Immune Flashcards
(52 cards)
Sever combined immunodeficiency disorder (SCID)
primary or secondary?
How is it passed on?
Severe deficiency of T & B cells ; so immune response is inhibited bc no memory
Primary due to being born with it
Autosomal & sex linked
Sever combined immunodeficiency disorder prognosis without tx
Will probably die from frequent infections if not treated
- can get treated and have another immediately bc of no T & B cells
Treatment for Sever combined immunodeficiency disorder focus?
Two medicines to do this?
the most invasive form of treatment?
Lower risk to infections
prophylactic antibiotics
IVIG or pooling of immunoglobulins
stem cells transplant for leukocyte (T &B cells) production
IVIG concerns & preparation with Sever combined immunodeficiency disorder
How fast should infusion be?
Could be receiving a large amount & risk factor for anaphylactic response so give
- Tylenol or Nsaid
- histamine
- steroids
Start infusion very slow
- .01 mL/kg/min
- monitor it and in about 30 min bump it up .02-.05 until you are at .08
(if they’ve done the infusion before, you’ll probably know how to react)
Body system to be aware of with IVIG for patient with Sever combined immunodeficiency disorder ?
What other forms of IMG are there?
- be aware of fluid volume & kidney function
SubC and IM which is more concentrated
Best match for stem cell transfusion? What else?
A sibling
- bc has genes from parents too
Can get from parents
Unrelated donors may have a match too for bone marrow registry
How will the stem cell transplant go in Sever combined immunodeficiency disorder patient?
Is it always successful?
Wipe out abnormal bone marrow and then introduce new stem cells
NO, there can be rejections.
T/F
You can give only give irritated blood products and non-activated vaccines for those with immunodeficiency
true
- no MMR, polio etc
HIV is a retrovirus. what does this mean
transmitted through body secretions
- blood, semen, vagina, breast milk
HIV pathophysiology
T-cells called CD4 lymphocytes are affected and so the immune response can’t be launched
Is HIV a death sentence?
Nope it is more of a chronic illness now for adults and children
Diagnosis of HIV
About 15 days after exposure
But will want to follow up 30 days later on.
Most recommended testing of HIV
PCR and proviral DNA
- type of testing done will be based on likelihood of infection
- needle stick test of two negative patients won’t be using a high sensitivity test
HIV stats of kids in US
nationally?
Dramatic decline, so less than 150-200 in US
Especially in maternal fetus passage.
- we have education, screening, and treatment
Way bigger international problem bc more adults have HIV
What will symptoms be like of HIV if on meds?
Symptoms related to medication like diarrhea
- need dosage adjustment to fix
- make sure to double check symptoms are even related to the meds or if there’s another issue going on
Lymph, liver, spleen symptoms of HIV
enlarges and swells
Mouth symptoms related to HIV
Oral candidiasis shown as white patches
Gi symptoms related to HIV
Diarrhea
- could be from meds or the disease
- know the right diet ; low bacteria for prevention of infection of issues
treatment meds for HIV
How long will they need this?
antiretroviral meds
- suppresses replication of HIV so the CD4 t cells aren’t affected
- will be lifelong bc no cure
how do they protect HIV patients from pneumocytisis pneumonia?
what other meds do HIV kids need
Prophylactic antibiotics
immunoglobulin
What is the concern nationally with HIV treatment?
We have the meds to manage HIV but poverty governments may not have resources
Nursing goals with HIV
1) protect them from infection and support their nutrition
- do not give them live viruses
2) take care of symptoms
3) monitor their growth
Galactosemia
Not enough of galactose 1 phosphate enzyme so the “galactose” cannot be converted to glucose
- malnutrition and no energy causing failure to thrive
When is Galactosemia tested for?
Newborn screening so we can catch it early on
