Immunity Types and Immune Response Overview

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Questions and Answers

What adverse effect is most commonly associated with Rituximab?

Infusion reaction (correct)

Cardiac arrhythmia

Anemia

Hypercalcemia

What is a key risk factor for heart failure in patients receiving chemotherapy?

Cumulative lifetime dose exceeding 550 mg/m² (correct)

Cumulative lifetime dose exceeding 500 mg/m²

Prior history of hypertension

Age over 60 years

Which of the following symptoms is NOT part of the CRAB criteria for multiple myeloma?

High calcium levels

Bone fractures

Pulmonary edema (correct)

Renal failure

What type of monitoring is necessary for patients being treated with Epoetin alfa?

Frequent blood pressure checks Signup and view all the answers

In managing neutropenia during induction therapy, what is a priority nursing action?

Treat infections promptly Signup and view all the answers

Which of the following is a significant complication of raising hemoglobin levels with Epoetin alfa?

Thrombosis Signup and view all the answers

What characterizes multiple myeloma in terms of plasma cells?

Excessive production of abnormal immunoglobulins Signup and view all the answers

What is the primary focus of a MUGA scan?

Assess heart structure and function Signup and view all the answers

What is the primary target of HIV in the human body?

CD4 T cells Signup and view all the answers

Which of these medications is NOT classified as an antiretroviral?

Ganciclovir Signup and view all the answers

What action does Zidovudine perform in the treatment of HIV?

Inhibits reverse transcriptase Signup and view all the answers

Which of the following best describes the function of protease inhibitors like Saquinavir mesylate?

Alter and inactivate the virus by inhibiting enzymes necessary for replication Signup and view all the answers

Which of the following is a common metabolic disorder associated with HIV?

Hyperlipidemia Signup and view all the answers

What role do entry inhibitors like Enfuvirtide play in the treatment of HIV?

They prevent HIV from attaching and entering CD4 T cells Signup and view all the answers

What is the primary mechanism of action for Efavirenz?

Acts directly on reverse transcriptase to stop HIV replication Signup and view all the answers

Which medication is classified as a CCR5 antagonist?

Maraviroc Signup and view all the answers

What is the primary action of anticoagulants?

Inhibit the formation of clotting factors Signup and view all the answers

Which medication is classified as a long-acting bronchodilator?

Salmeterol Signup and view all the answers

Which drug is indicated for the management of acute bronchoconstriction?

Albuterol Signup and view all the answers

What is the main purpose of hormone replacement therapy (HRT)?

Manage hormonal imbalances Signup and view all the answers

Which medication is NOT recommended for acute asthma symptoms?

Salmeterol Signup and view all the answers

What is the mechanism of action (MOA) of Ipratropium?

Blocks acetylcholine receptors Signup and view all the answers

Which class of drug is tPA (alteplase) categorized under?

Antithrombotic Signup and view all the answers

Which medication is specifically used for the prevention of seasonal allergies in mild persistent asthma?

Cromolyn Signup and view all the answers

What is the primary goal of administering lactulose to patients?

To reduce ammonia levels by increasing stool frequency Signup and view all the answers

Which electrolyte levels should be specifically monitored in patients receiving lactulose?

Potassium, Sodium, and Chloride Signup and view all the answers

What is a normal serum ammonia level range that should be monitored in patients on lactulose?

15--45 µg/dL Signup and view all the answers

Which of the following is an important consideration when administering lactulose?

Monitoring renal function regularly Signup and view all the answers

What should be assessed to prevent complications from lactulose treatment?

Fluid balance and signs of dehydration Signup and view all the answers

What is the primary action of Class 1 antidysrhythmic drugs?

Block sodium channels to reduce depolarization rate Signup and view all the answers

What should be administered first to a patient experiencing chest pain?

Nitroglycerin Signup and view all the answers

Which adverse effect is associated with the use of antidysrhythmias?

Bradycardia Signup and view all the answers

Which of the following is a contraindication when using nitrates?

Concurrent use of ED drugs like Viagra Signup and view all the answers

What is the mechanism of action for Class 2 antidysrhythmic drugs?

Block beta-adrenergic receptors Signup and view all the answers

Which drug class is used to control ventricular response in atrial fibrillation?

Calcium channel blockers Signup and view all the answers

What is a common adverse effect of systemic antidysrhythmics?

Respiratory arrest Signup and view all the answers

Which drug class delays repolarization in cardiac cells?

Potassium channel blockers Signup and view all the answers

What is the primary role of Maraviroc in HIV treatment?

