Immune System
Type of immunity gained from a prior exposure to antigen, can be active or passive
What is Acquired Immunity?
The nurse is administering intravenous vancomycin. What is a priority nursing assessment if the patient begins to experience a possible allergic reaction?
What is airway assessment, monitoring, and management.
The initial nursing assessment and intervention needs to be directed toward evaluating breathing and maintaining an open airway, so the initial assessment will be for dyspnea, bronchospasm, and laryngeal edema. Hypotension, pruritis, and flushing may occur, but the airway is most important.
Painful phenomenon associated with scleroderma that causes exaggerated contraction of small blood vessels in fingers and toes. Patients often endorse severe pain in their digits.
What is Raynaud's Phenomenon?
RA attacks this part of the body, causing swelling and pain
What are Joints?
Lupus is a type of _________ disease
What is Autoimmune?
What organ is considered lymphoid tissue?
Lymphoid tissues, such as the thymus gland, tonsils and adenoids, spleen, and lymph nodes, play a role in the immune response and prevention of infection.
FYI- The pancreas, intestines, and liver are not lymphoid tissue.
The nurse is caring for a patient exposed to peanuts with a known allergy. What assessment is considered the most serious manifestation of angioneurotic edema?
A. Abdominal Pain
B. Conjunctivitis
C. Laryngeal swelling
D. Urticaria
What is C- Laryngeal swelling
Diffuse swelling can affect many regions: lips, eyelids, cheeks, hands, feet, genitalia, tongue, larynx, bronchi, and the gastrointestinal canal. The most serious is the larynx because of the potential for compromised breathing. Abdominal pain, conjunctivitis and urticaria are not the most serious manifestations.
This Inflammatory Rheumatic Disease is characterized by impairment of the endothelial lining of the blood vessels resulting in vasculitis.
What is Giant Cell Arteritis
GCA - is the most common form of vasculitis in adults impacting medium and large arteries. One of the most common vessels impacted are the temporal arteries (running along the temples in front of the ears) giving the disease the nickname "temporal arteritis"
What is Mobility?
It is important for patients with lupus to avoid ____ __________
What is Sun Exposure?
Will also accept:
What is stress? What is individuals with transmissible infections/illnesses?
A 25-year-old female is admitted to the ER in anaphylactic shock due to a bee sting. According to the patient's mother, the patient is severely allergic to bees and was recently stung by one. This type of anaphylactic reaction is known as a?
A. Type I Hypersensitivity Reaction
B. Type II Hypersensivity Reaction
C. Type III Hypersensivity Reaction
D. Type IV Hypersensivity Reaction
The answer is A.
Rationale: Type I Hypersensitivity Reactions are immediate and cause anaphylaxis. It occurs when an antigen (the allergen….in this case bee venom) attaches to immunoglobulin E (IgE) antibodies. These antibodies are created due to this allergen and attach to the mast cells and basophils. This leads to a system-wide release of inflammatory mediators (histamine and other inflammatory substances). It is important to note a patient must be sensitized (meaning the immune system has seen the allergen before and produced IgE antibodies in response to the allergen). When the person comes into contact with the foreign substance AGAIN (at a later time) the allergen will attach to that previously created IgE antibody on the mast cell. This will lead to a massive release of histamine and other inflammatory substances that will cause anaphylaxis and lead to anaphylactic shock.
A patient is given a dose of ketorolac, a nonsteroidal anti-inflammatory (NSAID) drug for complaints of abdominal pain. Ten minutes after receiving the medication, the client’s eyes, lips, and face begin to swell, and the nurse hears stridor. What priority intervention should the nurse anticipate/prepare to do?
A. Intubate client
B. Obtain an EKG
C. Assess VS
D. Administer Epinephrine
What is D Administer Epinephrine
Anaphylaxis is a rapid and profound type I hypersensitivity response. A massive release of histamine causes vasodilation; increased capillary permeability; angioneurotic edema (acute swelling of the face, neck, lips, larynx, hands, feet, genitals, and internal organs); hypotension; and bronchoconstriction. A nurse must administer 0.3 mg of epinephrine subcutaneously to a patient experiencing a severe allergic reaction. It is outside of the nurse’s practice to intubate a patient. Performing an ECG and assessing the vital signs delays the treatment of the patient and can have negative outcomes.
