HIV and SLE: Nursing Care and Management
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Questions and Answers

What is a primary difference in the immune system between children and adults?

  • Disorders of the immune system manifest similarly in children and adults
  • Disorders of the immune system manifest differently in children than adults (correct)
  • The immune system is stronger in children than adults
  • The immune system matures faster in children

    • What occurs when the immune system overfunctions?

  • Increased susceptibility to infection
  • Increased phagocytosis and elimination of cellular waste products
  • Production of antibodies against cells of the body, allergies, and autoimmune disease (correct)
  • Immunity to all diseases

    • What is a common indicator of HIV in children?

  • High fever
  • Rash
  • Sudden weight gain
  • Recurrent bacterial infections (correct)

    • What is the primary goal of caring for a patient with an immunodeficiency?

    <p>Create barriers to prevent contact with organisms</p> Signup and view all the answers

    What is a function of the specific immune system?

    <p>Humoral response and cell-mediated response</p> Signup and view all the answers

    How is HIV typically transmitted?

    <p>Through blood and bodily fluids</p> Signup and view all the answers

    What is the primary goal of respiratory management in patients with HIV?

    <p>Preventing infection</p> Signup and view all the answers

    What is the treatment of choice for controlling the inflammatory response in patients with systemic lupus erythematosus?

    <p>Steroids</p> Signup and view all the answers

    What is the recommendation for administering vaccines to immunosuppressed persons?

    <p>Administer killed virus vaccines only</p> Signup and view all the answers

    What is the primary goal of medication adherence in patients with HIV?

    <p>Preventing infection transmission</p> Signup and view all the answers

    What is the gold standard of pharmacologic treatment for HIV?

    <p>Antiretroviral therapy</p> Signup and view all the answers

    What is the purpose of reporting adverse reactions via the vaccine adverse reaction (VAR) reporting system?

    <p>To identify potential adverse reactions to vaccines</p> Signup and view all the answers

    What is the recommended age for introducing infants to peanuts?

    <p>By 4-6 months</p> Signup and view all the answers

    What is the primary goal of management in anaphylactic shock?

    <p>Ensuring an adequate airway</p> Signup and view all the answers

    What type of hypersensitivity is associated with allergic rhinitis and hives?

    <p>Type I immediate hypersensitivity</p> Signup and view all the answers

    What is the recommended duration of breastfeeding for allergy prevention?

    <p>At least 6 months</p> Signup and view all the answers

    What is the purpose of hydrolyzed formula in allergy prevention?

    <p>For high-risk babies who are unable to breastfeed</p> Signup and view all the answers

    What is a symptom of impending anaphylaxis?

    <p>Sneezing</p> Signup and view all the answers

    Study Notes

    Hypersensitivity Reactions

    • Type I: Immediate hypersensitivity (anaphylactic), causes allergic rhinitis, acute anaphylaxis, hives, eczema, and asthma
    • Type II: Cytotoxic hypersensitivity, causes transfusion reaction after receiving incompatible blood
    • Type III: Arthus hypersensitivity (immune complex), causes serum sickness, glomerulonephritis
    • Type IV: Delayed cell-mediated hypersensitivity, causes contact dermatitis (poison ivy)

    Common Food Allergens

    • Peanuts
    • Tree nuts
    • Seafood
    • Milk
    • Eggs
    • Seeds

    Allergy Prevention Measures

    • Breastfeeding for all babies until at least 4 months of age and ideally for 6 months
    • Hydrolyzed formula for high-risk babies who are unable to breastfeed
    • Introduce high-allergy foods at home
    • No whole milk until after 1 year of age
    • Introduce infants to peanuts by 4-6 months of age

    Anaphylaxis

    • Symptoms: Sneezing, laryngeal edema, tightness, tingling of mouth or face, subsequent swelling of lips and tongue, severe flushing, urticaria, and itching
    • Management: Ensure adequate airway, administer epinephrine, oxygen, corticosteroids, and antihistamines, keep the child warm and lying flat or with feet slightly elevated, start an IV

    Priority Action

    • Ensure an adequate airway

    Immune System

    • Major components: chemical barriers, interferon, inflammation
    • Pediatric differences: organs mature during infancy and childhood, immaturity of the immunologic system places the infant and young child at greater risk for infection, disorders manifest differently in children than adults
    • Nonspecific immune functions: chemical barriers, interferon, inflammation
    • Specific immune functions: humoral response (B-cells and helper T-cells), cell-mediated response (T-cells and helper T-cells)

    Immune System Dysfunction

    • Under function: increased susceptibility to infection
    • Over function: produces antibodies against cells of the body, allergies, and autoimmune disease

    Nursing Care for Immunodeficiency

    • Prevent contact with organisms
    • Create barriers if contact is unavoidable
    • Kill organisms if contact is made

    HIV Indicators

    • Failure to thrive
    • Recurrent bacterial infections
    • Opportunistic infections
    • Chronic or recurrent diarrhea
    • Recurrent or persistent fever
    • Developmental delay
    • Prolonged candidiasis

    HIV Transmission and Treatment

    • Transmission: not specified
    • Gold standard of pharmacologic treatment: not specified
    • PCP and other infections: addressed with therapy
    • Nursing challenges: respiratory management, promoting normal growth and development, preventing infection, providing comfort, supporting families, infection transmission, medication adherence

    AAP Statement on HIV Disclosure

    • Not specified

    Systemic Lupus Erythematosus (SLE)

    • Manifestations: malar butterfly rash, red, round raised patches, oral and nasal ulcers, arthritis, pleuritis, pericarditis, peritonitis, renal disorder, neurologic disorder, hematologic disorders, immunologic disorder, positive ANA assay
    • Treatment: avoid exposure to sun, prevent infections, wear sunscreen, steroids, NSAIDS, anticonvulsants, antihypertensives, hydroxychloroquine, killed virus vaccines rather than live virus vaccines

    Nursing Considerations for Immunizations

    • Do not administer live vaccines to immunosuppressed persons
    • Refer to individual vaccine for method of administration and contraindications
    • Report adverse reactions via the vaccine adverse reaction (VAR) reporting system

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    Description

    Test your knowledge on the gold standard of pharmacologic treatment for HIV, nursing challenges in addressing patient needs, and the manifestations and treatment of systemic lupus erythematosus (SLE).

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