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ADN005 Pediatrics > Week 2 Chapter 47 > Flashcards

Week 2 Chapter 47 Flashcards

1
Q

Antibodies are received from an external source

A

Passive
ex: mother to baby IVIG

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2
Q

Antibodies produced by native T Lymphocytes

A

Cellular

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3
Q

Antibodies produced by native B cell lymphocytes

A

Humoral

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4
Q

B Lymphocytes
Secrete antibodies to viruses and bacteria
Recognize antigens
Antibodies mark the antigen for destruction
NOT destroy foreign cell
Crosses the placenta in IgG

A

Humoral

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5
Q

T cells
Does not recognize antigens
Direct and regulate immune response
Attack infected or foreign cells
NOT cross the placenta

A

Cellular Immunity

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6
Q

GAE

A

Can’t bind to B lymphocytes

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7
Q

MD

A

Bind to b lymphocytes

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8
Q

1st antibodies secreted by B lymphocytes after infection

A

IgM

Close to adult level by age 1

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9
Q

IgD

A

Produced in small quantities

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10
Q

IgG

A

Most abundant and effective in fighting infections

50% age 1
100% age 7

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11
Q

Newborn exhibits

A

Decreased inflammatory response and phagocytic responses to invading organisms
Increased chance of infection
A functional spleen
Functional cellular immunity

Humoral develops over time
- Young children have large lymph nodes, tonsils, and thymus compared to adults

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12
Q

Health Hx for Immunologic Disorders

A

Maternal HIV infections
Frequent, recurrent infections
Chronic cough
Recurrent low grade fever
Two or more serious infections in early childhood
Recurrent deep skin or organ abscesses
Persistent thrush in the mouth
Extensive eczema
Growth Failure

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13
Q

Immunosuppressants
Cytotoxic Medications
Plasmapheresis
IV immunoglobulins IVIG
Antibiotics
DMARDs
Antiviral Meds
Immunizations
Bone Marrow and Stem Cell transplantation

A

Common Medications and Medical Treatments in Immune Disorders

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14
Q

Peripheral stem cells are removed from the donor via apheresis or stem cells are retrieved from the umbilical cord and placenta. Stem cells are then transplanted as an infusion into the recipient

A

Stem Cell Transplant

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15
Q

Transfer of healthy donor bone marrow cells into the veins of the recipient. Cells will ultimately migrate and grow in the bone marrow and recipient to restore immune functions

A

Bone Marrow Transplant

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16
Q

Most are hereditary or congenital

Humoral deficiencies
Cellular immunity
Combination of humoral and cellular immunity deficiencies
Phagocytic system defects
Complement Deficiencies

A

Primary Immunodeficiencies

17
Q

10 Warning Signs of Primary Immunodeficiency

A

4 or more new episodes of acute otitis media in 1 year
2 or more episodes of severe sinusitis
Tx c Abx for 2 months or longer with little effect
2 or more episodes of pneumonia in 1 year
Failure to thrive in infant
Recurrent deep skin organ abscess
Persistent oral thrush or skin candidiasis after 1 year of age
Two or more serious infections
Family Hx of primary immunodeficiency

18
Q

Wiskott Aldrich Syndrome

A

X linked genetic disorder affects males only

Nursing Assessment
- Hx of petechiae
- Bloody diarrhea
- Hx of hematemesis or intracranial or conjunctival hemorrhages
- Eczema
- Low IgM, elevated IgA and IgE and normal IgG

Therapeutic Management
IVIG, steroids, splenectomy to correct thrombocytopenia, stem cell transplant

19
Q

SCID

A

Rare X linked Autosomal Recessive Disorder
Absent T cell and B cell function

Nursing Assessment

Chronic Diarrhea
Failure to thrive
Hx of severe infections in infancy
Persistent Thrush
Adventitious Sounds

Therapeutic Management
-IVIG infusions to decrease infections until stem cell transplant

