Immune / Infectious NCLEX Clinical Study Booklet · 10 cards
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HIV / AIDS. Viral What is HIV / AIDS?
HIV attacks CD4+ T-cells, weakening cell-mediated immunity. AIDS at CD4 <200 or an AIDS-defining illness. What are the Causes / Risk Factors?
Blood, sexual contact, perinatal Sharing needles Untreated → progression What are the Symptoms?
Flu-like acute infection Fatigue, weight loss, night sweats Opportunistic infections (PCP, candidiasis, TB, Kaposi's) Recurrent infections How is it Diagnosed?
HIV antigen/antibody test, confirmatory testing CD4 count, viral load What is the Treatment?
ART (combination) — adherence critical (resistance) Prophylaxis for opportunistic infections Standard precautions U=U; PrEP for prevention NCLEX Tip ART adherence is critical — missed doses cause resistance. AIDS is defined by CD4 <200. Undetectable viral load = untransmittable (U=U).
Sepsis. Sepsis What is Sepsis?
Life-threatening organ dysfunction from a dysregulated response to infection. Progresses to septic (distributive) shock. What are the Causes / Risk Factors?
Bacterial (most), viral, or fungal infection Immunosuppression, indwelling devices Elderly, very young What are the Symptoms?
Early (warm): fever, tachycardia, warm skin, bounding pulses, ↑lactate, confusion Late (cold): hypotension, cool clammy skin, ↓urine output How is it Diagnosed?
Blood cultures (before antibiotics) ↑lactate, ↑WBC Identify the source What is the Treatment?
Cultures BEFORE antibiotics Broad-spectrum antibiotics within 1 hour Aggressive IV fluids; vasopressors (norepinephrine) if needed Monitor MAP ≥65, urine output, lactate NCLEX Tip Sepsis bundle: draw cultures before antibiotics, give broad-spectrum antibiotics within 1 hour, and fluid-resuscitate aggressively.
Isolation Precautions. Precautions Airborne
TB, measles, varicella, disseminated zoster Negative-pressure room, N95 respirator, door closed Droplet
Influenza, pertussis, meningitis, mumps, rubella Private room (or 3+ ft), surgical mask Contact
MRSA, VRE, C. diff, RSV, scabies Gown + gloves; C. diff / norovirus → soap and water (not alcohol gel) NCLEX Tip Airborne = negative pressure + N95; Droplet = surgical mask; Contact = gown + gloves. For C. diff, use soap and water — alcohol gel doesn't kill spores.
Anaphylaxis. Allergy What is Anaphylaxis?
Severe, rapid, systemic allergic (type I hypersensitivity) reaction. Life-threatening airway and circulatory compromise. What are the Causes / Risk Factors?
Foods (nuts, shellfish), medications (penicillin) Insect stings, latex Contrast dye What are the Symptoms?
Airway swelling, stridor, wheezing Hypotension, tachycardia (shock) Urticaria, angioedema Sense of impending doom GI cramping, vomiting How is it Diagnosed?
Clinical (rapid onset after exposure) What is the Treatment?
EPINEPHRINE IM (first & priority) Maintain airway; high-flow O₂ Supine with legs elevated; IV fluids Antihistamines, corticosteroids (adjuncts); remove allergen NCLEX Tip Anaphylaxis: give epinephrine IM immediately — it's the first-line, life-saving drug. Then support the airway and circulation.
Systemic Lupus Erythematosus. Autoimmune What is Systemic Lupus Erythematosus?
Chronic autoimmune disease affecting multiple systems. Antibodies attack the body's own tissues. What are the Causes / Risk Factors?
Autoimmune Genetic + environmental (sun, hormones) More common in women What are the Symptoms?
Butterfly (malar) rash, photosensitivity Joint pain, fatigue, fever Nephritis (kidney involvement) Pleuritis, pericarditis Remissions & exacerbations How is it Diagnosed?
