NURS 7110 - Module 6 - Immune
System Exam Questions and Answers
12 Lead ECG & Sepsis Diagnostics - ANSWER-Gives baseline information regarding
the patient's cardiac rhythm. Can also help to differentiate if the heart is a potential site
of infection (peri/endocarditis), as well as give information in relation to severity of
sepsis and MODS potentially signifying poor perfusion to the heart
2 Essential Components of Immune Response - ANSWER-1. Recognition of the
presence of foreign substances
2. Taking action to destroy foreign substances.
2nd Line of Defense - ANSWER-Inflammatory Response
- Dilation and permeability of vessels to trap harmful molecules.
-Inflammation eliminates the cause, restore metabolism and functions of the organ to a
state of dynamic balance.
3rd Line of Defense - ANSWER-Immune Response
- Acquired immunity, more slowly than inflammatory response and can be induced
naturally or by vaccination
ABG's & Sepsis Diagnostics - ANSWER-Used to evaluate end organ perfusion to the
lungs as well as any acid/base imbalance in relation to poor oxygenation/ventilation, as
well as metabolic changes r/t compensation or poor perfusion of the tissues. ABGs are
required when an accurate PaCO2 level and/or a PaO2 is necessary as when for
patients in severe shock and hypercapnia.
Acute Kidney Injuries (AKI) - ANSWER-AKI is an abrupt decrease in kidney function
meeting this following criteria:
- Increase serum creatinine (SCr) by 0.3 mg/dL or more within 48 hours.
- Increased in SCr to 1.5 times or more the baseline within 7 days prior.
Decreased urine output to less than 0.5mL/kg/hour for 6 hours.
Adaptive (Acquired) Immunity (3rd Line of Defense) - ANSWER-- Pathogen & Antigen
Specific Response
-Delay between exposure and maximal response
-Cell-mediated and humoral components
-Exposure leads to immunological memory
, Hemoglobin & Sepsis Diagnostics - ANSWER-Assesses the oxygen carrying capacity of
the blood and may indicate the need for transfusion if severely depleted.
Hyperkalemia & AKI - ANSWER-normal excretion of potassium is impaired. Potassium
is released from damaged cells. Metabolic acidosis increases potassium levels as
hydrogen ions enter the cells and force potassium out of the cells. Can cause cardiac
dysrhythmias, peaked T waves, prolongation of PR interval, widening QRS complexes,
and PVCs. Untreated can lead to V. Tach, V. Fib, and cardiac arrest
Hypotension & SIRS - ANSWER-vasodilation, venous pooling, relative hypovolemia and
inability to mount a sufficient increase in CO.
Hypovolemia & SIRS - ANSWER-due to capillary leak, poor oral intake, and fluid loss
due to sweating, tachypnoea, vomiting, or bleeding
Indications fo RRT - ANSWER-- volume overload, compromised oxygenation, metabolic
acidosis, cardiac dysrhythmias, pericarditis, pericardial effusion, and impaired
neurological status.
Infection - ANSWER-Host response to the presence of microorganisms or tissue
invasion by microorganisms
Initial Onset Phase of AKI - ANSWER-Between the injury and by identifying hypotensive
episodes, nephrotoxic agents and other risks.
Injuries causing AKI - ANSWER-Acute post-streptococcal glomerulonephritis and E.
Coli gastrointestinal infection are examples.
Innate Immune System (1st & 2nd line of defense) - ANSWER--Response is non-
specific
-Exposure leads to immediate maximal response
-Cell-mediated and humoral components
-No immunological memory
Intrarenal AKI - ANSWER-Direct injury to the kidneys (blood vessels, glomeruli or
tubules-interstitium) Possible causes - ischemia resulting in prolonged decrease in renal
perfusion, nephrotoxins, infections, atheroembolic renal disease, and primary renal
disease.
Lactate & Sepsis Diagnostics - ANSWER-Assesses baseline and any abnormalities that
may need to be corrected. For example, Abdul may have elevated potassium if he is
experiencing Renal dysfunction. Other electrolytes that may be added are magnesium,
calcium and phosphate, as these are essential for cellular metabolism and action
potential.
