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NUR 113 Immunity/Infection
Immune System Tissues
Characteristics
Bone Marrow
B Cells and T Cells Formed
B Cells Mature
Thymus
T Cells Tested For Self-Response
T Cells Mature
Lymph Nodes
Mature B Cells and T Cells Monitor Lymph For Pathogens
Spleen
Mature B Cells and T Cells Monitor Blood For Pathogens
1 min
Skin Functions
Characteristics
Thermoregulation
Protection
Innate Immune Protection
Synthesize Vitamin D
Water and Salt Excretion
Dilated Capillaries are a Blood Reservoir
2 mins
Innate Immunity Barriers
Skin Protects Against Pathogens
Normal Flora Outcompete Pathogens
Lysozyme in Saliva, Tears, and Mucus
Mucous Traps Pathogens
Cilia Remove Mucus
Acid and Digestive Enzymes in the Stomach Kill Pathogens
2 mins
Innate Immunity Cellular Response
Characteristics
Natural Killer Lymphocytes Attack Abnormal Cells
Neutrophils in Blood
Infected Cells Release Interferon
Complement Proteins Lyse Pathogens/Infected Cells
Dendritic Cells in Tissue
Macrophages in Tissue
2 mins
Humoral Adaptive Immunity
Characteristics
B Cell Binds Free Floating Antigen
B Cell Presents Antigen to Helper T Cell
Helper T Cells Help B Cells Develop Antigen Specificity
Plasma B Cells Secrete Antibodies
Memory B Cells Cause Faster Secondary Response
2 mins
Cell-mediated Adaptive Immune Response
Characteristics
Macrophages and Dendritic Cells Present Antigens
T Cell Develops Antigen Specificity
Regulatory T Cells Suppress Response
Memory T Cells Cause Faster Secondary Response
Cytotoxic T Cells Lyse Infected Cells
Infected Cells Present Antigen On Surface
2 mins
WBC Differential Lab Value
White Blood Cells (WBC)
5-10 (5,000-10,000)
Leukocyte Differential
Neutrophils (50%-70%)
Bands (2%-5%)
Segs (50%-70%)
Lymphocytes (20%-40%)
Monocytes (4%-8%)
Eosinophils (2%-4%)
Basophils (0.5%-1.5%)
2 mins
Fever
Flushed skin, warm to touch
Chills
Sweating
Change in LOC
Provide adequate fluids
Monitor Electrolytes and Fluid
Monitor vital signs, esp temperature
Remove excess clothing and blankets
Sponge bath with tepid water
2 mins
Influenza
Assessment
High Fever
Cough
Headache
Muscle Aches
Chills
Intervention
Vaccination
Drug Therapy
Zanamivir (Relenza)
Oseltamivir (Tamiflu)
2 mins
Otitis Media Interventions
Antipyretics
Analgesics
Antibiotics
Irrigation
Position on Affected Side
Myringotomy
Tympanostomy Tube
2 mins
Otitis Media Assessment
Red or Bulging Tympanic Membrane
Ear Pain
Pulling at Ear
Fever
Upper Respiratory Infection
Considerations
More Common in Young Children
Eustachian Tube Narrower
Conductive Hearing Loss
Smoking Increases Risk
2 mins
Ear Drops Medication Administration
Indications
Earwax Buildup
Ear Infections
Pulling The Pinna
Child - Back and Downward
Adult - Back and Upward
Procedure
Side-Lying with Ear Up
Instill Medication
Stay for 2-3 Minutes
Nursing Considerations
Room Temperature
May Massage Tragus
Perforated Eardrum
2 mins
Pneumonia Assessment
Risk Factors
Older Adult
Immunocompromised
Long Term Care
Assessment
Shortness of Breath (SOB)
Hypoxemia
Cough and Sputum Production
Wheezing or Crackles
Fever
Pleuritic Pain
Diagnosis
Chest X-ray
2 mins
Pneumonia Intervention
Interventions
Humidified Oxygen
Deep Breathing Exercises
Position of Comfort
Increase Fluid Intake
Manage Fever
Medications
Antibiotics
Mucolytics
Expectorants
Considerations
Pneumococcal Vaccine
Sepsis
Acute Respiratory Failure (ARF)
Prevention Education
2 mins
Tuberculosis Assessment
Etiology
Airborne Droplet
Assessment
3 Week Productive Cough
Night Sweats
Chest Pain
Fever
Weight Loss
Fatigue
Diagnosis
Chest X-Ray
Blood Tests
Mantoux Skin Test
3 Positive Sputum Tests
1 min
Tuberculosis Skin Mantoux Test (PPD)
Delayed Hypersensitivity (Cell Mediated Response)
Intradermal Injection
Read 48-72 hours
Positive Results
≥ 5 mm Induration
Immunosuppressed
≥ 10 mm Induration
High Risk Patients
≥ 15 mm Induration
Considerations
Chest X-Ray
3 mins
Tuberculosis Intervention
Hospital Care
Airborne Isolation
Drug Therapy
Combination Drug Therapy (RIPE)
6-12 Months
Considerations
DOT
BCG Vaccination
Medication Education
3 Negative Sputum Specimens
Infection Control
2 mins
Urinary Tract Infection Symptoms
More Common in Elderly
Most Common in Females and Babies
Change in LOC
Dehydration
Fever
Urgency
Urethral Infection
Burning
Smelly Urine
Dark Cloudy Urine
Frequency of Urination
2 mins
Urinary Tract Infection Prevention and Treatment
Prevention
Shower after Sex
Urinate after Sex
Wipe front to Back
Treatments and Considerations
I and Os with Daily Weights
Increase Water Intake
Antibiotics
Avoid Caffeine
Dr Appointment in 2 Weeks
Void every 2 - 4 hours
2 mins
Creatinine Lab Values
Measures Renal Function
0.6 - 1.3 mg/dL
1 min
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