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37 Cards in this Set

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anaphylaxis
severe systemic type I hypersensitivy reaction

IgE antibodies produced from prior exposure to antigens attach to mast cells

because mast cells exist system wide, allergic reaction caused by exposure to antigen is system wide

S/S: generalalized smooth muscle spasms - bronchial narrowing - stridor - wheezing - dyspnea - laryngeal edema - respiratory arrest- cramps - diarrhea - nausea - vomiting - increased capillary permeability - hypotension - tachycardia
histamine
substance released from mast cells that causes vasodilation, changes in vascular permeability, increase in mucus production, & contraction of various mooth muscles
uriticaria
AKA hives

IgE antibodies cause release of mast cell contents, especially histamine

S/S: raide, pruritic, nontender lesions on skin - concentrated on trunk & proximal extremities
angioedema
a form of uriticaria

patho same as uriticaria EXCEPT angioedema affects submucosal & subcutaneous tissue (not skin)

S/S: dermal erythematous & subcutatneous eruptiosn - skin & mucous membrane edema - eruptions may last longer than with uriticaria
allergic rhinitis
result of antigen-antibody reaction

ciliary action decreases & mucus secretions increase

vasodilation & local tissue edema occur

S/S: sneezing - nasal itching, runny nose - red eyes - dark circles under eyes - venous congestion in maxillary sinuses
atopic dermatitis
AKA eczema

inflammatory skin response BUT specific antigen is not usually identified as cause

S/S: pruritus - edema - extremely dry skin - blisters - dermatitis
Type I Reactions
an immediately occuring reaction when exposure to specific antigen occurs

MUST have had previous exposure to antigen

- allergic rhinitis
- atopic dermatitis
- anaphylaxis
- urticaria
- angioedema
Type II Reactions
involves destruction of a cell or substance that has an antigen attached to its cell membrane

IgG or IgM determines cell/substance is a foreign antigen, antibodies attach to it, and it's destroyed

- hemolytic transfusion reaction
hemolytic transfusion reaction
RBcs w/antigens foreign to the individual are rapidly lysed

rapid RBC lysis ends in massive amount of cellular debris that occludes blood vessels & causes ischemia/negrosis

S/S: sudden low back/chest pain
Type III Reaction
patient is sensitized w/an initial exposure to antigen & on subsequent exposure the reaction occurs

reaction localized & evolves over several hours

- serum sickness
serum sickness
involves formation of antigen-antibody complexes within blood vessels as antigen is absorbed through vessel wall

in past, occurred after innocculation of equine antiserum for tetanus, diphtheria, etc.

now seen occasionally after administration of w/penicillin & sulfonamide

S/S: severe urticaria - angioedema - fever - malaise - arthralgia
Type IV Reaction
AKA delayed reaction

occurs when sensitized T lymphocyte comes in contact w/particular antigen to which it's sensitized

- contact dermatitis
- transplant rejection
contact dermatitis
substance or chemical comes in contact w/skin

it's absorbed into skin & binds w/haptens (skin proteins)

T memory cells formed in 7-10 days

S/S: area of contact becomes reddened - fragile vesicles - secondary infections possible
transplant rejection
any transplanted living tissue seen as foreign material by immune system
with lymphocytes sensitized during induction phase immediately after tissue transplant

sensitized lymphocytes invade transplanted tissue & destroy it via release of chemicals & macrophage activity

S/S: depends on tissue & severity of reaction - s/s reflect failure of organ or tissue
autoimmune disorders
immune system no longer recognizes body's normal cells as self & not foreign

instead the antigens on normal body cells are recognized as foregin & an immune response to destroy them is launched
pernicious anemia
antibodies against gastric parietal cells & intrinsic factor lead to destruction of cells & decrease secretion & function of intrinsic factor

intrinsic factor needed for vit B12 absorption in small bowel so deficiency results in decreased number of RBCs

S/S: mild fatigue - pallor - severe hypotension - dyspnea - palpitations - jaundice
Hashimoto's thyroiditis
autoantibodies for TSH form but, instead of inactivating TSH, they bind w/hormone receptors on thyroid & cause hyperthyroidism

thryoid infiltrated w/lymphocytes & phagocytes causing inflammation

different autoantibodies appear & destroy thyroid cells resulting in hypothyroidism

