HCC II Immunity

Attribute: Scope of Immune Response (Risk Factors)

- Age - Non- immunized state - Environmental factos - Chronic Illness - Medical Treatments - Genetics -High-Risk Behaviors/Abuse - Pregnancy

Pneumonia Risk Factors

- Age (older adults, children, infants) - Other illnessess/conditions - Lifestyle behaviors: Smoking

Immunity: Nursing Implications (Pharmacotherapy)

- Anti- inflammatory -antipyretics -Antibiotic therapy - Immunosuppressant Tx - Vaccinations - Immunoglobulin - Hematopoietic stem cell transplantation - Gene transfer

Immunity: Nursing Implications

- Assessment - Lifestyle managment - Monitoring Lab and Diagnostics - Vaccinations -Infection Control -RICE - Patient Education

Pnemonia: Critical Skills

- Assessment - Pt. teaching - Aseptic technique - Medication Adminstration

Appendicitis: Critical Skills

- Assessment, Pt. teaching, med admin before surgery. - VS - Pain level/pain management -NPO status -Fluid Balance - After surgery -I&O - Bowel sounds, passing flatus, bm - Wound Healing - Lab tests (like WBC)

Osteomyelitis Nursing Process

- Assessment: Comprehensive History Recent history Risk Factors Current Medications

UTI Assessment

- Comprehensive history -Current urinary symptoms -Risk factorys/ Previous history UTI - Current Medications

UTI: WBC/Neut

- Elevated WBC - Increased Neutrophils - Positive bacteria culture of urine.

Appendicitis: Diagnostic Tests

- Examination - CBC w/ differentials - Urinalysis - Abdominal X-ray - Intravenous Pyelogram - Abdominal Computed Tomography - Abdominal Ultrasound

Appendicitis: Risk Factors

- Gender - Age - Family History - Low Fiber, High Carb diet - Gastrointestinal Infection - Inflammatory Bowel Disease

Increased Risk for OM

- Gender (Male) - Age <5 - Lifestyle behaviors (bottle feeding, exposure to children, pacifiers) - Illness/ other conditions (down syndrome, allergic rhinitis) -Enlarged Adenoids -Cleft lip/palate

osteomyelitis risk factors

- Gender (Male) -Vertebrae are most common adult site.

Risks for UTI

- Gender (female) - Age -Other Illness/condition (DM, pregnancy, suppressed immunity - Lifestyle behavior (use of spermicides, condoms, or diaphragms.

Attribute: Scope of Immune Response (Risk Factors)

- Gender/Race/Ethnicity - Genetics - Environmental Exposure (food, pollen, dust, mold, venom) - Medication Exposure ( Drugs, vaccines, serums

Appendicitis: Clinical Management

- IV Fluids - Analgesics - Antibiotics preoperative and if peritonitis develops -Single does of broad-spectrum antibiotic

Appendicitis clinical manifestations

- Inflammatory response (increasing) - Generalized pain -Recurrence of vomiting - temperature increases to more than 101.4 - Generalized abdominal rigidity

Immunity Antecedents

- Intact non-specific defenses of barriers - Functional lymphatic system - Optimal innate immune system - Functional inflammatory response - Appropriate adaptive immune response

For a client with Hodgkin disease who has developed neutropenia, what is an appropriate nursing intervention to include in the care plan?

- Monitor temperature every 4 hours. For clients with neutropenia, monitoring temperature every 4 hours is essential.

Appendicitis: Pathophysiology

- Mucosal ulceration trigger inflammation, which temporarily obstructs the appendix. - Obstruction causes mucus outflow, increasing pressure in the distended appendix; the appendix then contracts. Fluids and mucus continue to be secreted and stagnate. -Bacteria multiply and inflammation and pressure increase, restricting blood flow and causing thrombus, abdominal pain, and ischemia to the wall of the appendix. -Continued inflammation, pressure, and fluid collection can lead to perforation and spillage of the appendices contents.

