RNSG 1128 Student Exam 1 blueprint 1 copy PDF

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RNSG 1128 Exam 1 – Student Blueprint Objective Explain the concept of Immunity (including definition, antecedents, and attributes).

Explain the concept of Immunity (including definition, antecedents, and attributes).

Explain the concept of Immunity (including definition, antecedents, and attributes).

Describe the optimal human

Focus

Integrated Process

1. Attribute Labs- normal WBC and differential count WBC- 5-10 Basophils- 0.3-0.5 Eosinophils- 1-3 Monocytes 3-7 Neutrophils 60-65 Negative bacterial and viral cultures Soft, non tender lymph nodes Recognition of self Recognition of foreign proteins 2.Antecedent Intact non specific defensesor barrier Functional lymphatic system Optimal innate immune response Functional inflammatory response Appropriate adaptive immune response 3.Sub-concepts Inflammatory response Infectious response Immune response

Physiological Integrity

4.Immune cells

Nursing Assessment Patient history Lab test Physical assessment

Physiological Integrity

Assessment

Physiological Integrity

Assessment

Physiological Integrity

Assessment

References

Immunity Module References

body immune response.

Describe the optimal human body immune response.

Describe the optimal human body immune response.

Monocytes/ macrophagesfirst to arrive on the scene and function as phagocytic cells, engulfing, ingesting, an destroying foreign bodies Dendritic cells- antigen presenting cells, initiate the adaptive immune response by presenting antigen T and B lymphocytes NK cells- does not respond to specific antigen, first line of defense against viral infections Basophils & eosinophilsincrease in number during allergic reactions and stress responses Neutrophils- first cells to arrive at the site where inflammation occurs 5.Lymphoid Tissue Spleen, Lymph nodes, Bone marrow, and Thymus gland

6.Immune cells Helper T cells- activated on

These cells are involved in the response of natural innate immunity. -nonspecific, broad spectrum of defense against and resistance to infection

Physiological Integrity

Physiological Integrity B cells- produce plasma cells

Assessment WBCs are produced in bone marrow Thymus bland maturation of T lymphocytes Assessment Cells involved in

Describe the optimal human body immune response.

Describe the optimal human body immune response.

Identify the pathophysiology of suppressed or exaggerated immune responses.

recognition of antigens and stimulate the rest of the immune system- secrete cytokine, activate other T cells and B cells Cytotoxic T cells- attack the antigen directly by altering the cell membrane, causing cell lysis, and releasing cytolytic enzymes and cytokines Suppressor T cells- ability to decrease B cell production Memory cells- responsible for recognizing antigens from previous exposure 7.Primary Immune Response When an antigen comes in contact to the immune system for the first time. Antigens learn to recognize and how to make antibody against it and eventually produce memory cells. 8.Secondary Immune Response Occurs times after the first exposure, At this point memory cells have been established and the immune response can start making antibodies immediately. 9. Hypersensitivity Reaction Type 1 Most common- allergic reactions

that produce antibodies IgG- 75% crosses placenta IgA- 15% passes in neonate in breast milk for protection IgM- 10% first produced in. response to bacterial/ viral infections IgD- 0.2% possible influences B lymphocytes differentiation IgE- 0.004% part i’m allergic and some hypersensitivity reactions, combats parasitic infections

acquired adaptive immunity. -develops as a result of prior exposure to an antigen through immunization/ contracting disease Cell mediated response- T cell activation Humoral response- B cell maturation and produces antibodies

Physiological Integrity

Assessment

Physiological Integrity

Assessment

Physiological Integrity

Assessment Local or atopic reactions -urticaria (hives)

Systemic or anaphylactic reactions

Identify the pathophysiology of 10. Hypersensitivity Reaction Anaphylaxis suppressed or exaggerated Systemic response to the immune responses inflammatory mediators released in type 1

