Chapter 42 Immune Peds

Assessment findings of anaphylaxis in order from first to last.

N/V, Diarrhea Urticaria, angioedema Bronchospasm Hypoxia Seizures

Parents demonstrate understanding of treatment of infantile eczema when they say the following:

"I know I have to follow all the directions while using the hydrocortisone cream."

The mother of a child with a possible food allergy asks the nurse for information about how to test for it. What response by the nurse would be most accurate?

"The best way is to eliminate the food from the diet and then look for improvement."

The nurse is talking to the parents of a child who has been diagnosed with severe combined immune deficiency (SCID). What statement by the parents best indicates that they understand their child's condition?

"We'll need to prepare him and ourselves for a bone marrow transplant."

When describing the different types of hypersensitivity reactions to a group of nursing students, the instructor identifies IgE as being involved in what types of reactions?

Anaphylaxis Type I Type III

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?

Acute otitis media, one episode q 3-4 weeks over the past year Recurrent deep abscess of the thigh Oral thrush, persistent over the past 6-7 months

The nurse is caring for a child who is having an anaphylactic reaction with bronchospasm. The nurse would expect to administer what for bronchospasm as ordered?

Albuterol

A child is diagnosed with severe combined immunodeficiency syndrome. What would the nurse expect to find when reviewing the child's history and physical examination?

Chronic diarrhea

The nurse is explaining to a parent that many "Summer colds" are actually cases of allergic rhinitis. What are typical S/S of allergic rhinitis?

Clear, watery nasal drainage Frontal HA Blackened areas under the eyes

The school nurse is walking through the lunchroom when one of the children says she feels strange after switching her lunch with her friend. What assessment would be most important?

Determining if her throat itches

After reviewing info about the diff types of immunodeficiency disorder, nursing students demonstrate the need for additional study when they identify what as a B-lymphoctye deficiency?

DiGeorge syndrome

The nurse is assessing a child with a pauciarticular-type juvenile idiopathic arthritis. What would the nurse expect to assess?

Eye inflammation

A child is diagnosed with a food allergy to milk. When teaching the parents about this allergy, what would the nurse suggest as possible substitutions?

Fruit juice Soy Milk Rice Milk

A nurse is describing to parents of a child with allergies the events of a type I hypersensitivity reaction. What would the nurse describe as being responsible for vessel congestion and edema.

Histamine Leukotrienes

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

When describing anaphylaxis to a group of parents whose children have experienced anaphylaxis from insect stings, the nurse integrates knowledge that this response is r/t which immunoglobulin?

IgE

When teaching a group of new parents about newborn care & development, what immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns?

IgG

A child is scheduled to undergo hyposensitization. The nurse understands that this therapy attempts to achieve what?

Increased concentration of IgG

The nurse is examining to the parents of a newborn some steps they can take to minimize the development of allergies. What would be included in this education process?

Keep the room dust free Use laundry solutions that have as few chemicals as possible Avoid perfumes and room fresheners

The nurse is caring for a child with lupus. The doctor will most likely order what test to monitor the child's progression?

Lymphocyte immunophentyping T-cell quantification

A child is diagnosed with juvenile idiopathic arthritis and is receiving several different medications listed in the MAR. What agent would the nurse identify as being used to prevent disease progression?

Methotrexate

The nurse is reviewing the lab test results of a child who is suspected of having systemic lupus erythematosus (SLE). What would the nurse identify as supporting this diagnosis?

Positive antinuclear antibody (ANA) Thrombocytopenia Leukopenia

A nurse is preparing a teaching plan about environmental control measures for the patient of a child with an allergy. What would the nurse include?

Removing any fur or woolen items from the child's wardrobe Encasing the mattress and pillow in a sturdy plastic

What nursing problems could be associated with a child with primary immunodeficiency?

Risk for Infection Altered skin integrity Delayed growth and development

What immune cells are disrupted when a child is infection with HIV?

T cells B cells Phagocytes

An infant presents with a rash and signs of secondary infection on the face. The nurse suspects infantile eczema based on what assessment findings?

The child is irritable The lesion are found on the extensor surfaces The child is 9 months old

The nurse explains to the parent of a child with latex allergy that the first sign of an anaphylactic reaction is often

Vomiting

Drug allergies can cause many types of symptoms. What might you expect to see in a child with a severe penicillin allergy?

Wheezing Urticaria Serum sickness

A nurse is providing care to a child with HIV who is prescribed therapy with a nucleoside reverse transcriptase inhibitor. What would the nurse expect to administer?

Zidovudine

Testing & treatment for allergic rhinitis are typically determined by

how disruptive the symptoms are to the child

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 non nucleoside analog reverse transcriptase inhibitors (NNRTIs) the nurse is cognizant that the child will be taking what additional medication as part of the 3-drug regimen?

Protease inhibitors