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Patho II > Theory: Immune > Flashcards

Theory: Immune Flashcards

1
Q

Nursing Care

A
  • Immunization schedules
  • Education
  • Documentation
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2
Q

Medications to Relieve Reactions to Medications

A
  • Epinephrine/ Epi‐pen
  • Antihistamines‐Benadryl,Chlor‐Trimeton
  • Nasal decongestants‐sudafed
  • Glucocorticoids‐prednisone
  • Antipruritic drugs
  • Mast cell–stabilizing drugs‐Intal
  • Leukotriene receptor antagonists‐singulair
  • Desensitization
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3
Q

Anaphylaxis

A

The cardinal principle in therapeutic management is speed:
• recognizing signs and symptoms of an anaphylactic reaction
• establishing and maintaining a patent airway
• preventing spread of the allergen with the use of a tourniquet
• administering drugs, and
• performing treatment for shock

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4
Q

Anaphylaxis

A

Ensure patent airway.
Remove insect stinger if it is present.
Administer epinephrine 1 : 1000, 0.2 to 0.5 mL SC for mild symptoms; repeat at 20‐minute intervals.
Epinephrine 1 : 10,000, 0.5 mL IV at 5‐ to 10‐minute intervals for severe reaction
Administer high‐flow oxygen via non‐rebreather mask.
Place patient in recumbent position, and elevate his or her legs. Keep patient warm.
Administer diphenhydramine (Benadryl) IM or IV.
Administer histamine H2 blockers such as cimetidine.
Maintain patient’s blood pressure

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5
Q

Latex Allergy in the Workplace

A

• Use nonlatex gloves for activities that are not likely to involve contact with infectious materials (e.g., food preparation, housekeeping)
• Use powder‐free gloves with reduced protein content.
• Do not use oil‐based hand creams or lotions when wearing gloves.
• After removing gloves, wash hands with mild soap, and dry
thoroughly.
• Frequently clean work areas that are contaminated with latex‐
containing dust.
• Know the symptoms of latex allergy, including skin rash; hives;
flushing; itching; nasal, eye, or sinus symptoms; asthma; and shock.
• If symptoms of latex allergy develop, avoid direct contact with latex
gloves and products.
• Wear a medical alert bracelet, and carry an epinephrine pen.

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6
Q

Medications to Relieve Symptoms fo Autoimmune Disorders

A
  • Anti‐inflammatory medications
  • Anti‐rheumatic medications
  • Cytotoxic medications‐Imuran,methotrexate
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7
Q

Medications to Prevent Tissue Rejection

A 
• Preoperative medications
-Antibiotics
– Antiviral agents
• Postoperativemedications
– Immunosuppressive drugs 
– Corticosteroids
– Cytotoxicagents
– Monoclonalantibodies
– Antilymphocyte globulins
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8
Q

Client Teaching for Clients with Autoimmune Disorders

A
  • Stress reduction techniques
  • Good nutrition
  • Medication use and side effects
  • Remission of the disorder
  • Referrals to support groups or agencies
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9
Q

Collaborative Care

A

Monitoring HIV disease progression and immune function
Initiating and monitoring antiretroviral therapy (ART)
Preventing and detecting opportunistic infections

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10
Q

Collaborative Care

A

Preventing and treating complications of therapies
Ongoing health assessment
– Baseline data including H&P, immunization history, psychosocial and dietary evaluation

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11
Q

Collaborative Care

A

Education about spectrum of HIV, treatment, preventing transmission, improving health, and family planning
Repeating and clarification of information is necessary due to shock and denial

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12
Q

Nursing management: Nursing Assessment

A

Dependent upon the stage of the disease

  • Prevention
  • Treatment
  • Terminal phase
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13
Q

Health History

A
  • Sexually transmitted infection history
  • Surgical history
  • Medication history and allergies
  • Immunization history
  • Family history
  • Sexual history
  • Needle and blood exposure history
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14
Q

Health History

A
  • Tobacco/alcohol use history
  • Illegal drug use history
  • Pet history
  • Occupational history
  • Nutritional history
  • Gynecologic history
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15
Q

Physical Examination

A
  • Height, weight, vital signs
  • Skin
  • Head, ears, eyes, nose, and throat
  • Lymphatic system
  • Respiratory system
  • Cardiovascular system
  • Abdominal
  • Musculoskeletal
  • Neurologic
  • Genitourinary
  • Laboratory profile
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16
Q

Assessment

A

• Signs and symptoms of infection
– Most common sites are lungs, mouth, GI tract, skin, blood, and central nervous system
• Any changes should be reported to a registered nurse or physician
• Determine how much patient knows about the disease and treatment
• Assess how patient is coping with disease

17
Q

Nursing Assessment: Social Factors

A
  • Self‐esteem
  • Sexuality
  • Family interactions
  • Finances
18
Q

Nursing Management: Planning

A
  • Adhere to drug regimens
  • Promote healthy lifestyle
  • Prevent opportunistic infections
  • Prevent transmission to others
19
Q