Normal Results: - Neutrophils - Lymphocytes - Monocytes

- Neutrophils: 50%- 62% - Lymphocytes: 25%-40% - Monocytes: 3%-7%

Attribute: Antigen Response (Chain of Infection)

- Portal of Entry - Susceptible Host - Infectious agent - Reservoirs - Portal of Exit - Means of Transmission.

Osteomyelitis Critical Skills

- Promote self care, encourage pt. participation. - encourage and promote rest/relaxation -Anti- embolism stocking or sequential compression stockings to prevent VTE - Provide measures to reduce fever -Encourage pt. to preform ROM to unaffected extremities. - Assess affected extremity for skin color, pulses, pain, and paresthesia. -Prepare pt./family for possible surgery.

Pneumonia Clinical Manifestations

- Respiratory symptoms - Bacterial Pneumonia: Abrupt onset of fever, shaking, chills, coughs causing chest pain, purulent sputum, pleuritic type chest pain. -Viral Pneumonia (Nonbacterial): Gradual insidious onset headache, sore throat, muscle soreness, fatigue, dry cough mucoid sputum, generally do not experience fever and chiils. -Other: Fatigue, weakness, muscle aches, dyspnea, nasal congestion, pain with breathing, restlessness

UTI diagnostic tests

- Urunalysis and urine C&S - Kidney and Bladder - Voiding cysturethrogram - CT scan or MRI - Radionuclide Scan - Cystoscopy and Urodynamic studies

Immunity: Exemplars

- Vaccines - Otitis Media - UTI - Cellulitis - Pneumonia - Appendicitis - Trauma (Sprain)

Trauma-Sprain: Diagnostic Tests

- X-Ray - CT Scan

Osteomyelitis Diagnostic Tests

- x-rays may show overlying edema and bone involvement, periosteal thickening or elevation, sclero and irregularity. - Bone scan may detect early infection - Ultrasonography may reveal soft-tissue abscess or fluid collection. -CAT and MRI scan may show extent of infection -Needle biopsy or open bone biopsy identifies organism (Gold Standard)

Trauma-Sprain: Clinical Skills

-Assessment -Prescription of RICE (Rest, Ice, Compression, Elevation)

Pneumonia: Diagnostic Test

-Blood and sputum C&S - Chest x-ray - ABGs - CBC w/differential - Pulmonary Function Test - Pulse Oximeter

Osteomyelitis clinical manifestations

-Clinical Manifestations: Tachycardia, Swelling/restricted movement over infection site, Tenderness/warmth over infection site, Persistent pus drainage from an old pocket in a sinus tract, Non-healing ulcer. draining sinus.

Urinary Tract Infection Pathophysiology

-Colonization occurs, the organism ascends by way of the urethra to into the bladder. - Local defense mechanisms in the bladder break down. - Bacteria invade the bladder mucosa and multiply. - Bacteria can"t be readily eliminated by normal urination.

Cellulitis Nursing Process Assessment

-Comprehensive history - Recent history or skin disease -Risk Factors for allergies -Family History -Current Medication

Pneumonia Nursing Process Assessment

-Comprehensive history -Current respiratory symptoms -Risk Factors and previous history of respiratory illness -Current Medications

Penicillin Uses/Side Effects

-Gonorrhea -Perionitis -UTI -Pneumonia/ Respiratory infections -Septicemia -Meningitis *GI distress, Oral/Vaginal candidiasis, Rash, anaphylaxis

Osteomyelitis Treatments

-Hyperbaric Oxygen Therapy -Neg Pressure wound therapy -Free tissue transfers -Ilizarov apparatus device - Venous thromboembolism (VTE) prophylaxis.

Colony Stimulating Factor Medication Adverse Effect

-Hypertension -Nausea - Vomiting

Osteomyelitis Pathophysiology

-Infection spreads from adjacent soft tissue and joints trough the blood or by direct inoculation from trauma or surgery. -During the initial infection, organisms settle in a hematoma or weakened area and spread directly to bone. - In the first stage, pus i produced and pressure build withing the rigid medullary cavity. -Pus is forced through the Haversian canals -A sub-periosteal abscess forms. -Bone is deprived of its blood supply -Second stage- Necrosis results and new bone formulation is stimulated. -Dead bone detached and exits through abscess.

Cellulitis Risk Factors

-Moisture -Obesity -Atopic Dermatitis -Systemic corticosteroids -Antobiotics -Chronic Disease

UTI- Nursing interventions

-Primary Prevention: Pt. education about clinical indicators and risk factors or UTI, promote urinary health. -Secondary Prevention: Screening for immune disorders. -Tertiary Prevention: Promote return to urinary health, pharmacological treatment and follow up.

Osteomyelitis Non-pharmacologic

-Standard precautions/hand hygiene. - Perform wound care with strict aseptic technique. - Assiste with hyperbaric oxygen therapy or neg pressure wound therapy. - Pin site care to skeletal traction. -Protect bone from injury -Allow pt. to verbalize feelings/concerns and provide emotional support.

For Trauma: Sprain, put ice on the injury for _____ minutes at a time, 4 to 8 times per day.

20

Abnormal Results: WBC Count

A high count (Leukocytosis) may indicate an infection. a low count (Leukopenia) may indicate a problem with bone marrow production/chronic infection, adverse affect medication.

Antecedent: Inflammatory Response

A non-specific response to something that is harmful to the body. -e.g., infection, injury, or allergen Inflammatory Response: -Inactivates and elliminates harmful antigens - Removes destroyed tissue - Initiates tissue repair and healing

A client has begun to suffer from rheumatoid arthritis and is being assess for disorders of the immune system. The client works as an aide at a facility that cares for children infected with Aids. What is the most important factor related to the client's assessment?

A nurse needs to review the client's drug history. This data will help to assess the client's susceptibility to illness because certain past illnesses and drugs. The age, home environment and diet do not have major implications.

Immunity

A physiologic process that provides an individual with protection or defense from disease.

Abnormal Results: Basophils

An increased percentage may be due to a splenectomy or an allergic reaction. A decreased percentage may be due to acute infection.

Abnormal Results: Eosinophils

An increased percentage may be due to an allergic reaction.

Abnormal Results: Lymphocytes

An increased percentage may be due to chronic bacterial infection, infectious mononicleosis, lymphocytic leukemia, or multiple myeloma. A decreased percentage may be due to sepsis or steroid use.

Attribute: Antigen Response

Antigens -Foreign Proteins entering the body - Induce and immune response - Found within: microorganisms vaccines Transplanted organs Allergens

Trauma- Sprain: Nursing Process

Assessment - Comprehensive History - Review of risk factors - Determine cause of injury

Appendicitis: Nursing Process

Assessment - Comprehensive history - Review current GI symptoms - Review of Risk Factors

Helper T cells stimulate the function of ____ _____

B-cells

Cellulitis Pathophysiology

Break in skin integrity almost always precedes infection. - As the offending organism invades the compromised area, it overwhelms the defensive cells (neutrophil, eosinophils, basophils, mast cells) that normally contain and localize the inflammation. - As cellulitis progresses, the organism invades tissue around the initial wound site.

____________ ___________ presents with itching, burning, redness, rash on contact with substance.

Contact dermatitis

Blood types that are negative indicate a lack of the _____ antigen.

D

_________ ____________ presents with sudden generalized bright red rash, itching, fever, malaise, headache, arthralgias.

Dermatitis medicamentosa

A client with an allergic disorder is in treatment for their disorder. What might their treatment be?

Drug therapy

Signs of Otitis Media

Ear pain, sense of fullness/pressure, snapping/popping, vertigo, hearing changes. Fever, fussiness, pulling of ears, anorexia, vomiting, diarrhea. Redu, bulding tympanic membrane, air/fluid bubbles behind TM

Cellulitis

Elevated WBC Positive Bacterial Culture

Pneumonia Attribute

Elevated WBC Positive bacterial culture of sputum/blood.

Appendicitis: Attribute

Elevated WBC count Positive bacterial or viral cultures

Otitis Media with Effusion (OME)

Fluid/ Potential hearing loss

UTI Symptoms

Frequency, urgency, dysuria, fever, suprapublic pain, fatigue/weakness, muscle aches.

