Cholesterol
T/F: Most serum cholesterol comes from dietary sources
False: endogenous sources-- produced in the liver
The nurse determines that the patient has understood the discharge teaching regarding warfarin based on which of the patient's statements?
"I should keep taking ibuprofen for my arthritis."
"I should use a soft toothbrush for dental hygiene."
"I should decrease the dose if I start bruising easily."
"I will double my dose if I forget to take it the day before."
"I should use a soft toothbrush for dental hygiene."
The body's first line of defense is....
the second line of defense is ....
first: skin and secretions
second: inflammation, phagocytosis, NK cells
Differentiate between cell mediated and humoral response
Cell mediated: CD8 (cytolytic T cells) and macrophages attack the foreign object after being activated by CD4 cells (Helper T cells)
Humoral: B cells make antibodies to attach to the foreign substance
Define hypersensitivity
Altered immunologic response to an antigen that results in disease or damage
Laboratory reports indicate that a patient's serum cholesterol concentration is 250 mg/dL and triglyceride levels are 450 mg/dL. The health care provider prescribes atorvastatin to lower cholesterol levels. What is the desired effect of the drug on the patient's lipoprotein levels?
decrease in LDL
A patient who has been taking warfarin is admitted with coffee-ground emesis. What can the nurse anticipate being prescribed for this patient?
Vitamin E
Vitamin K
Protamine sulfate
Calcium gluconate
vitamin K
Treatment for inflammation is
Rest
Ice
Compress
Elevate
List the antibody classes and functions
IgA: mucous membranes of GI tract and lungs; transferred via breast milk to infants
IgD: found on “B” Cells serves as a receptor for antigen recognition
IgE: causes the symptoms of allergies (EEEEES), binds to parasites (Evil worms) allowing eosinophils to lyse the parasite
IgG: “G” greatest amount of antibody, promotes target cell lysis, phagocytosis, crosses the placenta to protect newborns
IgM: first antibody produced, promotes target cell lysis, presents on surface of “B” Cells to serve as a receptor for antigen recognition
Is inflammation the same as infection?
No, but infection can cause inflammation
The nurse is assessing a patient who has been prescribed atorvastatin. What instruction should the nurse provide for the patient to ensure proper administration of the medication?
"Take the drug after breakfast."
"Take the drug in the evening."
"Take the drug with an antacid."
"Take the drug on an empty stomach."
"Take the drug in the evening."
The patient is being treated with a continuous intravenous (IV) infusion of heparin. What is the nurse's highest priority?
Ensure that protamine sulfate is readily available at all times.
Ensure that the patient's laboratory values are monitored correctly.
Ensure that a loading dose was initially administered when treatment began.
Ensure that the patient is taught dietary restrictions while on the medication
Ensure that protamine sulfate is readily available at all times.
List the signs and symptoms of inflammation
erythema, heat/fever, swelling, pain, loss of function
Explain major histocompatibility complex molecules
genes expressed on all cells to differentiate between self and non-self (helps immune system know what to attack)
A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicate a potential adverse effect of this drug?
Muscle pain and tenderness
Platelet count of 100 × 10 3/mm 3
Blood pressure of 140/90 mm Hg
Wheezing and shortness of breath
Muscle pain and tenderness
Which therapeutic lifestyle changes are shown to reduce low-density lipoprotein (LDL) cholesterol? Select all that apply.
Active exercise for 30-60 minutes five days a week
Reduction of tobacco to occasional use
Active exercise for 15 minutes two to three days a week
Reduction of saturated fat intake
Weight loss with metabolic syndrome
Active exercise for 30-60 minutes five days a week
Reduction of saturated fat intake
Weight loss with metabolic syndrome
A patient is receiving an intravenous heparin drip. Which laboratory value requires immediate action by the nurse?
Platelet count of 150,000 mm 3
International normalized ratio (INR) of 1.0
Blood urea nitrogen (BUN) level of 12 mg/dL
Activated partial thromboplastin time (aPTT) of 120 seconds
Activated partial thromboplastin time (aPTT) of 120 seconds
List some adverse effects of corticosteroids
-reduces WBC (decreased immune response and risk for infection)
-increases tissue breakdown
-delayed healing
-delayed growth in children
-Na and H2O retention
Name the 3 ways that antibodies work
opsonization: antibody binds to help other immune cells attach
activate complement system: results in cell destruction
neutralize toxins
antigenic shift: major changes in antigenicity
antigenic drift: virus undergoes yearly mutations in surface antigens
The nurse is assessing a patient with diabetes who has hyperlipidemia. The patient asks the nurse to suggest either an herbal medication or a dietary modification to reduce cholesterol levels. Which suggestion given by the nurse would be most beneficial to the patient?
"Include flax seeds in your food."
"Eat foods rich in omega-3 fatty acids."
"Consume excessive amounts of garlic."
"Take 20 mg of St. John's wort regularly.
"Eat foods rich in omega-3 fatty acids."
In which patient would a low-dose aspirin be contraindicated?
A patient with thrombosis
A patient with a heart problem
A patient with a hemorrhagic stroke
A patient with a deep vein thrombosis
A patient with a hemorrhagic stroke
List the chemical mediators and their function in inflammation
Histamine: vasodilation and increase capillary permeability
Prostaglandins: vasodilation, capillary permeability, pain
Bradykinin: increase capillary permeability and pain
Differentiate between macrophages and the different types of granulocytes
macrophages/monocytes: main function is phagocytosis, found in acquired/natural/inflammation, helps CD4 in delayed hypersensitivity
eosinophils: bind to IgE or parasitic worms, moderate inflammatory response
Basophils: release histamine
Neutrophils: phagocytize bacteria, bind to IgG
List the manifestations of hypersensitivity
itching, conjunctivitis, hypotension, rhinitis, bronchospasm, dysrhythmias, GI cramps