Chapter 42: Nursing Care of a Family when a Child has an Immune Disorder
The parents of a 5-month-old infant diagnosed with humoral IgA deficiency question the nurse about why the infant was not diagnosed sooner. Which response by the nurse most appropriate?
"Maternal antibodies crossed the placenta preventing infections until now." IgA deficiency does not have a specific treatment, is usually found when evaluating other illnesses, and is associated with allergies. However, the nurse's most appropriate response to the parents' question about why the infant was not diagnosed sooner is to explain how maternal antibodies prevent manifestation of the deficiency until the infant approximately 4 months old.
A nurse is caring for a 12-year-old girl with a severe peanut allergy. The girl's parents are upset because the school does not permit her to carry her EpiPen with her. It must remain in the school's office per school regulations. Which response by the nurse would be most appropriate?
"She is allowed by law to carry her EpiPen with her; I will talk to school authorities." Public Law No. 108-377, the Asthmatic Schoolchildren's Treatment and Health Management Act of 2004, was passed by the U.S. Congress. This law is intended to ensure that students with severe allergies can carry prescribed medications such as an EpiPen with them at all times.
The nurse is caring for a child who is having an anaphalatic reaction with bronchospasm. The nurse would expect to administer what medication for bronchospasm relief?
Albuterol The nurse would expect to administer bronchodilation inhalation treatment (albuterol) if bronchospasm is present. Epinephrine, diphenhydramine, and/or corticosteroids are administered to reverse the allergic process.
Question 5 See full question 39s A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority?
Ineffective protection related to impaired humoral defenses The child with a primary immunodeficiency lacks the necessary immune responses that provide protection from infection. Therefore, the priority nursing diagnosis would be ineffective protection.
A group of nursing students are reviewing information about the immune system. The students demonstrate understanding of the information when they identify what as being produced by the thymus?
Lymphocyte T cells
Which nursing action is most appropriate when caring for a child with positive serum IgE antibodies, a white blood cell count of 6,000 mm3, and 10% eosinophils?
Obtain a careful health history. The child with positive serum IgE antibodies, a white blood cell count of 6,000 mm3, and 10% eosinophils indicates allergies, making obtaining a careful history to assess for symptoms and familial tendency the most appropriate action.
A nursing is providing education to pregnant women diagnosed with HIV. Which statement indicates the need for further teaching?
Pregnancy will accelerate the progression of the disease. There isn't any research showing pregnancy accelerates the progression of the disease. Women with HIV should not breastfeed, because they could transmit the virus to the baby via the breastmilk. Early use of antiretroviral medications are effective in reducing transmission, and a cesarean birth may be scheduled to reduce potential transmission to the newborn.
The nurse is caring for a 6-month-old infant whose mother tested positive for HIV during her pregnancy. The infant had a positive polymerase chain reaction (PCR) for HIV at birth. Which medication would be prescribed for the prevention of pneumocystis pneumonia (PCP)?
Trimethoprim-sulfamethoxazole (TMP-SMZ) Trimethoprim-sulfamethoxazole (TMP) is the drug of choice for the prevention of pneumocystis pneumonia. Prophylaxis usually begins at the age of 6 months.
A mother, who is HIV positive, is distraught when she learns that her 6-month-old baby is also human immunodeficiency virus (HIV) positive. The child had undergone open heart surgery as a newborn and had received numerous blood transfusions. The nurse recognizes that the most likely means of transmission of the disease to this child was:
placental spread during pregnancy Although it is decreasing in incidence, transmission of HIV from mother to child by placental spread is still the most common reason for childhood HIV infection in the United States.
The nurse is observing a child demonstrate the use of an Epipen. The nurse determines that the child has performed the procedure correctly. Place the steps in the proper sequence that was demonstrated by the child.
1-Grasps Epipen with black tip pointing downward 2-Forms a fist around the Epipen 3- Pulls off the gray safety release 4- Jabs the Epipen firmly into the outer thigh at a 90-degree angle 5- Holds Epipen in place for 10 seconds 6- Massages site for 10 seconds after removing Epipen
