Fab 5
What are the normal lab ranges for WBC count?
5,000 - 10,000 / mm3
What cell is the first responder during infection? AND
What cell is active during an allergic rxn?
Neutrophils
- levels can tell how strong pt. immunity is
Eosinphils
What is the normal glucose range?
70 - 105 mg/dL
What is a common drug resistant organism acquired in the hospital? AND
What is the #1 way to reduce it's spread?
MRSA
Hand Hygiene!
Who is more at risk for developing an autoimmune disease?
A. A 29 y/o female who takes NSAIDs every day before pilates and cut out antioxidants from her diet
B. A 32 y/o male who works in construction and has a mom with an autoimmune disease, who does not exercise
A. A 29 y/o female who takes NSAIDs every day before pilates and cut out antioxidants from her diet
risk factors: Female, toxin exposure, medications, diet ( high fat, low antioxidant), lifestyle
A patient shows a PLT count of 175,000/ mm3, is this a normal or abnormal lab finding?
Normal!
150,000 - 400,000 / mm3
Skin, stomach acid and phagocytes are an example of what category of immunity?
Innate immunity aka what you were born with
What does BUN stand for?
Blood urea nitrogen
To prevent infection, nursing considerations include what regarding invasive devices and ambulation?
Remove invasive devices ASAP
Early and frequent ambulation
ANA is the diagnostic to recognize what disorder?
Anti-CCP is the diagnostic to recognize what disorder?
SLE ( systemic lupus erythematosus)
RA (rheumatoid arthritis)
A 60 year old patient with a chronic illness shows a lab value of 3.9 million RBC, what is the target range for RBC's?
4.5 -5.5 million RBC
What isolation precaution is meant for immunodeficient patients?
What PPE does it include and its restrictions?
Neutropenic (reverse)
Mask to protect patient
No plants, animals, fruit, sick visitors
Patient wears a mask during transportation
What 2 lab values represent kidney function?
BUN : 5-20 mg/dL
Crt : 0.6 - 1.2 mg/dL
Describe trough dosing?
What other body systems need to be taken into account when it comes to processing medications?
Peak and trough are the safe amount of med in the bloodstream, so trough dosing is ensuring the medication is enough by testing is at it's lowest point before the next dose, to ensure effectiveness and prevent toxicity.
Liver (AST/ALT) and Kidney function (BUN/Crt)
What is the first line response for allergic rhinitis?
What are 3 important education pieces for intranasal glucocorticoids?
Antihistamine
Only use intranasal glucocorticoids on a wet nose and the full effect may take 1-2 weeks (not as direct as antihistamine) AND it will suppress the immune system
What are the units that represent Hgb? AND what are the Hgb ranges for both females and males?
g/dL
Females: 12 - 16 g/dL
Males : 14 - 18 g/dL
During an infection, what would be some good diagnostics/tests to take?
Do cultures have to be taken before or after medication administration?
CBC w/ differencial
Inflammatory markers : Erythrocyte sedimentation rate (ESR) RBC clump and drop faster, C-Reactive protein
blood/sputum cultures -> taken BEFORE med admin
What body system is most important with an altered sodium level? AND what is the normal sodium range?
Neuro!
135 - 145 mEq/L
Describe the 3 classes of immunomodulators?
Interferon
Monoclonal
DMARDs (just the disease)
Colony stimulating factor
Interferon : interfere with viral/foreign replication
Monoclonal: proteins clones from WBC (mimics WBC), bind/tag to abnormal cell for destruction
DMARDs : for Rheumatoid arthritis
Colony stimulating factor: stimulate production of blood cells, typically WBC (for immunodeficient pt)
A patient comes into the ED with urticaria, angioedema, bronchoconstriction and hypotension. What is the medication of choice for this patient?
What would be patient education to prevent another situation like this?
Epinephrine IM! -> also secure the patients airway/ sit them upright and administer Iv fluids to increase BP
Wear an allergy bracelet, know how to use an epipen!
What does Hematocrit as a percentage represent? AND wat are the normal Hematocrit ranges for both females and males?
Hematocrit is the percentage of RBC compared to the total blood volume.
Females : 37 - 47 %
Males : 42 - 52 %
Explain the primary jobs of each Ig?
IgD
IgM
IgA
IgE
IgD : B cell receptor stimulates IgM
IgM : Immune system memory, first responder
IgA : "All secretions", protects in/out of body by mucosa
IgE : Allergy activity
What body system is most important when dealing with an altered Potassium level? AND what is the normal K+ range?
Cardiac!
3.5 - 5 mEq/L
A patient comes into the ED, a 30 year old male who is experiencing diaphoresis, hypotension, tachycardia, tachypnea and a high fever. These are 5 key s/s of what condition?
Sepsis!
Hypotension from fluid leakage, then tachycardia to compensate
Also causes decreased urine output from organ damage and a possible change in orientation.
What kind of immunomodulator would be utilized for a patient that is immunodeficient and why?
colony stimulating factor because it stimulates WBC