test 2
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| 5,000 - 10,000ul | ||
| 4.5 - 6 million ul | ||
| 150,000 - 400,000 ul | ||
| 12 - 18 grams | ||
| 36 - 54% | ||
| 54 - 62% | ||
| 1 - 3% (if elevated, allergic reaction or parasites) | ||
| .75% (if elevated, inflammation) | ||
| 3 - 7% (if elevated, chronic infection) | ||
| 25 - 33% | ||
| 135 - 145 mEq/L | ||
| 97 - 107 mEq/L | ||
| 3.5 - 5.3 mEq/L | ||
| 80 - 120 (70 - 110) | ||
| 0.5 - 1.5 mg/dl | ||
| 5 - 20 mg/dl | ||
| 3.50 - 5.5 g/dl | ||
| 4.5 - 5.5 mEq/L - 8.6 - 10.0 mg/dl | ||
| 3.0 - 4.5 mg/dl | ||
| 1.3 - 2.5 mEq/L | ||
| 50 - 180 u/dl | ||
| 10 - 15 seconds | ||
| 20 - 36 seconds | ||
| 7.35 - 7.45 | ||
| 80 - 100 mmHg | ||
| 35 - 45 mmHg | ||
| 22 - 26 mEq/L | ||
| 96 - 100% | ||
| 1.010 - 1030 | ||
| 600 - 2,000 mg/ 24 hours (males higher than females); 80 - 135 ml/min | ||
| self cells and foreign cells in one's body | ||
| the regular cells in your body | ||
| invading cells "antigens" | ||
| inactivates, eliminates, or destroys foreign cells thru antibody formation or t - cell attacks | ||
| determines tissue type of a person; key for recognition and self tolerance | ||
| source of all blood cells including immune system cells | ||
| (pluripotent) undifferentiated | ||
| (WBCs) recognition vs. self tolerance, destruct foreign invaders, produce antibodies, compliment activation | ||
| produce cytokines | ||
| innactive proteins that attach themselves to the foreign body | ||
| provides immediate protection against the effects of injury or foreign invaders/ proteins | ||
| important in ridding the body of harmful organisms | ||
| stimulates both antibody and cell-mediated actions for full immune response | ||
| occurs in response to tissue injury and to the invasion of organisms | ||
| usually accompanied by inflammation | ||
| account for 50 - 75% of WBCs | ||
| belong to the granulocyte group; billions released every day | ||
| takes 12 to 14 days for maturation; once released, lives only 12-18 hours | ||
| mature neutrophils | ||
| immature neutrophils | ||
| differentiates between mature and immature neutrophils | ||
| when band neutrophils outnumber segmented neutrophils in the blood stream | ||
| when the neutrophil attatches itself to the antigen, then chews it up and spits it out (like a cow) | ||
| can no longer break up another foreign particle | ||
| do same things as phagocytes, only can last years | ||
| arise from immature monocytes released into the bloodstream | ||
| from myeloid cells | ||
| important in immediate inflammatory responses through phagocytosis | ||
| can be used over and over again - unlike neutrophils | ||
| stimulates cell and antibody mediated immunity | ||
| cause obvious s/s of inflammation | ||
| contain vasoactive amines that act on blood vessels | ||
| capillary permeability, which leads to swelling and redness during an inflammatory response | ||
| produce inflammatory reactions when released; especially in the case of parasites or an allergic reaction | ||
| help control the extent of an inflammatory response, especially during an allergic reaction | ||
| increase of blood flow to the area causing hyperemia (redness) and edema | ||
| macrophages are most active; limited phagocytosis d/t small amt. available immediatley after injury | ||
| stimulated to release more neutrophils and attracts the to the site of injury | ||
| increase in neutrophils (up to 5x's more) at site of injury; pus is formed | ||
| pus; comes from neutrophils | ||
| bone marrow | ||
| bands are released which won't help out with phagocytosis and chances of a microbial infection are increased | ||
| starts during the onset of an injury | ||
| leukocytes stimulate nearby healthy tissue to divide and help replace the injured tissue and stimulate new blood vessel growth and scar tissue formation | ||
| native immunity/ natural immunity | ||
| skin, mucous, complement, and natural killer cells | ||
| when a large number of antigens enter the body and avoid detection and elimination by natural immune defenses | ||
| "acquired immunity"; the body learns to make it | ||
| body takes active role when antigens enter; produced by host after antigens enter | ||
| most effective and longest lasting - the best! | ||
| vaccination or immunization | ||
| PREformed antibodies or T - cells are injected or passes person to person - from an outside source | ||
| antibodies passed from mother to fetus through breast milk, placenta... | ||
| antibodies injected from another source, like rabies, tetanus, snake venom, etc... | ||
| B - lymphocytes must recognize the antigen as non-self | ||
| assist B-lymphocytes by helping to recognize the antigen, then attaching itself to the antigen. It then get handed off to the Helper T-cell | ||
| process the antigen and expose the antigen's recognition sites | ||
| delivers the antigen to the B-lymphocytes so that recognition can occur | ||
