INFECTIONS
MEDICAL MANAGEMENT FOR AN INFECTION
What is Antibiotics and Assessing Liver and Kidney Function (AST/ALT - Cr - BUN)
COMMON S/s of IMMUNODEFICIENCY
What is Recurrent Infections - slow recovery - poor wound healing - FATIGUE - MALAISE - OPPORTUNISTIC INFECTIONS
COMMON S/S of AUTOIMMUNE DISEASES
What is chronic inflammation (JOINT - swelling)
- fatigue
- fever
- specific organ involvement (skin rash in lupus)
- periods of remission and exacerbation
ANAPHYLAXIS - ALLERGIC RHINITIS - ASTHMA are examples of WHAT TYPE OF HYPERSENSITIVITY?
What is TYPE 1: IMMEDIATE REACTION?
TRANSFUSION REACTION S/S
- FEVER
- CHILLS
- FLANK PAIN
- HEMOGLOBINURIA
Symptom Management for Infection
What is Antipyretics and Hydration?
DIAGNOSTICS for IMMUNODEFICIENCY
- IMMUNOGLOBULIN LEVELS
- GENETIC TESTING
DIAGNOSTIC for AUTOIMMUNE DISEASES
AUTOANTIBODIES:
-POSITIVE ANA
- RHEUMATOID FACTOR
- ANTI-CCP ANTIBODY (RA)
ESR + CRP + FIBRINOGEN = inflammatory markers
CBC: Hgb + Hct + RBC + WBC
A patient is displaying S/S of bronchoconstriction - wheezing - stridor - dyspnea - and N/V/D: what type of reaction is the patient displaying?
What is ANAPHYLAXIS?
SLE IS AN EXAMPLE OF WHAT TYPE OF HYPERSENSITIVITY?
WHAT IS A TYPE 3: THE IMMUNE COMPLEX: CAUSES INFLAMMATION
localized or systemic inflammation:
- FEVER
- RASH
- JOINT PAIN
NURSING priorities/interventions for infection
What is Monitoring for changes in VS and signs of sepsis or worsening infection?
MEDICAL MANAGEMENT for IMMUNODEFICIENCY
- TREAT THE UNDERLYING CAUSE
- IMMUNE GLOBULIN REPLACEMENT THERAPY
MEDICAL MANAGEMENT for AUTOIMMUNE DZs
1. IMMUNOSUPPRESSANTS - CORTICOSTEROIDS
2. SYMPTOM MANAGEMENT - NSAIDS (inflammation and pain relief)
3. INSULIN for TYPE 1 DM
DIAGNOSTIC FOR ANAPHYLAXIS
What is:
- allergy Hx
- CBC w diff
- SKIN or BLOOD TESTS: allergy skin test
- total serum IgE
- RAST TEST
NURSING PRIORITIES for a TYPE 3: IMMUNE COMPLEX HYPERSENSITIVITY REACTION
WHAT IS: MONITOR FOR:
- S/S of SYSTEMIC ORGAN DAMAGE
- ADMINISTER NSAIDS or CORTICOSTEROIDS for INFLAMMATION
NURSING priorities/interventions for SEPSIS
What is ABX - HYGIENE - ASEPTIC TECHNIQUES - HYDRATION - NUTRITION - EDUCATION?
NURSING priorities/interventions for IMMUNODEFICIENCY PATIENTS
- monitor for EARLY SIGNS of INFECTION
- PROMOTE a clean environment
- encourage ADHERENCE
- AVOIDANCE: avoid exposure to sick people
- RECOGNIZE s/s of infection!!
NURSING PRIORITIES/INTERVENTIONS FOR AUTOIMMUNE DISEASES
MONITOR FOR:
side effects of immunosuppressive therapy
- infection
- weight gain
- hyperglycemia
IMMEDIATE INTERVENTIONS FOR ANAPHYLAXIS
What is:
1. AIRWAY ASSESSMENT
2. ADMINISTER EPI - first line
2. ADMINISTER ANTIHISTAMINES - benadryl
3. ADMINISTER CORTICOSTEROIDS - METHYLPREDNISONE (to reduce inflammation)
4. IV FLUIDS
5. MONITOR VS - RESPIRATORY EFFORT - MENTAL
CONTACT DERMATITIS that occurs HOURS - DAYS AFTER EXPOSURE IS KNOWN AS WHAT TYPE OF HYPERSENSITIVITY REACTION?
WHAT IS TYPE 4: DELAYED HYPERSENSITIVITY REACTION
(T-CELL MEDIATED RESPONSE)
Early Signs versus Actual Signs of SEPSIS
EARLY SIGNS: high fever - difficulty breathing. ACTUAL SIGNS: diaphoresis - hypotension - tachy - decreased urine output - confusion
Example of an ACQUIRED IMMUNODEFICIENCY
What is: - HIV/AIDS
- CHEMOTHERAPY
- MEDICATION
PATIENT EDUCATION FOR AUTOIMMUNE DISEASES
recognize early signs of EXACERBATION
- adherence to the Tx and follow-up APTS
- balance life (to manage FATIGUE)
- adopt a healthy lifestyle
HEMOLYTIC ANEMIA or a TRANSFUSION REACTION IS AN EXAMPLE OF WHAT TYPE OF HYPERSENSITIVITY?
WHAT IS TYPE 2: CYTOTOXIC: IgG - IgM REACTION
monitor for COMPLICATIONS
(hemolysis - renal failure)
A PATIENT IS DISPLAYING S/S of what type of hypersensitivity reaction?
- localized erythema
- swelling and itching at site
- blistering
- peeling
TYPE 4: DELAYED REACTION: CONTACT DERMATITIS
APPLY TOPICAL CORTICOSTEROIDS FOR LOCAL REACTIONS