NUR2571 Exam 3 Module 9 Content Guide Professional Nursing II PN 2.pdf, Exams of Biosafety

Download NUR2571 Exam 3 Module 9 Content Guide Professional Nursing II PN 2.pdf and more Exams Biosafety in PDF only on Docsity! 1 NUR2571 Exam 3 Module 9 Content Guide Professional Nursing II / PN 2 Exam 3 (Module 9) - CONTENT GUIDE HIV – Etiology – Transmitted by blood, semen, vaginal secretion, breast milk, Not spread through casual contact like hugging, kissing, sharing eating utensils, or toilet seats. Pathophysiology: HIV is a ribonucleic acid virus – it’s called a retrovirus because it moves backward going from RNA to DNA. Binds to CD4 specific cells (macrophages, lymphocytes, Helper T cells, astrocytes and oligodendrocytes) and chemokine receptors risk factors: needle sticks, sharing needles, contact with blood products, drug users, multiple sex partners. diagnostic tests: ELISA: Rapid- screening used to detect development of antibodies to HIV: results positive or negative – Western Blot: used to confirm HIV infection, detects both HIV antibodies and individual viral components that cause reactive bands, results are positive or negative – PCR – detects proviral DNA, Tests 3-6 months after exposure disease progression – When PT CD4 drops below 200 or below 500 with opportunistic infection. Treatment beings with counts drop below 500. AIDS – CDC diagnostic criteria: Normal CD4 800-1200. CD4 (Helper T lymphocytes) less than 200 diagnosis of AIDS OR less than 500 with infection (Kaposi Sarcoma, Pneumonia Jiroveci, Pneumonia Carnii) S/S: Acute infection: Flulike symptoms (swollen lymph nodes, sore throat, headache) occurs 2-4 weeks after infection. Lasts 1-2 weeks. Asymptomatic infection: fatigue, headache, low-grade fever, night sweats. Symptomatic infection: when CD4 drop 200-500. Symptoms become worse. therapeutic communication. Be sensitive Medication Goals for HIV/Aids: ART therapy, decrease viral load, increase CD4, prevent infections SLE – Etiology: Caused by development of antibodies that fight body’s own tissue, cells. Multi-system disease. Pathophysiology: A combination of factors is involved in the development of ANAs. The hyperactivity of B cells and a defect in the body’s T suppressor cell that normally protects the body from developing ANAs triggers the inflammatory cascade of events that result in systemic tissue damage. diagnostic studies: ANA Titer PT education – Avoid Sun (UV light), Infection, Triggers (environmental & emotional stress), Oral contraception (estrogen level), Skin care, nutrition, minimize infections, 2 Rheumatoid Arthritis – Nursing assessment: Symmetrical join deformity. Pain, stiffness and low grade fever. Worse in AM. 3+ joints S/S: Symmetrical joint deformity. Worse in the morning. Pain, stiffness, low grade fever medication management: NSAIDS, ASA, DMARDS. Apply heat or cold. AVOID massages. possible side effects of medications used in RA management. ? Types of hypersensitivity reactions – Type 1 (anaphylactic -Hypersensitivity – immediate reaction). Through contact, inhalation, ingestion, or injection of allergen. Allergic reaction mediated by IgE antibodies, release of histamine from cells, causing local or systemic reaction. Anaphylaxis, hay fever, atopic eczema, drug allergy! Type 2 (Blood transfusions – Hypersensitivity – Cytotoxic reaction) – Antibody is directed against an individual’s own cells or foreign body, can be life threatening. Blood transfusions, myasthenia gravis, autoimmune hemolytic anemia Type 3 (Immune complex – Hypersensitivity – Immune complex reaction) – Immune complexes are deposited into the tissue, causing local tissue damage & inflammation. Pneumonitis, SLE, RA, post- streptococcal glomerulonephritis. Type 4 (Delayed Hypersensitivity – Hypersensitivity – Cell-mediated reaction) - Also called delayed hypersensitivity – Most common skin reaction after exposure to an ointment or cream. Crohns, transplant rejection, leprosy, tuberculosis. Nursing considerations when giving a leukotriene modifier to an Asthma patient. – Inhibits the allergic process – an anti-inflammatory. NOT used for ACUTE attacks, used to PREVENT inflammation – must be taken even when feeling good. Contact dermatitis – Type 4 allergic reaction or delayed hypersensitivity. S/S: itching, redness, swelling, small blisters. medication management: Moisturizing creams, topical steroid ointments, antibiotics. Prednisone, Benadryl. Moisturize right after bath Anaphylactic reactions – Occurs w/in mins of exposure – progresses rapidly & can result in anaphylactic shock & death w/in 15 mins. Concerns: recognize & maintain patent airway, prevent spread of allergen, Admin Meds, Place pt in recumbent pos, elevate legs, keep pt warm, admin oxygen, administer epinephrine, Benadryl & diphenhydramine used to prevent – IV fluids to maintain BP & prevent hypovolemic shock = irreversible tissue damage and death. Treatment: Epi pen. Cellulitis – Potentially serious bacterial infection often due to streptococcus or staphylococcus organisms enter the wound through an insect or animal bite, or an injury with a break in the skin. Can occur anywhere but most common on legs, arms or fact. If not treated it can lead to systemic sepsis. Assessment: Cardinal signs: heat, redness, swelling, pain, glossy or stretched look, flu like symptoms, fever, headache, aching, and malaise. Monitor for spreading – change dressing frequently!!! Risk Factors: PVD, diabetes, obesity, lymphedema, chronic steroid or immunosuppressant meds and Edema. Treatment: antibiotics, silver sulfadiazine cream, analgesic, rest, elevate, Types of wound debridement exemplar (mechanical). – Wet-to-dry dressing – dressing change painful, bleeding common during gauze removal. Impetigo. 5 Meniere’s disease. P. 1112 Degenerative condition that leads to progressive hearing loss in middle age. Excessive accumulation of fluid in the labyrinth or inner ear. S/S: dizziness, unilateral ringing in ear (tinnitus), pressure or fullness in ear (infection), unilateral hearing loss, severe headache, vertigo, nyslagmus, N/V, hearing loss How these tests are performed the Weber, Voice-whisper, and Rinne test? P. 1116 Rinne test: (air/bone) The nurse places the tuning fork behind the ear on the mastoid process and has the patient say when the sound is no longer heard. Next, the tuning fork is moved to the front of the ear just outside the os (opening), & the patient is again asked to 6 indicate when sound is no longer heard. *The Rinne test is normal if air conduction is twice as long as bone conduction Weber Test: The nurse places the tuning fork on the front mid-portion of the patient's head, then has the patient indicate if he or she hears the sounds equally in both ears, which tests for a unilateral deficit. *The sound will be louder in the affected ear if it is a conductive loss and louder in the good ear if it is a sensorineural loss. Possible complications of a mastoidectomy. P 1120 An incision in the mastoid sinuses, which are located directly behind the ear Infection of the mastoid sinuses, bleeding, fever, neck stiffness, limited neck ROM, vomiting, dizziness, disorientation, headaches, avoid infection to the brain! Nursing assessment and for the ears. Pain, drainage, symmetry, obstruction, onset, ringing, dizziness. Otitis Media – Risk: Males, multiple ear infections, daycare, < 2 years, bottle-fed, Pacifier use after 6 mo., cold weather, Most common cause of conductive hearing loss Otalgia: Ear Pain – can be associated with a variety of conditions. Pedidulosis capitis Lice – Medication: Mermettrin – Wash in HOT water