Chapter 19 Nursing Care of Patients with Immune Disorders

Answers CHAPTER 19 NURSING CARE OF PATIENTS WITH IMMUNE DISORDERS AUDIO CASE STUDY Ayla and Systemic Lupus Erythematosus 1. Discoid lupus erythematosus (skin), drug-induced lupus erythematosus, and systemic lupus erythematosus. 2. Women between the ages of 15 and 40, Hispanics, African Americans, Native Americans, and Asians. 3. Avoid triggers for flares, get 8 hours of sleep at night and nap during the day, stay active and get exercise, take warm baths for morning stiffness, use hot and cold compresses, avoid sun exposure to prevent butterfly shaped rash on cheeks, maintain a healthy diet. VOCABULARY 1. (10) 2. (11) 3. (8) 4. (13) 5. (3) 6. (9) 7. (16) 8. (14) 9. (2) 10. (4) 11. (6) 12. (7) 13. (15) 14. (1) 15. (5) 16. (12) IMMUNE DISORDERS 1. type I, type II, type III, type IV 2. hay fever 3. sinusitis, nasal polyps, asthma, chronic bronchitis 4. Infection 5. epinephrine 6. hives 7. nonpruritic, longer 8. Coombs test 9. Shock, acute kidney injury 10. penicillin, sulfonamides 11. Monosodium glutamate (MSG), bisulfites 12. Poison ivy (or oak) 13. vitamin B12 14. Erythrocytapheresis 15. spine, sacroiliac area, limb 1 2 Chapter 19 Answers IMMUNE WORD SEARCH X Z Y G L L D W X T X L T J K R Y R M S G X Q L L B J J P L Z W T L Z X N T R H I M R T H A I R A C I T R U P V R L D W G T X L C A T G Z N D B X K P T H T H M Q R I W Y O K T C X L O D N P J N N K H Z N B L P C R K K O L J T I D M R M W B H H F T Y L T T H K N P L R D T N W Q H P V J M S D N V I D F J F I T Q Y A L H N N I J M E N N C C X V J C T C T K R N S L N M K D X O C Z O P G T L Z D D K R L I F Z L T W E P Y K S F Z L T Z N D E I Z E T M J M X L S G H T J G T R P E D H R C F L U K H X P G T Z E T R N N Y N P L T M V K Z L V Y M N M C R N R K A Z O J I Q D A W T F G D O I R N R O X N L N R O K N V T T M W N G C S N K I V E B I G N K K B Y Q X I K Y R A O G M D D D S K V Y L D H C F K B T N B R L C P S K O L G V C M C B M C C R R I Y N Y R T N E Z L G H K N G K N P Q R F Q S D K T X R F Y Q Y N T T G F Q M W Q B L G P N T L R F P W M M F C Y T O K N E S R M A H I IMMUNE PUZZLE Across Down 1. Pernicious 3. Fifteen 6. Anaphylaxis 8. Humoral 9. Medicines 13. Hypothyroidism 15. Nasal polyps 17. Angioedema 19. Intrinsic factor 20. Butterfly 21. Discord 1. Penicillins 2. Obstruction 4. Epinephrine 5. Fatigue 7. Hypogammaglobulinemia 10. Sacroiliac 11. Mast cells 12. Latex allergy 14. Autoimmunity 16. Allergen 18. Stress Chapter 19 REVIEW QUESTIONS—CONTENT REVIEW The correct answers are in boldface. 1. (4) is correct. Respiratory distress with wheezing occurs in anaphylaxis. (1, 2, 3) are incorrect. 2. (1) is correct. Epinephrine is the initial treatment for anaphylaxis. (2, 3, 4) are incorrect. 3. (4) is correct. (1, 2, 3) are incorrect. 4. (1) is correct. (2, 3, 4) are incorrect. REVIEW QUESTIONS—TEST PREPARATION The correct answers are in boldface. 5. (1) is correct. An infection can develop if treatment is not followed. (2, 3, 4) are incorrect. 6. (3) is correct. The medication should not be given, and the health care provider must be informed to determine if the medication should be given. It is not within the nurse’s scope of practice to make that decision. (1, 2, 4) are incorrect. 7. (4) is correct. The antibiotic, which is the cause of the problem, should be stopped immediately so that no more medication enters the patient. (1, 2) would be done next or as the antibiotic is stopped if assistance is available. (3) is incorrect. 8. (1) is correct. Red blood cells are destroyed by this condition, so red cell fragments would be present. (2, 3, 4) are incorrect. 9. (2) is correct. When a portion of the stomach is removed, intrinsic factor, which is necessary for the absorption of vitamin B12, is reduced. Patients must have lifelong vitamin B12 to prevent pernicious anemia from developing. (1, 3, 4) are incorrect. 10. (2) is correct. It is an autoimmune disorder in which autoantibodies destroy thyroid cells. (1, 3, 4) are incorrect. 11. (3, 5, 6) are correct. Respiratory distress with stridor and dyspnea occurs in anaphylaxis. Tachycardia occurs as a compensatory mechanism. (1, 2, 4) are incorrect. 12. (2) is correct. Opening windows will allow pollen to enter the car. (1, 3, 4) will control the allergy. Answers 3 13. (4) is correct. Allergic rhinitis is a type-I hypersensitivity reaction in which the causative antigens are environmental and airborne, such as pollen and mold. (1, 2, 3) are incorrect. Medications or foods do not cause allergic rhinitis. 14. (2) is correct. Angioedema is a result of vascular permeability that increases in the submucosal and subcutaneous layers. (1, 3, 4) are incorrect. Angioedema is usually nonpruritic, does not have fluid-filled vesicles, and lasts longer than urticaria. The lesions of urticaria are raised, pruritic, nontender, and erythematous wheals on the skin. 15. (1) is correct. Fatigue occurs commonly in patients with systemic lupus erythematosus. (2, 3, 4) are not common nursing diagnoses for systemic lupus erythematosus. 16. The nurse would look for the presence of allergic shiners under the eyes when collecting data on a patient who has allergic rhinitis.