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    《ISPN学习》总第506期
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    《ISPN学习》总第576期
    日期:2020-02-02 10:41:11    
     
    《ISPN学习》2019年12月25日总第576期
     
    May I be strenuous, energetic, and persevering.
    愿我奋发向上、勤奋不懈、不屈不挠
     
     
     
    ISPN  Review  
     
    Body Defense: Cellular Defenses and Lymphoid Tissues
    机体防御:细胞防御和淋巴组织

     
    Cellular Defenses 细胞防御
     
    Any foreign pathogen that manages to get past the barrier defenses will encounter the human inflammatory and immune systems, or mononuclear phagocyte system (MPS). Previously called the reticuloendothelial system, the MPS is composed primarily of leukocytes, lymphocytes, lymphoid tissues, and numerous chemical mediators.
     
    想设法穿过屏障防御的任何外来病原体都将遭受人炎症和免疫系统,或单核吞噬细胞系统(MPS)。MPS以前被称为网状肉皮系统,主要由白细胞、淋巴细胞、淋巴样组织和各种化学介质组成。
     
    Stem cells in the bone marrow produce two types of white blood cells or leukocytes: the lymphocytes and the myelocytes. The lymphocytes are the key components of the immune system and consist of T cells, B cells, and natural killer cells (see later discussion of the immune response). The myelocytes can develop into a number of different cell types that are important in both the basic inflammatory response and the immune response. Myelocytes include neutrophils, basophils, eosinophils, and monocytes, or macrophages (Figure 15.1).
     
    骨髓干细胞产生两种白血细胞或白细胞:淋巴细胞和髓细胞。淋巴细胞是免疫系统的关键成份,由T细胞、B细胞和天然杀伤细胞组成。髓细胞可发展为不同的细胞类型,对基础性炎症响应和免疫响应都很重要。髓细胞包括中性白细胞、嗜碱细胞嗜曙红细胞和单核细胞或巨噬细胞。
     
    Lymphoid Tissues 淋巴组织
     
    Lymphoid tissues that play an important part in the cellular defense system include the lymph nodes, spleen, thymus gland (a bipolar gland located in the middle of the chest, which becomes smaller with age), bone marrow, and lymphoid tissue throughout the respiratory and GI tracts. The bone marrow and the thymus gland are important for creation of the cellular components of the MPS. The bone marrow has a role in the differentiation of these cellular components. The thymus gland is responsible for the final differentiation of the T cells and for regulating the actions of the immune system. The lymph nodes and lymphoid tissue store concentrated populations of neutrophils, basophils, eosinophils, and lymphocytes in areas of that body that facilitate their surveillance for and destruction of foreign proteins. Other cells travel through the cardiovascular and lymph systems to search for foreign proteins or to reach the sites of injury or pathogen invasion.
     
    淋巴组织在细胞防御系统中起着重要作用。淋巴组织包括淋巴结、脾、胸腺(位于胸部中间的双相腺体,年龄增长腺体变小)、骨髓和遍及呼吸和GI道的淋巴样组织。骨髓和胸腺对MPS细胞成份的创造极为重要。骨髓在这些细胞成份的分化中发挥作用。胸腺负责T细胞的最后分化和免疫系统作用的调节。淋巴结和淋巴样组织储存浓缩的中性白细胞、嗜碱细胞、嗜曙红细胞和淋巴细胞,这些细胞位于身体可促进其异物生存和消灭的地方。其他细胞通过心血管和淋巴系统搜索异物,或到达损伤或病原体入侵部位。
     
