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DISODERS
By:
Manuel L. Hermosa, EdD
Professor
2. Maintenance of homoeostasis, a
state of equilibrium of the internal
environment
a. transporting lymph
a. Functions of complement
- Cell lysis
- Neutralization of viruses
1. Types of immunity
- Memory cells do not secrete antibodies, but on reexposure to the specific antigen, they develop into
antibody secreting plasma cells.
A. Assessment
1. Health history
- General
- Recurrent infections
- Seasonal symptoms
- Weight loss
- Fever
- Head
- Respiratory System
- Cough
- Dyspnea
- Recurrent infection
- Cardiovascular system
- Pain
- GI System
- Diarrhea
- Genitourinary System
- Recurrent infections
- Musculoskeletal system
- Neurologic System
- Altered level of
consciousness
- Paresthesias
2. Physical Examination
a. Inspection
b. Palpation
c. Auscultation
c. Ig assays (IgG, IgA, IgM) can detect and monitor immune deficiencies
d. Serum complement assays test for C3 and C4 complement when total
complement level is decreased
e. Autantibody tests
B. Nursing Diagnoses
6. Deficient knowledge
9. Ineffective coping
D. Implement
3. Provide pain relief. Assess the clients pain, rule out any
complications, implement any nonpharmacologic
interventions (i.e. ice, cold, massage) to relieve pain,
administer pain medication, and evaluate the effectiveness
of interventions
b. Provide referrals
E. Outcome evaluations
d. nutritional deficits
TYPES OF LEUKOLCYTES
Cell Type
Normal Cell
Characteristic
s
Function
Granulocytes
Basophils
Eosinophils
Neutrophils
5,000 to
10,000/mm3
< 1% of all
leucocytes
2% to 4% of all
leukocytes
50% to 70% of
all leucocytes
* Formed in
bone marrow
* Granular
(under
microscope)
* Granules filled
with heparin,
histamine
* Contain
heparin,
histamine
* 12 hour
lifespan; 2 to 4
hour lifespan
with infection
* immediate
response to
cellular injury
* Play role in
inflammatory
* Play role in
hypersensitivity
* Phagotic
* First cell to
site of cellular
injury
* Contain
lysosomes
TYPES OF LEUKOLCYTES
Cell Type
Normal Cell
Characteristic
s
Agranilocytes
Lymphocytes
Monocytes
* Produced in
lymphatic
* 25% to 33% of system
all leukocytes
* Nongranular
(under
microscope)
* Classified as B
* 4% to 6% of
cells or T cells
all leukocytes
* Circulate in
blood but also
settle in tissue,
where they are
transformed in
macrophages
Function
* Fight infection
* Phagocytosis
* Release of
lymphokines
* Production of
gamma
globulins
* Cell mediated
reactions
* Phagocytosis
(can ingest
larger particles
that
neutrophils; five
times as many
in one
ingestion)
HEPATITIS A
HEPATITIS B
INFLUENZA Flu
shot
PNEUMOCOCC
AL
TETANUS
DIPTHERIA (Td)
tetanus shot
VACIRELLA
DISORDERS
ALLERGIC RHINITIS
A. Description. Allergic rhinitis (i.e.
hay fever) is an allergic reaction to
inhaled airborne allergens
characterized by seasonal
occurrences. It is the most common
form of respiratory allergy. Although
children and adolescents have an
especially high incidence, it occurs in
all age groups
D. Assessment findings
2. Clinical manifestations
d. Sneezing
E. Nursing Management
ALLERGIC DERMATOSES
A. Description. Allergic dermatoses is
a group of inflammatory conditions
caused by skin reaction to irritating
or allergenic materials. They include
allergic contact dermatitis and atopic
dermatitis
B. Etiology
1. Allergic contact dermatitis is produced by
many substances. Common causes include
exposure to poison ivy, topical medications,
cosmetics, soaps, and industrial chemicals.
2. Although the cause of atopic dermatitis is
unknown, the condition appears to be
associated with a family history of allergic
respiratory disorders (e.g. allergic rhinitis,
asthma). Exacerbating factors amy include
irritants, infection, and certain allergens
C. Pathophysiology
D. Assessment findings
2. Clinical manifestations
b. Atopic dermatitis
- Pruritus
b. Atopic dermatitis
E. Nursing Management
ALLERGIC ASTHMA
A. Description. Allergic asthma is a
chronic reactive respiratory disorder
producing episodic, reversible airway
obstruction. The estimated incidence
is 3% to 8% of the population; more
than one half of cases found in
children younger than age 10
D. Assessment findings
2. Clinical manifestations
a. Chest tightness
c. Wheezing on expirations
g. Anxiety
E. Nursing Management
c. Elevate the head of the bed, and lean the client forward to
provide maximum lung expansion and esae respiratory effort
5. Provide referrals
ANAPHYLAXIS
A. Description. Anaphylaxis is an
acute, life threatening allergic
reaction marked by rapid
progressively urticaria and
respiratory distress that may result in
anaphylactic shock.
C. Pathophysiology
B. Assessment findings
b. Systemic manifestations
E. Nursing Management
4. Provide referrals
RHEUMATOID ARTHRITIS
A Description. Rheumatoid arthritis is
a chronic, progressive disease
involving inflammation of ten
synovial joints. The incidence is three
times greater in women that in men.
