Hypersensitivity

A patient exposed to pollen dust is seen at the medical clinic with acute symptoms of dyspnea and shortness of breath. Which other symptoms might the nurse observe in this patient? Select all that apply. Angioedema Poor muscle tone Hoarseness and stridor Red conjunctiva with drainage Swelling below surface of the skin around mouth and eyes

Angioedema Rationale: Patients who are exposed to pollen dust may experience type I hypersensitivity reaction. Therefore, the patient may have angioedema along with dyspnea and shortness of breath. Hoarseness and stridor Rationale: Type I hypersensitivity reaction may lead to bronchospasm, causing narrowing of the airways. This may result in hoarseness and stridor. Swelling below surface of the skin around mouth and eyes Rationale: Swelling below surface of the skin around mouth and eyes is one of the clinical manifestations seen in patients with type I hypersensitivity reaction. Test Taking Tips:It is important to recognize that pollen exposure causes histamine release and hypersensitivity reactions.

A patient is diagnosed with systemic lupus erythematosus (SLE). The laboratory reports show increased neutrophils and monocytes. Which type of hypersensitivity reaction might have occurred in the patient? Type I Rationale: Allergic rhinitis and asthma may occur when mediators such as histamine and prostaglandins are involved as mediators of injury, resulting in type I hypersensitivity reaction. Type II Rationale: Type II hypersensitivity reaction is cytotoxic mediated and immediate, which occurs in transfusion reaction and Goodpasture syndrome. Type III Type IV Rationale: Type IV hypersensitivity reaction is a delayed-type hypersensitivity reaction that may occur in contact dermatitis involving cytotoxic cells.

Type III Rationale: Type III hypersensitivity reaction involves IgG- and IgM-mediated release of neutrophils and monocytes as mediators of injury. It is an immune complex-mediated hypersensitivity reaction that occurs in SLE.

The nurse is teaching a patient diagnosed with type IV hypersensitivity. Which statements made by the patient indicate effective teaching? Select all that apply. "I will not change litter boxes." Rationale: Litter boxes expose the patient to toxoplasmosis. Therefore, patients with medication-induced immunosuppression should not change litter boxes. It is acceptable for type IV hypersensitivity. "I will wear a medical alert bracelet." "I will avoid turtles and reptiles as pets." Rationale: Turtles and reptiles can cause Salmonella. This is not relevant for patients with type IV hypersensitivity. "I will avoid crowds or large gatherings." Rationale: Patients with immune dysfunction or suppression may develop infections when exposed to large gatherings or crowds. However, patients with type III hypersensitivity may develop infections when exposed to a specific allergen. "I will use an epinephrine injection if there is an allergic response."

"I will wear a medical alert bracelet." Rationale: A medical alert bracelet helps others to be aware of the patient's allergic condition and of what to do in an emergency. "I will use an epinephrine injection if there is an allergic response." Rationale: The epinephrine injection (EpiPen) provides small doses of epinephrine to counteract an allergic response.

The patient presents with signs of a type II hypersensitivity reaction that includes a complement and antibody-mediated inflammation. The patient's symptoms are blood in the sputum and urine. What should the health-care team anticipate is the cause? Graves' disease Allergic rhinitis Goodpasture syndrome Systemic lupus erythematosus (SLE)

Correct : Goodpasture syndrome Rationale: Goodpasture syndrome is a type II hypersensitivity reaction.Graves' disease Rationale: Graves' disease is a type IV hypersensitivity reaction Allergic rhinitis Rationale: Allergic rhinitis is a type I hypersensitivity reaction. Systemic lupus erythematosus (SLE) Rationale: SLE is a type III hypersensitivity reaction.

The nurse is reviewing the laboratory and diagnostic reports of a patient with allergic rhinitis. Which findings of the patient support the diagnosis? Eosinophils 8% Neutrophils 95% Rationale: Normal range of neutrophils is 50% to 70%. Neutrophil count is increased mostly in cases of type III hypersensitivity because they are the mediators of injury in type III reactions. Positive Mantoux test Rationale: The Mantoux test is used to test for tuberculosis (TB), not rhinitis. Positive reaction for scratch test Western blot test-Bruton tyrosine kinase (BTK) expression present Rationale: Western blot test is performed to diagnose X-linked agammaglobulinemia.

Eosinophils 8% Rationale: Allergic rhinitis is a type I reaction. Eosinophils are the key inflammatory cells in type I reactions. Normal eosinophil count is 2%. Their count increases with the severity of the allergy. Positive reaction for scratch test Rationale: Scratch testing helps to determine specific allergens; therefore, a scratch test is performed to detect the allergen in type I reactions such as allergic rhinitis.

A patient diagnosed with anaphylaxis is treated with a beta agonist to decrease bronchospasms. Which assessment finding indicates effective outcome of the treatment? Peripheral capillary oxygen saturation (SPO2) 92% Pulse rate 112 beats/min Blood pressure 80/45 mm Hg Respiratory rate 16 breaths/min

Respiratory rate 16 breaths/min Rationale: Anaphylaxis leads to bronchoconstriction, resulting in increased respiratory rate. Beta agonists facilitate bronchodilation by bronchial smooth muscle relaxation, leading to normal respiratory rate. Respiratory rate of 16 breaths/min is normal.

A patient client with a hemoglobin of 6.2 g/dL who has type A blood receives blood from a donor with type AB blood. Which type of hypersensitivity reaction will most likely be seen in this patient? Type I Rationale: Type I hypersensitivity may occur from exposure to environmental allergens such as certain foods, medications, insect bites, dust, molds, pollens, or animal dander. Type II Rationale: Type II hypersensitivity reaction may occur if incompatible blood is transfused. Because a patient with type A blood has anti-B antibodies and A antigens, that patient cannot receive type B or type AB blood. Transfusion of AB blood to this patient may lead to agglutination. Type III Rationale: Examples of type III hypersensitivity reactions are systemic immune complex reactions such as systemic lupus erythematosus, rheumatoid arthritis, and local immune complex reaction such as the Arthus reaction. Type IV Rationale: Poison ivy, Mantoux test for tuberculosis, and latex allergy are examples of type IV delayed-type hypersensitivity reactions. Test Taking Tips:If you do not understand the hemoglobin level, do not worry about it. You do not need to understand the hemoglobin level to answer the question.

Type II Rationale: Type II hypersensitivity reaction may occur if incompatible blood is transfused. Because a patient with type A blood has anti-B antibodies and A antigens, that patient cannot receive type B or type AB blood. Transfusion of AB blood to this patient may lead to agglutination.