4-2024-Immune-System_Handout.pdf

15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE...

15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® An autoimmune disorder IMMUNE SYSTEM occurs when the body’s immune system mistakenly attacks its own! Philippine Nurses Licensure Examination ©The Ray A. Gapuz Test Prep System For PNLE FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® PNLE FOCUS Myasthenia gravis is an autoimmune disease! MYASTHENIA GRAVIS FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Myasthenia gravis, an autoimmune disorder affecting the myoneural junction, is NMJ characterized by varying degrees of weakness of the voluntary muscles. PTOSIS FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM - ORBICULARIS OCULI Impaired impulse transmission from nerve to muscles DESCENDING PARALYSIS 1  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Autoimmune Attack at the NMJ In Myasthenia Gravis, Complement-mediated Destruction and Muscle the antibodies attack the Fiber Atrophy acetylcholine receptor sites, Thymic Abnormalities and T Cell Dysfunction which impair the transmission of impulses. Muscle Weakness and Fatigue (hallmark manifestation): typically worsens with continued use and improves with rest Ocular and Bulbar Symptoms: ptosis, diplopia, difficulty chewing and swallowing, speech changes FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® The cause of MG is unknown. Some possible risk factors include: Myasthenia gravis involves deficiency of acetylcholine 1. Abnormal thymus gland – overproduction fo AChR antibodies receptor sites leading to Killer T cells weakness of voluntary 2.T-cell involvement – recognizes AChR as muscles. foreign and contributes to the immune response against it FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® In myasthenia gravis muscle diplopia weakness leads to double vision, Myasthenia gravis is common drooping eyelids, difficulties in both men (>60) ptosis dysphonia with speech, absent gag reflex, and women ( Pag na inhibit nito yung acetylcholinesterase and naretain nito yung Tinatanggal ng Ach, maii-stimulate yung remaining receptors and mai-improve yung acetylcholinesterase yung Ach pag impulse transmission then magkakaroon ng contraction. 15/01/2024 nagamit na sa muscle - Pang diagnose lang ito dahil short-acting lang yung effect 5-15 mins The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Tensilon test or Edrophonium Edrophonium chloride (Tensilon), test is the gold standard an ACh inhibitor, is injected. confirmatory test for MG. Positive Tensilon test occurs when rapid and significant client improvement is observed. This result strongly suggests the presence of MG. SGPharma. (n.d.). Edrophonium Chloride Injection USP. Retrieved from https://sgpharma.com/home/product_details.php?ProductID=121. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN TENSILON TEST Functional Concept ® No author. (2013). Diagnosis of Myasthenia Gravis Confirmed with Tensilon Test. Retrieved from https://mmcneuro.wordpress.com/2013/12/11/diagnosis- of-myasthenia-gravis-confirmed-with-tensilon-test/. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Diagnosis of myasthenia paralysis gravis involves neuro checks, There is no cure for Myasthenia ice pack test, blood analysis, Gravis. EMG, CT scan, MRI and pulmonary function tests. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 2. Electromyography (EMG) -To check how well the muscles respond to nerve signals 3. Nerve Conduction Test (NCT) - It measures the speed and strength of nerve stimulation. 4. CT/MRI 4 - To detect Thymoma - Long acting anticholinesterase drugs -> improve impulse transmission -> improve muscle contraction > Onset is 20-30 mins after intake and will last for 4-6 hrs. > Neostigmine, Physostigmine, and Pyridostigmine 15/01/2024 > For example, may problema sa chewing and swallowing (dysphagia). Ibibigay yung drug 20-30 mins BEFORE MEALS. Need i-repeat yung dose after 4-6 hrs. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Medications for MG Medication Purpose Anticholinesterase drug - Long acting Cholinesterase inhibitors (pyridostigmine) *s/e excessive salivation, sweating, diarrhea and nausea To improve muscle strength and It is imperative to instruct the client to take medication on contraction anti-inflammatory Corticosteroids(prednisone) To limit antibody *may lead to weight gain, fractures Sandimmune production Immunosuppressants (azathioprine, cyclosporine) To alter the immune schedule *may lead to increased infection, liver and kidney response damage prevent attacking own cells IV immunoglobulin and monoclonal antibody To provide normal (rituximab, eculizumab) antibodies. 