Trauma- Sprain: Grades

Grade 1 (mild): Minor or partial ligament tear with normal join stability and function. Grade 2 (moderate): Complete tear of some but not all collagen fibers in the ligament, with mild joint laxity and some function loss. Grade 3 (Severe): Complete tear or separation of ligament from bone, causing total joint laxity and function loss.

Pneumonia Pathophysiology

Inflammation of the lung parenchyma caused by pathogen. Pneumonitis is a more general term that describes an inflammatory process in the lung tissue that may predispose or place the pt. at risk for microbial invasions. (Pneumonia and flu are the most common causes of death form infectious diseases in the US)

Trauma-Sprain: Clinical Manifestations

Inflammatory response: - local edema, warmth, redness, increased nerve sensitivity and pain decreased mobility/stability of joint. - Neurovascular compromise coolness, pallor, decreased pulse.

secondary immunodeficiency

Is a loss of functioning in a person previously normal immune functioning as a result of illness or medication.

primary immunodeficiency (PI)

Is a situation in which the entire immune system is inadequate.

Appendicitis Warning

NEVER APPLY HEAT to the right lower abdomen, this can cause the appendix to rupture.

Low _________ leave people vulnerable to infection due to immunosuppression

Neutrophils

Acute Otitis Media (AOM)

Pain (Pulling at ear, low appetite, node enlargment, fever.

Appendicitis Prevention

Primary Prevention: Educate Secondary Prevention: Screen Tertiary Prevention: Follow up after sugery

Pneumonia: Clinical Management

Primary Prevention: Pt. education about clinical indicators and risk factors of pneumonia and URIs and general measure to promote respiratory health and prevention of recurrent URIs. Secondary Prevention: Screening for Immune Disorders Tertiary Prevention: Promote return to health, pharmacological treatment.

Osteomyelitis Clinical Managment

Primary Prevention: Pt. education clinical manifestations and risk factors. Secondary Prevention: Pt. screening for immune disorders Tertiary Prevention: Pt. education to promote healing.

Cellulitis Nursing Interventions

Primary Prevention: Pt. education including S&S, risk factors, and general measures to prevent cellulitis. Secondary Prevention: Screening for immune disorders and other conditions which effect immune system function. Tertiary Prevention: Follow up antibiotic therapy, pt.education about cellulitis.

Trauma- Sprain: Nursing Interventions

Primary Prevention: Warm up and strech exercises. Secondary Prevention: Screening for unstable joint function. Tertiary Prevention: strength and conditioning

Involves the direct administration of the suspected allergen to the sensitive tissue such as conjunctiva.

Provocative testing

Immunity: Nursing Implication (RICE)

REST - Prevents further injury ICE - Vasoconstriction COMPRESSION - Redice edema ELEVATION -Reduces Inflammation After 72 hours: Apply heat to promote vasodilation and absorption. Used to minimize swelling associated with: Inflammation

A client's exposure to an infection microorganism has stimulated the client's immune response including activation of effector (cytotoxic) T cells. These cells will help to eliminate pathogens by:

Releasing cytokines that will destroy the foreign cells

The capacity of the immune system to differentiate self from non-self is called

Self tolerance

Which test indicates the quantity of allergen necessary to evoke an allergic reaction?

Serum-specific IgE test

Does not indicated the quantity of allergen

The scratch test

________ presents with itching, swelling, redness, and wheals of superficial skin layers.

Urticaria

The use of CSF medication is not recommended for clients with ________________, and is not a treatment used to treat it.

hypothyroidism

Depression, anxiety, and suicidal ideation have been reported in a substancial number of patients taking _________ _______ -_____.

interferon alfa-2a

Lymphoid Organs

- Bone Marrow - Thymus Gland - Spleen - Tonsils - Adenoids - Appendix

Immunity: Nursing Implications: Labs and Diagnostics

- Complete blood count (CBC) - Erythrocyte sedimentation rate (ESR) - Enzyme immunoassay and enzyme-linked immunosorbent assay (ELISA) - Immunoglobulins - Polymerase chain reaction - Rapid HIV Tests - Radioallergosorbent test - Skin Reactions - Western Blot test - Complement -C- Reactive Protein (CRP) - Computerized axial tomography -Cultures

