ch.34 prep u

A home health nurse is reinforcing health education with a patient who is immunosuppressed and his family. What statement best suggests that the patient has understood the nurse's teaching?

"My family needs to understand that I'll probably need lifelong treatment."

While monitoring the patient's eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of what percentage of the total leukocyte count?

15% to 40%

A patient comes to the clinic with pruritus and nasal congestion after eating shrimp for lunch. The nurse is aware that the patient may be having an anaphylactic reaction to the shrimp. These symptoms typically occur within how many hours after exposure?

2 hours

The nurse is providing care for a client who has experienced a type I hypersensitivity reaction.

A client with an anaphylactic reaction after a bee sting

anaphylaxis signs and symptoms are attributable to

A massive release of histamine

anaphylactic shock, nurses first action

Administer epinephrine, as ordered.

The nurse is preparing to administer IVIG to a patient who has an immunodeficiency. What nursing guideline should the nurse apply?

Administer pretreatment medications as ordered 30 minutes prior to infusion.

hypersensitivity reaction may be characterized by an immediate reaction beginning within minutes of exposure to an antigen. EXAMPLE

Anaphylactic reaction immediately following a bee sting

adverse effect of IVIG administration

Anaphylaxis

potential adverse effect of IVIG administration

Anaphylaxis

Early in the day, the student reports eye swelling and dyspnea to the OR nurse

Anaphylaxis due to a latex allergy

A patient was seen in the clinic for hypertension and received a prescription for a new antihypertensive medication. The patient arrived in the emergency department a few hours after taking the medication with severe angioedema. What medication prescribed may be responsible for the reaction?

Angiotensin-converting enzyme (ACE) inhibitor

A client has been transported to the emergency department after a severe allergic reaction. How should the nurse evaluate the client's respiratory status?

Assess breath sounds. Measure the client's oxygen saturation by oximeter. Monitor the client's respiratory pattern. Assess the client's respiratory rate.

A school nurse is caring for a 10-year-old who appears to be having an allergic response. Which intervention should be the initial action of the school nurse?

Assess for signs and symptoms of anaphylaxis

A client with a diagnosis of primary immunodeficiency disease informs the nurse that the client has been experiencing a new onset of a dry cough and occasional shortness of breath. After determining that the client's vital signs are within reference ranges, what action should the nurse take?

Assess the client for signs and symptoms of infection.

neutrophil level of 21,000 mm3, prioritize what assessment

Assessing the client for signs and symptoms of infection

A nurse is admitting a patient with an immunodeficiency to the medical unit. In planning the care of this patient, the nurse should assess for what common sign of immunodeficiency?

Chronic diarrhea

A nurse should prioritize and closely monitor a client for a potentially severe anaphylactic reaction after the client has received which medical intervention?

Computed tomography with contrast solution

most frequent route of exposure to a latex allergy

Cutaneous

What medication should be administered prior to initiating an IVIG infusion

Diphenhydramine

A nurse is caring for a patient with a phagocytic cell disorder. The patient states, "My specialist says that I will likely be cured after I get my treatment tomorrow." To what treatment is the patient most likely referring?

Hematopoietic stem cell transplantation

Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle

Histamine

elimination diet to assist in identifying food allergens, NOT included in teaching

If symptoms return after reintroducing foods, this confirms the food is an allergen that should be avoided.

A client with a family history of allergies has experienced an allergic response based on a genetic predisposition. This atopic response is usually mediated by which immunoglobulin (Ig)

IgE

result from deficiency in the normal level of complement

Increased susceptibility to infection

result of a deficiency in the normal level of complement

Increased susceptibility to infection

**safest route for administering skin testing

Intradermal

A client is learning about a new diagnosis of asthma with the asthma nurse. What medication will best prevent the onset of acute asthma exacerbations?

Montelukast

oxymetazoline nasal spray, prevention of "rebound congestion

Only use the nasal spray for 3 to 4 days once every 12 hours.

A 6-month-old infant has been diagnosed with X-linked agammaglobulinemia and the parents do not understand why their baby did not develop an infection during the first months of life. The nurse should describe what phenomenon?

Passive acquired immunity

A nurse is caring for a patient who has an immunodeficiency. What assessment finding should prompt the nurse to consider the possibility that the patient is developing an infection?

Persistent diarrhea

The client is scheduled for a tilt-table test to assist in the diagnosis of chronic fatigue syndrome (CFS). What is the nurse's responsibility while the client is having the test?

Position the client while monitoring blood pressure and pulse.

single most important aspect for the client at risk for anaphylaxis

Prevention

Wiskott-Aldrich syndrome (WAS), prioritize

Protective isolation

A client was prescribed an oral antibiotic for the treatment of sinusitis. The client has now stopped, reporting the development of a rash shortly after taking the first dose of the drug. Which response by the nurse would be most appropriate?

Refer the client to a primary care provider to have the medication changed.

An infant is born to a mother who had no prenatal care during her pregnancy, what may have occured

Rh-hemolytic disease

ataxia-telangiectasis, at risk for

Risk for Falls Due to Loss of Muscle Coordination

The nurse is planning the care of a client who has a diagnosis of atopic dermatitis, which commonly affects both of her hands and forearms. What risk nursing diagnosis should the nurse include in the client's care plan?

Risk for disturbed body image related to skin lesions

The nurse is providing care for a client who has a diagnosis of hereditary angioedema. When planning this client's care, what nursing diagnosis should be prioritized?