Class of medication that is often prescribed to patients experiencing an exacerbation or "flare" of an inflammatory rheumatic disorder.
What is a Corticosteroid?
FYI: most often this is either Prednisone or Methylprednisolone.
These are two inflammatory markers you would expect to be elevated during RA exacerbation (flare)
What are ESR & CRP
The ESR and CRP tend to be significantly elevated in the acute phases of most inflammatory rheumatic diseases, especially RA & SLE, and are therefore useful in monitoring active disease and disease progression.
Roughly 40-50% of patients diagnosed with SLE will have systemic involvment of this organ system
What is Renal system
Will also accept cardiac or hematologic
Most often mortality for those with SLE involves renal failure.
Other commonly impacted organ systems with lupus include the vascular system and almost all patients have joint involvement
What are the primary participants in the immune system?
What are Lymphocytes, which are either T-cell or B-cell lymphocytes, comprise 20% to 30% of all leukocytes. T-cell and B-cell lymphocytes are the primary participants in the immune response.
A patient asks the nurse if it would be okay to take an over-the-counter (OTC) antihistamine for the treatment of allergic rhinitis. (A mild type I hypersensitivity reaction) What should the nurse educate the patient is a major side effect of antihistamines?
What is drowsiness, fatigue, sedation
Antihistamines are the major class of medications prescribed for the symptomatic relief of allergic rhinitis. The major side effect is sedation, although H1 antagonists are less sedating than earlier antihistamines.
Initiation of treatment with any Biologic DMARD will take roughly this long to ilicit therapuetic effects?
What is 6 weeks
Patients generally report a beneficial effect w/in 6 wks but response is patient specific. It is important to educate patients on this and that therapuetic effects may take as long as 3 months
Prior to starting on adalimumab (Humira) the provider will most likely order this to ensure safe initiation of the medication?
What are serum lab tests (labs/blood tests)
Patients should be tested for tuberculosis (TB) before beginning this medication. Patients should also complete baseline lab work that includes CBC and CMP. If a tuberculosis test comes back postivite (or indeterminate) a chest x-ray will be ordered to rule out TB,
This is an exageration of symptoms often provoked by stressors like illness or injury
What is an exacerbation or "flare"
The abrupt cessation of this classification of medication may result in adrenal crisis, a life-threatening condition characterized by circulatory collapse.
What are corticosteroids?
This assessment finding (especially heard without the use of a stethoscope) is indicative of upper airway obstruction and warrants immediate life-saving medical attention.
What is stridor.
Stridor is continuous, high-pitched, musical sound heard on inspiration, best heard over the neck; may be heard without use of a stethoscope, secondary to upper airway obstruction
Wheezes are continuous musical sounds associated with airway narrowing or partial obstruction
what is scleroderma
Manifestations: dry skin, stiffness & declining mobility
Systemic: esophagus & intestines become sclerosed, lungs becomes scarred, vascular involvement of kidneys leads to malignant HTN & renal insufficiency
Common medication for RA, known for causing immunosupression, hepatotoxicity, interactions with several antibiotics, and severe GI discomfort
What is Methotrexate?
Methotrexate (MTX) often the 1st line treatment option for RA (also useful in SLE) MTX may be given orally or by intramuscular or subcutaneous injection.
Assess for: bone marrow suppression, GI ulcerations & upset, skin rashes, alopecia, bladder toxicity, increased infections. Educate pt on these side effects
Monitor CBC, liver enzymes (hepatotoxic), creatinine (baseline, 6 wk after start, then q2–3 mo or as ordered)
Advise/educate on contraceptive measures because of teratogenicity
Common medication used to decrease the antibodies attacking the body for long term control of lupus, also an anti-malarial
What is Hydroxychloroquine?