NSG 4513 Adult Health - Immune Deficiency Disorders

NSG 4513 Adult Health 3 Study Guide

Chapter 32 - Management of Patients with Immune Deficiency Disorders

• Primary immunodeficiency involves education and care plan
• Live vaccines are contraindicated in patients with antibody deficiency disorders.
• Family planning, caregiver education on medication administration and early signs of infection, as well as the importance of proper hand hygiene are crucial.
• Care plan varies by deficiency.
• Treatment includes infection management, immunoglobulin administration(IVIG), and stem cell transplants.
• Nursing includes; hand hygiene, infection interventions, monitoring for infection, medication administration and lifestyle modifications.
• When to follow-up with MD.
• HIV/AIDS covers the patho, prevention, older adult considerations, and stages of HIV

Cellular

• Characterized by antibodies produce by B lymphocytes
• T lymphocytes are responsible for cellular immunity as they mature from the bone marrow to the thymus gland and differentiated roles in defense against bacteria, viruses, fungi, parasites, and malignant cells.
• T cells directly attack foreign invaders

Chapter 31 - Assessment of Immune Function

• Natural and Acquired Immunity
• Natural immunity provides first line of host defense, following antigen exposure
• Acquired immunity usually develops due to prior through immunization or contracting a disease, both of which generate a protective immune response.
• Humoral vs Cellular Immune response pg 991-992

Tumor Lysis Syndrome (GOOGLE)

• A group of potentially life-threatening conditions that may occur within hours/days after cancer treatment.
• It can rapidly become a medical emergency, necessitating treatment with medication and IV hydration.
• Healthcare providers are to prevent it before it occurs.

Spinal Cord Compression (GOOGLE)

• Occurs when there is pressure on an area of the spinal cord.
• Can be caused by cancer cells and metastases.
• Can lead to pain, vertebral collapse, and irreversible loss of spinal cord function.

Oncologic Emergencies

• Superior Vena Cava syndroms, Tumor Lysis Syndrome and Spinal cord Compression

Superior Vena Cava Syndrome (GOOGLE) Pg 360

• The superior vena cava carries blood from the upper body to the heart; compression or invasion of the SVC by a tumor results in a group of symptoms.

Complications following cancer treatment

• Neutropenia with an ANC less than 1,000 is associated with an increased risk of infection
• Thrombocytopenia with bleeding with a decrease in circulating platelet count is more common in cancer patients, spontaneous bleeding can happen if platelets are less than 10,000.

Surgery Types

• Primary: Removal of entire tumor or as much as possible
• Prophylactic: Risk reduction by removing non-vital tissue to reduce the chance of developing cancer
• Palliative: Relieve symptoms
• Reconstructive: cosmetic effect

During implanted medical devices

• Remain in the hospital for some time after the implant is placed.
• Limit the number of visitors.
• Avoid pets and children.
• Stay in a private hospital room to protect others from radiation.
• Nurses and staff will provide protective clothing.
• Consider condoms during sex.
• Intense doses of radiation beyond a dose usually provided by EBRT

Myelosuppression

• From bone marrow suppression
• Results in leukopenia, anemia, and neutropenia
• Causes infections and bleeding

IV Extravasation

• When IV medication leaks into the surrounding tissues
• Leads to tissue damage, skin irritation and even tissue necrosis

Nursing interventions

• Assess fluids and electrolytes
• Assess cognitive status
• Modify risks for infection and bleeding
• Preventing extravasation
• Preventing N/V
• Manage Cognitive Status
• Manage Fatigue
• Assessing for cognitive changes.
• Assessing for F/E status
• Addressing Sexuality
• Psychological and Psychosocial distress
• Altered self-esteem
• Altered body image.

Radiation

• Side effects
  • skin and hair
  • stomatitis and Mucositis
  • Gl symptoms
  • Systemic
• Have emergency spill kits
• Wear PPE

Brachytherapy precautions

• Placement of radioactive sources within or immediately next to the cancer site in order to provide a highly targeted.