Risk for impaired gas exchange related to airway obstruction

When preparing the patient for self-infusion of IVIG in the home setting, what education should the nurse prioritize?

Signs and symptoms of adverse reactions

immunosuppressive disorder, continued monitoring so that

So that early signs of impending infection can be detected and treated

characterized by an increased autoantibody production

Systemic lupus erythematosus (SLE)

disorder that is characterized by an increased autoantibody production

Systemic lupus erythematosus (SLE)

The client presents to the emergency department with a suspected allergic reaction to the antibiotic they were given at the quick care clinic to treat their pneumonia. What are the priority actions the nurse should take? Select all that apply.

Take vital signs. Place oxygen on the client. Insert an intravenous line.

immunotherapy injection, monitoring

The client will remain in the clinic to be monitored for 30 minutes following the injection

Reproductive health education for women who are HIV-positive

The female condom

A nurse is providing health education regarding self-care to a patient with an immunodeficiency. What teaching point should the nurse emphasize?

The need for thorough oral hygiene

The home health nurse is assessing a client who is immunosuppressed. What is the most essential teaching for this client and the family?

The need to report any slight changes in the client's health status

long-term corticosteroids

The patient should not stop taking the medication abruptly and should be weaned off of the medication

self-administer epinephrine in what site

Thigh

T-cell deficiency occurs when which gland fails to develop normally during embryogenesis?

Thymus

The nurse is teaching a client newly diagnosed with a peanut allergy about how to manage the allergy. What information should be included in the teaching?

Wear a medic alert bracelet. List symptoms of peanut allergy. Identify ways to manage allergy while dining out. Carry EpiPen autoinjector at all times.

A young couple visits the nurse practitioner stating that they want to start a family. The husband states that his brother died of a severe infection at age 6 months. He says he never knew what was wrong but his mother had him undergo "blood testing" as a child. Based on these statements, what health problem should the nurse practitioner suspect?

X-linked agammaglobulinemia

A client is distressed and frustrated reporting severe, ongoing fatigue that doesn't subside with rest. The nurse explains that chronic fatigue syndrome results from:

a combination of immune defects and viral assaults. immune system dysregulation. impaired activation of three neuroendocrine structures: the hypothalamus, pituitary gland, and adrenal glands.

A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include

adrenal suppression.

potentially life threatening allergic reaction

angioedema

The nurse observes diffuse swelling involving the deeper skin layers in a client who has experienced an allergic reaction. The nurse would correctly document this finding as

angioneurotic edema.

mild itching and a rash on both hands

chemical and latex glove use

Fibromyalgia is a common condition that involves

chronic fatigue, generalized muscle aching, and stiffness.

intranasal corticosteroid

fluticasone

most benefit to PIDD

hematopoietic stem cell transplantation (HSCT)

most important chemical mediator involved in the allergic response

histamine

A teenager is diagnosed with cellulitis of the right knee and fails to respond to oral antibiotics. He then develops osteomyelitis of the right knee, prompting a detailed diagnostic workup that reveals a phagocytic disorder. This patient faces an increased risk of what complication?

neutropenia

A nurse has developed a latex allergy and now uses latex-free purple gloves to avoid a hypersensitivity response. What in this nurse's reaction to latex differs from all other types of hypersensitivity responses?

no antibody production

A client is presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. What type of hypersensitivity did this client exhibit?

type I

The nurse explains to a client that immunotherapy initially starts with injections at which interval?

weekly

A nurse has asked the nurse educator if there is any way to predict the severity of a client's anaphylactic reaction. Which response by the nurse educator would be best?

"The faster the onset of symptoms, the more severe the reaction."

nasal spray education

"The full benefit of the medication may take up to 2 weeks to be achieved."

Antihistamines would be contraindicated in the care of

A client who is at 30 weeks' gestation

treatment option for the patient with severe combined immunodeficiency disease (SCID)

Bone marrow transplantation

scheduled for a skin test, the client used a corticosteroid earlier today to alleviate allergy symptoms. Which nursing intervention should the nurse implement?

Cancel and reschedule the skin test when the client stops taking the corticosteroid.

A nurse educator is explaining that patients with primary immunodeficiencies are living longer than in past decades because of advances in medical treatment. This increased longevity is associated with an increased risk of what?

Cancer

anaphylactic reaction, priority teaching

Carrying an epinephrine pen

risks of stroke related to the new prescription for this COX-2 inhibitor

Celecoxib

acute hemolytic reaction. What actions should the nurse take?

Check for low back pain. Assess for anxiety and mental status changes. Notify the health care provider.

what precautionary step is most important for preparing a client for allergy skin testing

Emergency equipment should be readily available.

chronic fatigue syndrome (CFS), emphasize

Ensure a balance of activity and rest.

A middle-aged man has presented for care to a nurse practitioner because his seasonal allergies are detracting from his quality of life. What should the nurse teach this patient about allergic rhinitis?

Immunotherapy may have the potential to provide long-term relief from symptoms.

self-administer epinephrine

Jabs the autoinjector into the outer thigh at a 90-degree angle

emphasize during health education about infection prevention

Perform frequent handwashing.

prescribed antihistamines, avoid

alcohol.

In scratch testing, which part of the body is more sensitive to allergens

back

most common cause of anaphylaxis

penicillin

In attempting to narrow down the possible allergen, it is important to consider that clinical manifestations generally correlate with

route of exposure.