Immunology Diseases

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  1. What is Scleroderma?
    • “Turning to Stone” d/t excessive production of collagen 
    • A rare chronic  disorder of diffuse fibrosis (thickening and hardening) of the skin,  arteries, joints and internal organs including the lungs,  and kidneys
    • --Lungs usually go first, so Dx is usually done with PFTs and CX.
  2. What is CREST as it relates to scleroderma?
    • C=calcinosis (calcium lumps)
    • R=Raynaud’s
    • E=Esophagus
    • S=sclerodactyly ( tapering deformity of the bones)
    • T=Telangiectasias=small red spots on the skin of the fingers, face and inside of mouth

    • 80% end up with CREST syndrome
    • Diffuse (20%)—rapid progression of visceral organ disease and death within a few years
    • Tx is largely supportive and symptomatic.
  3. Risks of acquiring HIV
    • The higher the viral load greater the risk 
    • Blood and blood products greatest risk when injected
    • Mucosal exposure to blood 90% less risky than needle stick
    • Dx with ELISA or Western Blog. Blot is more accurate, but more expensive.
  4. What can nurses do with regard to HIV testing?
    • Obtain consent
    • Provide pre/post testing information
    • Perform Point of care HIV testing
    • Assess Hx
  5. What are some markers for infection of HIV?
    • CD4 counts and viral load
    • CD4: 200-500 = moderate immunosuppression. <200--> ^opportunistic nfxn.
    • Viral load:
    • goal is for viral load to be undetectable.
    • When it reaches ~10K, time to rethink treatment.
    • >100K-->AIDS. 
    • In HIV/AIDS pts, both markers are check every 4-6 weeks.
  6. What is nursings' role in managing HIV?
    • Centers around keeping the immune system functional
    • Assisting the client in coping with a chronic disease, and maintaining emotional and spiritual well-being.  
    • This requires early assessment and intervention, comfort with asking about high risk behaviors and developing sensitive teaching and counseling skills
  7. Definition and SnSs of AIDS after HIV.
    • Presence of HIV infection and a CD4 count of less than 200 or HIV infection or diagnosis or indicator disease with no other cause of immunodeficiency
    • Cancer
    • Kaposi’s Sarcoma: Flat, pink turning to dark violet or black
    • Pneumocystis carinii
    • White out: RAISE head of bed, assess LOC (hypoxia) etc.
    • Many unrelated pathologies all present simultaneously or in succession.
  8. What other non-obvious symptoms will AIDS pts have?
    • neuropathy/dementia 
    • encephalopathy
    • lethargy, withdrawal, depression
    • limb spasticity
    • dysfunctional bladder/bowel
    • wasting syndrom (TPN)
    • --Not always successful since the body saves fat when it needs protein. 
    • --Nutritional supplements high in protein and well-balanced meals with multiple vitamin/mineral supplementation (NO IRON) and adequate calories and adequate fluids
    • --Recombinant human growth hormone may be helpful
    • lymphomas
  9. Nursing diagnoses are going to be pretty much all of them
Card Set:
Immunology Diseases
2013-03-05 17:53:52

Adult MedSurg 2
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