It prevents HIV from entering lymphocytes. Signup and view all the answers

What is the main purpose of HAART in HIV treatment?

To reduce the amount of virus and increase CD4 counts. Signup and view all the answers

When should lovastatin be administered for optimal effectiveness?

At bedtime to coincide with cholesterol synthesis. Signup and view all the answers

What serious adverse effect is associated with statin use?

Rhabdomyolysis Signup and view all the answers

Which of the following vaccines is recommended for children aged 1-2 years?

Hepatitis A Signup and view all the answers

What complication is primarily caused by a complete blockage of a major coronary artery?

STEMI Signup and view all the answers

What is the primary treatment provided to patients suffering from STEMI?

Thrombolytic therapy to dissolve the clot. Signup and view all the answers

In which circumstance should statins be used with caution?

Patients with liver disorders. Signup and view all the answers

Study Notes

Different Types of Immunity

Active immunity develops when the immune system produces antibodies in response to an antigen entering the body. It develops over several weeks to months and is long-lasting.
Passive immunity is temporary. It develops when antibodies are created by another human or animal and then transferred to a recipient. They do not independently develop antibodies.

Components of an Immune Response

T cells are white blood cells (WBCs) playing a central role in the adaptive immune response, primarily through signaling and activating other immune cells. Types include helper T cells and cytotoxic T cells.
Cytotoxic T cells, activated by helper T cells, destroy infected or cancerous cells by releasing toxins.
Helper T cells recognize antigens and release cytokines to activate other immune cells, including cytotoxic T cells and B cells, to target the pathogen.
B cells produce antibodies, proteins that bind to specific antigens on pathogens, marking them for destruction by other immune cells.

Immunosuppressants (Cyclosporine)

Adverse effects include gingival hypertrophy, hirsutism, hypertension, hyperlipidemia, and nephrotoxicity.
Patient teaching should emphasize using effective contraception, protective clothing, and sunscreen to decrease skin exposure and thus skin cancer risk.
Nursing considerations include monitoring white blood cell (WBC) counts, as immunosuppressants can increase infection risk. Monitoring for organ rejection symptoms and kidney function (e.g., BUN/creatinine) is critical due to the narrow therapeutic range of cyclosporine.

MUGA Scan

MUGA stands for mitigated acquisition scan, a noninvasive nuclear imaging test to assess the heart's structure and function.
Cardiotoxic effects, such as heart failure, increase with cumulative lifetime doses above 550 milligrams per square meter.

Adverse Effects of Monoclonal Antibodies (Rituximab)

Rituximab is used for non-Hodgkin's lymphoma, multiple myeloma, and chronic lymphocytic leukemia.
Adverse effects include infusion reactions, rash, fever, fatigue, nausea, diarrhea, weight gain, bone marrow suppression, cough, increased ALT, hypotension, bronchospasm, and angioedema.

Multiple Myeloma

Multiple myeloma is a disease where plasma cells excessively produce immunoglobulins, infiltrating the bone marrow.
CRAB symptoms include elevated calcium levels (hypercalcemia), kidney problems, low red blood cell counts (anemia), and bone damage.
Nursing considerations involve monitoring blood pressure, checking for signs of headache/seizures due to high hematocrit, and monitoring for thrombosis.

Patho of Different Blood Cancers

Acute myeloid leukemia is a defect in stem cells, differentiating into all myeloid cell types—monocytes, granulocytes, erythrocytes, and platelets. It commonly affects older patients.
Chronic myeloid leukemia involves a mutation in myeloid stem cells, leading to uncontrolled proliferation and the formation of the Philadelphia chromosome by the fusion of chromosomes 9 and 22.
Acute lymphocytic leukemia arises from uncontrolled proliferation of immune cells from lymphoid stem cells. It predominantly affects children but outcomes vary with age.
Chronic lymphocytic leukemia is a common malignancy in older adults arising from B lymphocytes, typically diagnosed in later adulthood.

HIV

CD4 T cells are the target of HIV, a retrovirus.
It replicates by converting RNA to DNA using reverse transcriptase.
Associated metabolic disorders include hyperlipidemia, insulin resistance, bone disease, and renal disease, amongst others.
Medications include antiretrovirals like Trimethoprim/Sulfamethoxazole and acyclovir,etc.