Benign Tumors

• Small
• Slow-growing
• Non-invasive
• Well-differentiated
• Stay localized
• Can't metastasize or invade

Malignant Tumors

• Large
• Fast-growing
• Invasive
• Poorly-differentiated
• Metastasize

Chapter 12 - Management of Patients with Oncologic Disorders

Cancer prevention

• Primary: Reduce disease risks through prevention, example immunizations to reduce risk of cancer by reducing infections
• Secondary: Screening and early detection
• Tertiary: Monitoring and preventing relapses and diagnostic evaluation

Grading/staging (TNM)

• Pathologic classification of tumor cells, chart 12-3 pg 312
• Size of local invasion, lymph note involvement, and distant metastasis

TNM stages for breast cancer

• Tumor size (T)
  • T-1: 0-2 centimeters
  • T-2: 2-5 centimeters
  • T-3: > 5 centimeters
  • T-4: Tumor has broken through skin or attached to chest wall
• Lymph node status (N)
  • N-0: Surgeon can't feel any nodes
  • N-1: Surgeon can feel swollen nodes
  • N-2: Nodes feel swollen and lumpy
  • N-3: Swollen nodes located near collarbone
• Metastasis (M)
  • M-0: Tested nodes are cancer-free
  • M-1: Tested nodes show cancer cells or micrometastasis

Chemotherapy

• Adverse effects, IV extravasation, nursing interventions, and administration of anti-neoplastic medications are all covered here
• Effects of chemo occur in any body system

The transport equation

1. Conservation laws

• Example 1: Traffic flow
  • ρ(x,t): density of cars
  • q(x,t): the flux

2. The transport equation

• Simplest conservation law: ρt + (u ρ)x = 0, where u is a constant
• ρ is constant along the line x(t) = x0 + ut
• Characteristics Lines

3. The advection equation

• Characteristics are given by dx/dt = u(x,t)
• ρ is constant along the characteristic

Algèbre Linéaire et Analyse Matricielle

Chapitre 1: Matrices

1.1 Introduction

• Linear algebra is the study of vector spaces and linear transformations.

1.2 Définitions

• 1.2.1: Matrix is a rectangular array of numbers with m rows and n columns
• 1.2.2: Vector single row or column
• 1.2.3: Square Matrix same number of rows and columns
• 1.2.4: Null Matrix all elements are equal to zero
• 1.2.5: Identity Matrix element diagionals equal to onther is zero

1.3 Opérations sur les matrices

• 1.3.1: Addition and subtraction performed element by element; works when the matrices are the same size.
• 1.3.2: Multiplication by a scalar multiplies each element
• 1.3.3: Matrix multiplicaiton:
  • A and B is a matrix
  • C=Summation.
• 1.3.4: Transposition rows become columns. * If A is amxatrix m × n, thenATis a matrix n × m

1.4 Propriétés des opérations matricielles

• 1.4.1: Addition: Commutativity, Associativity, Élémen
• 1.4.2: Multiplication by a scalar: Associative
• 1.4.3: Matrix Multiplication: Not Commuititve
• 1.4.4: Transposition: (A+B)T=AT+BT

1.5 Types spéciaux de matrices

• 1.5.1: Diagonal Matrix non diagionals equal zero
• 1.5.2: Upper and lower triangular matrix with elements that exist above or below the diagonal zero.
• 1.5.4: Symmetric Matrix:AT=Ais a square matrix
• 1.5.5: Antisymmetric Matrix :AT=−A

Chemical Kinetics

Reaction Rate

• aA + bB → cC + dD
  • Rate = $-\frac{1}{a}\frac{d[A]}{dt} = -\frac{1}{b}\frac{d[B]}{dt} = \frac{1}{c}\frac{d[C]}{dt} = \frac{1}{d}\frac{d[D]}{dt}$

Rate Law

• Rate = $k[A]^x[B]^y$

Integrated Rate Laws

Arrhenius Equation

• $k = Ae^{-E_a/RT}$

Two-Point Arrhenius Equation

• $ln\frac{k_2}{k_1} = \frac{E_a}{R}(\frac{1}{T_1} - \frac{1}{T_2})$

Catalysts

• Catalysts speed up a reaction by lowering the activation energy.