Physiological Integrity

Identify the pathophysiology of suppressed or exaggerated immune responses

11. Hypersensitivity Reaction Type 2 Complement and antibody mediated cell destruction, inflammation, cell dysfunction

Physiological Integrity

Identify the pathophysiology of suppressed or exaggerated immune responses

12. Hypersensitivity Reaction Type 3 Free floating antigen+ antibody = circulating immune complex

Physiological Integrity Systemic- autoimmune vasculitis, glomerulonephritis, serum sickness (antibiotics, food, venom)

-rhinitis (hay fever) -atopic dermatitis -bronchial asthma -food allergies Assessment Histamine, Ach, kinins, leukotrienes, and postglandins all cause vasodilation= decrease BP Ach, kinins, leukotrienes, and postglandins all cause bronchoconstriction = difficulty breathing Assessment IgG or IgM binds antigens on cell surfaces RBC/WBCtransfusion reactions, drug reactions On tissuesgoodpasture syndrome, graves’ disease, myasthenia gravis

Assessment Immune complexes deposit on walls of blood vessels and activate complement=

Local- arthus reaction

damaged blood vessels Assessment Direct cell mediated cytotoxicity- cytotoxic T cells, viral reactions Delayed type hypersensitivitymacrophages, T helper cells, tuberculin test, allergic contact dermatitis, hypersensitivity pneumonitis Assessment Most common amount women Androgen= immunosuppressive

Identify the pathophysiology of suppressed or exaggerated immune responses

13. Hypersensitivity Reaction Type 4 Cell mediated- sensitized T cells attack antigen

Physiological Integrity

Analyze conditions that place a patient at risk for suppressed or exaggerated immune function, acute and chronic inflammation, or localized and systemic infection Analyze conditions that place a patient at risk for suppressed or exaggerated immune function, acute and chronic inflammation, or localized and systemic infection

14.Autoimmune Disease Self tolerance breaks down and the immune system attack self antigens= destroys body tissue

Physiological Integrity

15.Autoimmune Disease

Physiological Integrity

Assessment Lab testing Signs and symptoms

Analyze conditions that place a patient at risk for suppressed or exaggerated immune function, acute and chronic inflammation, or localized and systemic infection

16. Altered immune function Immunosuppression contributes to the development of cancers Chemotherapy and other cancer treatments affect

Physiological Integrity

Teaching/Learning

Analyze conditions that place a patient at risk for suppressed or exaggerated immune function, acute and chronic inflammation, or localized and systemic infection Analyze conditions that place a patient at risk for suppressed or exaggerated immune function, acute and chronic inflammation, or localized and systemic infection

bone marrow function, destroying cells that contribute to an effective immune response 17. Altered immune function

Safe and Effective Care Environment

Teaching/Learning History of organ transplantation or surgical removal

18. Altered immune function

Safe and Effective Care Environment

Teaching/Learning Major burns cause impaired skin integrity and compromise the body’s first line of defense Increased serum cortisol contributes to suppression

Discuss assessment data used for planning and implementing nursing care for individuals experiencing health problems related to immunity.

19. Nursing Care

Safe and Effective Care Environment

Nursing Process: Intervention

Discuss assessment data used for planning and implementing nursing care for individuals experiencing health problems related to immunity Discuss assessment data used for planning and implementing nursing care for individuals

20.Adaptive Immune Response

Physiological Integrity: Physiological Adaptation

Teaching /Learning

21.Adaptive Immune Response

Physiological Integrity: Physiological Adaptation

Nursing Process: Evaluation

experiencing health problems related to immunity Discuss assessment data used for planning and implementing nursing care for individuals experiencing health problems related to immunity Discuss assessment data used for planning and implementing nursing care for individuals experiencing health problems related to immunity Discuss assessment data used for planning and implementing nursing care for individuals experiencing health problems related to immunity Discuss assessment data used for planning and implementing nursing care for individuals experiencing health problems related to immunity

22. Adaptive Immune Response

Physiological Integrity: Physiological Adaptation

Nursing Process: Assessment

23. Adaptive Immune Response

Physiological Integrity: Physiological Adaptation

Nursing Process: Assessment

24. Adaptive Immune Response

Pharmacologic therapies

Nursing process assessment

25. Adaptive Immune Response

Reduction of Risk Potential

Teaching / learning

Gas Exchange – items 26-40 Explain the concept of Gas Exchange (including definition, antecedents, and attributes).

