May I be strenuous, energetic, and persevering. 愿我奋发向上、勤奋不懈、不屈不挠
★ISPN Review ★
Cellular Defenses: Neutrophils
细胞防御：中性白细胞
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.
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.
Neutrophils are polymorphonuclear leukocytes that are capable of moving outside of the blood stream (diapedesis) and engulfing and digesting foreign material (phagocytosis). When the body is injured or invaded by a pathogen, neutrophils are rapidly produced and move to the site of the insult to attack the foreign substance. Because neutrophils are able to engulf and digest foreign material, they are called phagocytes.
中性白细胞是多形核白细胞，可离开血流（血细胞渗出），吞噬和消化异物（吞噬作用）。当身体受伤或被病原体侵入时，中性白细胞迅速产生，移动到损伤部位，攻击异物。因为中性白细胞能够吞噬和消化异物，他们又被称为吞噬细胞。
Phagocytes are able to identify non–self-cells by use of the MHC, and they can engulf these cells or mark them for destruction by cytotoxic T lymphocytes.
Preparing for the NCLEX can be a challenging task! One of the questions many new graduates ask about their NCLEX prep is: How long do I need to study for the NCLEX? Recommended study times may vary depending upon the level of preparation needed and can range anywhere from 4 – 8 weeks. This article will provide a four-week strategy for how to study for the NCLEX in 30 days! Week 1: Developing a Road Map (Study Plan)
First things first. You won’t know where you’re going without a road map. This week, spend 2-4 hours developing a study schedule. You can use a blank sheet of paper with thirty boxes or a digital or paper planner. If you already keep a personal calendar, consider integrating your study schedule with the system you already use. First, select an NCLEX Test Date and write it on your calendar. You can always change this later, but having a date to work towards will help guide your studying. Once your test date is set, work on scheduling practice tests, along with review and remediation times for filling in for the remaining dates leading up to test day.
The secret to NCLEX success is question exposure. Taking, reviewing and remediating as many test questions as possible is KEY! Plan to pull together practice question resources that will expose you to a minimum of 3500 questions. That might seem like a lot of questions. And it is! But the key to NCLEX success is answering questions, not studying content. There will be a time in your study when you will need to review previously learned content. For now, though, the goal is to get through as many questions as possible. For example: 3500 questions/28 days = at least 125 questions per day. Set a regular schedule to answer 63 questions in the morning and 63 questions in the evening. Follow each testing session with a review and remediation period of ALL the questions, not just the questions answered incorrectly. It is important to review all questions in order to ensure that you clearly understood why the correct answer was right and that it wasn’t just a lucky guess. Weeks 2 & 3: Working Your Action Plan for NCLEX Success
Continue to work through practice questions, taking breaks after each testing session. Review and remediate the previous practice set PRIOR to taking the next practice set. Remediation is just as important, if not more important, than answering questions. This phase of NCLEX prep will not only help you understand your test taking style but also reinforce less familiar content. Having this content refresher may assist you in selecting correct responses on future practice questions, especially if you are able to gain a clear understanding of why you responded to or answered a question the way that you did. Week 4: Countdown to the NCLEX
As test day approaches, your anxiety may begin to rise. Self-regulation techniques, such as mindfulness techniques (meditation, yoga, reciting positive affirmations) and exercise can help improve your focus and stamina while reducing anxiety. Negative self-talk may also cause a loss of focus and create additional stress. Here are a few stress relievers to get you through this last week:
Make sure you take regular breaks throughout study periods
Keep healthy snacks on hand
Stay hydrated. Drink lots of water, and low or no caffeine!
Go for brisk walks. Exercise will help allay anxiety and promote relaxation
Get adequate sleep. Plan your schedule so that you are getting at least 7-8 hours of sleep
(By Kaplan)
★Test ★
1. A nurse is evaluating a client who is HIV positive who is prescribed with Pentamidine (Pentam) IV for the treatment of Pneumocystis carinii pneumonia. Which of the following assessment after the administration is the most important to relay to the physician?
A. Blood pressure of 100/62 mm/Hg.
B. Redness and pain at the site of the infusion.
C. Sudden sweating and hunger.
D. Unusual taste or dryness in the mouth. 2. A client is prescribed with Pentamidine (Pentam) IV for the treatment of Pneumocystis carinii pneumonia. Suddenly, the client develops a temperature of 101.5°F. The nurse in charge knows that this sign would mostly indicate on which of the following?
A. An overdosage of the medication.
B. The need for an additional dosage.
C. The client has developed another infection.
D. The client is experiencing the therapeutic effect of the medication.
答案 Answers
1. Answer: C. Sudden sweating and hunger.
Pentamidine can cause fatal hypoglycemia, so symptoms such as sudden sweating and hunger are indicative of a low blood sugar indicates a need for change in the treatment. 2. Answer: C. The client has developed another infection.
Pentamidine can cause low white blood cells or low platelets in your blood, so the client is most likely developed another infection brought about these side effects.
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