Handout 1

• Normal Values


  • Bleeding time (1-9 min)
  • Prothrombin time (10-13 sec)
  • Hematocrit (Male: 42-52%, Female: 36-48%)
  • Hemoglobin (Male: 13.5-16 g/dl, Female: 12-14 g/dl)
  • Platelet (150,000- 400,000)
  • RBC (Male: 4.5-6.2 million/L, Female: 4.2-5.4 million/L)
  • Amylase (80-180 IU/L)
  • Bilirubin (direct: 0-0.4 mg/dl, indirect: 0.2-0.8 mg/dl, total: 0.3-1.0 mg/dl)
  • pH (7.35- 7.45)
  • PaCo2 (35-45)
  • HCO3 (22-26 mEq/L)
  • Pa O2 (80-100 mmHg)
  • SaO2 (94-100%)
  • Sodium (135- 145 mEq/L)
  • Potassium (3.5- 5.0 mEq/L)
  • Calcium (4.2- 5.5 mg/dl)
  • Chloride (98-108 mEq/L)
  • Magnesium (1.5-2.5 mg/dl)
  • BUN (10-20 mg/dl)
  • Creatinine (0.4- 1.2)
  • CPK-MB (Male: 50 –325 mu/ml, Female: 50-250 mu/ml)
  • Fibrinogen (200-400 mg/dl)
  • ESR (Male: 15-20 mm/hr, Female: 20-30 mm/hr)
  • Glycosylated Hgb (HbA1c) (4.0-7.0%)
  • Uric Acid (2.5 –8 mg/dl)
  • Cholesterol (150- 200 mg/dl)
  • Triglyceride (140-200 mg/dl)
  • Lactic Dehydrogenase (100-225 mu/ml)
  • Alkaline phospokinase (32-92 U/L)
  • Albumin (3.2- 5.5 mg/dl)
  • FBS (80-120 mg/dl)
• Nursing


  The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health, its recovery, or to a peaceful death. The client will perform these activities unaided if he had the necessary strength, will or knowledge. Nurses help the client gain independence as rapidly as possible.
• The earliest hospitals established in the Philippines were:
• Prominent persons involved in nursing works during the Philippine Revolution included:
• Some of the early nursing schools established in the Philippines were:
• The first colleges of nursing in the Philippines were:
• Basic Human Needs


  • Physiologic (oxygen, fluids, nutrition, body temperature, elimination, rest and sleep, sex)
  • Safety and Security (physical, psychological, shelter, freedom from harm and danger)
  • Love and Belonging (to love and be loved, care and be cared for, affection, meaningful relationships)
  • Self-Esteem (self-worth, self-identity, self-respect, body image)
  • Self-Actualization (learn, create, understand, harmonious relationships, beauty, spiritual fulfillment)
• Characteristics of Basic Human Needs:
• Immunity


  The body's specific protective response to a foreign agent or organism
• Barriers that help prevent invasion of pathogens

  • Anatomical barriers (e.g. skin)
  • Physiological barriers (e.g. enzymes in saliva)
  • Normal flora of microorganisms
• Immune memory


  A property of the immune system that provides protection against harmful microbial agents despite the timing of re-exposure to the agent
• Major components of the immune system

  • Central and peripheral organs
  • Tissues
  • Cells

  
• Bone Marrow


  • Where white blood cells (WBCs) involved in immunity are produced
  • Lymphocytes are generated from stem cells
• Types of lymphocytes


  • B lymphocytes (B cells)
  • T lymphocytes (T cells)
• Lymphoid Tissues


  • Remove foreign material from the lymph system before it enters the bloodstream
  • Serve as centers for immune cell proliferation
• Basic function of the immune system

  To remove foreign antigens such as viruses and bacteria to maintain homeostasis
• Natural (innate) immunity


  Non-specific immunity present at birth that provides a broad spectrum of defense against and resistance to infection

  
• Cells involved in natural immunity

  • Monocytes
  • Macrophages
  • Dendritic cells
  • Natural killer (NK) cells
  • Basophils
  • Eosinophils
  • Granulocytes
• Granulocytes