8IVIg may cause fluid retention, dizziness and headache FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Scheduled activities (meals) with peak drug effects And keep a diary to learn when medication is wearing off for medication scheduling. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Thymectomy may be performed Robot assisted thymectomy for the client with Myasthenia involves making Gravis in an effort to improve small incisions on the weakness caused by MG. the side of the chest to remove Removing thymus gland the thymus gland. Cleveland Clinic. (n.d.). Thymectomy. Retrieved from https://my.clevelandclinic.org/health/treatments/25041-thymectomy. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 5  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN PNLE QUICK FIX Functional Concept ® MYASTHENIC CRISIS Muscle weakness may & indicate a complication of myasthenia gravis. CHOLINERGIC CRISIS FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® MYASTHENIA GRAVIS Weakness Cause Myasthenic Crisis is a medical TOO LITTLE MEDICATION TOO MUCH MEDICATION MYASTHENIC CRISIS CHOLINERGIC CRISIS emergency. Manifested by: Tensilon Manifested by: Test Respiratory failure Respiratory failure Bronchorrhea Bronchorrhea coughing with excessive mucus production Increased salivation Increased salivation Bradycardia Tachycardia Tachycardia to bradycardia + DTR Treated with: Treated with: Neostigmine Atropine and Pralidoxime FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Muscle weakness with Muscle weakness with bradycardia may indicate tachycardia that progresses to myasthenic crisis in a bradycardia may indicate client with MG. cholinergic crisis in a client with MG. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 6  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Muscle weakness that is Muscle weakness that worsens relieved with Tensilon may with Tensilon may indicate indicate myasthenic crisis. cholinergic crisis. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® To differentiate myasthenic crises from cholinergic crises. A Atropine Sulfate is the drug of tensilon test is performed. If choice for cholinergic crisis. positivemuscle weakness improves with Tensilon, then it is a myasthenic crisis. If muscle weakness negative worsens, then it is a cholinergic crisis. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Muscle weakness with Muscle weakness with tachycardia indicates bradycardia indicates myasthenic crisis which is cholinergic crisis which is treated with neostigmine. treated with atropine sulfate. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 7  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® PNLE FOCUS In cholinergic crisis, SLUDGE syndrome occurs. HODGSKINS Salivation PNS Lacrimation vs Urinary incontinence Diarrhea NON-HODGSKINS DISEASE GI upset HODGKINS AND NON HODGKINS DISEASE (LYMPHOMA) Emesis FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Lymphoma Lymphoma is a blood cancer Hodgskin’s Non-Hodgskin’s affecting the lymphatic system abnormal growth tumors develop leading to change and of lymphocytes from lymphocytes proliferation of WBC. More common Cause is unknown Age above 60 Common between Use of ages 15 to 40 and immunosuppressants above 55 Infection- HIV, H. Pylori Linked to Epstein- Exposure to chemicals and Barr virus insect killers FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® LYMPHOMA Lymphocyte abnormalities: normal lymphocytes transform into cancerous cells Hodgskin’s Non-Hodgskin’s Lymphadenopathy Formation of Reed-Sternberg Originates from various types of cells, which are large, lymphocytes, including B cells, T cells, abnormal B lymphocytes and natural killer (NK) cells. Genetic mutations leading to tumor formation Hall mark sign: enlarged lymph nodes (lymphadenopathy) Systemic “B” Symptoms: Low-grade fever, profuse night sweats, unintentional weight loss (>10% body weight in 6 mos) Kim, C. & Werner-Wasik, M. (2008). Lymphadenopathy. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMicm071065. Presence of Reed-Sternberg cells Extra nodal involvement Progressing to adjacent lymph nodes Specific symptoms based on sub-type HexaHealth Care Team. (2023). Difference between Hodgkin and Non Hodgkin Lymphoma. Retrieved from https://www.hexahealth.com/blog/difference-between-hodgkin-and-non-hodgkin-lymphoma. