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ADULT HEALTH 1 > Exam 4-Care of Pts with Immune Function Excess > Flashcards

Exam 4-Care of Pts with Immune Function Excess Flashcards

1
Q

Hypersensitivities/Allergies

A

Increased/excessive response to presence of antigen exposure

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2
Q

Degree of rtx:

A
  • Uncomfortable: itchy watery eyes, sneezing

- Life threatening: allergy asthma, anaphylaxis, bronchoconstriction circulatory collapse

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3
Q

TYPE I: Rapid Hypersensitivity Rtx (also an atopic allergy)

A
  • Most common type
  • some rtx occur only in areas of antigen exposure
  • caused by increased production of IgE antibody class
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4
Q

TYPE I: Rapid Hypersensitivity Rtx causes

A

Inhalation: pollens, spores, animal dander, dust

Ingestion: foods, food additives, drugs

Injection: insects (bee sting), drugs

Contraction: latex, food, environmental proteins

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5
Q

TYPE I: Rapid HR -Anaphylaxis

A

blood vessel dilation, decreased cardiac output, bronchoconstriction

occurs very quickly

also known as anaphylactic reaction

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6
Q

TYPE I: Allergic Rhinitis (Hay fever)

A

triggered by airborne allergens: plant pollen, molds, dust, animal dance, wool, food, air pollutants

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7
Q

Allergic Rhinitis: Primary phase

A

allergens binds to 2 adjacent IgE molecules

Histamine is released

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8
Q

Allergic Rhinitis: Secondary Phase

A

release of other proteins, general inflammatory reaction develops

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9
Q

TYPE I PT COLLABERATIVE CARE

A
  • Hx
  • Lab assessment: increased eosinophils (normal 1%-2%), IgE, RAST
  • Allergy testing: scratch testing & intradermal testing, repeat open application testing (ROAT)
  • Oral food challenge
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10
Q

Oral food challenge

A

taking away everything and introducing one food at a time

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11
Q

scratch testing & intradermal testing

A

antihistamines & glucocorticoids discontinued for 4 wks prior to testing

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12
Q

TYPE I: Environmental changes

A
  • air conditioning, air cleaning units
  • cloth drapes
  • upholstered furniture
  • carpeting
  • change clothes when come inside to make home free of outside allergens
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13
Q

TYPE I: Pet intervention

A
  • pets that shed
  • bathe pets
  • no sleeping with pets
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14
Q

TYPE I: Drug therapy

A 
Decongestants 
Antihistamines
Corticosteroids 
Mast cell stabilizers 
Leukotriene antagonists
Complementary & Alternative therapy: Aromatherapy, Unprocessed honey 
Desensitization therapy (allergy shots)
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15
Q

Anaphylaxis

A

-1st feelings of uneasiness, apprehension, weakness, impending doom
-pruitis and urticaria
-Erythema, sometimes angioedema of eyes, lips, tongue
Tx: EpiPen
-Emergency situation
-histamine causes capillary leak, bronchochonstriction, mucosal edema, excess mucus secretion

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16
Q

Anaphylaxis s/s

A 
Congestion
Rhinorrhea
Dyspnea
Increasing Respiratory Distress 
with audible wheezing

-can be fatal
common cause: Drugs and dyes

17
Q

Anaphylaxis Inerventions

A
  • EpiPen or Twinject
  • Assess respiratory function; establish airway
  • CPR (if needed)
  • Epinephrine
  • Antihistamines (for angioedema & urticaria)
  • O2
  • Tx bronchospasm
  • IV fluids
18
Q

TYPE I: Latex

A
  • protein found in natural latex rubber products is specific allergen
  • allergen causes interaction with IgE
  • Incidence of latex allergy is increasing
  • can develop rtx later in life
  • health care workers especially susceptible
19
Q

TYPE II Cytotoxic rtx

A

body makes special autoantibodies directed against self cells that have some form of foreign protein attached to them

20
Q

TYPE II: Cytotoxic ex

A

Hemolytic anemias
Thrombocytopenic purpura
Hemolytic transfusion rtx
Goodpasture’s syndrome

21
Q

TYPE III: Immune Complex rtx

A
  • excess antigens cause immune complexes to form in blood
  • circulating complexes lodge in small blood vessels (damage of organ its going to)
  • Usual sites: kidneys, skin, joints, small blood vessels
  • Deposited complexes trigger inflammation, result in tissue or vessel damage
22
Q

TYPE III: Immune Complex Causes

A

Rheumatoid arthritis
systemic lupus erythematosus
serum sickness occur

23
Q

TYPE IV: Delayed Hypersensitivity Rtx

A
  • Reactive cell is T-lymphocyte
  • antibodies & complemnet not involved
  • Local collection of lymphocytes & macrophages cause edema, induration, ischemia, tissue damage at site
24
Q

TYPE IV: Delayed Hypersensitivity Rtx Examples

A
  • Positive purified protein:TB skin tests
  • Contact dermatitis
  • Posisn ivy skin rashes: exposure may not show until the next day
  • Insect stings: rtx the following day
  • Tissue transplant rejection
  • Sarcoidosis
25
Q

TYPE V: Stimulatory Rtx

A
  • excess stimulation of normal cell surface receptor by autoantibody
  • results in continuous “turned-on” cell state
    ex. Graves’ disease
26
Q

Autoimmunity

A
  • person develops inappropriate immune response
  • antibodies/lymphocytes directed against healthy normal cells & tissues (autoantibodies)
  • Immune system fails to recognize certain body cells/tissues as self, triggers immune rtx

Ex. SLE, scleroderma, rheumatoid arthritis

27
Q

SJOGREN’S SYNDROME

A
  • often appears with autoimmune disorders
  • insufficient tears causing inflammation/ulceration of cornea
  • no cure; intensity & progression can be slowed
28
Q

SJOGREN’S SYNDROME S/S

A

dry eyes
dry mucous membranes of nose & mouth (xerostomia)
vaginal dryness

29
Q

GOODPASTURE’S SYNDROME

A
  • autoantibodies made against glomerular basement membrane & neutrophils
  • lungs & kidneys

Tx: High-dose corticosteroids
-may require dialysis or kidney transplant

30
Q

GOODPASTURE’S SYNDROME S/S

A 
shortness of breath
hemoptysis
decreased urine output 
weight gain 
edema 
hypertension
tachycardia

ADULT HEALTH 1 (4 decks)

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