Immune Sys Dysfunction (13-15 ques, high priority)

Question 1

Juvenile Idiopathic Arthritis (JIA)

Answer 1

autoimmune disease

connective tissue w/inflammation of synovia; possilbe joint destruction

Question 2

JIA - eyes

Answer 2

assess for uveitis (inflammation)
iridocyclitis (scarring & adhesions of the iris & ciliary body) –> cataracts, loss of vision
slit lamp exam

Question 3

JIA - how treated?

- interventions?

Answer 3

anti-inflammatory
promote exercise, range of motion activities
- physicial therapy, reg activity
- splinting, positioning
allow extra time
apply warm compress, warm baths

Question 4

How children infected w/HIV?

Answer 4

> 90% are born to women w/it

<10% are adolescents w/high risk behaviors

Question 5

How prevent HIV?

Answer 5

Counseling to pregnant women

HIV testing for pregnant women

Question 6

Assessment findings for HIV/AIDS

Answer 6

chronic diarrhea
weight loss; failure to thrive
lymphadenopathy
hepatomegaly
splenomegaly
recurrent opportunistic infections
persistent oral candidiasis
progressive neurologic impairment - loss of motor milestones; language deficits

Question 7

testing babies born to HIV + moms

Answer 7

definitive exclusion of HIV infection ==> 2 or more negative tests
Impt – testing is done over time; not able to determine at birth
- 14-21 days
- 1-2 months
- 4-6 months
OR 2 negative tests from separate specimens at > 6 months

Question 8

Treatment

Answer 8

Antiretroviral drugs (ARV)– babies born to HIV+ moms - Zidovudine (AZT) prophylaxis until status is determined

• Start 6-12 hours after birth
• 4 week course if mom was on ARV
• 6 week course if not + other ARV therapy
• if status is +, change to combination ARV therapy

Question 9

Intervention

Answer 9

• prevent transmission –> moms w/HIV
• ARV therapy
• delivery type dependent on viral load
• avoid breastfeeding
• avoid pre-masticated food for baby
• minimize exposure to infections
• provide high calorie, high protein
• comfort/pain managemnt
• psychosocial support

Question 10

anticipatory guidance

Answer 10

patient/family education
- use 10% bleach in water over 1 min to kill HIV outside body
immunizations
- avoid live vaccines (rotavirus, nasal influenza)
- OK to give MMR & Varicella