+ANA, anti-dsDNA ↑ESR, ↓complement Clinical criteria; monitor renal function What is the Treatment?
NSAIDs, antimalarials (hydroxychloroquine) Corticosteroids, immunosuppressants Sun protection (avoid UV triggers) Monitor for lupus nephritis; infection precautions NCLEX Tip Protect SLE patients from the sun (UV triggers flares) and monitor kidney function — lupus nephritis is a serious complication.
Immunity & Vaccines. Concept Types of Immunity
Active: body makes antibodies (infection or vaccine) — long-lasting Passive: antibodies given (maternal, immunoglobulin) — immediate but temporary Vaccine Types
Live attenuated (MMR, varicella): avoid in pregnancy & immunocompromised Inactivated / subunit: safer for immunocompromised Nursing Points
Screen for allergies (egg, prior reaction) Educate on schedule & side effects Document lot number & site NCLEX Tip Live vaccines (MMR, varicella) are contraindicated in pregnancy and in immunocompromised clients. Active immunity lasts; passive is immediate but temporary.
Clostridioides difficile. Bacterial What is Clostridioides difficile?
Bacterial colon infection, often after antibiotics. Causes severe watery diarrhea; spore-forming. What are the Causes / Risk Factors?
Recent antibiotic use (disrupts normal flora) Hospitalization Older age, immunosuppression What are the Symptoms?
Frequent watery diarrhea Abdominal cramping Fever Leukocytosis Risk of toxic megacolon How is it Diagnosed?
Stool test for C. diff toxin What is the Treatment?
CONTACT precautions + SOAP and water (alcohol gel doesn't kill spores) Oral vancomycin or fidaxomicin Stop the offending antibiotic if possible Dedicated equipment; bleach cleaning NCLEX Tip For C. difficile use contact precautions and wash hands with SOAP AND WATER — alcohol-based rubs do not kill the spores.
Multidrug-Resistant Organisms. Bacterial What is Multidrug-Resistant Organisms?
Bacteria resistant to multiple antibiotics (MRSA, VRE). Spread in healthcare settings. What are the Causes / Risk Factors?
Antibiotic overuse / misuse Incomplete antibiotic courses Healthcare exposure What are the Symptoms?
Depends on the infection site (wound, blood, urine) Colonization may be asymptomatic How is it Diagnosed?
Culture & sensitivity Surveillance screening What is the Treatment?
CONTACT precautions Appropriate antibiotics (vancomycin for MRSA; linezolid for VRE) Antibiotic stewardship Hand hygiene; complete antibiotic courses NCLEX Tip MRSA and VRE require contact precautions. Prevention hinges on antibiotic stewardship, hand hygiene, and completing prescribed courses.
Influenza. Viral What is Influenza?
Contagious viral respiratory infection. Seasonal; can be severe in high-risk groups. What are the Causes / Risk Factors?
Influenza virus (droplet spread) Close contact, crowded settings What are the Symptoms?
Sudden fever, chills Myalgia, headache Cough, sore throat Fatigue Complication: pneumonia How is it Diagnosed?
Rapid influenza test Clinical What is the Treatment?
Droplet precautions Antivirals (oseltamivir) within 48h Rest, fluids, antipyretics Annual vaccination (prevention) NCLEX Tip Antivirals like oseltamivir work best within 48 hours of symptom onset. Use droplet precautions and promote annual vaccination.
Chain of Infection & Hand Hygiene. Concept Chain of Infection
Agent → reservoir → portal of exit → transmission → portal of entry → susceptible host Break any link to stop spread Hand Hygiene (#1 measure)
Soap & water for visible soil, C. diff, norovirus Alcohol-based rub otherwise Before and after every patient contact Stages of Infection
Incubation → prodromal → illness → convalescence NCLEX Tip Hand hygiene is the single most effective way to prevent infection. Breaking any link in the chain of infection stops transmission.
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