegaly

what are lymphomas?

cancer of the lymph system - swollen lymph nodes (non-painful) in neck and supraclavicular areas

what is the most common lymphoma?

hodgkins - upper body (chest, neck, upper arms); primarily in 20-30 yr olds

what test is done to determine if you have a lymphoma?

biopsy - reed-sternburg cells: abnormally large B lymphocytes

what is a non-hodgkins lymphoma?

could happen to any age, any nodes, and risk increases with age

what is leukemia?

cancer of the WBCs - cells are not dying when they should (apoptosis)

what are symptoms of leukemia?

petechiae (tiny red, purple, or brown spots that show on the skin), frequent infections, pallor, fatigue, bleeding gums, weight loss, anorexia

what is multiple myeloma?

cancer of plasma cells; usually occurs in older adults

what are the symptoms of multiple myeloma?

bone pain, low BC counts, hypercalcemia

how is multiple myeloma found?

routine blood tests that show anemia and elevated proteins

RBC diseases

anemia, iron deficiency, sickle cell, thrombocytopenia, hemophilia, von willebrands, pernicious anemia

anemia

decrease of RBCs (impairs blood O2 carrying capacity, think HEMOGLOBIN) - pts with kidney failure will have this

what are symptoms of anemia?

pallor, SOB, fatigue, tiredness, syncope, dizziness, tachycardia

what lab value shows that you have anemia?

if hemoglobin is below 13.5 g/dl in males and below 12 g/dl in women

iron deficiency

supply of iron is inadequate to produce hemoglobin

most common RBC disease; common in women of child-bearing age, children under 2, and elderly

what are symptoms of iron deficiency?

brittle nails, pica, stomatitis (inflamed and sore mouth), developmental delays

pernicious anemia

vitamin B 12 deficiency

lack of intrinsic factor (protein in the stomach that is required to absorb vitamin B 12), atrophy of gastric mucosa

what are symptoms of pernicious anemia?

paresthesia (feeling of tingling or numbing), memory changes, unsteady gait (uncoordinated walking), stomatitis (inflamed and sore mouth), bleeding gums

sickle cell

hemolytic anemia - makes RBCs break down faster than the body can replace them

RBCs are crescent or sickle shaped; hemoglobin S: sickle shaped→decreased O2 carrying capacity

how is sickle cell acquired?

it’s inherited

sickle cell crisis precipitated by…

dehydration, stress, high altitudes, fever, extreme temperature

what is sickle cell pain caused by?

obstruction of small blood vessels as sickle cells clog up the vessels leading to ischemia and necrosis

what are symptoms of sickle cell?

joint swelling, pain (due to obstruction of small vessels)

what is treatment for sickle cell?

oxygen, hydration, pain control

hemophilia

blood does not clot

how is hemophilia acquired?

it’s inherited and X-linked

what is the treatment for hemophilia?

replacement of clotting factors - DDAVP (nasally): helps body release factor VIII (clotting factor) stored in lining of blood vessels

what are bleeding precautions for pts with hemophilia?

only electric razors, soft bristle toothbrushes, and injury prevention