Equilibrium

• K > 1: Products are favored at equilibrium
• K < 1: Reactants are favored at equilibrium

van't Hoff Equation

• $ln\frac{K_2}{K_1} = \frac{\Delta H^{\circ}}{R}(\frac{1}{T_1} - \frac{1}{T_2})$

Le Châtelier's Principle

• Stresses include: Addition of heat, Addition of reactants or products, Change in pressure or volume

Algèbre linéaire

1.Matrices

• Ensemble des matrices à n lignes et p colonnes à coefficients réels.

1.2 Opérations

• **Addition:**Si A,B∈Mn,p(R),alorsA+B=(ai,j+bi,j)
• **Multiplication par un scalaire:**SiA∈Mn,p(R)etλ∈R,alorsλA=(λai,j)
• **Produit matriciel:**SiA∈Mn,p(R)etB∈Mp,q(R),alorsAB=(ci,j)où ci,j=∑k=1pai,kbk,j

1.3 Matrices particulières

• **Matrice carrée:**A∈Mn,n(R)
• Matrice identité:
• **Matrice diagonale:**A=(ai,j)tellequeai,j=0sii≠j
• **Matrice triangulaire supérieure:**A=(ai,j)tellequeai,j=0sii>j
• **Matrice triangulaire inférieure:**A=(ai,j)tellequeai,j=0sii<j
• **Matrice symétrique:**A=(ai,j)tellequeai,j=aji
• **Matrice antisymétrique:**A=(ai,j)tellequeai,j=−aji

1.4 Inverse d'une matrice

Inverse d'une matrice: A−1=1det(A)Com(A)T où Com(A) est la comatrice de A.

2.Déterminants

• Applications:Calcul de l'inverse d'une matrice

3.Espaces vectoriels

• 3.1 Définition:Un espace vectoriel est un ensemble E muni de deux opérations
• 3.2 Exemples
• 3.3 Sous-espaces vectoriels
• 3.4 Combinaisons linéaires
• 3.5 Familles génératrices: Une famille de vecteurs est génératrice de E si tout vecteur de E peut s'écrire comme combinaison linéaire
• 3.6 Familles libres: Une famille de vecteurs est libre si la somme des vecteurs = 0
• 3.7 Bases: Une base de E est une famille libre et génératrice de E.
• 3.8Dimension: La dimension de E est le nombre de vecteurs dans une base de E

4.Applications linéaires

• Noyau: Ker(f)={u∈E∣f(u)=0F}
• Image:Im(f)={f(u)∣u∈E}
• Lemme du rang: lemme
• 5.Diagonalisation
• Vecteurs propres:5.1 Lemme

Capítulo 3. Determinantes

3.1 Introducción

• En el Capítulo 2, aprendimos que una matriz cuadrada A es invertible si y sólo si su forma escalonada reducida por filas es la matriz identidad.

3.2 El determinante de una matriz

• El determinante es una función que toma una matriz cuadrada como entrada y produce un número real como salida. Si A es una matriz cuadrada, entonces el determinante de A se denota por det(A) o |A|.

det(A) = a_{11}C_{11} + a_{12}C_{12} +... + a_{1n}C_{1n}

Study guide for NSG 4513 Adult Health 3, Chapter 32. Covers primary immunodeficiency, HIV/AIDS (patho, prevention and stages), care plans, treatments like IVIG and stem cell transplants, and nursing interventions. Includes education on infection management, medication, and hygiene.