Ch 31: Immunologic System Introduction

A patient has a neurrophil count that is 70% of his total wbc count. you should suspect infection caused by what

• cancer

• pneuomina

• heart diesease

• bacteria

Answer explanation

Neutrophils fight bacterial infections. They are the most numerous of the white blood cells (WBCs), comprising approximately 60% of all the WBCs. The bone marrow is capable of producing huge numbers of neutrophils to fight infection.

Mr. B had chickenpox as a child. when he was exposed to chickpox years later, he did not become infected. his resistance was mostly the result of which type od acquired immunity

• active

• passive

• short

• long

Answer explanation

Acquired antibody immunity can be active or passive. Active acquired immunity occurs when a person synthesizes his or her own antibodies in response to a pathogen. A person develops active acquired immunity when he or she manufactures antibodies in response to an infection or a vaccination. Active acquired immunity is permanent

which of the following correctly describe(s) the effects of age-related changes in immune system

• the bone marrow becomes kess productive with advacing age

• the immune system functions under normal circumstances

• lymphatic tissue shrinks so that fewer and smaller lymph nodes exist

• the bone marrow can usually respond to increased demand given more time

Answer explanation

With advancing age, the bone marrow becomes less productive and the immune system function is generally not affected under normal circumstances. The lymphatic tissue shrinks, resulting in fewer and smaller lymph nodes. Even if a higher production of blood cells is needed, the bone marrow usually can respond to the increased demand, given more time. However, as with the bone marrow, this does not generally affect the overall health of an individual.

- bone marrow: less productive in older person s

- lymphatic tissue: tissue shrinks; lymph nodes are smaller and fewer

- despite changes, immunologic function is generally adequate unless a person is unusually stressed by trauma, a chronic infection, or treatment for cancer

following bone marrow transpllantation; patients are at greatest risk for infection during which time frame

• 24 hours

• 2 weeks

• 1 month

• 6 months

Answer explanation

For approximately 2 weeks after transplantation, when the new bone marrow is engrafting, patients are severely neutropenic and at very high risk for infection.

when the nurse is collecting data about the patient with an immunologic disorder, which of the following is the priorty

• signs and symptoms of infections

• unexplained changes in weight

• increased blood pressure

• chacteristic of urine

Answer explanation

Immunodeficiency occurs when the body is unable to launch an adequate immune response, resulting in an increased risk for infection. Assessing for signs and symptoms of infection is a priority when collecting data on a patient with an immune disorder. Unexplained weight loss, increased blood pressure, and characteristics of urine are important to assess, but signs and symptoms of infection are the most important to determine.

during a report it is noted that your patient's wbc is 20,000. what is the best interpreation of this laboratory finding report,

• your patient could have a mild infection

• your patient's infection is resolving

• your patient could have a severe infection

• your patient is producing excess neutrophils, artificially raising the wbc

Answer explanation

Normal white blood cell (WBC) counts range between 5000 and 10,000 WBCs per cubic millimeter (mm³) of blood. A person’s WBCs can vary by 2000/mm³ of blood on a given day, so a WBC count of 20,000/mm³ is interpreted as the patient having a severe infection. It is too high to interpret as a mild infection or that the infection is resolving. If a person has a low and not high or excessive neutrophil count (as tested in a complete blood count), then it is interpreted as the patient being at increased risk for infection.

when the nurse is assigned to a patient who is compromised host precaution are required

sata

• visitors and staff should wash their hands before patient contact

• the patient can have no fresh, raw fruits and vegtables

• staff should always wear mask when in the patient room

• the patient will be placed in an isolation room

Answer explanation

Compromised host precautions are needed when a patient’s absolute neutrophil count (ANC) falls below 1000 cells/mm³. Thorough hand washing by visitors and staff caring for these patients is of extreme importance. Because patients with low white blood cell (WBC) counts can become infected with their own microorganisms through their gastrointestinal tract, consider discouraging patients from eating fresh fruits or vegetables and from drinking milk products. Once the patient’s ANC climbs above 1000 cells/mm³, compromised host precautions can be discontinued and a regular diet resumed without restrictions. Staff does not need to wear masks when in the patient’s room, and an isolation room is not needed. Complete vital signs need to be taken every 4, and not 8, hours.

neutropenia abnormally low

caused by decreased bone marrow production, chemo, radiation, meds (zidovudine, clozapine)

have increase risk for infection

classic signs may not be seen (redness, swelling pain), fever may be only sign

common infections: pneumonia, septicemia, skin, UTIs, mucositis (inflammation of mucose membrane), esophagitis, perirectal lesions. May also have fungal and viral infections (HIV).

treatment: antibiotics, compromised host precautions

• neutropenia

• non-hodgkin lymphoma

• hodgkin disease

• leukemia

neutropenia

the goal antibiotic therapy is support the patient tills patient's own wbc are available to fight the infections

true/false

• true

• false

lymphoma characterized by Reed Sternberg cells in lymph nodes

highest incidence in 20s and 50s

men more likely than women to have disease

treatment: radiation or chem, bone marrow transplant, stem cell transplant

• neutropenia

• non-hodgkin lymphoma

• hodgkin disease

• leukemia

Answer explanation

tx: patient sometimes have late effects of therapy that occur months or years after

chemo: use multiple drug- combination

surgery: depends on stage

survival rate depends on stage

Tags

NGSS.HS-LS1-4