NUR 202 Peds Immune Disorders TTT

Nursing students demonstrate correct understanding when they identify which immunoglobin as occurring most frequently in plasma and the major one to be synthesized during secondary response?

IgG is the most frequent antibody in plasma and is the major immunoglobin to be synthesized during the secondary response.

A 7-year-old girl has been battling leukemia and receiving radiation therapy. She is highly susceptible to infections, and the nurse recognizes that this is because she is experiencing secondary immunodeficiency. Which of the following are factors that cause secondary (acquired) immunodeficiency?

*Cancer *Radiation therapy *Severe stress *Malnutrition Secondary immunodeficiency, or loss of immune system response, can occur from factors such as severe systemic infection, cancer, renal disease, radiation therapy, severe stress, malnutrition, immunosuppressive therapy, and aging.

The nurse is caring for an infant exposed to HIV. The polymerase chain reaction (PCR) test was negative at birth. The nurse tells the mother that the child will most likely be tested again at what age?

4 to 7 weeks. Virologic testing for HIV-exposed infants should be done with the polymerase chain reaction test at birth, at 4 to 7 weeks, and again at 8 to 16 weeks. Serologic testing is done at approximately 12 months of age to document disappearance of the HIV-1 antibody.

A child is diagnosed with severe combined immunodeficiency syndrome. Which of the following would the nurse expect to find when reviewing the child's history and physical examination?

Assessment findings associated with severe combined immune deficiency include chronic diarrhea, failure to thrive, adventitious lung sounds, persistent oral thrush, and low levels of all immunoglobulins.

A nursing student correctly identifies the inability to distinguish self from nonself, causing the immune system to carry out immune responses against normal cells, as which of the following?

Autoimmunity results from an inability to distinguish self from nonself, causing the immune system to carry out immune responses against normal cells and tissue.

Nursing students are reviewing information about the immune system. They demonstrate understanding of the information when they identify which of the following as being produced in the bone marrow?

Bone marrow produces B lymphocytes and T lymphocytes.

Nursing students are reviewing the events involved in humoral immunity. They demonstrate understanding of the information when they identify which of the following as occurring with complement activation?

Complement activation results in increased vascular permeability, smooth muscle contraction, chemotaxis, phagocytosis, and lysis of the foreign antigen.

A child with primary immune deficiency is about to receive an infusion of IVIG. Which of the following is the most appropriate premedication to minimize the reaction?

Diphenhydramine and acetaminophen are the most commonly used medications for this purpose.

anaphylactic response.

Exposure to allergen Rapid immune response Vasodilation Bronchoconstriction Circulatory collapse

After teaching a class of nursing students about acquired immunodeficiency, the instructor determines that the teaching was effective when the students identify which of the following as a contributing factor?

Factors contributing to secondary (acquired) immunodeficiency include severe systemic infection, cancer, renal disease, radiation therapy, severe stress, malnutrition, immunosuppressive therapy, and aging.

A child is scheduled to undergo hyposensitization. The nurse understands that this therapy attempts to achieve which of the following?

Hyposensitization works by increasing the plasma concentration of IgG antibodies. IgG acts to prevent or block IgE antibodies from coming into contact with the allergen.

Which is the immunoglobulin associated with allergic reactions?

IgE is responsible for immediate hypersensitivity reactions.

A nursing instructor is preparing a teaching plan for a class about the immune response. When discussing the immune response, which of the following would the instructor describe as being primarily involved in a secondary immune response?

IgG- Only IgM and IgG are involved in primary and secondary immune responses. The main immunoglobulin produced in a secondary response is IgG. With a primary immune response, IgM antibodies peak at 14 days after an initial exposure to an antigen and then decline. This is followed by the production of IgG, which remains high for several weeks. IgE antibodies are involved in an immediate hypersensitivity reaction.

When teaching about primary and secondary humoral responses, what should the nurse identify as the immunoglobin that is first to appear in the serum?

IgM is the first immunoglobin to appear in the serum with the primary and secondary humoral responses

A group of nursing students are reviewing information about the immune system. The students demonstrate understanding of the information when they identify which of the following being produced by the thymus?

Lymphocyte T cells

Which of the following nursing problems could be associated with a child with primary immunodeficiency?

Risk for infection, Altered skin integrity, Delayed growth and development

The nurse is explaining patterns of incidence and transmission of HIV to a group of adolescent girls. She explains that the risks for this population are much higher because of the possibility of both vertical and horizontal transmission. Horizontal transmission refers to transmission of the disease during which of the following?

Sexual contact. Horizontal transmission refers to person-to-person transfer of the virus. Transmission by feeding with breast milk, birthing, and pregnancy are all examples of vertical transmission.

To establish whether the problem is truly a milk allergy in a child who is suspected of having this condition, milk should be reintroduced every 6 to 12 months.

True. If the problem is a true milk allergy, signs will recur.

A 7-year-old girl is rushed into the emergency room after being stung by a yellow jacket in a park nearby. She is nauseated and vomiting and is experiencing itching and swelling on the arm where she was stung. She is having trouble breathing. The nurse recognizes this as which type of hypersensitivity response?

Type I: anaphylaxis

The nurse is reviewing the medical history of a 4-year-old child. Which of the following would the nurse identify as potentially indicative of a primary immunodeficiency?

