_N113 Unit 2 Support Spring 2025 (2).pptx 2

Unit Overview

• Course: Support N113

• Term: Fall 2023

Objectives

• Correlate the pathophysiology, etiology, and clinical manifestations of patients with alterations in the immune system:

  • Hypersensitivity reactions (Types I-V)

  • HIV/AIDS and opportunistic diseases

  • Cancer and oncologic emergencies

• Interpret and analyze procedures and diagnostic tests for alterations in the immune system:

  • Common tests include CBC with WBC differential, rapid HIV testing, RAST, and biopsy

  • Understand the importance of tests like CD4 T-cell count and viral load.

• Understand pharmacological and non-pharmacological therapies for patients with immune alterations:

  • Pharmacological: Antihistamines, corticosteroids, antiretroviral therapy (ART)

  • Non-pharmacological: Lifestyle modifications and self-care strategies

Teaching and Learning Topics

• Promote self-care in patients with altered immune systems:

  • Recognizing allergens, managing medications (e.g., EpiPen), and understanding HIV screening

  • Infection and cancer prevention and management of side effects from treatments (chemotherapy, radiation)

• Identify resources for patients:

  • Agencies like the National Institute for Allergy and Infectious Diseases and the American Cancer Society

HIV Overview

• Transmission: Viral RNA becomes viral DNA, altering cellular structure for replication.

• Infection Stages:

  • Asymptomatic chronic infection

  • Symptomatic chronic infection

  • AIDS defined by CD4+ count < 200 cells/μL or an AIDS-defining illness.

Clinical Manifestations of HIV

• Common symptoms:

  • Fever, cough, weakness, nausea/vomiting, diarrhea, etc.

  • Lymphadenopathy and flu-like symptoms are also prevalent.

• