Immune disorders

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?

IgE

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

A nurse is preparing a presentation for a group of nurses about human immunodeficiency virus infection. Which of the following would the nurse include as the major means of transmission responsible for almost all new HIV infections in the pre-adolescent population?

Mother-to-child transmission

A nurse is promoting vaccine administration. When instructing on the physiological changes, which statement best explains what occurs in the child when vaccines are administered?

The child develops an active immunity.

Most children who are diagnosed with acquired immunodeficiency syndrome (AIDS) are within which age range?

1 to 4 years of age

The health care provider has prescribed diphenhydramine 5 mg/kg/dose for a child with urticaria weighing 33 lb (15 kg). The medication is supplied as 12.5 mg/5 ml. How many milliliters will the nurse administer to the child for one dose? Record your answer using a whole number

30

Which client will the nurse assess first after receiving shift report?

A client with human immunodeficiency virus (HIV) whose temperature is 102.2°F (39°C)

The nurse is reviewing the medical history of a 4-year-old child. What would the nurse identify as potentially indicative of a primary immunodeficiency? Select all that apply

Acute otitis media, one episode every 3 to 4 weeks over the past year. Recurrent deep abscess of the thigh Oral candidiasis (thrush), persistent over the past 6 to 7 months

The nurse in the emergency department is examining an 18-month-old child who recently received a first dose of penicillin. The nurse notes lip edema, urticaria, stridor, and tachycardia. Which action will the nurse take next?

Administer epinephrine

A nursing instructor teaching about allergies in children informs students that the underlying cause of all allergic disorders appears to be an excessive antigen-antibody response when the invading organism is which of the following?

Allergen

A 7-year-old boy has been rushed to the clinic with multiple bee stings on his face, neck, and arms. After immediate treatment with epinephrine, which of the following would be the priority?

Checking for laryngeal edema

The nurse is educating a child with a peanut allergy about the signs and symptoms of an anaphylactic reaction. The nurse realizes additional teaching is needed when the child identifies which sign/symptom?

Constipation

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients?

Contact precautions

A 12-year-old with juvenile rheumatoid arthritis has pain and swelling of the hands. During a visit with the occupational therapist, the parent states, "I want her to become involved with volleyball at school. She won't participate in any sports like her sister." What caregiver response is the parent exhibiting?

Denial

The parents of an adolescent tell the nurse, "Our child seems to have allergy symptoms every time we visit our favorite cafe. I don't understand since the only allergy indicated in the testing was to eggs?" How should the nurse respond?

Does your child get a whipped cream or foam topping on their favorite drink?

The nurse is discussing infection control with the parents of an immunocompromised child. Which causative factors should be presented as the most effective means to prevent infection?

Eggs Shrimp Peanuts

The nurse is helping the parents of a toddler identify foods that are causing allergic symptoms in the child. Which strategy should the nurse encourage the parents to use?

Elimination diet

The nurse is discussing infection control with the parents of an immunocompromised child. Which causative factors should be presented as the most effective means to prevent infection?

Hand washing

To avoid anaphylactic reactions in children, which question would be most important to ask a parent before administering penicillin to her infant?

Has she ever had penicillin before?

The parent of a school-age child comments to the nurse, "Every time my child eats enchiladas at our local Mexican restaurant he gets a rash. It just doesn't make sense to me." How should the nurse respond?

Has your child ever been tested for a peanut allergy?

The nursing instructor has completed a presentation on normal immune function. Which statement by a student would suggest a need for further education?

Humoral immunity is generally functional at birth

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

The mother of a 5-year-old child with allergies to a variety of foods including eggs, milk, peanuts, and shellfish asks if her child will "always have these problems." What response by the nurse is most accurate?

In most cases allergies to peanuts and shellfish persist into adulthood but the others may diminish and disappear

The nurse is caring for a school-age child recently diagnosed with an allergy to peanuts. Which nursing action is a priority?