Implementation: Drug therapy for opportunistic diseases

A
  • Delay or treat with adequate antiretroviral therapy

- Disease‐specific prevention measures

20
Q

Health Promotion: Prevention of HIV

A

Decreasing risks related to:

  • Sexual intercourse
  • Drug use
  • Perinatal transmission
  • Work
21
Q

Health Promotion: Prevention of HIV

A

Decreasing risks related to perinatal transmission

  • Prevent HIV infection in women
  • Treat HIV in pregnant women with zidovudine (ZDV, AZT, Retrovir)
  • Combination ART for the mother’s HIV infection can ↓ transmission to fetus to less than 2%
22
Q

Health Promotion: Prevention of HIV

A

Decreasing risks related to work

  • Greatest risk is through puncture wounds
  • Splash exposure of blood on skin with open lesion presents some risk, though much lower than puncture
  • Exposure to HIV‐infected fluids requires post‐exposure prophylaxis with combination ART
23
Q

HIV Testing and Counseling: Determine if client has infection

A

Negative results relieve anxieties about past behaviours and provide opportunities for prevention education
Positive results provides impetus to seek treatment and to protect sexual and drug‐using partners

24
Q

Acute Intervention

A

Early intervention promotes health and delays disability
Reactions to positive HIV test
- Life‐threatening, chronic illness
- Panic, fear, guilt, depression, denial, thoughts of suicide

25
Q

Antiretroviral Therapy

A

Adherence to drug regimens is critical to:

  • prevent disease progression
  • prevent opportunistic disease
  • viral drug resistance
26
Q

Medical Treatment: Highly Active Antiretroviral Therapy (HAART)

A

• Recommended for HIV viral load of 5000‐30,000 copies/mL and CD4 counts of 350‐500 cells/mm
• Usual drug combination: 1 protease inhibitor and 2 nucleoside reverse transcriptase inhibitors
• Ability/willingness to comply with therapy
– If patient will not be compliant with the medication regimen, better to not even start
• GI upset common; reason for noncompliance
• Many side effects; usually subside in a few weeks

27
Q

Acute Exacerbations

A

Infections, cancers, debility, and psychosocial/economic issues affect client’s ability to cope

28
Q

Social Constructs Surrounding HIV

A

Negative social attitudes label clients
Behaviours associated with HIV may be viewed as immoral and sometimes illegal
Infected individuals can transmit the virus to others

29
Q

Ambulatory and Home Care

A

Often experience anxiety, fear, diarrhea, depression peripheral neuropathy, pain, nausea, vomiting, and fatigue
Symptom management similar to other chronic illness

30
Q

Terminal Care

A

Dementia often present in final stages of HIV

- “AIDS‐dementia complex” and cognitive motor complex

31
Q

Ambulatory and Home Care

A

Nursing interventions focus on safety, self‐ care, and to help caregivers support those activities
Prevent confusion by maintaining meaningful environment, frequent reorientation, and stress reduction measures

32
Q

Ambulatory and Home Care

A

Emphasis is placed on providing support to family members and significant others who may have difficulty dealing with deterioration of mental and physical status

33
Q

Interventions

A

• Ineffective Therapeutic Regimen Management

  • Patient should receive accurate, consistent information from all members of the health care team
  • Clinical nurse specialist or other specially trained nurse can provide information about disease and treatment
34
Q

Interventions: Anxiety

A
  • Dealing with emotions of facing a life‐
    threatening illness
  • Encourage patients to ask questions and talk about their feelings
  • Information about disease and treatment may help patient and family deal with their anxiety
  • May need referral to a social worker, chaplain, or mental health counselor
35
Q

Interventions: Infection

A

Early detection and prompt treatment are vital
May be on anti‐infective drugs prophylactically
Important to take drugs as prescribed
May need intravenous antibiotics
• Clinic or home administration

36
Q

Interventions: Impaired Oral Mucous Membrane

A

Encourage regular teeth and mouth cleaning with dental floss and a soft toothbrush
Encourage fluids to maintain hydration to keep mucous membranes moist
Topical anesthetics applied before eating
Regular dental evaluations can help prevent and manage oral disease and infections

37
Q

Interventions: Imbalanced Nutrition (Less than body requirements)

A

Refer to dietitian for nutrition counseling as soon as the patient is diagnosed
Oral supplements with Carnation Instant Breakfast, Ensure, Sustacal, or Resource
Administer medications
• Improve appetite (megestrol, dronabinol)
• Relieve nausea (prochlorperazine, metoclopramide)
• Control diarrhea (diphenoxylate hydrochloride with atropine sulfate)

38
Q

Interventions: Disturbed Thought Processes

A

Patients with HIV encephalopathy may experience cognitive and motor impairment
May withdraw from social activities because of embarrassment
May become angry and hostile
Safety constantly reevaluated based on mental and physical capabilities

39
Q

Interventions: Pain

A

From opportunistic infections, viral invasion into the nerves and muscles, malignant tumors, and diagnostic procedures
Closely monitor pain level and medication use
Flow sheet of pain reports on a 10‐point scale
Pain and amount of medication used can guide nurse and physician to the appropriate type and amount of pain medication

Patho II (9 decks)

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