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Pediatric Nursing Care > Chapter 42: The Child with an Immunologic Alteration > Flashcards

Chapter 42: The Child with an Immunologic Alteration Flashcards

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1
Q

Why does HIV have a more rapid disease progression in infants than teenagers?

A

Infants have naturally decreased or immature immune systems to begin with.

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2
Q

Diagnosis of HIV in children uses the tests __________ and ___________.

A

HIV DNA PCR
HIV RNA Assay

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3
Q

_____________________ disorders occur when the body’s immune system can no longer differentiate its own cells from antigens.

A

Autoimmune

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4
Q

Treatment goal of Systemic Lupus Erythematosus (SLE)

A

prevent organ damage

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5
Q

____________ infants have longer immunity

A

Breastfed

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6
Q

Sneezing; tightness, tingling of mouth or face with subsequent swelling of lips and tongue; severe flushing, urticaria, and itching (especially head and upper trunk); rapid development of erythema; and a sense of impending doom are manifestations of _____________.

A

initial anaphylaxis

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7
Q

The newborn receives __________ by placental transfer, which disappears by _____________

A

IgG, 6-8 weeks

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8
Q

Classic sign of SLE

A

butterfly rash

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9
Q

The spleen reaches its full size at _________________

A

adulthood

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10
Q

___________ help build the immune system

A

Vaccines

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11
Q

When is oral ZDV given to infants

A

within first 6-12 hours after birth until 6 weeks old or positive HIV diagnosis

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12
Q

What is required for HIV to be considered negative in children?

A

2 negatives on 2 different occasions at 1 month and 4 months

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13
Q

Lymphoid tissue (increases, decreases) in males during __________ and ____________

A

increases, infancy, childhood

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14
Q

Treatment given to the mother during labor for HIV-exposed infants

A

IV ARV

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15
Q

Diagnosis for SLE involves this test

A

positive ANA assay

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16
Q

Type II hypersensitivity also known as

A

cytotoxic hypersensitivity

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17
Q

An acquired cell-mediated immunodeficiency disorder that is chronic and causes a widespread spectrum of illnesses in children

A

HIV

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18
Q

Why is CD4 direct count not monitored in children?

A

CD4 count can vary greatly based on age

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19
Q

Allergic rhinitis, acute anaphylaxis, hives, eczema, and asthma are examples of __________ hypersensitivity

A

Type I (immediate, anaphylactic)

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20
Q

Most likely method of HIV transmission in adolescents

A

sexual transmission or illegal drug use (due to high risk behaviors)

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21
Q

Type III hypersensitivity also known as

A

arthrus hypersensitivity (immune complex)

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22
Q

Other causes of anaphylaxis in children

A

medication, insect stings

23
Q

What therapy is initiated after an infant receives a positive HIV diagnosis

A

antiretroviral (ARV) therapy

24
Q

Children have ____________ capacity to mount an antibody response

A

limited

25
Q

Recurrent upper respiratory infections and ear infections are common with this disorder

A

HIV

26
Q

Immunologic alterations are usually ________________ with intervals of ___________ and ____________

A

chronic, wellness, relapses

27
Q

This type of therapy acts as natural products of the adrenal glands and reduces systemic inflammatory symptoms

A

corticosteroid therapy

28
Q

Preferred method of birth for HIV positive mothers

A

Cesarean section

29
Q

Chemotherapy drug that decreases immune response and is also used for SLE

A

cyclophosphamide

30
Q

The number of Peyer patches (increases, decreases) until __________________

A

increases, adolescence

31
Q

Type I hypersensitivity also known as

A

immediate (anaphylactic) hypersensitivity

32
Q

Diagnosis of SLE requires _______ or more of the manifestations to be present.

A

4

33
Q

For treatment of anaphylactic shock, ensure an adequate ___________ and __________ if necessary. Administer _________________, _____________, ______________, and/or _____________ as ordered. Keep the child (warm, cold) and lying ______ or with feet ________________. Start an ____________.

A

airway, intubate
epinephrine, oxygen, corticosteroids, antihistamines
warm, flat, slightly elevated
IV line

34
Q

The thymus gland is fully functional until ____________, when it begins to __________ and is ultimately replaced by _________________________

A

puberty, shrink, fatty tissue

35
Q

Encourage to have low ________ and low ___________ diet to preserve renal function (in SLE that affects kidneys)

A

sodium, protein

36
Q

Serum sickness and glomerulonephritis are examples of _________ hypersensitivity

A

Type III (arthrus, immune complex)

37
Q

Long-term use of ___________________ results in adrenal suppression

A

corticosteroids

38
Q

Treatment given to HIV-exposed infants after birth

A

oral ZDV

39
Q

Transfusion reaction after receiving incompatible blood is an example of _________ hypersensitivity

A

Type II (cytotoxic)

40
Q

Contact dermatitis (such as from poison ivy) is an example of ________ hypersensitivity

A

Type IV (delayed cell-mediated)

41
Q

Why is the western blot assay inaccurate under 18 months?

A

Mother’s antibodies are still present

42
Q

A common autoimmune disorder that results in connective tissue inflammation

A

Systemic Lupus Erythematosus (SLE)

43
Q

What is required for a positive diagnosis of HIV in children?

A

2 positive tests on 2 different occasions

44
Q

(Increased/Diminished) immune response allows for spread of ___________

A

Diminished, infection

45
Q

Most common cause of anaphylaxis in children

A

food allergies

46
Q

To be diagnosed with adrenal suppression, the patient is administered _______, and the _______________ level does not elevate as it should.

A

ACTH, serum cortisol

47
Q

Type IV hypersensitivity also known as

A

delayed cell-mediated hypersensitivity

48
Q

Amount of HIV virus detected in bloodstream

A

viral load/burden

49
Q

Most likely method of HIV transmission in infants

A

mother to infant across placenta or during childbirth

50
Q

More severe complications include osteoporosis, amenorrhea, cataracts, and pancreatitis

A

corticosteroid therapy

51
Q

Short-term use of _____________________ can shorten the span of illness and improve patient wellbeing

A

corticosteroids

52
Q

Instead of CD4 direct count, what levels should be monitored in children with HIV?

A

CD4 percentage

53
Q

Manifestations include edema, GI upset, bruising, increased infection, increased appetite and weight, muscle atrophy, hypertension, and growth limitations.

A

corticosteroid therapy

Pediatric Nursing Care (17 decks)

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