S/S: HYPER - restlessness - tremors - diarrhea - heat intolerance - weight loss HYPO - fatigue - bradycardia - hypotension - dyspnea - constipation - weight gain - slowing mental process
ankylosing spondylitis
AKA rheumatoid spondylitis

chronic progressive inflammatory disease of sacroiliac, costovertebral, & large peripheral joints

begins in lower back & progresses upward

histocompatibility antigen (antigen that identifies self), human leukocyte antigen (HLA) B27, formed that stimulates immune response

S/S: lower back stiffness & pain (worse in a.m.) - back muscle spasms - curvature of lower back flattens (lordosis) - curvature of upper back increases (kyphosis)
immune deficiencies
occur when one or more components of immune system are either completely absent or deficient in quantities sufficient to elicit or sustain an adequate immune response to combat an infectious agent
hypogammaglobulinemia
absence/deficiency of one or more of five classes of immunoglobulins (IgG, IgM, IgA, IgD, & IgE) from defective B-cell function

leaves patient prone to infections

S/S: infant asymptomatic up to 6 months when maternal immunoglobulins are gone

many recurrent infections begin (especially Staph & Strep)
The nurse is contributing to the plan of care for a patient with allergic rhinitis. Which of the following interventions should the nurse anticipate will be included in the treatment plan?
a. Epinephrine
b. Gold salts
c. Anticholinergic medication
d. Avoiding environmental stimuli
d. Avoiding environmental stimuli
A patient who has an allergy to penicillin is receiving preoperative meds, which include ranitidine (Zantac), metoclopramide (Reglan), and cefazolin (Ancef) intravenously. Fifteen minutes after the cefazolini is started, the pt reports an uneasy feeling, as well as feelig very warm. The nurse would appropriately recognize that the patient is experiencing which of the following?
a. Urticaria
b. Anaphylaxis
c. Angioedema
d. Contact dermatitis
b. Anaphylaxis
The nurse is contributing to the plan of care for a pt w/ankylosing spondylitis. Which of the following interventions would be appropriate for the nurse to suggest?
a. Avoid massage
b. Use interferon injections
c. Avoid one position for prolonged periods
d. Use topical steroids
c. Avoid one position for prolonged periods
The nurse is contributing to the plan of care for a pt w/an immune system deficiency. Which of the following complications should the nurse consider is most likely to occur when recommending prevention interventions?
a. Overwhelming infection
b. Fatal allergic reaction
c. Asphyxiation
d. Delayed anaphylactic reaction
a. Overwhelming infection
A pt is admitted w/an autoimmune disease & asks the nurse what autoimmune means. which of the following would be the appropriate response by the nurse?
a. "Immune cells produce too many antibodies."
b. "Immune cells grow and multiply too rapidly."
c. "Immune cells are not produced in sufficient amounts."
d. "Immune cells are unable to distinguish between 'self' and 'not self'."
d. "Immune cells are unable to distinguish between 'self' and 'not self'."
Inflammation of the tongue.

SLITSISGO
GLOSSITIS
Medication that counteracts the action of histamine

MANESHIITTAIN
ANTIHISTAMINES
Another term for hives.

URICTARAI
URTICARIA
The first drug of choice in anaphylaxis.

PEPNINEHIRE
EPINEPHRINE
Medications to reduce inflammation.

DOICSSTORTOICER
CORTICOSTEROIDS
Complication of atopic dermatitis.

IFNETCOIN
INFECTION
Types of medications used to prevent transplant rejection.

IMPRESSIONUSUMPNO
IMMUNOSUPPRESSION
A defect in the production of the plasma cells occurs in pernicious anemia.

TRUE or FALSE
FALSE

A defect in the production of the RED BLOOD CELLS occurs in pernicious anemia.
A common cause for contact dermatitis is poison ivy.

TRUE or FALSE
TRUE
Allergic shiners are the dark circles under the eyes of a patient who has allergic rhinitis.

TRUE or FALSE
TRUE
IgM triggers mast cells to burst and release their contents of histamine.

TRUE or FALSE
FALSE

IgE triggers mast cells to burst and release their contents of histamine.
With anaphylactic reactions, there is usually a previous exposure to the antigen.

TRUE or FALSE
TRUE