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26 Cards in this Set
- Front
- Back
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What are the diagnostics for allergic disorders?
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- CBC with differential
- WBC - IgE, T-cell, and B-cell quantification (PCR) - skin testing - RAST - Exposure control |
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What type of a reaction are latex allergies?
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Usually type I or IV
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What's the tx for cytotoxic/cytolitic Cellular destruction) reactions?
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antihistamines, steroids, IV fluids
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What do interleukins do?
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They affect B cells and activate T cells and macrophages
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What do histamine and serotonin do?
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Inflammatory and allergic response
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Type II hypersensitivity reactions: Cytotoxic/cytolytic
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Antibody mediated - IgM and IgG. Complement system is activated to clear pathway. Increased phagocytosis. Cellular tissue destruction (caused by released toxins).
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What are some types of cytolytic/cytotoxic reaction?
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- ABO and rH incompatibilities, hemolytic anemias
- Goodpasture's syndrome - ARF (HgB and cytotoxic waste accumulation (blocked tubules - clogged kidneys) |
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What are hemolytic anemia?
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Autoimmune or a drug reaction (ex - penicillin)
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Good pasture's syndrome
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Involves the kidneys and luns - autoimmune. Renal and resp. failure. Rapidly progresses.
Tx involves steroids, immunosuppressants, and dialysis. |
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Type III Immune complex reactions
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- complement system involved
- humoral-mediated - autoimmune - Immune complexes aggregate in tissue or small blood vessels. The complexes release chemotactic factors. - activate inflammatory process - tissue is destroyed. - Tissue destruction (kidneys, vessels, lungs, joint cartilage) Seen in Lupus, RA, Acute Glanular Nephritis) - RA, LE, AGN - chemical manifestations depending on the tissues involved. |
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What's the difference between type II and type III immune complex reactions?
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- type II is more acute, involves RBC's
- type III is more chronic - fungal, bacterial, or viral |
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What happens systemically with anaphylaxis (target organs)?
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- vasodilation and increased vascular permeability (kinins and leukotrienes). Edema, pruritis at allergen exposure site (contact site)
- smooth muscle constriction causes angioedema and bronchio edema/constriction: dyspnea - shock: decreased cardiac output. Weak and thready pulse, no urine output, mottled skin. |
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What antibodies mediate an anaphylaxic response?
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IgE
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Anaphylaxis: What potent chemical mediators are released?
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- histamine
- serotonin - leukotrienes (released by damaged cells) - ECF-A - SRA-A Complement system gets set off. |
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Eosinophils
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They have granules to fight parasites, but they damage the airway.
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S/S of anaphylaxis
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- difficulty breathing
- itchy skin - anxious |
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Emergency care for anaphylaxis
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- Recognize the event
- maintain airway - mitigate - drug admin - treat for shock - Iv access, IV fluid, volume expanders - colloidal IV fluids, albumin. - Mild, early onset: epi 1:1000 SC, IM - severe: epi 1:10000 IV - O2, high flow - histamine blockers (diphenhydramine IM or IV) |
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Nursing interventions for anaphylaxis
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- lie flat (elevate HOB if mild symptoms to facilitate breathing)
- monitor VS, O2 sats, cardiac rhythm (put leads on) - vasopressors - dopamine to increase b/p - mechanical ventilation - prepare for tracheotomy for severe laryngeal edema |
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Asthma
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Chronic inflammatory airway disorder (episodic). Allergen is encountered and IgE is produced. Airway hyperresponsiveness. Air gets trapped in alveoli.
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S/S of asthma
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- bronchospasm, constriction, and hyperventilation. VS increase. Color becomes cyanotic.
- ABG's - acidotic - rebound occurence hours later |
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What do IV steroids, IV aminophylline, and cromolyn do for status asthmaticus?
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IV steroids - for inflammation
IV aminophylline - relax bronchial smooth muscle. Cromolyn - mast cell stabilizing drug, prevent histamine release. |
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What are some alkylating agents and what are some S/E?
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Nitrogen mustard, cytooxan (bladder toxic) - secondary malignancies such as leukemia.
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What do nitrosureas do and what is an example?
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They can cross the blood/brain barrier. (Carmustine)
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What can happen with platinums?
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They are nephrotoxic. An example is cisplatin.
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What are antimetabolites used for and some examples?
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These are effective in rapid groth tumors. ERxamples are 5-FU and Methotrexate. (immunosuppressant)
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What are some antitumor antibodies, what do they cause, and what should be done prior to giving them?
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They can cause cardiomyopathy. You need to get a baseline echocardiogram first. Examples are Doxorubicin (Adrianmycin bright red urine) and Bleomycin.
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