Immunity: Nursing Implications (Infection Control)

- Proper hand hygiene - Vital signs - Encourage adequate nutritional intake - Skin, mouth, perineal, wound, and intravenous site care - Aseptic Technique - Universal Precautions - Isolation Guidelines (Standard precautions, Transmission precautions) - Reportable Infectious diseases ( CDC)

Three Primary Protective Functions

- Protects the body from invasion of microorganisms and other antigens. - Removes dead or damaged tissue and cells. -Recognizes and removes cell mutations that have demonstrated abnormal cell growth and development.

Immunity: Nursing Implications (Patient Education)

- Risk Factors - Lifestyle Management - Infection Control and Communicable Disease (Communicable diseases, isolation precautions) - Medications ( Multi-drug resistant organisms) - Hypersensitivity (s/sx & tx anaphylaxis)

Immune Response

<Suppressed -Optimal- Exaggerated>

A person with type A blood who exhibits the D antigen would be considered to ave which blood type?

A+ Persons who express the D antigen are designated Rh positive.

Antecedent: Lympatic System

Adaptive Immunity- Lymphatic System: - Lymphatic organs ( bone marrow, thymus, spleen, tonsils, adenoids, and appendix.) - Lymph nodes (Neutrophils and macrophages carry antigens to the lymph nodes) - Lymphatic vessels and lymphatic capillaries (Transport vessels)

A client comes to the clinic with a runny nose and scratchy throat the nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. What is most likely the cause of the symptoms?

Allergic reaction ( Or parasitic infection)

Abnormal Results: Neutrophils

An increase percentage may be due to acute infection or acute stress. A decreased percentage may be due to aplastic anemia, chemo, influenza, viral infection, or widespread severe bacterial infections.

Abnormal Results: Monocytes

An increased percentage may be due to chronic inflammatory disease or viral infection.

_________ presents with itching, swelling, redness of deeper tissues and mucous membranes.

Angioedema

Immunity: Pharmacotherapy- Anti-infective

Antibiotic- Selection based on organism - Aminoglycosides - Tetracylcinces - Macrolides - Cephalosporins - Penicillins - Sulfonamides - Flouroquinolones Antifungals- targets fungal plasma membrane Antiretrovials- target specific phase of viral replication Antihelminthic- target parasites Antimalarial- interrupts the lifecycle of plasmodium

Effector T cells do not contain ____, which are produced by B cells

Antibodies

Some _______ (Cancer drugs also are used for their immunosuppressant effects. _________ drugs do not decrease the body's risk for infection; an autoimmune disease is not a neoplastic disease.

Antineoplastic

When an attenuated toxin is administered to a client the B lymphocytes create memory cells that recognize the antigen if it invades the body at a future time. What kind of immunity is this?

Artificial acquired active immunity

Attribute: Recognition of SELF

Auto-Immune Disorders - Breakdown of "Self-Tolerance" (Immune System attacks and destroys healthy cell) - Affect Multiple Organ Systems - Potential Outcomes (Destruction of body tissue, abnormal or organ growth, changes in organ function) - Genetic Predisposition

What type of hypersensitivity reaction involves failure of the development of self-tolerance?

Autoimmune reaction

____________ happens when the normal protective immune response paradoxically turns against or attacks the body, leading to tissue damage. It is not an immune deficiency.

Autoimmunity

The humoral response is characterized by the production of antibodies by ______ in response to a specific antigen.

B Lymphocytes

__ ______________ are the only cells capable of producing antibodies. They are the cells that mediate humoral immunity and differentiate into plasma cells which produce antibody.

B Lymphocytes (B-Cells)

Attribute: Bacterial and Viral Cultures

Bacterial and viral cultures are negative Common Organisms by Body Area. etc Colonization - Grow and multiple but do not cuase disease. Sensitivities - Anti microbial sensitivity

T cell mediated graft rejection is called cellular rejection and is induced by two mechanisims:

CD8 Cytotoxic T cells

The capacity of the immune system to differentiate self from non-self is called self tolerance.The development of self tolerance replies on two coordinated processes:

Central Peripheral

Immunity Antecedent: Innate Immune System Characteristics

Characteristics: - Includes cells, tissues, and organs located throughout the body. -Present at birth Provides resistance to infection and disease -Removes dead or damaged tisses or cells - Promotes healing

What assessment should be conducted by the nurse before the administration of tuberculin intradermal injection?

Checking for documented allergies to food and drugs.

Administered to treat or prevent infection, by minimizing neutropenia.

Colony- stimulating factors

_______ increase in number during allergic reactions and parasitic infections.

Eosinophiles

A monoclonal antibody, is administered orally. All other monoclonal antibodies are administered parenterally.

Erlotinib

A client with lupus has had antineoplastic drugs prescribed. Why would they physician prescribe antineoplastic drugs for an autoimmune disorder?

For their immunosuppressant effects.

Attributes: Lymph Nodes

Functioning Lymph Nodes - Location - Assessment: soft, moveable, nontender - Aging: Non-Palpable in older adults

The _____ vaccine is estimated to rude the risk of cervical cancer by 97%.

HPV

_____ is implicated in cancer of the vulva, vagina, and cervix.

HPV

In __________ thyroiditis the normal protective immune response attack the body, damaging tissues.

Hashimoto's

Immunity: Nursing Implications (Assessment)

History - Medical (allergies, immune deficiencies, medications) -Family hx (immune disorders), Social hx, travel hx Growth and Development - Immunizations - Age related changes - Pregnancy Lifestyle - Tobacco Use - High Risk behaviors - Exposure to toxins

Urticaria is also known as

Hives

Antecedent: Adaptive Immune Response

Humoral Immunity and B Lymphocytes - Immunoglubulin- 5 classes of Antigens. (IgG, IgA, IgM, IgD, IgE) T Lymphocytes - Cytotoxic and Helper T Vaccines - Containing antigenic molecules which stimulate an immune response (Active Immunity) - Common Vaccienes (DTaP, MMR, Flu, PNA, ect.)

Attribute: Scope of Immune Response ( Exaggeration)

Hypersensitivity Disorders 4 Types - Atopic (allergic); IgE; mast cells - Cytotoxic (tissue specific); IgG and IgM; macrophages - Cell mediated (delayed hypersensitivity; none; lymphocytes/ Macrophages - Localized or systemic

Effector T cells do not initiate the _______ response

Imflammatory

Immunity: Sub-Concepts

Immune Response Inflammatory Response Infections Response

Attribute: Scope of Immune Response (Suppression)

Inadequate Functioning Immunodeficiency > Primary: - Entire immune system is compromised - Common: defect in antibody formation Secondary: - Loss of immune function by illness or treatment - Ex: multiple myelomas, chemotherapy

What interferes with the ability of viruses in infected cells to replicate and spread to uninfected cells.

Interferons

A client is exposed to a viral infection. What role with interferon most likely play during this exposure?

It will interfere with the ability of viruses in infected cells to replicate and spread to uninfected cells. (Interferons do not stimulate b lymphocyte activity, stem cell multiplication, or growth of lymphoid cells. )

A client is exposed to a viral infection. What role will interferon most likely play during this exposure?

It will interfere with the virus replication.

Immunity Antecedent: Defense and Barriers

Mechanical and Physical Barriers - Intact skin and mucous membrane - Mucus formation - Cough and sneezing reflexes - Celia in respiratory gastrointestinal tracts Chemical Barriers - pH of Skin - Hydrochloric acid in the stomach Microbiological competition by normal flora.

A client is scheduled for a renal angiography. What would be appropriate before the test?

Monitor the client for an allergy to iodine contrast material. (The procedure would be contraindicated)

If a client with _________ develops a fever, the client is considered to have an infection and is usually admitted to the hospital. Culture of blood, urine, and sputum, as well as chest x-ray, are obtained.