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM 8  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Other symptoms include: The most common symptom of HD is the painless swelling of Night sweats Itchy skin the lymph nodes in the neck, Fever arm pit and groin. Fatigue Enlarged spleen Persistent cough and chest pain Pain in the lymph node after drinking alcohol FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY GAPUZ REVIEW SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Diagnosis for HD: Lymph node or tissue biopsy is the X ray To check lymph node swelling gold standard diagnostic test. This CT scan allows examination of lymphoma Lymph node biopsy cells to determine its CBC blood cancer, wbcs characteristics, grade, and stage. Bone marrow biopsy dito na po-produce yung blood Lung function test Difficulty breathing copyright 2012 by R.A. Gapuz. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Staging Stage 1 – early- affects one lymph node region (90 % survival rate) Stage 2 – locally advanced- affects two lymph node regions and one side of diaphragm (90 % survival rate) Treatments include: Stage 3 – advanced- affects lymph nodes regions above and below the diaphragm (80 % survival rate) Stage 4 – widespread in other organs (65 % survival rate) Chemotherapy Radiation therapy Immunotherapy Leukemia & Lymphoma Society. (n.d.). Hodgkin Lymphoma Staging. Retrieved from https://www.lls.org/ly mphoma/hodgkin- lymphoma/diagnosis/ hodgkin-lymphoma- staging. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 9  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Symptoms of NHL Mammogram is necessary after Night sweats (same with HD) treatment for HD as the risk for Fever Fatigue a second cancer is high. Swollen lymph nodes Abdominal pain or swelling Difficulty breathing Chest pain FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Diagnosis for NHL: Night sweats Fever PE Fatigue Blood and urine tests Swollen lymph nodes Biopsy X ray CT scan occur in both NHL and HD MRIs PET scans Imaging test that uses radiotracer copyright 2012 by R.A. Gapuz. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® LET’S Treatments include: Chemotherapy Radiation therapy Stem cell transplant FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 10  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Lymphoma Ray A. Gapuz’s Hodgskin’s Non-Hodgskin’s FUNCTIONAL CONCEPTS painless enlargement of lymph nodes fever, night sweats, fatigue on Common between ages 15 to 40 and above 55 Age above 60 Use of immunosuppressants Disorders of the Immune System Infection- HIV, H. Pylori Linked to Epstein-Barr virus Exposure to chemicals and insect killers FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN In a client with allergy, In a client with immunodeficiency , The PRIORITY is: The PRIORITY is: AIRWAY PROTECTION from INFECTION The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN In a client with infection, PNLE RN Strategies for The PRIORITY is : MASTERING THE MOST COMMON ISOLATE the INFECTION DISORDERS of the IMMUNE SYSTEM 11  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN FOCUS CARDINAL HIV – AIDS MANIFESTATIONS (Human Immunodeficiency Virus - Acquired immunodeficiency Syndrome) of Immunodeficiency The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® HIV transmission and entry: virus enters the body Acute HIV Infection FLU-LIKE SYMPTOMS: Initial Stage Fever Destruction of CD4+ T cells and other immune cells (first few weeks after exposure) Fatigue Sore throat Muscle & joint aches Acute HIV Infection Swollen lymph nodes Head ache FIRST SIGN Initial Stage (first few weeks after exposure) Rash Chronic HIV Infection (last for years) Chronic HIV Infection ASYMPTOMATIC STAGE (last for years) Mild/non-specific symptoms some have swollen lymph nodes AIDS (final and most advanced stage) FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Advanced Chronic HIV SYMPTOMATIC STAGE: Infection Weight loss Night sweats Thrush (oral candidiasis) Respiratory infections Neurological symptoms Antibody tests detect presence of HIV antibodies. Herpes zoster (shingles) AIDS CD4+ T Cell counts (15%. part of routine health care. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® A separate written consent for The normal CD4 count range from 500 cells/mm3 to 1000 HIV testing is not required. cells/mm3. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® AIDS is diagnosed when the CD4 Drugs used in the treatment of count is below 200 cells/mm3. HIV are called ARVs (antiretroviral drugs). FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 14  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® WHO recommends first-line ART regimen which often include a combination of: Antiretroviral Therapy (ART) 1.Two nucleoside reverse transcriptase inhibitors suppresses viral replication, (NRTIs) (e.g., Tenofovir alafenamide) slows disease progression, and 2.One integrase strand transfer inhibitor (INSTI) preserves immune system. (e.g., Dolutegravir) or 1.One non-nucleoside reverse transcriptase inhibitor (NNRTI) (e.g., Dolutegravir) FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® The WHO recommends a combination of ARVs for people starting HIV treatment: Female circumcision does not protect against HIV. TDF (tenofovir) 3Tc (lamivudine) or FTC (emtricitabine) EFV (efavirenz) FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Male circumcision helps protect against HIV by reducing the risk You have the right to be by 60%. circumcised at any age or to refuse circumcision. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 15  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® HIV infection spreads easily Swollen lymph nodes is often one of during primary infection. the first signs of HIV infection. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN TRENDING ! Functional Concept ® TYPES OF IMMUNITY Types NATURAL ACQUIRED of Species-specific ACTIVE PASSIVE Immunity The host The host PRODUCES its RECEIVES natural own antibodies or artificial in response to antibodies natural or produces by artificial antigens another source. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Terms to Remember TYPES OF ACQUIRED IMMUNITY or viral ACTIVE PASSIVE Vaccine – modified bacterial cells Toxoid – weakened bacterial toxin NATURAL ARTIFICIAL NATURAL ARTIFICIAL Antitoxin – antibody formed by the body against a toxin Active infection Introduction Placenta Immune Serum Antibody – active natural of antigens Colostrum Antibodies (vaccines or Antibodies from Anti toxin or artificial produced by Toxoids) other sources the body Ig antibodies FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 16  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN TYPES OF IMMUNITY TYPES OF IMMUNITY Passive immunity – external source Antitoxin – passive, artificial Active immunity – internal Antibody – active natural source or artificial Natural immunity – developed by the body Artificial immunity – developed outside the body The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept Functional Concept ® When administering vaccines, the age For injured persons with proof of: of the client must be considered: 1. Complete primary immunization DTap containing tetanus toxoid Children below 7 years old 2. Booster shot within the last 5 years DT Td Older children and adults NO additional tetanus toxoid dose is Tdap needed Lilinisin lang yung wound FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM Tetanus (lockjaw) The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept Functional Concept ® Functional Concept Functional Concept ® For injured persons whose booster For pregnant women with no shot is more than 5 years, TT immunization, administer at least 2 doses at 4 weeks interval at least Administer 0.5 mL of tetanus 2 weeks before delivery. toxoid immediately FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 17  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept Functional Concept ® Immunoglobulins For injured persons whose immunization Ig G -body fluids history is inadequate, administer: -smallest and most common 1500 IU tetanus antiserum or 250 units -can cross the placenta of tetanus immune globulin and -fights bacterial and viral infections Ig A -body surface 0.5 mL of tetanus toxoid Ig M -blood and lymph fluids using different syringe at -first produced in response to infection Ig E -lungs skin and mucous membranes different body parts -allergies followed by a 2nd dose after 2 weeks and Ig D -small amounts in the tissues of the belly or chest a 3rd dose after a month -undefined functions FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® tTg-IgA Immunoglobulin A (IgA) anti- The most sensitive antibody tissue transglutaminase tests are of the antibody is the single immunoglobulin A (IgA) class; preferred test for detection of however, immunoglobulin G celiac disease. (IgG) tests may be used in Intestinal villus atrophy people with IgA deficiency. Gluten intolerance FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® A positive West Nile Virus Immunoglobulin M (IgM) test has been reported by and Immunoglobulin G (IgG) a few people who take obtained thru esomeprazole (Nexium). ELISA detects West Nile Virus West nile virus test positive is reported only by a few people who take Nexium. (ehealthme.com) FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 18  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® LET’S The most sensitive antibody tests for CELIAC DISEASE are of the immunoglobulin A (IgA) class; however, immunoglobulin G (IgG) tests may be used in people with IgA deficiency. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® DISEASE IMMUNOGLOBULIN CELIAC DISEASE Ig A IgG is elevated in bacterial Ig G WEST NILE Ig G and viral infection. VIRUS Ig M FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® The tTG-IgA test anti-tissue transglutaminase (tTG) antibodies The tTG-IgA test is the preferred screening method and has a sensitivity of 93%, yielding few false negative results. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 19  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Endomysial antibodies A jejunal biopsy may help (EMA)- IgA is highly diagnose clients who are EMA specific for celiac disease, or tTG negative and suspected with 99% accuracy. of having celiac disease. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN LET’S Functional Concept ® TEST INDICATION tTG IgA Screening for Celiac disease EMA IG A Specific for Celiac disease JEJUNAL BIOPSY Suspected Celiac disease, (-) EMA or tTG FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN FUNCTIONALConcept Functional CONCEPT® FUNCTIONAL CONCEPTS Hepatitis B vaccine can be given ON to people with a history of multiple sclerosis, Guillain-Barré IMMUNIZATION syndrome, autoimmune disease, or other chronic disorders, as well as to pregnant women. copyright 2012 by R.A. Gapuz. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 20  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN FUNCTIONALConcept Functional CONCEPT® FUNCTIONALConcept Functional CONCEPT® Live attenuated vaccine Rotavirus vaccine should not Immunization against influenza is be given to.infants with recommended for.all persons older than 6 months. a known immunodeficiency or history of intussusception. The shot is approved for adults and children Rotavirus is the single most important cause of 6 months of age and older, while the nasal severe diarrhea and dehydration in infants and spray is approved only for those between young children. A rotavirus vaccine is recommended for all infants in the United States. 24 months of age and 49 years of age. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® KEY POINTS ON A total of 10 vaccines are given to a IMMUNIZATION SCHEDULE child as follows: At birth: Hepatitis  Dtap -5 DOSES  Hib, IPV, PCV -4 DOSES College entrants: MCV Meningococcal Vaccine  RV -3 DOSES  Varicella, MMR, Hep A -2 DOSES Pregnant client : Inactivated Influenza vaccine  Hep B -at birth Elderly: Annual influenza vaccine and  Influenza -yearly Pneumonia vaccine FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM HRV The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® The 6 vaccines given at 2 months include: The 5 vaccines given at 4 months include:  DTaP  DTaP  Hib  Hib DHHIPR  IPV  Hep B  IPV  PCV  PCV  RV  RV FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 21  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® TRENDING CONCEPTS ! Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine CONTRAINDICATIONS component SCID (Severe Combined Immunodeficiency) to Altered immunocompetence other than SCID History of intussusception Chronic gastrointestinal disease IMMUNIZATION Spina bifida or bladder exstrophy Moderate or severe acute illness with or without fever. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Contraindications to ALL VACCINES include: Anaphylactic reaction to eggs needs to be assessed  Allergy to the vaccine before administration of  Moderate or severe influenza vaccine. illness with or without fever FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® UPDATE! An allergy to eggs or egg protein needs to be assessed before administration of influenza vaccine. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 22  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Immunosuppresion is a contraindication to measles vaccine. LET’S SIMPLIFY ! FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Contraindications to HIB include: Functional Concept ® Live attenuated vaccines are  Severe allergic reaction (e.g., contraindicated to clients who are : anaphylaxis) after a previous dose or to a vaccine component pregnant  Age younger than 6 weeks immunocompromised undergoing chemotherapy  Moderate or severe acute taking steroids illness with or without fever HIV + FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® PREGNANCY is a contraindication ALLERGY TO EGGS is a to the following vaccines: contraindication to: 9 months and 1 yr  MMR  VARICELLA  VARICELLA FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM 23  15/01/2024 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® ALLERGY TO ANTIBIOTICS is a contraindication to: Severe allergic reaction and seizures are contraindications to  MMR DTaP vaccines.  VARICELLA  IPV FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® MMR and varicella vaccines can Hepatitis B vaccination should be be administered on the same day. deferred when any of the following conditions exist: If not administered on the same day, these vaccines should be 1. infants weighing