Zidovudine, Efavirenz, Saquinavir Mesylate, Enfuvirtide, Maraviroc, HAART

Zidovudine is a nucleoside reverse transcriptase inhibitor that reduces HIV replication. This results in decreasing HIV manifestations.
Efavirenz is a nonnucleoside reverse transcriptase inhibitor that stops HIV replication.
Saquinavir inhibits HIV enzymes needed for replication
Enfuvirtide blocks the attachment and entry of HIV into CD4T cells.
Maraviroc binds to CCR5 on cell membranes inhibiting HIV entering lymphocytes,
HAART is an aggressive treatment using three or more medications to reduce virus and increase CD4 counts, particularly Trimethoprim sulfamethoxazole.

Statins

Statins are administered orally, with evening dosage recommended as cholesterol is synthesized during the night.
Adverse effects include hepatotoxicity and myopathy.

Hep A and B vaccines

Hep A is recommended for children and international travelers aged 2–18.
Hep B is administered within 24 hours of birth and at 2 months with Tdap and HPV, with second dose at 16-18 years old

STEMI and NSTEMI protocols

STEMI involves a complete blockage of a major coronary artery, causing significant muscle damage. Treatment includes thrombolytic therapy and percutaneous coronary intervention (PCI).
NSTEMI involves a partial blockage. Treatment involves cath lab intervention with medications like aspirin, anticoagulants, beta-blockers, and ACE inhibitors.

Medications for MI and chest pain (MONA)

Morphine, oxygen, nitroglycerin, and aspirin (MONA) are used during myocardial infarction (MI) and chest pain to relieve pain, improve oxygenation, dilate blood vessels, and reduce blood clots. The medications are administered by specific pathways and in a time-sensitive manner.

Hyperthyroidism, Hypothyroidism, Thyroid Storm

Hyperthyroidism is characterized by a hypermetabolic state, including heat intolerance, weight loss, tachycardia, and nervousness.
Hypothyroidism is marked by an underactive thyroid, causing cold intolerance, weight gain, lethargy, and constipation.
Thyroid storm is a life-threatening acute exacerbation, often in untreated hyperthyroidism, characterized by extreme symptoms like tachycardia, hypertension, fever, and altered mental status.

Addison's Disease, Cushing's Disease

Addison's disease is an adrenal insufficiency marked by hypotension, weakness, and hyperpigmentation. Treatment involves hydrocortisone.
Cushing's disease involves elevated cortisol levels. Characterized by obesity, moon face, buffalo hump, thin skin, easy bruising, and susceptibility to infection. Treatment is with Ketoconazole

Endocrine Disorders, Lab Values

TSH (thyroid-stimulating hormone), T3 (triiodothyronine), and T4 (thyroxine) are used to assess thyroid function. Elevated free T4 in hyperthyroidism, while decreased T4 and elevated TSH in hypothyroidism.

Prevention of Bacterial Meningitis, Encephalitis

Bacterial meningitis is a severe infection of the membranes surrounding the brain, while encephalitis is inflammation affecting the brain tissue. Aseptic meningitis is caused by viral infections, while septic meningitis is caused by bacteria. Proper nursing care emphasizes assessing vital signs, protecting patients from injury related to unusual activity or altered LOC, monitoring electrolytes and urine output.

Lifestyle Changes for Hyperlipidemia

Lifestyle changes for hyperlipidemia include eating a balanced diet, exercising regularly, and maintaining a healthy weight to control cholesterol and blood lipid levels.

Nursing Considerations for Benzos

Benzos should be administered with caution, monitoring for adverse effects like respiratory depression, and excessive drowsiness. Interactions with other CNS depressants can increase these effects.

Ascites, Allopurinol

Ascites is fluid accumulation in the peritoneal cavity, common in liver dysfunction. Treatment involves alleviating the fluid and maintaining electrolyte balance.
Allopurinol is used to lower uric acid levels, reducing crystal formation. Administered orally or intravenously when a patient cannot swallow.

Proper Administration of Lactulose

Lactulose is given orally or via NG tube in doses of 15-30 mL (depending on the patient's response), to increase stool frequency for ammonia excretion.

Electrolyte levels (Potassium, Sodium, Chloride)

Electrolytes like potassium, sodium, and chloride must be monitored, as diarrhea caused by lactulose can disrupt their balance. Their normal ranges need to be closely monitored.

Renal Function Monitoring

Monitoring BUN (blood urea nitrogen) and creatinine is essential to detect kidney issues that may arise as a complication of the presence of lactulose and other treatment factors.

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Description

This quiz covers the different types of immunity, including active and passive immunity, as well as the key components of the immune response such as T cells and B cells. Understand how these immune cells function and their roles in protecting the body against pathogens.