Neutropenia

______ is a group of inflammatory diseases of the middle ear.

Otitis media -Elevated white blood cell count. -Infection/ Chronic Inflammatory response ( Tissue integrity, comfort, functional ability, thermoregulation)

Immunity Antecedent: Innate Immune System

Phagocytic cells - Neutrophils - Macrophages Natural Killer cells - Specialized lymphocytes Complement System - Plasma proteins tag organisms for destruction

Formerly know as RAST. Radioimmunoassay that measures allergen-specific IgE. Indicated quantity of allergen necessary to evoke an allergic reaction.

Serum- specific IgE test

Research has shown that ______ ______ can restore and immune system that has been destroyed.

Stem Cells

What is absolutely vital to the success of HIV Treatment?

Strict adherence to the drug schedule.

A client with cirrhosis has just received a liver transplant. Tissue rejection can be best prevented by what means?

Suppression of CD8 + cytotoxic T cells

__ ______ are more closely associated with cellular immunity, and the action circulating lymphocytes containing antigenic messages.

T cells

Effector (cytotoxic) ______ cells release cytokines that either destroy the pathogen directly or mark it for destruction by phagocytes.

T-cells

The placenta is the site where antibodies in the mother's blood pass into the fetal circulation. These antibodies give passive immunity to the fetus for several common childhood diseases. There are some infections from which the mother does not provide antibodies to the fetus. What infection is the fetus not protected from?

The fetus does not receive immunity to rubella, cytomegalovirus (CMV), varicella, or measles. Fetal infection may occur.

A nurse is providing health education to a client who has recently been diagnosed with HIV and will soon begin antiretroviral therapy. What teaching point should the nurse prioritize?

The need to adhere rigidly to the prescribed drug schedule.

Attribute: WBC and differential

WBC- 4,5000- 10,000 cells/microliter - Neutrophils: 40%- 60% - Lymphocytes: 20%- 40% - Monocytes: 2%- 8% - Eosinophils: 1% -4% - Basophils: 0.5% - 1% -Band (Young Neutrophils): 0% - 3%

A pediatric client was brought to the emergency department y the parents after experiencing extensive urticaria following consumption of a seafood dinner. Upon discharge from the facility the nurse provided client teaching. What statement by the parents indicate learning occurred?

We need to go get our child a medical alert bracelet as soon as possible in case this happens again.

A nurse is administering colony-stimulating factors to an older adult client after chemotherapy. The nurse should explain to the client that this medication is being administered for which reason?

Your body is going to have trouble fighting off infections on it's own. This medication will help with that.

What do interferons not do?

- Stimulate b lymphocyte activity - Stem Cell multiplication -growth of lymphoid cells

While strict adherence to the HIV drug schedule is a priority, what other things should the client learn?

- There is a possibility of hypersensitivity, but incidence and prevalence are unimportant. - Adverse effect, but adherence is the top priority.

Immunity: Interrelated Concepts

- Tissue Integrity - Cellular regulation - Thermoregulation - Comfort - Coping - Nutrition - Mobility - Functional ability

Normal Results: -Eosinophils -Basophils -Band (Young Neutrophil)

-Eosinophils: 0%-3% -Basophils: 0%-1% -Band: 0%-3%

Attributes of Immunity

-Normal WBC and differential counts - Negative bacterial and viral cultures. - Soft, non-tender lymph nodes -Recognition of self - Recognition of foreign proteins

Immunity: Nursing Implications (Physical Assessment)

-Vital signs ( elevated pulse, BP, temp) - Skin and Mucous membranes (moisture, temperature) - S/SX infection (Redness, edema, drainage, tenderness @ local site - Lymph nodes - Joint (inflammation, ROM deficits) - Respiratory Impairment (O2 Sats, dyspnea, adventitious breath sounds

Nursing Implications: Pharmacotherapy- Inflammation

Nonsteroidal Anti-inflammatories - Bloc prostaglandin synthesis - Cox 1 and 2: Ibuprofen - Cox 2: Celecoxib - Salicylates: Aspirin Corticosteriods - Modify immune response - prednisone Immunizations - Provide active or passive immunity - Follow recommended immunization schedules

Preparing the syringe with medication is considered _________, not assessment.

Planning

The administration of immunizations to a client is a form of what type of immunity?

Artificial active immunity