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hypersensitivity

excessive reaction to a harmless substance

factors influencing hypersensitivity

nature of allergen, route of allergen entry

assessment in hypersensitivity

history of exposure to antigen, onset, nature, duration, frequency, aggravating or alleviating factors, history of anaphylaxis

Benadryl

antihistamine used for urticaria and pruritus

Prednisone

corticosteroid used for erythema and edema

Albuterol

bronchodilator used for bronchospasm and decreases wheezing

intervention in hypersensitivity

wet compresses and soothing baths to provide comfort

urticaria

presence of wheals or hive

signs of urticaria

pruritus, edema, burning pain, dyspnea

angioedema

from of urticaria in subcutaneous tissue

signs of angioedema

bruning, pruritus, acute pain, respiratory distress

contact dermatitis

caused by hypersensitive, inflammatory reaction due to contact with environmental agent

signs of contact dermatitis

burning, pain, pruritus, edema, vesicles, papules

treatment for contact dermatitis

burrow's solution, cool environment, cold compressess

eczema

tiny blisters that itch and ooze on the skin, primarily in infants

signs of eczema

papular and vesicular lesions surrounded by erythema, yellow tenacious exudate, pruritus, scratching

treatment of eczema

tepid soaks for 15-20 minutes

at risk for latex allergies

known allergy to bananas and kiwi, women

dermatitis venenata

contact with certain plants, poison ivy, poison oak

exfoliative dermatitis

infestation by certain heavy metals, or by antibiotics, aspirin, gold or iodine

dermatitis medicamentosa

drug allergies, penicillin, codeine, iron

signs of dermatitis

mild to severe erythema and vesicular lesions, respiratory distress

treatment for dermatitis

therapeutic baths, corticosteroids

asthma

narrowing of the lung airways due to bronchospasm, edema of the mucous membrane, and inflammation

extrinsic asthma

pets, cold weather, smoke, wind

signs of asthma

dyspnea on exertion, wheezing, tachycardia, diaphoresis, use of accessory muscles, nasal flaring

transfusion reaction

may occur during or after a blood transfusion often due to mismatched blood

signs of transfusion reaction

dermatitis, diarrhea, fever, chills, urticaria, cough, orthopnea, wheezing, back pain, hematuria

priority in blood transfusion

vital signs before and after and every 15 minutes, checked by two licensed nurses, check identification band, remain with patient for first 15 minutes

O negative

universal donor

AB positive

universal recipient

transplant rejection

delayed T cell hypersensitivity reaction

immunotherapy

a special treatment of allergic responses that injects increasingly larger doses of the offending allergens to gradually develop immunity

anaphylaxis treatment with immunotherapy

0.3 mL of 1:1000 epinephrine hydrochloride SQ every 15 minutes for three doses

anaphylactic shock

immediate IgE mediated hypersensitivity reaction

signs of anaphylactic shock

cyanosis, pallor, sneezing, dyspnea, bronchospasm, hypotension, decreased cardiac output, tachycardia, urticaria, pruritus

delayed hypersensitivity

occurs 24 to 72 hours after exposure to soaps, lotions, poison ivy, poison oak, causes contact dermatitis

immunodeficiency

abnormal condition of the immune system in which cellular and humoral immunity is inadequate and resistance to infection is decreased

priority in immunodeficiency

monitor WBC count for infection

primary immunodeficiencies

phagocytic dysfunction, B cell deficiencies, T cell deficiencies, B and T cell deficiencies, and deficiencies of the complement system

priority in deficiencies of the complement system

protect from infection, no flowers, wash hands, private room, no raw foods, limit vistors

immunosuppressive meds

suppress the immune system

chemotherapeutic meds

methotrexate, cytoxan

autoimmune disorder

disorders in which the body fails to recognize itself and launches an immune response

examples of autoimmune disorders

pernicious anemia, ulcerative colitis, MS, Crohn's disease, thrombocytopenic purpura, Sjogrens syndrome

pernicious anemia

lack of intrinsic factor in the stomach which is needed for the absorption of B12

signs of pernicious anemia

sore beefy red tongue, weakness, fever, jaundice, weight loss, paresthesias, neuropathy

treatment of pernicious anemia

B12 injections for life, folic acid, iron supplements, conserve energy

ulcerative colitis

inflammatory bowel disease with tiny abscesses, purulent drainage, mucosal sloughing, ulcers

signs of ulcerative colitis

diarrhea containing blood, mucus and pus, abdominal pain, urge to defecate 15-20 times a day, weight loss, abdominal distention

priority in ulcerative colitis

reduce stress, high protein, high calorie, milk free, spice free diet

crohn's disease

chronic inflammatory bowel disease associated with altered immune mechanisms, primarily affects small intestines, may lead to malabsorption and development of pernicious anemia

signs of crohn's disease

diarrhea with mucus, steatorrhea, fistula formation

priority in cohn's disease

monitor skin for breakdown, lactose, brassica, spicy and caffeine free diet

rheumatoid arthritis

chronic, systemic autoimmune disease characterized by inflammatory changes in connective tissue, lack of treatment can lead to ankylosis

signs of rheumatoid arthritis

symmetrical joint pain, edema, subcutaneous nodules, limited ROM, involves the small joints

treatment for rheumatoid arthritis

chemotherapeutic drugs, analgesics

priority in rheumatoid arthritis

rest, exercise, heat to relax

systemic lupus erythmatosus(SLE)

genetic chronic, progressive, systemic inflammatory disease that can cause major organs and systems to fail

risk factors for SLE

medications, stress, genetics, sunlight or ultraviolet light, pregnancy

signs of SLE

raised red rash on the face or upper body, fever, malaise, anorexia, weight loss, redness of the palms, joint pain, photosensitivity

priority in SLE

use organic soaps, allow frequent rest periods, high vitamin, iron, carbohydrate, nitrogen diet

treatment for SLE

methotrexate for bone marrow suppression

good pasture's syndrome

auto-antibodies are made against the glomerular base membrane and neutrophils, common in young males, primarily affects the lungs and kidneys

signs of good pasture's syndrome

SOB, Hemoptysis, decreased urine output, edema, weight gain, HTN, Tachycardia

host versus graft disorders

graft attacks immunocompromised host, bone marrow transplantation

allogenic donor marow

donor is a sibling or parent with similar tissue type

synogenic donor marrow

from an identical twin

autologous donor marrow

most common type, donor is the recipent

scleroderma

multisystem disease with hardening of visceral organs and skin, leads to inability of involved organs to function normally, autoimmune

signs of scleroderma

pitting edema of the hands and fingers, taut, shiny skin with no wrinkles, stiffness, muscle weakness, pain

polyarteritis nodosa

collagen disease that leads to inflammation of arteries and subsequent thickening with impaired circulation, autoimmune

signs of polyarteritis nodosa

weakness, fatigue, weight loss, abdominal pain, bloody diarrhea, elevated ESR

pemphigus

skin disorder beginning with lesions on oral mucosa that spread to generalized body areas, autoimmune

signs of pemphigus

large fragile blisters, malaise, pain, impaired chewing or swallowing, foul-smelling skin discharge, positive nikolsky's sign

nikolsky's sign

when skin is rubbed, epidermis separates from underlying skin

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