Hypersensitivity Reactions
Name the hypersensitivity reaction that is caused by a release of histamine from mast cells
Type 1 hypersensitivity reaction
Name two adverse effects of cyclosporine
1. Nephrotoxicity
2. Infection
3. Hypertension
4. Hirsuitism
What is the characteristic rash called in a patient that has systemic lupus erythematous (SLE)?
Butterfly rash
What is HIV?
A mother that is Rh- but delivers a baby that is Rh+ will be given this medication to prevent future issues with blood type incompatibility of a future fetus.
Rhogam
When histamine is released what effects will it have on the body? (Name at least 2)
Bronchoconstriction
Vasodilation
Increased capillary permeability
Increased mucus
Runny nose
If it is systemic it can cause anaphylaxis
Name two foods that can interfere with the absorption of levothyroxine
1. Iron
2. Antacids
3. Calcium carbonate
4. MVIs if they contain iron
5. Sulcralfate
6. Cholestyramine
Discuss some labs that maybe tested in a patient that has SLE. Name at least 2
ESR
CRP
ANA titer
CBC
Anti Ro, Anti La, Anti smith antibodies
What is the diagnosis of AIDs?
CD4 count < 200
Name 3 signs of a blood transfusion reaction
1. Lower back pain
2. Chest pain
3. Urticaria
4. Hypotension
5. Tachycardia
6. Temperature rising more than 1 degree celcius
7. Tachypnea/wheezing/dyspnea
8. Chills
If a patient is given the wrong type of blood what type of hypersensitivity reaction will it cause?
Type 2 hypersensitivity reaction
Involves destruction of a cell or substance that has an antigen attached to it by lysis or phagocytosis
Sensed by IgG or IgM antibodies
Name two adverse effects of tacrolimus
1. Nephrotoxicity
2. Neurotoxicity
3. GI effects
4. Hypertension
5. Hyperglycemia
Name 3 risk factors for SLE
1. Women of childbearing age
2. Sun exposure, UV light
3. First degree relatives with lupus
4. Ethnicity (Black, Asian, Hispanic, American Indian)
Before a patient starts antiretroviral therapy (ART) what 2 labs will be checked that will help determine overall effectiveness of the ART?
1. Viral load
2. CD4 count
Receiving a vaccination is considered what type of immunity?
Active artificially acquired
Transplant rejection is what type of hypersensitivity reaction?
Type 4
Delayed reaction
When a sensitized T lymphocyte comes in contact with the particular antigen to which it is sensitized
Causes necrosis
Cell mediated immune response
If a patient is taking Hydroxychloroquine (Plaquenil) for long term control of systemic lupus erythematous what are some nursing interventions/education you will advise. Name at least 1
1. Regular eye examinations (Must have done prior to, and while on medication)
2. May take weeks to months for effects to be noticed
3. Take before or after meals at the same time each day
Name 3 symptoms of hypothyroidism
1. Weight gain
2. Constipation
3. Cold
4. Mental slowness
5. Fatigue
6. Severe could cause hypotension and bradycardia
Name the 3 routes of HIV transmission
Parenteral
Sexual
Perinatal
Name the three different types of lupus
1. Discoid
2. Drug induced lupus
3. SLE
What is serum sickness? (You also need to include what type of hypersensitivity reaction it is when you answer this)
Antigen–antibody complexes form from exposure to nonhuman proteins that occur in a type 3 hypersensitivity reaction.
Immune complexes formed by antigens and IgG antibodies in the blood vessel walls
A patient is taking the immunosuppressant medication, Azathioprine. Discuss at least 2 nursing interventions/education.
1. Increases risk of cancer
2. Increases risk of infection
3. Monitor CBC
4. Monitor renal function
5. Monitor LFTs
6. Monitor for abnormal bleeding
Name the 2 different causes for pernicious anemia
1. Nonacquired:
Autoimmune (Auto antibodies against gastric parietal cells interfering with intrinsic factor)
2. Acquired:
Gastric surgery or small bowel resection
A patient that has AIDs is at risk for this type of pneumonia that is considered an opportunistic infection
Pneumocystis pneumonia (PCP)
What are some nursing interventions you would discuss with a patient that has HIV to avoid the opportunistic infections cryptosporoidosis/giardia.
Deli, leftovers, meat spreads, ready to eat, refrigerated plates