Warning signs associated with primary immunodeficiency include 8 or more episodes of acute otitis media in 1 year (one episode every 3 to 4 weeks results in at least 12 episodes in the past year), recurrent deep skin or organ abscesses, persistent oral thrush or skin candidiasis after 1 year of age. A history of infections that do not clear with IV antibiotics or two or more episodes of pneumonia in 1 year would be considered warning signs.

events of anaphylaxis

a child may have n/v and diarrhea, because of the sudden increase in GI secretions produced by the stimulation of histamine. This is followed by urticaria and angioedema. Bronchospasm can become so severe the child becomes dyspneic and hypoxemic. Continued bronchospasm leads to hypoxia. As blood vessels dilate, the blood pressure and pulse rate fall. Seizures and death may follow as soon as 10 minutes after the allergen is introduced into the child's body.

The nurse is explaining to a parent some of the basic aspects of the immune system and its functions. She informs them that B cells, also known as _________ cells, will attack __________ antigens.

humoral; bacterial. B cells are also called humoral cells and typically attack bacterial organisms. Another term for T cells is killer cells, and they most commonly attack viral organisms.

A nurse is assisting with skin testing for allergies in a 14-year-old girl. Which of the following should the nurse do to ensure an accurate test?

Be certain that the child has not received an antihistamine in the past 8 hours

A woman in her fourth month of pregnancy has recently learned that her sexual partner is HIV positive. She agrees to be tested for the virus but asks the nurse what early symptoms she should be looking for in herself. Which of the following should the nurse mention to the client?

Fatigue, anemia, diarrhea, and weight loss. The initial invasion of the virus may be accompanied by mild, flulike symptoms.

A newborn is found to have Di George syndrome and has misshaped ears, a small mandible, and an absent thymus. The nurse recognizes that this condition is associated with which of the following types of immunodeficiency disorders?

T-lymphocyte immunodeficiencies involve inadequate numbers or inadequate functioning of one or more types of T lymphocytes; this affects cell-mediated immunity and also, because of helper T-lymphocyte function, possibly humoral immunity as well. Di George syndrome is a chromosomal disorder in which there is deletion of a small piece of chromosome 22. This leads to not only a T cell defect but misshaped or low-set ears, smaller than usual mandible, absent thymus, neonatal tetany, and congenital heart disease.

A young patient is admitted to the hospital directly from the clinic. The physician suspects a problem with the patient's immune system. What test does the nurse anticipate the physician will order for this patient?

When there is a deficiency of immunocompetent cells, an assessment will focus on analysis of blood components, particularly white blood cells.

A 6-month-old boy has been admitted to the hospital with severe bloody diarrhea. The nurse notes petechiae and eczema with signs of secondary infection. As the nurse documents the boy's history, the parents report easy bruising and prolonged bleeding after circumcision. Based on these findings, the nurse suspects a diagnosis of which of the following?

Wiskott-Aldrich syndrome

Which of the following immune cells are disrupted when a child is infected with HIV?

• T cells • B cells • Phagocytes

The nurse is discussing food allergies with parents of a young child. She explains that a very effective way to determine which foods a child may be allergic to is to implement

An elimination diet

When describing anaphylaxis to a group of parents whose children have experienced anaphylaxis from insect stings, the nurse integrates knowledge that this response is related to which immunoglobulin?

Anaphylaxis is an acute IgE-mediated response to an allergen that involves many organ systems and may be life-threatening.

The mother of a child with a possible food allergy asks the nurse for information about how to test for it. Which response by the nurse would be most appropriate?

Food allergies are best identified by eliminating a suspected food from the diet and observing whether symptoms improve. After a time of improvement, the food is reintroduced and if the child is allergic to the food, the symptoms will return.

A nurse is preparing a presentation for a group of new parents and is planning to discuss nutrition during the first year. As part of the presentation, the nurse is planning to address foods that should be avoided to reduce the risk of possible food allergies. Which of the following would the nurse most likely include?

Foods that should be avoided in children younger than 1 year of age include: cow's milk, eggs, peanuts, tree nuts, sesame seeds, kiwi fruit, and fish and shellfish (ie, shrimp).

What advice would be most appropriate for the child with a stinging-insect allergy?

Obtain a Medic-Alert bracelet so the presence of the allergy can be identified easily.

An infant born to a mother who was HIV positive was tested at birth and found to be negative. The infant is scheduled for follow up testing. Which test would the nurse expect to be performed?

PCR is preferred to determine HIV in infants over 1 mo. The ELISA is positive in infants of HIV-infected mothers because of transplacentally received antibodies. These antibodies may persist and remain detectable up to 24 months of age, making the ELISA test less accurate at detecting HIV infection in infants and toddlers than the PCR.

The most accurate screening test for the presence of HIV antigen in young children is

PCR tests directly for the HIV antigen. ELISA and the Western blot test detect the presence of HIV antibodies. The CD4 count is used as a measure of disease status and progression.

The nurse is teaching the parents of a 4-year-old boy with a peanut allergy about diet and possible unexpected locations of peanuts or peanut oil in food products. After describing this to the parents, which response by the mother would indicate a need for further teaching?

Peanut oil might be a hidden ingredient in barbecue sauce, commonly used on hamburgers and hot dogs. Baked goods, hot chocolate, and Asian foods may contain hidden peanuts.

The nurse is preparing an informational brochure about risk factors for immune disorders. Which of the following disease processes can indicate a potential underlying immunologic disorder?

Persistent oral thrush, Chronic cough, Extensive eczema

A mother, who is HIV positive, is distraught when she learns that her 6-month-old baby is also HIV positive. The child had undergone open heart surgery as a newborn and had received numerous blood transfusions. The nurse recognizes that which of the following is the most likely means of transmission of the disease to this child?

Placental spread during pregnancy