Test 4 Allergies & immune disorders Flashcards
- What are the different OTC medications for seasonal allergies? What are the advantages and disadvantages of each? (ch.34 pp slide 9)
Drug therapy: diphenhydramine (Benadryl), pseudoephedrine hydrochloride (Sudafed), fexofenadine (less sedating), take care w/sedating antihistamines
Desensitization: immunotherapy, client receives weekly or twice weekly injections of dilute but increasingly higher concentration of an allergen w/out interruption
- What is the vaccine for HPV (733)? What is HPV (pg.1016)?
Gardasil
sexually transmitted infection that causes venereal warts; transmitted by genital–genital, genital–anal, or genital–oral contact with an infected person and contagious as long as the warts are present.
- Lupus manifestations
Alopecia
Butterfly rash on nose & cheecks, dry brittle skin
Later sx: peripheral edema & impaired renal function
Blurred vision, weakness
Anemia, anorexia, weight loss
Fatigue/malaise
Fever, joint pain, swelling & tenderness
Pericarditis, Raynaud’s phenomenon
Depression
- Lupus Risk groups
More common in woman than men
Females age 15-45 years old
Asian, Hispanic, or African decent
Can be caused by environmental or genetic factors
Intake of meds used for seizures, HTN & infections
- Lupus client education
Avoid sunlight & ultraviolet radiation
Use sunscreens of SPF of 15 or higher & wear clothing that covers the arms and legs along w/wide brimmed hat to shade the face (no sunlamps or tanning booths)
Allow for adequate rest periods w/regular activity to promote mobility, prevent joint stiffness & fatigue (major issue)
Maintain well-balanced diet & increase fluids to raise energy levels & promote tissue healing
Avoid crowds, people w/infections
Periodically review medication program w/providers
Take meds exactly as directed (DON’T STOP MEDS IF SX ARE RELIEVED)
If sx become worse don’t increase the dosage or used over the counter drugs unless advised by provider
Nonpharmacologic comfort measures: A moist form of heat may relieve joint stiffness (warm NOT hot soaks, wraps, towels), making sure not to burn skin
Wash hair w/mild shampoo & soaps, avoid irritants
- Fibromyalgia: manifestations, client education (ATI pg.520)
Manifestations:
All-over joint pain
Migraines, IBS
Client Education:
Limit intake of caffeine, alcohol & other substances that interfere w/sleep
Avoid: cured, red meats, fried foods/artificial trans-fat, artificial sweeteners & foods high in carbs
Some clients are advised to change or reduce their work schedules in order to improve overall health
healthy diet: dark leafy greens, bananas, sweet potatoes, healthy fats, antioxidants
Engage in regular, low impact exercise
Develop a routine for sleep
- RA: manifestations (ATI pg.425)
Swelling
Redness
Warmth
Pain at rest or after immobility (morning stiffness)
- Methotrexate K,H,K (Pharm ATI.pg.240, Pg.213)
Immunosuppressant: avoid large crowds, fresh fruits, or flowers, people w/infections
Avoid alcohol
Given for RA (cytotoxic drug)
Avoid live vaccinations(MMR, rotavirus, small pox, chicken pox, yellow fever)
Report manifestations of infection (fever, sore throat)
Can cause alopecia, renal damage, hepatotoxicity w/long term use (monitor LFT’s & kidney function tests)
- Gout manifestations
Severe joint pain (specially in metatarsophalangeal joint of the great toe)
Redness, swelling & warmth on affected joint
Painful, swollen joint that is very painful if touched or moved
Appearance of tophi (deposits of uric acid crystals)
tight appearance in skin
- Gout causes
Uric acid production that is greater than excretion of it by the kidneys
Genetics
Middle & older adult males
Secondary: caused by another disease or condition (chronic kidney failure, some carcinomas, excessive diuretic use), can affect people of any age.
- Gout client education
Stay on a low-purine diet, which includes no organ meats or shellfish.
Limit alcohol intake
Avoid starvation diets, aspirin & diuretics
Limit physical or emotional stress
Increase fluid intake
Practice medication adherence
Use stress management techniques
- Allergy testing and client education (ch.34 pp slide 8)
Diagnostic Tests:
Radioallergosorbent blood test (RAST)
Scratch or prick test, patch test, intradermal injection test, skin testing w/extracts of various substances (antigens)
Elimination diets: try to establish cause & effect relationships
Client Education:
Clients w/inhalant allergies or allergic rhinitis may develop nasal polyps from the chronic inflammation
Prone to sinus infections, secondary pulmonary infections & asthma
- Hydroxychloroquine K,H,K (pg.869)
May cause blurred vision (monitor corneal changes)
Produces immune suppression but reduces inflammation (avoid large crowds, fresh fruits, or flowers, people w/infections)
Report manifestations of infection (fever, sore throat)
Monitor for rashes (steven Johnson’s syndrome)
Not safe during pregnancy
- Lyme disease: stage 1
Red macula/papule @ site of bite
Bull’s eye rash (erythema migrans)
Round rings surrounding the center
Neck stiffness, Headaches
Pain
- Lyme disease: stage 2
Pruritic lesions
Fever, chills, malaise
Papules (develops 20-30 days after bite)
N/V
Sore throat, flu- like sx
- Lyme disease stage 3
@ least 4 weeks after bite
Arthritis
Musculoskeletal problems
Joints (mainly knees) are warm, swollen & painful
Joint erosion resulting from inflammation
- Lyme disease prevention (pg.880)
Wear light colored clothing (increases tick visibility)
Wear long sleeved shirts & long pants (tuck pants into socks or boots)
Treat clothing w/tick repellant
Wear a hat, pull long hair back so it doesn’t brush against shrubs or other vegetation
Walk in the center of a path surrounded by grass, brush or woods
Take a shower ASAP after potential exposure to ticks (tick check in hairy areas & back of the knees & neck)
Run clothes in hot dryer for 10 mins before washing them to kill any ticks left on the clothes. (remove ticks w/tweezers)
Apply antibacterial ointment to bite
- Allergies: subjective manifestations
Pruritus
Nausea
Uneasiness- oxygen
- Allergies objective manifestations
Sneezing
Excessive nasal secretions & tearing
Dark circles under eyes
Inflamed nasal membranes
Skin rash
Diarrhea
Cough, wheezes, impaired breathing
- Allergy nursing considerations/preventions
-remove rings from swollen fingers
-schedule for diagnostic skin testing: avoid taking prescribed or over the counter antihistamines or cold preparations for at least 48-72hrs before testing.
-Instruct on use of epipen
-Administer serial doses & monitor after desensitization
-Client & family teaching to avoid or reduce exposure
-Latex allergies: use non latex gloves & non latex equipment, avoid rubber stoppers on vials
- Types of Immunity (CH.34 pp slide 3)
Naturally Acquired active: occurs as a direct result of infection by a specific microorganism (measles)
Artificially acquired active: results from administration of a killed or weakened microorganism or toxoid (influenza)
Passive immunity: ready-made antibodies are given to a susceptible person (newborns receive passive immunity to some disease for which their mothers have manufactured antibodies)
- Autoimmune disorders nursing management (pp slide 15)
-Obtain fam hx & V/S
-Examine client for signs of localized inflammation & compromised body functions
-Assess pharynx & level of energy
-Review lab test findings (report patterns to identify exacerbations)