Peak age of onset is between age 30
and 60, but the disease can develop
in any age.
D. Assessment findings
1. Clinical manifestations
c. Erythrocyte sedimentation
rate is significantly elevated
E. Nursing Management
3. Promote self-care
C. Pathophysiology
1. SLE involves markedly increased B-cell
hypergammaglobulinemia, autoantibody
production, and decreased T cell functions.
Symptoms result from immune complex
invasion of body systems. Disease progression,
which is characterized by recurring remissions
and exacerbations, is widely variable
2. Prognosis is good with early detection and
treatment however, SLR can lead to potentially
serous complications, including cardiovascular,
renal, and neurologic problems and serve
bacterial infections
D. Assessment findings
a. Musculoskeletal system
b. Integumentary system
c. Cardiovascular system
- Pericarditis
d. Respiratory sytem
- Pleural effusion
- Pleuritis
e. Neurologic system
f. Other systems
- Lymphadenopathy
E. Nursing Management
9. Provide a referral
B. Etiology
c. IV drug abusers
D. Assessment findings
1. Associated findings. The Client may report recurring viral and bacterial
infections
2. Clinical manifestations
a. Fatigue
c. Weight loss
d. Generalized lymphadenopathy
h. Edema
i. Visual impairment
l. Joint pain
7. Discuss ways the client and family can assist with mental status problems.
These includes putting notes on the refrigerator or note boards, using
calendars and clocks to orient the clients to time and place, and assisting the
client with paying bills, shopping and other households activities
11. Teach ways to cope with chronic illness to the client and his family.
Always include the family in teaching and care, and provide family members
with grief counseling. Discuss advanced directives and durable power of
attorney for health care
Indicatio
ns
Selected Interventions
Adrenergic
Albuterol
Epinephrine
Isoetharine
Isoproterenol
Metaproteren
ol
terbutaline
Relax
smooth
bronchial
muscle
and dilate
airways
Antibiotics
Aminogycosid
es
(gentamicin,
tobramycin)
Amoxicillin
Erythromycin
Penicillin
tetracycline
Prevent
or
treat
infections
caused by
pathogeni
c
microorga
nisms
Indications
Selected Interventions
Antidiarrheal
Attapulgite
Bismuth
subsalicylate
Diphenoxylate
and atropine
loperamide
Absorb excess
water from stool
Antiemetics
Benzquinamide
Dimenhydrinate
Trimethobenza
mide
Hydrochloride
Promethazine
scopolamine
Indications
Selected Interventions
Antihistamines
Cetirizine
Cholorphenira
mine maleate
Descloratadin
e
Diphenhydram
ine
Fexofenadine
Loratidine
terfenadine
Inhibit
histamine
release by binding
selectively to H,
receptors
Antipruritic
agents
Topical
steroids
Desoximetaso
ne
Hydrocosrtison
Relieve or prevent
itching (may be
topical steroids or
anesthetics)
Indications
Selected Interventions
Antiretrovirals
Nucleoside
inhibitors
Didanosine
Zidovudine
Nonnucleoside
reverse
Transcriptase
inhibitors
Delavirdine
Nevirapine
Protease
inhibitors
Indinavir
ritonavir
Corticosteroids
Inhaledfluticasone;
beclomethason
e
Oral
hydrocortisolo
ne,
prednisone)
Topical
Ensure a potent,
local acting antiinflammatory and
immune modifier
effect; also used
to strengthen the
biologic
membrane, which
inhibits capillary
permeability, and
Selected Interventions
* Monitor serum level of theophylline
(therapeutic level, 10 to 20 ug/ml)
* Provide the medication at regular
intervals, before meals, and with a full
glass of water
* Instruct the client to notify his health
care provider of irritability, restlessness,
headache,
insomnia,
dizziness,
tachycardia, palpitations, or seizures
* Do not crush sustained release
medication
* Caution the client not to exceed the
maximum daily dose of 4 sprays/nostril
* Instruct the client to rinse his mouth
after each use to prevent nasal
candidiasis
* Instruct the client to take the
medication exactly as directed and to
taper it rather than stop it abruptly,
which could cause serious withdrawal
symptoms
leading
to
adrenal
insufficiency, shock, and death
COX-2 inhibitors
Celecoxib
rofecoxid
Indications
Inhibit the
formation of
substances that
can cause joint and
connective tissue
problems
Leukotriene
Reduce
receptor antagonist inflammation in airmontelukast
ways; used for
prophylactic and
maintenance drug
therapy for chronic
asthma
Selected
Interventions
* Instruct client to
take medication in
the evening
without food
* Explain that the
medication is not
for acute asthma
attacks
Indications
Selected
Interventions
Inhibit
mast
cell,
thereby
releasing
chemical
mediators
that
result
in
bronchodilation and a
decrease in airway
inflammation
Indications
Selected
Interventions
Nonopiod analgesics
Nonsteroidal
Anti-inflammatory
drugs
Acetylsalicylate acid
ibuprofen
Vasopressors
Metaraminol
norepinephrine