[Exam 4] Chapter 47 – Alteration in Immunity or Immunologic Disorder Flashcards
Variations in Anatomy, Lymph System: What happens to lymph nodes during infection to infants?
WBCs will make their way there and enlarge the lymph nodes.
Variations in Anatomy, Lymph System: How is the thymus here?
Is enlarged at birth and remains so until 10 years of age.
Variations in Anatomy, Phagocytosis: The complement system is how in a newborn?
It contains opsonization (process of making microorganisms more susceptible to phagocytosis) and chemotaxis, and is immature
Variations in Anatomy, Cellular Immunity: When doees T cell production begin?
In early gestation. They may become sensitized to antigens that do cross the placenta.
Variations in Anatomy, Cellular Immunity: What contributes to depression in T cell function?
Viral infecction or drugs taken by the mother.
Variations in Anatomy, Cellular Immunity: Why is TB test not given to thsoe under 1?
BEcause delayed hypersenssitivity reactions are mediated by T cells rather than antibodies.
Variations in Anatomy, Humoral Immunity: How are newborns B cells here?
They do not respond well to infection. REsponse for antibody formation. IgM is gotten from mom.
Variations in Anatomy, Humoral Immunity: When does IgG production begin?
Between 2-6 months of age.
HIV Infection: What is vertical transmission?
Perinatal (in utero or during birth) transmission or via breast milk
HIV Infection: What is horizontal transmission?
TRansmission via nonsterile needles (drug use) or via intimate sexual contact.
HIV Infection: Survival has improvved to do what?
highly active antiretroviral therapy.
HIV Infection - Patho: How does this affect immune system?
Via alterations in T-Cell function, but also affects B-Cells, natural killer cells, and monocyte function.
HIV Infection - Patho: What does HIV infect?
T Helper cells. replicates itself via the CD4 cells and renders cell dysfunction.
HIV Infection - Patho: What ends up happening to T cell?
loses reponse to recall antigens, and this loss increaases chance of bacterial infection
HIV Infection - Patho: What happens to B cells?
Demonstrate impaired response to mitogens and antigens. Also exhibit lack of antibody production.
HIV Infection - Patho: What happens to natural killer cells?
Decline, leading to increased severity of viral infection in HIV - infected child.
HIV Infection - Patho: What happens to monocytes and macrophages?
Macro , exhibit decreased chemotaxis
Mono - antigen-presenting capability is defective
HIV Infection - Patho: What does this do to CNS?
Rapidly invades. Causes encephalopathy, causing microcephaly, motor deficits , or loss or previously achieved milestones occur.
HIV Infection - Therapeutic Mx: Current tx recommendation?
Use of combination antiretroviral drugs. Single drug for asymptomatic HIV newborn to combination antiretroviral drugs for highly active
HIV Infection - Therapeutic Mx: what is one of the goals of hightly activel retroviral therapy? (HAART)
Prevent or arrest progressive HIV encephalopathy
HIV Infection - Health Hx: Common signs of this?
Failure to thrive, recurrent bacterial ifnections
Chronic diarrhea
Recurrent or persistent fever
HIV Infection - Health Hx: Risk factors?
maternal hiv infections or aids, receipt of blood transfusion or sexual abuse
HIV Infection - Inspection: Note presence of what?
Fever. Also check for candidiasiss.
HIV Infection - Inspection: Measure what?
height, length, head circumference. also measure breathing work.
HIV Infection - Labs: What would be ordered?
Reverse Transcriptase - Polymerase Chain REaction: Positive in infected infant
ELISA Test: Positive in infants of HIV infected mothers
CF4 coutns (low in hiv infection)
HIV Infection - Nursing Mx: What does this include?
Avoiding infection
Promote compliance with meds
Promtoe nutrition
Provide pain management
HIV Infection - Nursing Mx, Prevenitng HIV Infection: What should children born to HIV postive mothers receive?
6-week course of zidovudine (ZDV) therapy.
HIV Infection - Nursing Mx, Promote Compliance with Antiretroviral Therapy: What does adherence to HAART prevent?
Precvents progression and prevents encephalopathy.