| the B-lymphocyte becomes sensitized to the angtigen - this can only happen once, but once sensitized, ALWAYS sensitized | ||
| Plasma cells and memory cells | ||
| immediately begin forming antibodies; has short life span | ||
| remain dormant until the next antigen exposure | ||
| plasma cells | ||
| blood stream and other extracellular fluids as antibodies; circulate for 30 days; can be transferred person to person for immediate immunity with short duration | ||
| most abundant; crosses placenta & from breast milk; provides sustained immunity against bacterial and viral infections | ||
| protectiv mechanism; inhibits bacteria and viruses from adhering to skin and mucous membranes; protects internal environment; more skin diseases | ||
| helps to identify; serves as an activated receptor on B-lymphocytes | ||
| mediates autoimmune reactions; mediates ABO incompatibility reactions in blood transfusions | ||
| degranulation of basophils and mast cells during inflammatory responses; especially active in allergic reactions; assist in clearance of parasites; prevents pulmonary infections | ||
| provides humans with long - lasting immunity to a specific antigen | ||
| dividing into plasma and blast cells, where blast cells continue to divide and create more plasma cells | ||
| large amts. of the antibody specific for the sensitizing antigen; response so rapid person does not become ill | ||
| CMI; "cellular immunity"; involves many WBC actions and interactions | ||
| Helper/ inducer t-cells, suppressor t-cells, cytotoxic/ cytolytic t-cells, natural killer cells | ||
| "T4" or "CD4" cells; secrete lymphokines that regulate the activity of other leukocytes; increase bone marrow production; speed up maturation of cells of myeloid and lymphoid origin. A "calling to arms" | ||
| "T8" or "CD8" cells; prevent continuous overreactions/ hypersensativity reactions to exposure of non-self cells, preventing the formation of autoantibodies directed against healthy self-cells | ||
| secrete lymphokines that have an inhibitory action on cells of the immune system; inhibit growth and activation of immune system cells; | ||
| balance of 2 helper: 1 suppressor cell needs to occur to help revet overreaction or infection | ||
| overreaction of immune system | ||
| will suppress the immune system and not allow it to function | ||
| "Tc-cells"; subset of suppressor cells b/c they have T8 proteins; destroy cells that contain a processed antigen major histocompatibility complex protozoa | ||
| bind with the MHC of the organism, causing cell death (d/t puncturing holes in membrane) | ||
| direct cytotoxic effects on target non-self cells; no sensitization process; actions unrelated to WBC attacks or other leukocyte activity | ||
| conduct seek and destroy missions; most effective against destroying abnormal or unhealthy self cells like viral or cancer cells | ||
| natural killer cells and cytotoxic/ cytolytic cells | ||
| begins immediately on transplantation; an antibody - mediated response; host blood has pre-existing antibodies to donor's antigens; antibody/ antigen complexes adhere to lining of blood vessels, causing blood clotting> microcoagulation throughout the organ> leading to ischemic necrosis, inflammation with phagocytosis of necrotic blood vessels, release of lytiv enzymes into organ, causing graft loss | ||
| organ wrong ABO type, recieved multile blood transfusions prior to transplant, multiple pregnancies, underwent previous transplant- must have transplanted organ removed! | ||
| increase of immunosuppressants; occurs w/in 1 week to 3 months; r/t antibody mediated vasculitis w/in transplanted organ OR, cytotoxic t-cells and nk cells enter transplanted organ through blood, infiltrate organ cells, and cause lysis of organ cells - doesn't mean client will lose the organ! | ||
| functional tissue of transplanted organ replaced with fibrotic, scar-like tissue; ability of organ funtioning depends on how much organ tissue is damaged; longstanding problem as a response to blood vessel injury and ischemia; once there is enough organ damage that it can no longer function, pt. must have re-transplant | ||
| Cyclosporin (Sandimmune) - commonly used | ||
| Azathioprine (Imuran) | ||
| Mycophenolate mofetile (Cell-Cept) | ||
| Prednisone - not on for as long as other meds d/t side effects | ||
| Basiliximab (Simulect) - started 2 hours pre-surgery; doesn't allow t-cells to grow or become activated | ||
| Daclizumab (Zenapax) - started 2 hours pre-surgery; doesn't allow t-cells to grow or become activated | ||
| nephrotoxic, hepatotoxic, neurotoxic; increases BG; causes gingival hyperplasia; EXPENSIVE!; taken daily for life | ||
| rapid hypersensativity - most common; results from increased production of IgE antibodies; acute inflammatory reaction occcurs and causes release fo histamine and other vasoactive amines from basophils, eosinophils, and mast cells | ||
