Mod 6 Immunity

Nursing Actions for Skin allergy Testing:

(Back/Inner forearms) intradermal Prepare skin w/ soap and water Can have an anaphylactic reaction

Anaphylactic Reaction: Diagnosis

-Acute onset of illness -Life-threastening airway and/or breathing problems -Usually skin changes

Leukocytosis

-High WBC Steroids Inflammation Malignancies Infections

G2

-Tumor cells are moderately differentiated

G4

-Tumor cells are poorly differentiated and determination of the tissue of origin is difficult.

G3

-Tumor cells are poorly differentiated but the tissue of origin can be established

G1

-Tumor cells are well differentiated

Normal WBC count

5,000-10,000

New Development of Moles w/ Cancer

ABCDE

Mammogram

Annually for females 45-55 every 2 years after 55

SLE Classifications

DLE-Skin Systemic-Whole body Medication-induced-Medication causes (Hydralazine, Alpurinol)

HIV Patient Centered Care/Education

Daily weight Monitor daily intake Assessing lungs Checking skin integrity Onset of confusion Education: Neutropenic precautions-crowd, fresh veggies and fruit, undercooked meat,

Type 4 hypersensitivity reaction

Delayed or Cell-mediated -Chronic graft rejections PPD Test Latex Nickel Poision ivey

Breast Exam

Every 3 years (20-39) Annually over 40

Pap smear

Every 3 years 21-29 Every 5 years 40-65

SIADH

Excessive ADH secretions Fluid retention Low serum osmolarity Hypercalcemia (8.5-10.5)

Acute HIV

Flu-like symptoms that occur days to weeks contracting HIV

Gx-

Grade cannot be determined

HIV/AIDS

HIV-Retrovirus that is transmitted through blood and bodily fluids Viral load is how fast the virus is replicating Lymphadenopathy-persists throughout the disease process

Hypersensitivity Reactions Type 1

IgE mediated- allergic or immediate hypersensitivity, allergens such as -Bee Stings -Latex -Certain medications -Peanut butter

Hypersensitivtiy Type 2 Reaction

IgG and IgM -Cytotxic/Antibody mediated Caused by: -Hemolytic Reactions -Goodpasture syndrome -Hyperacute graft rejection

Type 3 Hypersensitivty Reaction

IgG/IgM -Immune Complex Caused by: -Hypersensitivtiy pneumonitis -Systemic lupus erythematosus -Polyarteritisnodosa -Serum sickness

Left Shift

Immature Neutrophils building up -Occurs with an acute infection

Complications of Cancer

Immunosuppression/Neutropenia Risk for serious infections when ANC is less than 1000 Neutropenic precautions

Tumor Grading

Is needed because some cancer cells are more malignant than others. Well differentiated means the cells look much like normal cells and tend to grow slowly Undifferentiated-or Poorly differentiated, means the cells do not look like normal cells and tend to grow quickly and spread

Chronic HIV

Known as the latent or asymptomatic stage; can last for several years

Treatment for Hypercalcemia

Lasix

Wasting Syndrome

Loosing weight very quickly Skin Integrity High Caloric intake and protein Woory about adherence

Leukopneia

Low WBC count -caused by: Drug toxicity Autoimmune issues Cancers

SLE Complications

Lupus Nephritis Pericarditis and myocarditis Increased inflammation with any organ in the body. Raynaud's Phenomenon White due to lack of blood flow (fingers) Blue lack of oxygen Red when blood flow returns

SVC Manifestations

Manifestations Periorbital and facial edema Erythema of the upper body Dypsnea Epistaxis

SIADH Symptoms

N/V Kidney stones/Constipation Bone pain Changes in mental status

Symptoms of Cancer treatment

Nausea Alopecia Hypersensitivity Oral effects: Mucositis Stomatitis

AIDS

Occurs when CD4 count falls below 200cells/mm3 Makes person vulnerable to opportunistic infections and AIDS-defining conditions

AIDS Manifestations

Oppurtunistic Infections Candidiasis Herpes Complex HIV-related encephalopathy Seizures DIC Kaposi's Sarcoma Pneumocystis Jirovecii PNA

SLE Patient Centered Care

Pain Mobility Fatigue ALT+AST monitoring Vital signs (Hypertension) Systemic Manifestaions Rhinostentesis Medications NSAIDS Corticosteroids Immunosuppressant agents

HIV is diagnosed by

Positive Eliza Confirm with Western Blot test Test viral load Check for CD4 counts Check brain MRI scan Identify the spread of virus Check chest x-ray KEY: Check viral load before beginning treatment because you want to knwo if the patient is compliant.

Fecal Blood test

Prostate screening annually for over 70 Screening gene mutations

The nurse working in the emergency department is asked to explain allergy testing to a client who experienced an allergic reaction to an unknown allergen. Which test indicates the quantity of allergen necessary to evoke an allergic reaction?

RAST

Neutropenia precautions:

Restricting Visitors Prohibiting visits by people who have an infection Restrcting exposure to live (cut or potted) plants Restricting ingestion of fresh fruits and vegetables

Superior Vena Cava Syndrome

Results from obstruction of venous return and enlargement of vessels from the head and upper body

SLE Lab Tests:

Skin Biopsy ANA-(+) C3,C4-Decreased ESR (+) CBC Renal fx

Health Promotion and Disease prevention of Cancer

Smoking Sedentary lifestyle Sun screen (Above 30) Maintaining healthy body Eliminating sugars and alcohol Avoid needle sharing Limiting drug use Breastfeed (for 6 months)

Prior to testing education/Questions:

Ask client about previous reactions to allergens Ask the client about medications taken over the past several days Inform the client to expect itching at the one site Obtain emergency resuscitation equipment

Colonoscopy

At age 50 then every 10 years

SLE: Systemic LUPUS Erthmatosus

Atypical immune response results in chronic inflammation and destruction of healthy tissues. Small intestines can bond with healthy tissues, body produces antibodies that attack the healthy tissue. Can be triggered by toxins, medications, bacteria, and viruses.

SLE Manifestations

Butterfly rash Pneumonia Pleuritis Pulmenorary hemorrhage/emboli Athersclerosis Fever Headache Fatigue Blood in urine Anemia Hypertension Joint aches

STG 2 HIV

CD4 Count 200-499

STG 1 HIV

CD4 Count 500 or more

Anaphylactic Reaction: Nursing actions

Call for help Lie patient flat Raise patients legs -Establish airway -High flow oxygen -IV fluid challenge

Neutropenia

WBC-Less than 2,000 Fight off infection MONITOR for CANCER pts

T0

no evidence of tumor

Tis

tumor in situ

Tx

unable to evaluate the primary tumor

Tumorlysis Syndrome Treatment

Treatment: Fluids Allopurinol K-exalate -Hyperkalemia Insulin cocktail

Tumorlysis Syndrome

Tumor breaks apart Hyperkalemia Cardiac Hyperuricemia Hyperphosphorus

•A client has sought care, stating that the client developed hives overnight. The nurse's inspection confirms the presence of urticaria. What type of allergic hypersensitivity reaction has the client developed?

Type 1

HIV/AIDS risk factors

Unprotected sex Sharing needles Prenatal exposure Occupational exposure Elderly under diagnosed Presents w/ flu like symptoms