Chapter 13: Immune Responses and Transplantation

The nurse teaches a patient about drug therapy after a kidney transplant. Which statement by the patient would indicate a need for further instructions?

"After a couple of years, I will be able to stop taking the cyclosporine."

Which statement by a patient would alert the nurse to a risk for decreased immune function?

"I had my spleen removed after a car accident."

A patient who collects honey to earn supplemental income has developed a hypersensitivity to bee stings. Which statement by the patient would indicate a need for additional teaching

"I will take oral antihistamines before going to work."

Which information about intradermal skin testing should the nurse teach to a patient with possible allergies?

"Plan to wait in the clinic for 20 to 30 minutes after the testing."

The charge nurse is assigning semiprivate rooms for new admissions. Which patient could safely be assigned as a roommate for a patient who has acute rejection of an organ transplant?

A patient with an anaphylactic reaction

Immediately after the nurse administers an intradermal injection of an allergen on the forearm, the patient reports itching at the site, weakness, and dizziness. What action should the nurse take first?

Place a tourniquet above the site.

A patient who is receiving immunotherapy has just received an allergen injection. Which assessment finding is most important to communicate to the health care provider?

There is a 2-cm wheal at the site of the injection.

An older adult patient who is having an annual checkup tells the nurse, "I feel fine, and I don't want to pay for all these unnecessary cancer screening tests!" Which information should the nurse plan to teach this patient?

Consequences of aging on cell-mediated immunity

A clinic patient reports experiencing an allergic reaction to an unknown allergen several weeks ago. Which action is appropriate for the registered nurse (RN) to delegate to a licensed practical/vocational nurse (LPN/VN)?

Administer a cutaneous scratch skin test.

A patient in the health care provider's office for allergen testing using the cutaneous scratch method develops itching and swelling at the skin site. Which action should the nurse plan to take first?

Administer a dose of epinephrine.

A patient is admitted to the hospital with acute rejection of a kidney transplant. Which intervention will the nurse expect for this patient?

Administration of immunosuppressant medications

A patient is anxious and reports difficulty breathing after being stung by a wasp. What is the nurse's priority action?

Assess the patient's airway.

Which example should the nurse use to explain an infant's "passive immunity" to a new mother?

Breastfeeding

Which patient should the nurse assess first?

Patient who is sneezing after subcutaneous immunotherapy

The nurse taking a health history learns that the patient, who has worked in rubber tire manufacturing, has allergic rhinitis and multiple food allergies. Which action by the nurse is correct?

Document the patient's history and teach about clinical manifestations of a type I latex allergy.

The nurse should assess the patient undergoing plasmapheresis for which clinical manifestation?

Extremity numbness

A patient is being evaluated for possible atopic dermatitis. The nurse should expect elevation of which laboratory value?

IgE

The health care provider asks the nurse to evaluate whether a patient's angioedema has responded to prescribed therapies. Which assessment should the nurse perform?

Observe for swelling of the patient's lips and tongue.

What instructions about plasmapheresis should the nurse include in the teaching plan for a patient diagnosed with systemic lupus erythematosus (SLE)?

Plasmapheresis prevents inflammatory mediators from injuring tissues.

A nurse has obtained donor tissue typing information about a patient who is waiting for a kidney transplant. Which results should be reported to the transplant surgeon?

Results of patient-donor crossmatching are positive.

The nurse provides discharge instructions to a patient who has an immune deficiency involving the T lymphocytes. Which health screening should the nurse include in the teaching plan for this patient?

Screening for cancers

Ten days after receiving a bone marrow transplant, a patient develops a skin rash. What should the nurse suspect is the cause of the rash?

The donor T cells are attacking the patient's skin cells.

An older adult patient has a prescription for cyclosporine following a kidney transplant. Which information in the patient's health history has implications for planning patient teaching about the safe use of cyclosporine?

The patient drinks grapefruit juice every day.

A patient seeks care in the emergency department after sharing needles for heroin injection with a friend who has hepatitis B. To provide immediate protection from infection, what medication will the nurse expect to administer?

b. Gamma globulin

The nurse reviewing a clinic patient's medical record notes that the patient missed the previous appointment for weekly immunotherapy. Which action by the nurse is appropriate?

c. Consult with the health care provider about giving a lower allergen dose.