     
    Vocabulary for Today   
     
    cellular defenses -- 细胞防御
    lymphoid – a. 淋巴样的
    encounter – v. 遭受,遭遇
    mononuclear – a. 单核的
    phagocyte – n. 吞噬细胞
    MPS – mononuclear phagocyte system单核吞噬细胞系统
    reticuloendothelial – a. 网状肉皮组织的
    leukocyte – n. 白细胞
    lymphocyte – n. 淋巴细胞
    chemical mediator –化学介质
    stem cells -- 干细胞
    myelocyte – n. 髓细胞
    natural killer cells – 天然杀伤细胞
    neutrophil – n. 中性白细胞
    basophil – n. 嗜碱细胞
    eosinophil – n. 嗜曙红细胞
    macrophages – n. 巨噬细胞
    thymus gland –胸腺
    differentiation – n. 分化
     
    Video  
     
    Breast Carcinoma
     
     
    NCLEX-RN Experience
    考试从来不易,前行者的经验可以使后来者少走不少弯路!
     
    学习讲究方法,复习也要讲究方法,除了自己的方法,别人的方法也有借鉴意义。
     
    NCLEX Tips: PASSED
    by Cecilia, BSN, RN
     
    Hello! I recently passed my NCLEX in 75 questions and would love to share how I studied, down to my studying methods.
     
    STUDY METHOD
    First and foremost, instead of studying random questions each day, I divided the topics and studied each of them for a certain amount of time. They are as follows:
    Adult Health: 3 weeks
    Pediatrics: 1 week
    Maternity: 1 week
    Pharmacology: 4 days
    Critical Care: 3 days
    Leadership: 3 days
    Mental Health: 3 days
    Review Period: 6 days
    Total: 7 weeks, 5 days
    I purchased the program uWorld to practice questions along the way and had two assessments available to use. My first assessment, prior to any studying, was a "Low Chance" of passing. My final assessment, 4 days prior to my exam, was a "Very High Chance" of passing (84th percentile).
    Prior to answering questions, I reviewed my notes to the best of my ability and would do 10 questions, then review and write the rationales, and continued that pattern until I reached about 50 to 70 questions each day.  Regarding writing rationales: if it was a topic that I did not fully understand, despite if I got the question wrong or right, I would write the rationale anyway.
    I did study about 7 to 8 hours a day, with light study days here and there. However, you may not need this many hours depending on your study method. My study method includes re-writing notes and remembering each line (doesn't need to be word for word). Because of this, studying was often slow for me, but allowed me to understand concepts well enough.
    Towards the end, I took some time to review my notes and rationales for each topic. I re-did the max amount of questions available for each topic (75 max if there were more than 76 practice questions). 4 days prior to my exam, after reviewing, I did my final assessment, and for the next 3 days, I reread whichever topics I felt uncomfortable with.
    The day prior to the exam, I spent most of the day for self-care, and spent the night re-reading the challenging topics again. The morning of, I re-read the smaller topics (Critical Care, Leadership, and Mental Health).
     
     
    Test  
     
    1. Sirolimus (Rapamune) is prescribed to a post-renal transplantation client. Upon the review of the chart, the nurse expects which of the following laboratory results?
    A. Elevated serum potassium.
    B. Decreased cholesterol level.
    C. Elevated platelet count.
    D. Elevated triglyceride level.
    2. A post-kidney transplant client went to the health care facility to ask the nurse regarding vaccinations while on Tacrolimus (Prograf) a medication used to prevent organ rejection. Which of the following is an appropriate response of the nurse?
    A. “Do not skip due doses of vaccination for this can help in your treatment”.
    B. “You can have live vaccinations even without the approval of the physician”.
    C. “Influenza can happen anytime, so a flu vaccine is a must.”
    D. “Do not receive any live vaccinations while on this treatment”.
     
     
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    答案

     
    1. Answer: D. Elevated triglyceride level.
    Sirolimus (Rapamune) raises cholesterol and triglyceride levels. This medication also causes a decrease in potassium and platelet count.
    2. Answer: D. “Do not receive any live vaccinations while on this treatment”.
    Tacrolimus may lower your body’s resistance and the vaccine may not work as well or the client may get the infection the vaccine is meant to prevent.





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