| inhalation of pollen, fungal spores, dander, dust, grass, ragweed; injestion of foods, food additives, drugs; injection of bee venom, drugs, contrast dyes, adrenocorticotropic hormone; contact with pollen, food, environmental proteins (latex, etc...) | ||
| affects 10%; IgE binds to basophils and mast cells which release vasoactive amines when stimulated; primary phase - binding causes cell degranulation ane release of amines (histamine), causing an allergic reaction of itchiness and redness; secondary phase - other vasoactive amines draw WBCs to the area, stimulating an inflammatory reaction | ||
| find out pt's h/x (what season are s/x worst? etc...); rhinorrhea (clear or white drainage), itchy watery eyes, sinus pressure, scratchy throat; CBC - increased eosinophils, RAST (radioallergosorbent test), serum IgE levels | ||
| d/c corticosteroids and antihistamines 5 days PRIOR to testing; small drops of sera scratched into skin; positive result occurs w/in 20min - cleanse site after testing | ||
| client eliminated suspected food 7-14 days prior to testing; client eats one type of food /day; monitor for s/s | ||
| vasoconstricts inflamed tissue, reducing edema | ||
| compete for histamine sites and block it from binding to the receptor | ||
| decrease inflammatory and immune responses | ||
| PO and nasal sprays; Ephedrine/ Pseudophedrine | ||
| diphenhydramine/ Benadryl - generation 1, makes you drowsy; Claritin, Allegra, Zyrtec | ||
| Solumedrol | ||
| preventative, NOT abortive; prevent mast cell membranes from opening when an allergen binds to IgE; DON'T help during an acute episode | ||
| take a week or so before; cromolyn sodium/ Accolate | ||
| sub-Q allergy shots (increasing increments of allergen per shot) | ||
| most dramatic and life-threatening example of a type 1 hypersensativity; effects multiple organs w/in seconds to minutes of exposure; can be fatal | ||
| uneasy/ anxious, decreased BP, apprehensive, weak, impending doom, generalized pruritis, urticaria (hives), erythema, angio edema, bronchoconstriction, mucosal edema, congestion, rhinorrhea, wheezes, lump in throat, stridor, hypoxemia, hypercapmia (increased CO2), HTN, rapid weak pulse, increased HR, loss of conciousness | ||
| priority! indicative of laryngio or bronchospasm; don't delegate someone else except RN or above! | ||
| #1 anaphylactic - PRODUCING drug if person is allergic! | ||
| epinephrine - vasoconstrictor; (1:1000) 0.3 to 0.5 mL sub-Q | ||
| antihistamines - diphenhydramine/ Benadryl - IV | ||
| aminophylline - treats bronchospasms - IV 6mg/kg over 20 to 30 minutes | ||
| aerosol t/x - Alupent or Proventil | ||
| emergency respiratory management - may require O2 by NC, mask, or ET tube<(intubation) | ||
| avoid allergens, wear medic allert bracelet, carry emergency anaphylaxis kit (EpiPen), inform Dr. of all allergies, have precaution equipment available if allergic med is necessary > trach kit or airway | ||
| type 1 sensitivity; foods r/t latex= bananas, kiwi, avocado, chestnuts, papaya, mango; comes from a tree | ||
| avoid latex products, use latex-free health care products, don't chew gum around latex allergic client; clients w/ spina bifida are almost always allergic! | ||
| allergic rhinitis "hay fever", anaphylaxis, and latex allergies | ||
| cytotoxic reactions - things that have to do w/ blood; an antigen - antibody complex forms and the self - cell is destroyed by phagosytosis | ||
| blood transfusions, hemolytic anemias, Goodpasture's syndrome, and thrombocytopenic purpura; t/x = d/c offending drug or blood product and do plasmapheresis | ||
| immune complex reactions - not directed to a particular site, you need to remove the source! - soluble immune complexes are formed, deposited on walls of small blood vessels on the kidney, skin, and joints and activates complement | ||
| Rheumatoid arthritis, lupus, serum sickness - after receiving serum or certain drugs, PCN, animal - based drugs | ||
| delayed hypersensitivity - sensitized T - lumphocytes from a previous exposure respond to an antigen by producing and releasing certain lymphokines and recruit, retain, and activate macrophages to destroy antigen; occurs w/in hours or days | ||
| PPD skin test, poisoned ivy, contact dermatitis, organ donation rejection | ||
| warmth, redness, swelling, pain, and decreased function | ||
| remove offending agent, monitor reation site and distally check for circulation | ||
| corticosteroids - reduce inflammation; DON'T use Benadryl - won't work b/c histamine is NOT main mediator | ||
| stumulatory reactions - excessive stimulation of normal cell surfaces - focus on one organ only - not generalized! | ||
| Grave's disease - autoantibody attatches to TSH to over-produce thyroid hormones> hyperthyroidism | ||
| reducing production of autoantibodies with immunosuppression; surgical or radiation of thyroid tissue |
