MS 34 quiz 7, immune mediated disorders

The immune system sometimes responds aggressively and destructively to substances that may not always be potentially harmful. Two examples of such a response include allergic and autoimmune disorders. This study guide covers these disorders, appropriate nursing care, and chronic fatigue syndrome (CFS) as a consequence of an immune-mediated disorder.

1. Overview of Immune Responses

The immune system may have exaggerated responses to non-threatening substances, leading to various disorders. Key categories include:

  • Allergic Disorders: Hyperimmune responses to generally harmless antigens (allergens).

  • Autoimmune Disorders: Immune responses attacking one’s own cells and tissues.

  • Chronic Fatigue Syndrome (CFS): A consequence of immune dysfunction, often characterized by unrelenting fatigue without clear cause.

2. Nursing Considerations
2.1 Gerontologic Considerations

  • Older adults often have increased adverse reactions to antihistamines (dizziness, sedation, confusion).

  • Utilize Beers criteria for evaluating medication safety in seniors; changes in cell sensitivity increase autoimmune disorder risks.

2.2 Assessment and Monitoring

  • Particularly monitor older males with benign prostatic hypertrophy for urinary issues linked to antihistamine use.

  • Elevated autoantibodies in aging can predict potential hypothyroidism or hypopituitarism.

3. Allergic Disorders
3.1 Definition and Characteristics

  • Allergic disorders manifest as an exaggerated immune response to allergens which can enter through ingestion, inhalation, contact, or injection.

  • Allergic reactions can vary widely and may change with age or repeated exposure to allergens.

3.2 Types of Allergens

  • Ingestants: Foods (e.g., peanuts, milk, eggs) or drugs (e.g., penicillin) potentially causing reactions like anaphylaxis.

  • Inhalants: Airborne particles (pollen, dust) leading to respiratory conditions.

  • Contactants: Substances that cause skin reactions (e.g., latex, cosmetics).

  • Injectants: Allergens introduced via insect stings or medicinal injections.

3.3 Common Allergic Reactions

  • Allergic rhinitis: Sneezing, itching, and nasal congestion managed with antihistamines or corticosteroids.

  • Contact dermatitis: Redness and rash from direct contact, treated through allergen avoidance.

  • Food allergies: Digestive or respiratory symptoms requiring food identification and avoidance strategies.

3.4 Pathophysiology and Etiology

  • Over 50 million Americans suffer from allergies; genetic predisposition plays a significant role.

  • First exposure to an allergen induces sensitization without symptoms; subsequent exposures cause hypersensitivity responses based on IgE, IgM, or IgG antibodies.

4. Immediate & Delayed Hypersensitivity Responses
4.1 Immediate Hypersensitivity

  • Types I-III hypersensitivity responses involve rapid reactions from IgE, IgM, or IgG antibodies.

    • Type I (Anaphylactic): IgE-mediated reactions leading to severe, systemic responses like anaphylaxis.

    • Type II (Cytotoxic): Occurs rapidly with IgM or IgG targeting specific cells.

    • Type III (Immune Complex): Peaks within 6 hours post-exposure with IgG involvement.

4.2 Delayed Hypersensitivity (Type IV)

  • Involves T cells. An antigen is processed by macrophages, leading to a T-cell mediated response that manifests days after exposure.

  • Examples include tissue rejection and delayed reactions to contact allergens like latex.

5. Management of Allergic Reactions

  • Medications: Antihistamines, corticosteroids, bronchodilators, and immunotherapy.

  • Clients with severe food allergies should carry emergency epinephrine for anaphylaxis.

6. Autoimmune Disorders
6.1 Definition

  • Autoimmune disorders arise when the immune system fails to distinguish self from non-self, leading to tissue damage.

6.2 Pathophysiology and Etiology

  • Various hypotheses explain autoimmunity, including genetic predispositions, viral infections, and tissue injuries.

  • A triggering event often precedes the onset of autoimmune responses.

6.3 Examples of Autoimmune Disorders

  • Blood: Hemolytic anemia.

  • Nervous System: Multiple sclerosis.

  • Endocrine: Hashimoto's thyroiditis, Type 1 diabetes.

  • Systemic: Systemic lupus erythematosus.

6.4 Assessment Findings

  • Symptoms vary based on which organs are targeted. Common manifestations include fatigue, malaise, and fluctuating inflammatory symptoms.

7. Chronic Fatigue Syndrome (CFS)
7.1 Definition & Characteristics

  • CFS is primarily marked by profound fatigue lasting at least 6 months, worsened by physical activity.

7.2 Epidemiology

  • Affects an estimated 2.5 million people in the U.S.; more prevalent among women aged 40-59.

7.3 Assessment Findings

  • Symptoms include malaise after exertion, sore throat, joint pain without swelling, unrefreshing sleep, and cognitive difficulties.

7.4 Diagnostic Approach

  • No single test confirms CFS; diagnosis is predominantly clinical, based on history and exclusion of other conditions.

7.5 Management Strategies

  • Focus on symptom relief; balanced activity and rest are crucial. Medications can include analgesics and antidepressants.

8. Nursing Guidelines

  • Engage in thorough assessments, patient education, and support for clients with allergic or autoimmune disorders.

  • Collaborate with clients to develop individualized management and education plans to minimize exposure to allergens and improve self-efficacy in managing their conditions.

9. Patient Education

  • Essential for those with allergies to recognize symptoms and manage reactions effectively, including understanding triggers and medication use.

  • Empower patients with knowledge about their autoimmune conditions, the importance of adherence to therapy, and coping mechanisms to handle chronic illness.

10. Conclusion

  • Understanding the complexities of allergic and autoimmune disorders is crucial for nursing care. Ongoing assessment, client education, and individualized management strategies enhance patient outcomes in these conditions.