System Exam Questions and Answers
12 Lead ECG & Sepsis Diagnostics - ANSWER-Gives baseline information regarding
the patient's cardiac rhythm. Can also help to differentiate if the heart is a potential site
of infection (peri/endocarditis), as well as give information in relation to severity of
sepsis and MODS potentially signifying poor perfusion to the heart
2 Essential Components of Immune Response - ANSWER-1. Recognition of the
presence of foreign substances
2. Taking action to destroy foreign substances.
2nd Line of Defense - ANSWER-Inflammatory Response
- Dilation and permeability of vessels to trap harmful molecules.
-Inflammation eliminates the cause, restore metabolism and functions of the organ to a
state of dynamic balance.
3rd Line of Defense - ANSWER-Immune Response
- Acquired immunity, more slowly than inflammatory response and can be induced
naturally or by vaccination
ABG's & Sepsis Diagnostics - ANSWER-Used to evaluate end organ perfusion to the
lungs as well as any acid/base imbalance in relation to poor oxygenation/ventilation, as
well as metabolic changes r/t compensation or poor perfusion of the tissues. ABGs are
required when an accurate PaCO2 level and/or a PaO2 is necessary as when for
patients in severe shock and hypercapnia.
Acute Kidney Injuries (AKI) - ANSWER-AKI is an abrupt decrease in kidney function
meeting this following criteria:
- Increase serum creatinine (SCr) by 0.3 mg/dL or more within 48 hours.
- Increased in SCr to 1.5 times or more the baseline within 7 days prior.
Decreased urine output to less than 0.5mL/kg/hour for 6 hours.
Adaptive (Acquired) Immunity (3rd Line of Defense) - ANSWER-- Pathogen & Antigen
Specific Response
-Delay between exposure and maximal response
-Cell-mediated and humoral components
-Exposure leads to immunological memory
, Hemoglobin & Sepsis Diagnostics - ANSWER-Assesses the oxygen carrying capacity of
the blood and may indicate the need for transfusion if severely depleted.
Hyperkalemia & AKI - ANSWER-normal excretion of potassium is impaired. Potassium
is released from damaged cells. Metabolic acidosis increases potassium levels as
hydrogen ions enter the cells and force potassium out of the cells. Can cause cardiac
dysrhythmias, peaked T waves, prolongation of PR interval, widening QRS complexes,
and PVCs. Untreated can lead to V. Tach, V. Fib, and cardiac arrest
Hypotension & SIRS - ANSWER-vasodilation, venous pooling, relative hypovolemia and
inability to mount a sufficient increase in CO.
Hypovolemia & SIRS - ANSWER-due to capillary leak, poor oral intake, and fluid loss
due to sweating, tachypnoea, vomiting, or bleeding
Indications fo RRT - ANSWER-- volume overload, compromised oxygenation, metabolic
acidosis, cardiac dysrhythmias, pericarditis, pericardial effusion, and impaired
neurological status.
Infection - ANSWER-Host response to the presence of microorganisms or tissue
invasion by microorganisms
Initial Onset Phase of AKI - ANSWER-Between the injury and by identifying hypotensive
episodes, nephrotoxic agents and other risks.
Injuries causing AKI - ANSWER-Acute post-streptococcal glomerulonephritis and E.
Coli gastrointestinal infection are examples.
Innate Immune System (1st & 2nd line of defense) - ANSWER--Response is non-
specific
-Exposure leads to immediate maximal response
-Cell-mediated and humoral components
-No immunological memory
Intrarenal AKI - ANSWER-Direct injury to the kidneys (blood vessels, glomeruli or
tubules-interstitium) Possible causes - ischemia resulting in prolonged decrease in renal
perfusion, nephrotoxins, infections, atheroembolic renal disease, and primary renal
disease.
Lactate & Sepsis Diagnostics - ANSWER-Assesses baseline and any abnormalities that
may need to be corrected. For example, Abdul may have elevated potassium if he is
experiencing Renal dysfunction. Other electrolytes that may be added are magnesium,
calcium and phosphate, as these are essential for cellular metabolism and action
potential.