26. Attribute RR- 12-20- eupnea pH- 7.35-7.45 O2 sat > 92% PaO2- 85-100

Physiological Integrity: Physiological Adaptation

Nursing Process: Assessment Lab testing

Gas Exchange Module References

Explain the concept of Gas Exchange (including definition, antecedents, and attributes).

Explain the concept of Gas Exchange (including definition, antecedents, and attributes).

PaCO2- 35-40 mm Hg Age appropriate level of consciousness Race appropriate skin color 27. Sub-concepts Inhalation and exhalation Oxygen carrying capacity Circulation

28. Positive consequences Eupnea Age appropriate mobility Capillary refill < 2sec Age appropriate response to environment Analyze conditions which place a 29. Alterations to Oxygenation patient at risk for Gas Exchange imbalance Analyze conditions which place a 30. Alterations to patient at risk for Gas Exchange Oxygenation imbalance Analyze conditions which place a 31. Alterations to Oxygenation patient at risk for Gas Exchange imbalance Identify when Gas Exchange 32. Negative consequences imbalance (negative Gas Exchange consequence) is developing or Respiratory compromise has developed Respiratory distress Respiratory failure 32. Negative consequences Identify when Gas Exchange Gas Exchange imbalance (negative Altered oxygen carrying consequence) is developing or capacity- hypoxemia( lack of has developed

Physiological Integrity: Physiological Adaptation

Physiological Integrity: Physiological Adaptation

Physiological Integrity: Physiological Adaptation Reduction of Risk Potential Physiological Integrity: Physiological Adaptation Reduction of Risk Potential Physiological Integrity: Physiological Adaptation Reduction of Risk Potential Physiological Integrity: Physiological Adaptation Reduction of Risk Potential

Physiological Integrity: Physiological Adaptation Reduction of Risk Potential

Nursing Process: Assessment Hemoglobin is the oxygen carrying capacity 12-18 4 O2 carrying capacity for hemoglobin Nursing Process: Assessment

Nursing Process: Assessment Nursing Process: Implementation Nursing Process: Assessment Nursing Process: Assessment

Nursing Process: Assessment

Identify when Gas Exchange imbalance (negative consequence) is developing or has developed

Apply the nursing process (including collaborative interventions) for individuals experiencing Gas Exchange imbalance. Apply the nursing process (including collaborative interventions) for individuals experiencing Gas Exchange imbalance Apply the nursing process (including collaborative interventions) for individuals experiencing Gas Exchange imbalance Apply the nursing process (including collaborative interventions) for individuals experiencing Gas Exchange imbalance Apply the nursing process (including collaborative

O2 in blood) Altered mental statusbelligerent ( not alert) Anoxia- w/o O2 33. Negative consequences Gas Exchange V/Q mismatch

Physiological Integrity: Physiological Adaptation Reduction of Risk Potential

Nursing Process: Assessment Increased ventilation over perfusion = dead space Increased perfusion over ventilation = shunt No function of either= silent unit Nursing Process: Assessment

34.Impaired gas exchange

Physiological Integrity: Physiological Adaptation Reduction of Risk Potential

35. Impaired gas exchange

Physiological Integrity: Physiological Adaptation Reduction of Risk Potential

Nursing Process: Assessment

36. Impaired gas exchange

Reduction of Risk Potential

Nursing Process: Assessment

37. Impaired gas exchange

Physiological Integrity: Physiological Adaptation Reduction of Risk Potential

Nursing Process : Implementation

38. Impaired gas exchange

Physiological Integrity : Reduction of Risk Potential

Nursing Process : Implementation

interventions) for individuals experiencing Gas Exchange imbalance Apply the nursing process (including collaborative interventions) for individuals experiencing Gas Exchange imbalance Apply the nursing process (including collaborative interventions) for individuals experiencing Gas Exchange imbalance

39. Impaired gas exchange

Reduction of Risk Potential

Nursing Process: Assessment

40. Impaired gas exchange

Safe and Effective Care Environment

Teaching / learning...