Med 2052 Exam #1 Flashcards
Risk factors of SLE
Females between ages 20-40
African American, Asian, Native American
Incidence of lupus declines in women following menopause
S/S of SLE
Fatigue/malaise Alopecia Blurred vision Pleuritic pain Anorexia, weight loss Depression Joint pain, swelling tenderness
Pathophysiology of SLE
The body produces antibodies against components of its own cells, such as antinuclear antibody, and immune complex disease then follows.
Client w/ SLE may produce antibodies against many different tissue components: RBCs, neutrophils, platelets, WBCs, or almost any organ or tissue in the body.
Discharge teaching for client w/ SLE
Avoid UV and sun exposure. Use sunscreen when outside and exposed to sunlight.
Use mild protein shampoo, and avoid harsh hair tx.
Use steroid creams for skin rash
Report peripheral and periorbital edema promptly,
Report evidence of infection r/t immunosuppression.
Avoid crowds and individuals who are sick, because illness can precipitate an exacerbation.
Instruct clients of childbearing age regarding risks of pregnancy w/ lupus and tx medication
Define autoimmunity
The failure of an organism to recognize its own parts as self
Discuss nature of T-cells
migrate from bone marrow to thymus gland; differentiate into CD4 helper cells, CD8 suppressor cells,, cytotoxic T and memory cells
Platelet
150,000-400,000
WBC
5,000-10,000
RBC
F:4.2-5.4
M:4.7-6.1
B-cells
migrate from bone marrow to lymphoid tissue; transform into plasma cells which make antibodies and memory cells
Angioedema
Forms of urticaria in subcutaneous tissue
s/s-burning, pruritis, acute pain, respiratory distress.
Tx-antihistamines, epinephrine, corticosteroids, cold compress
List medications used to tx allergic rhinitis
antihistamines, decongestants and nasal corticosteroids
List 4 Autoimmune disorders
Pernicious anemia ulcerative colitis crohn's disease RA SLE
List the medications, including the classification, used to treat systemic lupus erythematosus
NSAIDs
Corticosteroids (prednisone)
Immunosuppressant agents-methotrexate and azathiorine (imuran)
antimalarial-hydroxychloroquine (Plaquenil)
Active-natural immunity
develops when the body produces antibodies in response to exposure to live pathogen
Active-artificial immunity
develops when a vaccine is given and the body produces antibodies in response to expose to a killed or attenuated virus
Passive-natural
occurs when antibodies are passed from the mother to the fetus/newborn through the placenta and breast milk
Passive-artificial
immunity occurs after antibodies in the form of immune globulins are administered to an individual who requires immediate protection against a disease where exposure has already occurred. After several weeks or months, the individual is no longer protected.
Two ways to reduce the risk of blood transfusion reaction
Autologous for replacement therapy (use of own blood)
Common signs of inflammation
redness, warmth, swelling, pain, and decrease function
Nursing implications prior to administering varicella
Pregnancy, allergy to gelatin and neomycin, severe allergy after previous dose, severe immunodeficiency, recent transfusion w/ antibody-containing blood products.
What should the nurse monitor in the client taking prednisone (Deltasone)?
Monitor for fluid retention, HTN, and renal dysfunction
Describe the nursing interventions for suspected transfusion reaction
If reaction occurs: stop the transfusion immediately and administer normal saline by IV.
Administer steroids and diuretics as ordered.
Return blood to the lab/blood bank for testing.
Urine to lab to check for hemolysis.
