NUR 2349Exam 3 Study Guide/NUR 2349

***Exam 3 Study Guide***
NUR 2349: Professional Nursing I

MODULE 6: IMMUNITY
Chapter 17: Inflammation and Immunity

 Allergies
 True allergic reaction vs. side effects:
 A true allergic reaction occurs when your body sees something as harmful
and rejects it.
 You can have pruritis, urticaria, redness, rhinorrhea, sneezing, itchy
and watery eyes, crackles, wheezes, hoarseness, stridor, blood
vessel dilation, decreased cardiac output, bronchoconstriction, and
anaphylaxis.
 Adverse reaction.
 A side effect is a sensitivity and is not life-threating.
 It can include nausea, decreased energy, muscle aches, coughing,
constipation, diarrhea, easy bruising, ringing in the ears, or stuffy
nose.
 Angioedema may occur which is edema in lips, face, tongue, larynx,
neck. Generally caused by ACE inhibitors or NSAIDs.
 Something that isn’t detrimental.
 Anaphylactic shock (definition, care, etc.):
 Anaphylaxis is life-threatening reaction to a Type 1 hypersensitivity
reaction which occurs rapidly and systemically.
 Common causes are drugs, dyes, food, and insects.
 Nursing interventions include maintaining the airway, administering
epinephrine, and education on avoiding of allergen exposure and
use of epinephrine.
 The patient may need more than one shot of epinephrine.
 Remove and prevent allergen exposure if possible.
 Pharmacologic:
 Diphenhydramine/Benadryl
 Corticosteroids
 Epinephrine
 Antihistamines
 Leukotriene inhibitors
 Mast cell stabilizers
 Decongestants
 Allergy Shots
 Inflammation
 Pathophysiological process: (Cause of tissue damage.)

, Stage 1: Vascular response with blood vessel changes.
Constriction of small veins and dilation of arterioles. Redness and
warmth. Increased blood flow to the affected area which leads to
edema and capillary leak. Macrophage is the major cell type
involved and releases cytokines that stimulate more WBC
production.
 Stage 2: Cellular exudate. Exudate (pus) forms which contains
dead WBCs, necrotic tissue, and fluids. Neutrophils secondary to
cytokines from macrophages. Basophils and mast cells sustain and
continue initial responses. This stage may occur for several days.
 Stage 3: Tissue repair and replacement. WBCs induce the
remaining healthy cells to divide. Scar tissue is formed. Blood
vessels grow.
 Signs and Symptoms (localized and systemic):
 Localized inflammation symptoms are pain, redness, warmth,
decreased function, and welling.
 System symptoms are fever, increased WBC count (normal WBC
values are 4,500-10,000).
 Nursing care:
 When wrapping the affected extremity, start distal and work
proximal to promote return towards the heart. Never wrap down
because it will inhibit venous return.
 Medical treatment (medications, procedures, etc.):
 RICE – Rest, Ice, Compression, Elevated.
 Treatment includes resting the affected extremity.
 Applying cold/ice for 15-20 minutes every 2-3 hours.
 Utilizing compression devices to limit harmful swelling and promote
blood return to the heart.
 Elevating the affected extremity to promote blood and fluid return
to the heart.
 Immunity
 Types of immunity (acquired, innate, passive, etc.):
 Active immunity occurs when antigens enter a human and he/she
responds by making antibodies.
 Natural – Antibody formation without human assistance.
o Example would be contracting a disease.
 Artificial – Antibody formation with vaccination or
immunization.
o Example would be receiving a vaccination.
 Passive immunity is the transfer of antibodies to another human
from human or an animal.
 Natural – Passage from mother to fetus/infant via the
placenta or breast milk.
o Example would be breast milk.
 Artificial – Used for exposure to rabies, tetanus, or poisonous
snake bites to prevent disease or death.
o Example would be rabies.