Chapter 36: Management of Patients With Immunodeficiency Disorders

Chain of infection

~ Etiologic agent (microorganism) ~ Reservoir (source) ~ Portal of exit from reservoir ~ Method of transmission ~ Portal of entry to susceptible host ~ Susceptible host

S/S of Infection

~ Inflammation: Erythema Heat Pain Edema ~ Fever ~ Leukocytosis (increase of WBCs)

Thymus hypoplasia

~ T-cell deficiency that occurs when the thymus gland fails to develop normally during embryogenesis ~ AKA DiGeorge syndrome

Wiskott-Aldrich syndrome

Immunodeficiency characterized by thrombocytopenia and the absence of T- and B-cells

ESR (Erythrocyte sedimentation rate)

Measures the rate of blood cell sediment over 1 hr

Blood cultures

Must be drawn before antibiotic

Airborne precautions

~ Gown, gloves, N-95 respirator ~ TB, measles, chicken pox

Droplet precautions

~ Gown, gloves, mask ~ Pneumonia, meningitis, respiratory MRSA

Contact+ precautions

~ Gown, gloves, wash hands w/soap and water ~ C. diff

Nursing Dx

~ Risk for Infection ~ Anxiety ~ Hyperthermia ~ Impaired Oral Mucosa ~ Risk for Ineffective Therapeutic Regimen Management ~ Social Isolation ~ Spiritual Distress

Contact precautions

~ Wear gown and gloves ~ MRSA and shingles

Ataxia-telangiectasia

Autosomal recessive disorder affection T- and B-cell immunity primarily seen in children and resulting in a degenerative brain disease

Vascular infection pathophysiology

Capillaries dilate, fluid moves to tissues => edema

Angioneurotic edema

Condition marked by development of urticaria and an edematous area of skin, mucous membranes, or viscera (i.e., angioedema)

Severe combined immunodeficiency disease

Disorder involving a complete absence of humoral and cellular immunity resulting from an X-linked or autosomal genetic abnormality

Agammaglobulinemia

Disorder marked by an almost complete lack of immunoglobulins or antibodies

Panhypoglobulinemia

General lack of immunoglobulins in the blood

Nosocomial Infections

Healthcare-associated infections Manifest after 48 hours of hospitalization Causes: CAUTI, Pneumonia (if no IS), surgical errors due to lack of time outs

Description of vascular infection

Is it edematous? (swollen) Tender? Warm? Size? Erythematous? (red)

Hypogammaglobulinemia

Lack of one or more of the five immunoglobulins; caused by B-cell deficiency

Ataxia

Loss of muscle coordination

Immunocompromised host

Person with a secondary immunodeficiency and associated immunosuppression

Telangiectasia

Vascular lesions caused by dilated blood vessels

Cellular infection pathophysiology

WBC's increase, platelets move in... engulf invader