Include the child when discussing foods that contain peanuts

Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period?

Incubation period

A pediatric client is newly diagnosed with a stinging-insect allergy. Which advice is most appropriate for the nurse to provide this client's parent?

Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily

The nurse is preparing an informational brochure about risk factors for immune disorders. Which disease process can indicate a potential underlying immunologic disorder? Select all that apply

Persistent oral thrush Chronic cough Extensive eczema

A mother tells the clinic nurse that her family wants to go on vacation this year, but that they are afraid to go to their usual spot because their young daughter has problems with pollen-related allergies. What should the nurse recommend to this mother?

Plan the vacation at a time when the pollen count is lowest

The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen?

Protease inhibitors

The nurse is preparing to administer IVIG to an adolescent. Prior to administration, which baseline lab values does the nurse need to review? Select all that apply.

Serum creatinine BUN

The nurse is preparing to administer the child's dose of intravenous immune globulin (IVIG). Which actions should the nurse take? Select all that apply.

Take baseline vital signs and monitor the vital signs during the infusion. Prepare to give acetaminophen to the child. Prepare to give diphenhydramine to the child

The registered nurse (RN) and unlicensed assistive personnel (UAP) are caring for a pediatric client with an immune disorder receiving a stem cell transplant. Which action by the UAP will cause the RN to intervene?

The UAP takes a rectal temperature on the client.

A child will receive IV immunoglobulin (IVIG). The nurse assesses the child every 15 minutes for the first hour of infusion for symptoms of anaphylaxis. Which symptom(s) would indicate to the nurse that anaphylaxis is occurring? Select all that apply

The child's face is flushed. The child's temperature begins to elevate. The child appears increasingly anxious. Inspiratory wheezes are heard on auscultation

A nurse is reviewing the medical record of an infant whose mother is HIV positive. Which factor in the maternal history would the nurse interpret as helping to decrease the infant's risk for HIV transmission?

Use of zidovudine therapy during pregnancy

What nursing instruction would best identify foods to which a child is allergic?

Thoughtful elimination of diet choices

The nurse is teaching the parents of a 4-year-old client with a peanut allergy about dietary restrictions. Which response by the parents indicates a need for further teaching?

We cannot go wrong with barbeque and french fries

An older school-aged child is allergic to wasp stings. The nurse is teaching the child and her parents about ways to minimize her risk. Which of the following would the nurse include in the teaching plan? Select all that apply

Wearing appropriate footwear when going outside Having a readily available fast-acting insecticide when outdoors Not drinking from open soda cans when outside

The nurse is educating a child with a peanut allergy about the signs and symptoms of an anaphylactic reaction. The nurse realizes additional teaching is needed when the child identifies which sign/symptom?

constipation

The nurse is monitoring the labs of a child admitted for an exacerbation of juvenile pauciarticular arthritis. Which lab result does the nurse expect to be elevated?

erythrocyte sedimentation rate (ESR)

A child is diagnosed with a food allergy to milk. When teaching the parents about this allergy, what would the nurse suggest as a possible substitution(s) for milk? Select all that apply

fruit juice rice milk soy milk

The nurse is caring for a child with juvenile idiopathic arthritis (JIA). There is involvement of five or more small joints and it is affecting the body symmetrically. This tells the nurse that the child:

has polyarticular JIA

The immune system works to destroy pathogens by helping the body get rid of or resist the invasion of foreign materials The blood cells that surround, ingest, and neutralize the pathogens are:

macrophages

Which of the following is the drug of choice for multidrug-resistant strains of infection?

vancomycin

An older school-aged child is allergic to wasp stings. The nurse is teaching the child and her parents about ways to minimize her risk. Which of the following would the nurse include in the teaching plan? Select all that apply.

Wearing appropriate footwear when going outside Having a readily available fast-acting insecticide when outdoors Not drinking from open soda cans when outside