HIV Infection - Nursing Mx, Reducing RF Infection: What to know about live vaccines?
Do not administer live vaccines to immunocompromised child
HIV Infection - Nursing Mx, Promoting Nutrition: What should be donet o promtoe this?
Provide increased calorie formula as tolerated.
For child, provide high-calorie, high-protein meals.
Juvenile Idiopathic Arthritis: What is this?
Autoimmune disorder in which the autoantibodies mainly target the joints.
Juvenile Idiopathic Arthritis: Inflammatory changes in joints causes what?
pain, redness, warmth, stiffness, and swelling.
Juvenile Idiopathic Arthritis: When does stiffness occur?
After inactivity (morning , after sleep). May also affect eyes or organs.
Juvenile Idiopathic Arthritis: When does this become active?
They experience healthy periods then it flares up. Resolves as they get older.
Juvenile Idiopathic Arthritis: Therapeutic management focuses on what?
inflammation control, pain relief, promotion of remission, and maintenance of mobility.
Juvenile Idiopathic Arthritis: What drugs are given?
NSAIDS< corticosteroids , and antirheumatic drugs
Juvenile Idiopathic Arthritis: What helps with pain relief?
NSAIDS
Juvenile Idiopathic Arthritis: What prevents disease progression?
Disease-modifying (antirheumatic) drugs like methotrexate and etanercept
Juvenile Idiopathic Arthritis: What is prednisone used for?
To decrease infalmmatory response
Juvenile Idiopathic Arthritis, Nursing Assessment: Note history of what?
irritability or fussiness, which may be first sign
Juvenile Idiopathic Arthritis, Nursing Assessment: Document history of child doing what?
withdrawal from play or difficulty getting out of bed in the morning.
Juvenile Idiopathic Arthritis, Nursing Assessment: Inquire about history of what?
Fever above 39.5
Juvenile Idiopathic Arthritis, Nursing Assessment: Why should temperature be measured?
Fever present with systemic disease
Juvenile Idiopathic Arthritis, Nursing Assessment: How will skin appear
evanescent, pale red, nonpruritic macular rash with systemic disease
Juvenile Idiopathic Arthritis, Nursing Assessment: What to inspect at eat j oint?
Inspect and palpate each joint for edema, redness, warmth, and tenderness.
Juvenile Idiopathic Arthritis, Nursing Mx: This focuses on what?
Managing pain, maintaining mboility, and promoting a normal life
Juvenile Idiopathic Arthritis, Nursing Mx - Managing Pain: Hoow to maintain mobility?
exercise (PT or OT). Swimming is a useful activity without putting pressure on the joints.
Juvenile Idiopathic Arthritis, Nursing Mx - Promoting Normal Life: How can sleep be promoted?
By a warm bath at bedtime and warm compresses to affected joints or massage.
Juvenile Idiopathic Arthritis, Nursing Mx - Promoting Normal Life: How to prevent social isolation?
Encourage childl to attend school and ensure teachers know about disease
Juvenile Idiopathic Arthritis, Nursing Mx - Promoting Normal Life: What could help child with books?
Have two sets. One at school and one at home.
The nurse is caring for a 6-year-old with juvenile idiopathic arthritis. The mother states that she has trouble getting her daughter out of bed in the morning and believes the girl’s behavior is due to a desire to avoid going to school. What is the best advice by the nurse?
Refer the girl to a psychologist for evaluation of school phobia related to chronic illness. Administer a warm bath every morning before school. Give the child her prescribed NSAIDs 30 minutes before getting out of bed. Allow her to stay in bed some mornings if she wants.
Administer a warm bath every morning before school
A 4-month-old infant born to an HIV-infected mother is going into foster care because the mother is too ill to care for the child. The foster mother wants to know if the infant is also infected. What is the best response by the nurse?
“It’s too early to know; we have to wait until the infant has symptoms.” “Since the mother is so ill, it’s likely the child is also infected with HIV.” “The ELISA test is positive, so the child is definitely infected.” “The PCR test is positive; this indicates HIV infection, which may or may not progress to AIDS.”
“The PCR test is positive; this indicates HIV infection, which may or may not progress to AIDS.”
