chapter 32: immune deficiency

Primary Immune Deficiency Disorders (PIDD)

Genetic disorders in which part of the immune system is absent or dysfunctional, leading to increased susceptibility to infections.

Cause of PIDD

Inherited genetic mutations affecting immune function.

Immune Components Affected in PIDD

B cells, T cells, phagocytes, and the complement system.

Clinical Manifestations of PIDD

Recurrent infections, opportunistic infections, failure to thrive, poor growth, and persistent infections.

Diagnostic Tests for PIDD

CBC, immunoglobulin levels, lymphocyte counts, and genetic testing.

Treatment for PIDD

Intravenous immunoglobulin, prophylactic antibiotics, and stem cell transplantation.

Vaccination Considerations for PIDD

Live vaccines should be avoided.

Nursing Management of PIDD

Infection prevention, early detection, patient education, and supportive care.

Intravenous Immunoglobulin (IVIG)

Replacement therapy that provides antibodies to enhance immune function.

Human Immunodeficiency Virus (HIV)

A retrovirus that attacks CD4+ T-helper cells, weakening the immune system.

Acquired Immunodeficiency Syndrome (AIDS)

The most advanced stage of HIV characterized by severe immunosuppression.

Cells Targeted by HIV

CD4+ T-helper lymphocytes.

Definition of AIDS

CD4 count below 200 cells/mm³ or the presence of opportunistic infections.

Modes of HIV Transmission

Blood, semen, vaginal secretions, rectal fluids, and breast milk.

HIV Is Not Transmitted Through

Casual contact, saliva, tears, sweat, insects, or sharing utensils.

Perinatal Transmission

Transmission during pregnancy, childbirth, or breastfeeding.

Pre-Exposure Prophylaxis (PrEP)

Medication taken to prevent HIV infection in high-risk individuals.

Post-Exposure Prophylaxis (PEP)

Antiretroviral therapy taken after potential exposure to prevent infection.

Timeframe to Initiate PEP

Within 72 hours of exposure.

Standard Precautions

Infection control practices used to prevent exposure to blood and body fluids.

Pathophysiology of HIV

Progressive destruction of CD4+ T-helper cells leading to immunosuppression.

HIV Life Cycle

Attachment, fusion, reverse transcription, integration, transcription, translation, assembly, and budding.

Stages of HIV Infection

Stage 0, Stage 1, Stage 2, Stage 3 (AIDS), and Unknown.

Stage 1 HIV

Acute infection with CD4 counts ≥500 cells/mm³.

Stage 2 HIV

Chronic infection with CD4 counts between 200–499 cells/mm³.

Stage 3 HIV (AIDS)

CD4 count below 200 cells/mm³.

Antiretroviral Therapy (ART)

Lifelong treatment that suppresses HIV replication.

Goals of ART

Reduce viral load, restore immune function, prolong survival, improve quality of life, and prevent transmission.

Viral Load

The amount of HIV RNA in the blood and the best indicator of treatment effectiveness.

CD4 Count

A measure of immune system function.

Respiratory Manifestations of HIV

Pneumocystis pneumonia, tuberculosis, dyspnea, and cough.

Gastrointestinal Manifestations of HIV

Oral candidiasis, chronic diarrhea, nausea, vomiting, and wasting syndrome.

Oncologic Manifestations of HIV

Kaposi sarcoma and non-Hodgkin lymphoma.

Neurologic Manifestations of HIV

Peripheral neuropathy, HIV encephalopathy, and cognitive impairment.

Integumentary Manifestations of HIV

Herpes zoster and seborrheic dermatitis.

Gynecologic Manifestations of HIV

Recurrent vaginal candidiasis, pelvic inflammatory disease, and menstrual abnormalities.

Nursing Assessment for HIV/AIDS

Evaluation of physical, psychological, nutritional, neurologic, and immune status.

Priority Nursing Diagnosis for HIV/AIDS

Risk for infection related to immunosuppression.

Collaborative Problems in HIV/AIDS

Opportunistic infections, medication adverse effects, and HIV-associated neurocognitive disorders.

Planning Goals for HIV/AIDS

Prevent infections, maintain immune function, and promote quality of life.

Nursing Interventions for HIV/AIDS

Promote adherence to ART, prevent infections, and provide nutritional and psychosocial support.

Community Resources for HIV/AIDS

Home health services, support groups, transportation assistance, and financial programs such as the Ryan White HIV/AIDS Program.