Test 4 Immune Disorders

Question 1

1. What are the different OTC medications for seasonal allergies? What are the advantages and disadvantages of each?

Answer 1

• Drug therapy: diphenhydramine (Benadryl), pseudoephedrine hydrochloride (Sudafed)
• Fexofenadine- less sedating
- Educate to take care w/ sedating antihistamines.
• Desensitization: form of immunotherapy in which a person receives weekly or twice weekly injections of dilute

Question 2

2. What is the vaccine for HPV? What is HPV?

Answer 2

• 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

Question 3

3. Lupus client manifestations

Answer 3

• Alopecia
• Erythematous “butterfly” rash on the nose and cheeks (raised, dry, scaly)
• Late signs: Peripheral edema and renal function

Question 4

3. Lupus risk groups

Answer 4

• SLE is more common in women than in men
• Females age 15 to 45 years old
• Asian, Hispanic, or African descent
• Environmental and genetic factors
• Some medications may also trigger SLE, such as those used to treat seizures, hypertension, and infections.

Question 5

3. Lupus client education

Answer 5

• Avoid sunlight and ultraviolet radiation. Use sunscreens with a sun protection factor (SPF) of 15 or higher, and wear clothing that covers the arms and legs and a wide-brimmed hat to shade the face. Sunlamps and tanning booths are taboo.
• Fatigue is a major issue allow for adequate rest along with regular activity to promote mobility and prevent joint stiffness.
• Maintain a well-balanced diet and increase fluid intake to raise energy levels and promote tissue healing.
• Avoid crowds when possible and avoid people with known infections, such as colds.
• Periodically review the medication program with your health care providers.
• Take medications exactly as directed and do not stop the medication if symptoms are relieved.
• If symptoms become worse, do not increase the dosage unless advised to do so by the primary provider. Do not use over-the-counter drugs unless a primary provider approves their use.
• Use nonpharmacologic comfort measures. A moist form of heat may relieve joint stiffness. Use warm, not hot, soaks, wraps, or hot towels from the clothes dryer, and take care not to burn the skin.
• Wash hair with mild soaps and shampoo avoid those that have irritants.

Question 6

4. Fibromyalgia: manifestations

Answer 6

• Joint pain
• Migraines
• IBS

Question 7

4. Fibromyalgia: client education

Answer 7

• Healthy diet: dark leafy greens, banana, sweet potatoes, healthy fats, antioxidants, OMEGA-3s. Avoid: cured/red meat, fried food/artificial trans-fat, artificial sweeteners, foods high in carbs.
• Avoidance of caffeine and alcohol
• Regular exercise
• Decreased stress.
• Adequate sleep
• Some clients are advised to change or reduce their work schedules in order to improve overall health.

Question 8

5. RA: manifestations

Answer 8

• Swelling
• Redness
• Wrath
• Pain at rest or after (morning stiffness

Question 9

6. Methotrexate K,H,K

Answer 9

• Not safe for pregnancy
• No alcohol
• Neutropenic precautions: No fresh fruits and flowers, avoid large crowds.

Question 10

7. Gout: manifestations

Answer 10

• A sudden onset of acute pain and tenderness in one joint
• Skin turns red and the joint swells, so it is warm and hypersensitive to touch.
• Fever may be present.
• Tophi(nodules) may be palpated around the fingers, great toes, or earlobes, particularly if the client has chronic and severe hyperuricemia.
• The attack may last for 1 to2 weeks, but moderate swelling and tenderness may persist.
• Tight appearance in the skin

Question 11

7. Gout: causes

Answer 11

• 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.

Question 12

7. Gout: client education

Answer 12

• Stay on a low-purine diet, which includes no organ meats or shellfish.
• Limit alcohol intake
• Avoid starvation diet, aspirin & diuretics.
• Limit physical or emotional stress
• Increased fluid intake
• Practice medication adherence (don’t stop even if you feel better)
• Use stress management techniques.

Question 13

8. Allergy testing

Answer 13

• Radioallergosorbent blood test (RAST)
• Scratch or prick test, patch test, intradermal injection test, skin testing with extracts of various substances (antigens)
• Elimination diets: try to establish cause-and -effect relationships.

Question 14

8. Allergy client education.

Answer 14

• Clients w/inhalant allergies or allergic rhinitis may develop nasal polyps from the chronic inflammation
• Prone to sinus infections, secondary pulmonary infections & asthma

Question 15

9. Hydroxychloroquine K,H,K

Answer 15

• AE: blurred vision

Question 16

10. Lyme disease: stage 1

Answer 16

• Red macula or Papule @ site of bite
• Bull’s eye rash (aka erythema miavans)
• Round rings surrounding the center
• Neck stiffness
• Headaches
• Pain

Question 17

10. Lyme disease: stage 2

Answer 17

• Pruritic lesions
  • Fever
  • Chills
  • Malaise
  • Parules develops in 20-30 days after bite
  • N/V
  • Sore throat
  • Flu like symptoms

Question 18

10. Lyme disease: stage 3

Answer 18

• Arthritis
• Musculoskeletal problems
• Joints (more on knees) are warm, swollen & painful.
• Joint erosion resulting from inflammation.

Question 19

10. Lyme disease: prevention

Answer 19

• 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

Question 20

11. Allergies(Hypersensitivity): manifestations; subjective data

Answer 20

• Pruritus
• Nausea
• Uneasiness (oxygen)

Question 21

11. Allergies(Hypersensitivity): manifestations; objective data

Answer 21

• Sneezing
• Excessive nasal secretions and tearing
• Dark circles under eyes
• Inflamed nasal membranes.
• Skin rash
• Diarrhea
• Cough, wheezes, impaired breathing (priority)

Question 22

11. Allergies(Hypersensitivity): nursing considerations/preventions

Answer 22

• Remove rings from swollen fingers.
• Scheduled for diagnostic skin testing: avoid taking prescribed or over-the counter antihistamines or cold prescribed or over-the-counter antihistamines or cold preparation for at least 48 to 72 hours before testing.
• Instruct on use of EpiPen.
• Administer serial doses and monitor after desensitization.
• Client and family teaching to avoiding or reducing exposure.
• For latex allergies
- Use nonlatex gloves and nonlatex equipment.
- Avoid rubber stoppers on vials.

Question 23

12. Types of Immunity

Answer 23

• Naturally acquired active immunity occurs as a direct result of infection by a specific microorganism.
- Example: measles.

• Artificially acquired active immunity; results from administration of a killed or weakened microorganism or toxoid.
- Example: influenza.

• Passive immunity: ready-made antibodies are given to a susceptible person.
- Example: Newborns receive passive immunity to some disease for which their mothers have manufactured antibodies.

Question 24

13. Nursing Management autoimmune disorders

Answer 24

• Obtain a family history.
• Vital signs
• Examine the client for signs of localized inflammation and compromised body functions.
• Assess pharynx.
• Assess level of energy.
• Review laboratory test findings—report patterns to identify exacerbations.