20
Q

Causes of Secondary Immunodeficiency

A

Chronic illness
Malignancy and chemotherapy
Use of immunosuppressives
Malnutrition or protein losing state
Prematurity
HIV infection

21
Q

S/S of HIV infection in children

A

Failure to thrive
Recurrent bacterial infections
Opportunistic Infections
Chronic or recurrent diarrhea
Recurrent or persistent fever
Developmental delay
Prolonged candidiasis

22
Q

Lab and Diagnostic Testing for HIV infection

A

PCR
- Tests HIV genetic material
+ in infected infants month or older

ELISA
Tests for antibodies to HIV
Less accurate than PCR

Platelet less than 30 requires Tx

CD4 and ANC
-Low in HIV infection

23
Q

Goals of Nursing care of the child with HIV infection or other chronic immune disorder

A

Avoiding infection
Promoting compliance with medication regimen
Promoting nutrition
Providing pain management and comfort measures
Educating the child and caregivers
Providing ongoing psychosocial support

24
Q

Stressors involved with Diagnosis of HIV infection in Children

A

Diagnosis of an incurable disease
Financial difficulties
Multiple family members with HIV
HIV associated stigmas
Desire to keep HIV infection confidential
Multiple medical appointments and hospitalizations

25
Q

Family Education for the child with HIV

A

Medication Regimen
Ongoing follow up
When to call provider
Stress reduction
HIV education

26
Q

Influencing Factors for Autoimmune Disease

A

Heredity
Hormones
Self Marker Molecules
Environmental Influences
- Viruses
- Certain Drugs

27
Q

SLE

A

Multisystem autoimmune disorder affects humoral and cellular immunity with periods of exacerbation and remissions
- Rarely diagnosed before age 9 years

Causes inflammatory response resulting in vasculitis

28
Q

Complications of SLE

A

Ocular or visual changes
CVA, transverse myelitis, pericarditis, CAD, valvular heart disease, seizures

29
Q

Therapeutic Management of SLE

A

NSAIDs, corticosteroids, antimalarial agents, dialysis if ESRD occurs

30
Q

Most common clinical manifestations of SLE

A

Alpocecia
Anemia
Arthritis
Fatigue
Lupus Nephritis
Photosensitivity
Pleurisy
Raynaud Phenomena
Seizures
Skin rashes
Thrombocytopenia

31
Q

Common Lab and Diagnostic Tests for SLE

A

CBC
Platelet Count
WBC
Complement Levels
ANA titer

32
Q

Pauciarticular

A

Involvement of 4 or fewer joints; quite often the knee is involved

Non joint manifestations: Eye inflammation, malaise, poor appetite, poor weight gain

Complications: Iritis, uneven leg bone growth

33
Q

Polyarticular

A

Involvement 5 or more joints; frequently involves small joints and often affects the body symmetrically

Non joint manifestations: Malaise, lymphadenopathy, organomegaly, poor growth

Complications: Severe form of arthritis, rapid joint progression damage

34
Q

Systemic

A

Addition to joint involvement, fever, and rash may be present at diagnosis

Non joint manifestations: Enlarged spleen, liver, lymph nodes, myalgia, severe anemia

Complications: Pericarditis, pericardial effusion, pulmonary fibrosis

35
Q

Allergy

A

Immune mediated response resulting in an adverse physiologic event or reaction

Affects up to 25% of population in developed countries

Extent and response determined by the duration, rate, and amount of exposure to allergen

Anaphylaxis - Food, drug, and insect stings most common

36
Q

Antibody exposed to antigen (allergen) then?

A

Rapid cell activation (mediators and cytokines)

then
Changes in blood vessels, bronchi, and mucous secreting glands

37
Q

Therapeutic Management of Anaphylaxis

A

Antihistamine
Epinephrine
Albuterol
IV Fluids

38
Q

Common Food Allergens to Avoid in Children Younger than 1 Year

A

Cow’s Milk
Eggs
Peanuts
Tree nuts
Fish and Shellfish
Wheat
Soy

ADN005 Pediatrics (21 decks)

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