Risk factors for immune & Medications for Idiopathic & Lupus

A 13-year-old is being evaluated for lupus. The teen asks who is at risk for this condition. What information can be provided by the nurse? Select all that apply.

"Females are at a higher risk than males."" Excessive sun exposure is linked to the development of lupus." "Some clients will have had a recent infection."

Susie is a 3-year-old with a history of neonatal transmission of HIV and recent diagnosis of AIDS, as manifested by M. tuberculosis infection. To date, Susie has been relatively healthy with few illnesses associated with high fever; she has been developing appropriately and is at the 5th percentile for height and weight. Susie is at risk for all of the following diagnoses. Prioritize the order of urgency of these diagnoses based on the scenario provided. - Altered family coping related to new presentation of significant illness - Delayed growth and development related to frequent infections - Altered comfort related to severity of new illness - Inadequate nutrition related to side effects of medication - Inadequate adherence to medication regimen related to side effects

- Altered family coping related to new presentation of significant illness - Altered comfort related to severity of new illness - Inadequate adherence to medication regimen related to side effects - Inadequate nutrition related to side effects of medication - Delayed growth and development related to frequent infections

Which of the following nursing problems could be associated with a child with primary immunodeficiency? Select all that apply. a) Risk for infection b) Delayed growth and development c) Altered skin integrity d) Altered gastrointestinal function e) Altered fluid and electrolytes

- Risk for infection - Altered skin integrity - Delayed growth and development

The young girl has been diagnosed with juvenile idiopathic arthritis (JIA) and has been prescribed methotrexate. Which statements by the child's parent indicates that adequate learning has occurred? Select all that apply.

-"We'll need to bring her back in for some lab tests after she starts methotrexate." -"Swimming sounds like a good exercise for her." -"A warm bath before bed might help her sleep better."

The nurse is caring for a child who is receiving naproxen for treatment of juvenile idiopathic arthritis. What interventions should the nurse include in this client's care plan?

-Administer the medication with food -Monitor lab results for an increase in liver enzymes -Monitor renal labs for a decrease in renal function

The parents of a child with juvenile idiopathic arthritis bring the child to the emergency department because the child is very drowsy and breathing heavily. The child also has been vomiting and complaining of ringing in her ears. The nurse suspects that the child is experiencing a toxic reaction to one of her medications. Which medication would the nurse suspect? a) Aspirin b) Corticosteroid c) Etanercept d) Methotrexate

A. Aspirin

The nurse is explaining patterns of incidence and transmission of HIV to a group of adolescent girls. She explains that the risks for this population are much higher because of the possibility of both vertical and horizontal transmission. Horizontal transmission refers to transmission of the disease during which of the following? a) Sexual contact b) The birthing process c) Pregnancy d) Feeding with breast milk

A.) Sexual Contact

The nurse is assessing a child with a complex medical history that includes fatigue, Raynaud phenomenon, anemia and photosensitivity. The nurse should anticipate that this child may require which treatment?

Corticosteroid therapy

Which treatments are common to both systemic lupus erythematosus and juvenile idiopathic arthritis? Select all that apply.

Corticosteroids Nonsteroidal anti-inflammatories

A child with primary immune deficiency is about to receive an infusion of IVIG. Which of the following is the most appropriate premedication to minimize the reaction? a) Ketorolac b) Ibuprofen c) Diphenhydramine d) Solu-Medrol

Diphenhydramine

The nurse is assessing a child who is experiencing renal complications as a result of lupus. Which finding is of the greatest concern?

Elevated blood pressure

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)

The laboratory results of a child with juvenile arthritis are being evaluated. Which are consistent with this condition? Select all that apply.

Hemoglobin 9.3 mg/dL Erythrocyte sedimentation rate elevated

A young patient comes to the clinic with multiple symptoms of an infection. The nurse realizes that the patient has been seen in the clinic every month for the last 6 months for the same problems. Which body system does the nurse suspect is malfunctioning in this patient? a) cardiovascular b) respiratory c) immune d) gastrointestinal

Immune

A group of nursing students are reviewing information about the immune system. The students demonstrate understanding of the information when they identify which of the following being produced by the thymus? a) White blood cells b) Stem cells c) Lymphocyte T cells d) Antibodies

Lymphocyte T cells

A nursing student correctly identifies the inability to distinguish self from nonself, causing the immune system to carry out immune responses against normal cells, as which of the following? a) immunity b) autoimmunity c) delayed hypersensitivity d) allergen

autoimmunity

A young patient is admitted to the hospital directly from the clinic. The physician suspects a problem with the patient's immune system. What test does the nurse anticipate the physician will order for this patient? a) urine analysis b) blood analysis c) x-ray d) EKG

blood analysis

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.

A 4-year-old child is receiving monthly IgG transfusions for hypergammaglobulinemia. In assessing the child's current health status, the nurse will ask about several aspects of care, including which of the following? Select all that apply. a) Sleep disturbances b) Vacation plans c) Nutritional intake d) Frequency of recent illnesses e) Participation in activities

• Frequency of recent illnesses • Nutritional intake • Participation in activities • Sleep disturbances • Vacation plans

A nurse is preparing a presentation for a group of new parents and is planning to discuss nutrition during the first year. As part of the presentation, the nurse is planning to address foods that should be avoided to reduce the risk of possible food allergies. Which of the following would the nurse most likely include? Select all that apply. a) Peanuts b) Shrimp c) Eggs d) Carrots e) Oranges f) Potatoes

• Peanuts • Shrimp • Eggs

The nurse is preparing an informational brochure about risk factors for immune disorders. Which of the following disease processes can indicate a potential underlying immunologic disorder? Select all that apply. a) Persistent oral thrush b) Occasional rhinorrhea c) Chronic cough d) Illness with a high-grade fever e) Extensive eczema

• Persistent oral thrush • Chronic cough • Extensive eczema