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Allergies - Module #2 - Adult Health II |, Study notes of Nursing

Florida Hospital College of Health SciencesNursing

Allergies Material Type: Notes; Class: Nursing Science 2 - Intermediate; Subject: Nursing; University: Florida Hospital College of Health Sciences;

Typology: Study notes

2011/2012

Uploaded on 03/02/2012

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1๎˜ƒ
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NRSG๎˜ƒ230๎˜ƒโ€“๎˜ƒAdult๎˜ƒHealth๎˜ƒII๎˜ƒ
Module๎˜ƒ2๎˜ƒ:๎˜ƒAllergies๎˜ƒ
Notes๎˜ƒ
Stressors Affecting
Immune Functioning
Allergies (3 hrs)
Adult Health II
NRSG 230
Wanda R. Forbes ARNP, MSN, MPH
.
๎˜ƒ
๎˜ƒ
Objectives๎˜ƒ
๎˜ƒ
1. Describe๎˜ƒthe๎˜ƒbasic๎˜ƒstructure๎˜ƒof๎˜ƒthe๎˜ƒpt./client๎˜ƒwith๎˜ƒaltered๎˜ƒ
immunological๎˜ƒfunctioning๎˜ƒ
2. Id.๎˜ƒstressors๎˜ƒthat๎˜ƒinfluence๎˜ƒthe๎˜ƒimmune๎˜ƒsystem๎˜ƒ
3. Id.๎˜ƒthe๎˜ƒnormal๎˜ƒ&๎˜ƒflexible๎˜ƒlines๎˜ƒof๎˜ƒdefense๎˜ƒ
4. Determine๎˜ƒthe๎˜ƒeffectiveness๎˜ƒof๎˜ƒlines๎˜ƒof๎˜ƒresistance๎˜ƒ
5. Apply๎˜ƒthe๎˜ƒnursing๎˜ƒprocess๎˜ƒto๎˜ƒa๎˜ƒpt./client๎˜ƒwith๎˜ƒan๎˜ƒimmune๎˜ƒ
system๎˜ƒalterations๎˜ƒ
6. Id.๎˜ƒinterventions๎˜ƒnecessary๎˜ƒto๎˜ƒattain,๎˜ƒmaintain,๎˜ƒ&๎˜ƒretain๎˜ƒ
wellness๎˜ƒin๎˜ƒa๎˜ƒpt./client๎˜ƒdiagnosed๎˜ƒwith๎˜ƒan๎˜ƒimmune๎˜ƒsystem๎˜ƒ
alteration๎˜ƒ
7. Discuss๎˜ƒpharmacological๎˜ƒinterventions๎˜ƒR/T๎˜ƒthe๎˜ƒimmune๎˜ƒsystem๎˜ƒ
๎˜ƒ
Introduction๎˜ƒ
๎˜ƒ
States๎˜ƒof๎˜ƒIS๎˜ƒ
Immunocompetence๎˜ƒ
๎˜ƒ๎˜ƒ๎˜ƒ๎˜ƒItโ€™s๎˜ƒworking๎˜ƒ
Immunodeficiency๎˜ƒ
๎˜ƒ๎˜ƒ๎˜ƒItโ€™s๎˜ƒNOT๎˜ƒworking/or๎˜ƒworking๎˜ƒ๎˜ƒ
๎˜ƒ๎˜ƒ๎˜ƒpoorly๎˜ƒ๎˜ƒ
Autoimmunity๎˜ƒ๎˜ƒ
๎˜ƒ๎˜ƒ๎˜ƒDoesnโ€™t๎˜ƒ๎˜ƒrecognize๎˜ƒself๎˜ƒ๎˜ƒ
๎˜ƒ๎˜ƒ๎˜ƒAttacks๎˜ƒitself๎˜ƒ
๎˜ƒ๎˜ƒ๎˜ƒAttacks๎˜ƒnonโ€foreign๎˜ƒcells๎˜ƒ
๎˜ƒ
Hypersensitivity๎˜ƒ
๎˜ƒ๎˜ƒ๎˜ƒIt๎˜ƒoverreacts๎˜ƒ
๎˜ƒ
Allergies/BIG๎˜ƒproblem๎˜ƒ
๎˜ƒ๎˜ƒ6th๎˜ƒleading๎˜ƒcause/disease๎˜ƒ
๎˜ƒ๎˜ƒ50,000,000๎˜ƒAmericans๎˜ƒ
๎˜ƒ
๎˜ƒ๎˜ƒ
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Download Allergies - Module #2 - Adult Health II | and more Study notes Nursing in PDF only on Docsity!

NRSG 230 โ€“ Adult Health II Module 2 : Allergies Notes

Stressors Affecting

Immune Functioning

Allergies (3 hrs)

Adult Health II NRSG 230 Wanda R. Forbes ARNP, MSN, MPH . Objectives

  1. Describe the basic structure of the pt./client with altered immunological functioning
  2. Id. stressors that influence the immune system
  3. Id. the normal & flexible lines of defense
  4. Determine the effectiveness of lines of resistance
  5. Apply the nursing process to a pt./client with an immune system alterations
  6. Id. interventions necessary to attain, maintain, & retain wellness in a pt./client diagnosed with an immune system alteration
  7. Discuss pharmacological interventions R/T the immune system Introduction States of IS Immunocompetence Itโ€™s working Immunodeficiency Itโ€™s NOT working/or working poorly Autoimmunity Doesnโ€™t recognize self Attacks itself Attacks nonโ€foreign cells Hypersensitivity It overreacts Allergies/BIG problem 6 th^ leading cause/disease 50,000,000 Americans

Hypersensitivities/Why? Genetic Environment The antigen รŽ allergen รŽ hypersensitivity รŽ allergic response Reโ€exposure to antigen creates ร response Hypersensitivities/What/where? FIG. 14 โ€ 11 Clinical manifestations of a systemic anaphylactic reaction.

IgE โ€ with Type 1 reaction too Skin tests Applied/skin Reaction/mins Wheal & Flare Lasts 8 โ€ 12 hrs Serum/specific to pt. Anaphylactic reaction risk Do NOT leave alone/testing RAST IgE antibodies/specific allergens Types/Allergic Responses TABLE 14 โ€ 9 Types of Hypersensitivity Reactions Type I IgE mediated reactions Rapid/exaggerated Primary contact = allergen sensitizes the B lymphocytes รŽ IgE antibodies produced & bind to mast cells & basophils Repeated exposure Mast cells/basophils trigger degranulation & release of chemical mediators (histamine) รŽ vasodilation รŽ โ†“ B/P Smooth muscle contraction รŽ bronchial constriction

ร vascular permeability รŽ edema Pain/itching รmucous secretion/ body fluids Tendencies/inherited Local/systemic reaction Anaphylaxis Atopic Repeated exposureรŽ chronic disease Anaphylaxis Systemic reaction Lifeโ€threatening Allergens Drugs Bee sting Food Animal sera Death w/o immediate tx Atopic Allergic rhinitis/hay fever Asthma Atopic dermatitis Urticaria Angioedema Anaphylaxis Treatment Immediate reaction/SPEED Recognize S&S ABC Prevent spread Admin drugs Tx/shock PRN Meds Epinephrine 1: .2โ€.5 ml subQ/IV.q10โ€ 15 min โ†‘ dose & intervals/severe reaction Diphenhydramine IV/IM H2 blockers Vasopressors Volume expanders/fluids/maintain BP Other actions Anticipate/intubation Assess airway O 2 highโ€flow via nonโ€rebreather mask Cardiac output via VS, O 2 sat, LOC, cardiac rhythm Remember: This is an emergency situation

Most effective/pollens & house dust allergies Anticipate adverse effects Missed dose/ next dose Healthcare provider/ER equipment/drugs available Type II Hypersensitivities Cytotoxic/Cytolytic Reaction Direct binding of IgG/IgM antibodies to antigen/cell surface Antigenโ€antibody complex/activates complement system Destroys cellular tissue/rapidly Erythrocytes/platelets/leukocytes Type II reactions include: ABO incompatibility transfusion reaction Drug related hemolytic anemias Vascular spasms/kidney/block renal tubules  acute renal failure Type III Immune Complex Reaction Characterized by tissue damage Caused by activation of complement To antigenโ€antibody (immune) complexes/in tissues Involves IgG and IgM Reactions may be local or system/immediate or delayed Remember Secondary to antigen antibody complexes After the antigen/antibody โ€œbattleโ€ โ€œDebrisโ€โ€“destroyed tissueโ€”is cleaned up Homeostasis restored Type III responses Clean up does not happen! Complexes deposited in tissues รŽ injuring tissues Kidneys/skin/joints/blood vessels/lungs Type IV Delayed Hypersensitivity Reaction Cellโ€Mediated Response Sensitized T lymphocytes attack antigens/release cytokines No antibody/complement involved Clinical examples Sensitivity to fungal/bacterial/viral infections Transplant rejection Contact dermatitis May take 24 โ€ 48 hours for reaction to occur Latex Allergy โ†‘ concern topts/healthcare providers Clinical/occupational health problem Reaction to certain proteins /natural rubber latex From milky fluid/rubber tree (Hevea brasiliensis)

Causes S&S range: Sneezing/runny nose โ†’ anaphylaxis Occurs through Direct contact/ most common cause/i.e. gloves Inhalation/ latex particles Shed particles/become airborne At high Risk Children/spina bifida Healthcare workers People/history of allergies/food allergies Every hospital should have precaution protocols for latex allergy Abnormal reactions! IS believes substance/harmful โ€œSubstancesโ€ aka allergens Produces IgE antibodies โ†’ release of chemical mediators 4 types: Type I, II, III, IV Anaphylaxis: ER! Immunotherapy can help Latex allergies concern healthcare workers Need guidelines Next: Hematological Stressors!