NUR3985 Immunology/ Oncology Review

Hypersensitivity disorders

100

The radioallergosorbent test (RAST) (IgE antibody test) for hypersensitivity type 

I

200

Nursing Consideration for "Skin testing for allergens"

§Prepare the skin using soap and water.

§Use alcohol to remove any oil.

§Have emergency equipment available to treat anaphylaxis

Recommend an antihistamine or topical corticosteroid if skin itches after testing.

300

ANAPHYLAXIS 

Hypersenstivty Type I

400

•IgG and IgM involved in hypersensitivity type

II

•Erythroblastosis fetalis

•Myasthenia gravis

•Goodpasture syndrome

500

•Antigen-antibody complex that is deposited in the tissue and activates complement and attacking neutrophils

Type III

SLE

Glomerulonephritis

RA

Rheumatic fever 

600

SLE Clinical Manifestation:

Fatigue/malaise

Blurred vision

Anorexia/weight loss

Depression

Joint pain, swelling, tenderness

Fever (also a major indication of exacerbation)

Anemia

Lymphadenopathy

Pericarditis (presence of a cardiac friction rub or pleural friction rub)

Raynaud’s phenomenon (arteriolar vasospasm in response to cold/stress)

Erythematous “butterfly” rash on the nose and cheeks (raised, dry, scaly)

700

SLE Management

NSAIDs

Corticosteroids

Immunosuppressant agents

800

•Mediated by T-cells

Type IV Hypersensitivity

•Type I diabetes, Positive TB reaction

•Contact dermatitis as in nickel allergy and poison ivy.

•delayed Graft rejection 

HIV

100

HIV Targeted blood cells

•CD4+ T-cell (Helper T cells) Cell medicated and Humoral Mediated (T and B cells)

200

AIDS DIAGNOSIS

•CD4 levels Less than 200

•Multiple opportunistic infections:

•Resp

•Pneumocystic pneumonia (PCP)

•TB

•GI

•Candidiasis (thrush)

•Skin

•Gynecologic

•Immunologic

Oncology

100

Cancer Screening recommendations

Mammogram: Annually for female clients 45 to 54 years. At 55 years, clients can transition to every two years.

Colonoscopy: 

- At age 50 and then every 10 years

-Guaiac-based fecal occult blood test or fecal immunochemical test annually; 

- stool DNA test every 3 years.

Cervical Cancer:

- Pap test: Clients age 21 to 29, every 3 years.

-Clients age 30 to 65, every 5 years with an HPV DNA test, every 3 years with Pap test alone

200

Warning Signs of Cancer

•C- changes in bowel or bladder habits

•A- a sore throat that doesn’t heal

•U- unusual bleeding or discharge

•T- thickening of lump in breast

•I- Indigestion or difficultly swallowing

•O- Obvious changes in wart or mole

•N- Nagging cough or hoarseness

300

definitive diagnosis of cancer

Biopsy: Provides definitive diagnosis indicating the site of origin (specific cell type) and cell characteristics (specific receptors on cell surface). Can be obtained during other procedures (endoscopy, laparoscopy, thoracotomy).

400

Nursing Interventions for Chemo

•Hematologic

•Anemia

•Thrombocytopenia

•Neutropenic

•Pancytopenia

•Gastrointestinal

•Skin/Mucosal

500

Nursing Interventions for Internal Radiation Therapy

•Place the client in a private room. Keep the door closed as much as possible.

•Place a sign on the door warning of the radiation source.

•Wear a dosimeter film badge that records personal amount of radiation exposure.

•Limit visitors to 30‑min visits, and have visitors maintain a distance of 6 feet from the source.

•Individuals who are pregnant, trying to conceive, or under the age of 16 years should not enter the client’s room.

•Wear a lead apron while providing care, keeping the front of the apron facing the source of radiation.

•Keep a lead container in the client’s room if the delivery method could allow spontaneous loss of radioactive material

•Follow protocol for proper removal of dressings and bed linens from the room.