Chapter 36: Management of Patients With Immunodeficiency Disorders
Chain of infection
~ Etiologic agent (microorganism) ~ Reservoir (source) ~ Portal of exit from reservoir ~ Method of transmission ~ Portal of entry to susceptible host ~ Susceptible host
S/S of Infection
~ Inflammation: Erythema Heat Pain Edema ~ Fever ~ Leukocytosis (increase of WBCs)
Thymus hypoplasia
~ T-cell deficiency that occurs when the thymus gland fails to develop normally during embryogenesis ~ AKA DiGeorge syndrome
Wiskott-Aldrich syndrome
Immunodeficiency characterized by thrombocytopenia and the absence of T- and B-cells
ESR (Erythrocyte sedimentation rate)
Measures the rate of blood cell sediment over 1 hr
Blood cultures
Must be drawn before antibiotic
Airborne precautions
~ Gown, gloves, N-95 respirator ~ TB, measles, chicken pox
Droplet precautions
~ Gown, gloves, mask ~ Pneumonia, meningitis, respiratory MRSA
Contact+ precautions
~ Gown, gloves, wash hands w/soap and water ~ C. diff
Nursing Dx
~ Risk for Infection ~ Anxiety ~ Hyperthermia ~ Impaired Oral Mucosa ~ Risk for Ineffective Therapeutic Regimen Management ~ Social Isolation ~ Spiritual Distress
Contact precautions
~ Wear gown and gloves ~ MRSA and shingles
Ataxia-telangiectasia
Autosomal recessive disorder affection T- and B-cell immunity primarily seen in children and resulting in a degenerative brain disease
Vascular infection pathophysiology
Capillaries dilate, fluid moves to tissues => edema
Angioneurotic edema
Condition marked by development of urticaria and an edematous area of skin, mucous membranes, or viscera (i.e., angioedema)
Severe combined immunodeficiency disease
Disorder involving a complete absence of humoral and cellular immunity resulting from an X-linked or autosomal genetic abnormality
Agammaglobulinemia
Disorder marked by an almost complete lack of immunoglobulins or antibodies
Panhypoglobulinemia
General lack of immunoglobulins in the blood
Nosocomial Infections
Healthcare-associated infections Manifest after 48 hours of hospitalization Causes: CAUTI, Pneumonia (if no IS), surgical errors due to lack of time outs
Description of vascular infection
Is it edematous? (swollen) Tender? Warm? Size? Erythematous? (red)
Hypogammaglobulinemia
Lack of one or more of the five immunoglobulins; caused by B-cell deficiency
Ataxia
Loss of muscle coordination
Immunocompromised host
Person with a secondary immunodeficiency and associated immunosuppression
Telangiectasia
Vascular lesions caused by dilated blood vessels
Cellular infection pathophysiology
WBC's increase, platelets move in... engulf invader