  Leukocytes that fight invasion by foreign bodies or toxins by releasing cell mediators and engulfing them
• Types of granulocytes


  • Neutrophils (polymorphonuclear leukocytes [PMNs])
  • Eosinophils
  • Basophils
• Monocytes/Macrophages


  Nongranular leukocytes that function as phagocytic cells, engulfing, ingesting, and destroying greater numbers and quantities of foreign bodies or toxins than granulocytes
• Inflammatory response


  A major function of the natural immune system that is elicited in response to tissue injury or invading organisms
• Chemical mediators that assist the inflammatory response

  • Minimize blood loss
  • Wall off the invading organism
  • Activate phagocytes
  • Promote formation of fibrous scar tissue and regeneration of injured tissue
• Physical barriers


  • Intact skin
  • Mucous membranes
  • Cilia of the respiratory tract
• Cilia of the respiratory tract


  Filter and clear pathogens from the upper respiratory tract before they can invade the body further
• Chemical barriers


  • Mucus
  • Acidic gastric secretions
  • Enzymes in tears and saliva
  • Substances in sebaceous and sweat secretions
• Immune regulation


  • A successful immune response eliminates the responsible antigen
  • If an immune response fails to develop and clear an antigen sufficiently, the host is considered to be immunocompromised or immunodeficient
  • Autoimmune - recognition of one's own tissues as "foreign" rather than as self

  
• Acquired (adaptive) immunity


  Specific immunity that develops after birth, usually as a result of prior exposure to an antigen through immunization or by contracting a disease
• Mechanisms of acquired immunity

  • Cell-mediated response, involving T-cell activation
  • Effector mechanisms, involving B-cell maturation and production of antibodies
• Phagocytic immune response


  • The first line of defense, primarily involves WBCs (granulocytes and macrophages) that have the ability to ingest foreign particles and destroy the invading agent
  • Phagocytes also remove the body's own dying or dead cells
• Humoral or antibody immune response

  • The second protective response, begins with B lymphocytes that can transform into plasma cells that manufacture antibodies
  • Antibodies are highly specific proteins transported in the bloodstream that attempt to disable invaders

  
• Cellular immune response


  The third mechanism of defense, involves T lymphocytes that can turn into special cytotoxic (or killer) T cells that can attack the pathogens

  
• Antigen


  The structural part of the invading or attacking organism that is responsible for stimulating antibody production
• Recognition stage


  • Use of lymph nodes and lymphocytes for surveillance
  • Lymphocytes patrol tissues and vessels and recognize antigens on microbes as different (non-self) and antigenic (foreign)

  
• Proliferation stage


  • Circulating lymphocytes containing the antigenic message return to the nearest lymph node and stimulate some of the resident T and B lymphocytes to enlarge, divide, and proliferate
  • T lymphocytes differentiate into cytotoxic (or killer) T cells, whereas B lymphocytes produce and release antibodies

  
• Response stage


  • Production of antibodies by B lymphocytes in response to a specific antigen
  • Cellular response stimulates resident lymphocytes to become cytotoxic (killer) T cells that attack microbes directly
• Effector stage


  The antibody of the humoral response or the cytotoxic (killer) T cell of the cellular response reaches and connects with the antigen on the surface of the foreign invader, initiating activities involving interplay of antibodies, complement, and action by the cytotoxic T cells
• Functions of humoral immune response (B cells)

  • Bacterial phagocytosis and lysis
  • Anaphylaxis
  • Allergic hay fever and asthma
  • Immune complex disease
• Functions of cellular immune response (T cells)

  • Bacterial and some viral infections
  • Transplant rejection
  • Delayed hypersensitivity (tuberculin reaction)
  • Graft-versus-host disease
  • Tumor surveillance or destruction
  • Intracellular infections
  • Viral, fungal, and parasitic infections
• Types of immunoglobulins


  • IgG
  • IgA
  • IgM
  • IgD
  • IgE