Altered Immune Response: Hypersensitivity Disorders

Question 1

Altered Immune Response: Hypersensitivity Disorder

Answer 1

• Types
  > Type I - IgE mediated (allergy, angioedema, anaphylactic)
  > Type II - Cell specific (hemolytic reactions)
  > Type III - Immune Complex Mediated (autoimmune disorders)
  > Type IV - Cell Mediated (TB test, poison ivy, transplant)
• May occur simultaneously and/or sequentially

Question 2

Type I: IgE Mediated - Angioedema

patho

Answer 2

• Hypersensitivity reaction to an allergen
• Involves blood vessels, all layers of skin, mucous membranes, & subcutaneous tissues
• Most common area
  > lips, face, tongue, larynx, neck
• Cause: ingested meds
  > most common ACE-I & NSAID: greatest risk w/in first 24hrs after taking first dose, reaction can occur after days, mnths, & even yrs of therapy

Question 3

Angioedema - Collaborative Care

Answer 3

• Potential for airway obstruction due to mucosal swelling
• Anxiety due to cerebral hypoxia & threat of death

Question 4

Angioedema - Interventions

Answer 4

• Interventions Focus
  > stop reaction and ensuring an adequate airway
  > reverse angioedema before laryngeal edema forms & intubation is needed
• Maintain gas exchange
  > apply O2
• Dcr swelling
  > Epinephrine
  > Corticosteroids
  > Diphenhydramine
• Laryngeal Edema Forms
  > if intubation is not possible; emergency tracheostomy
• Antigen drug still in system; continue meds

Question 5

Type I: IgE Mediated - Anaphylaxis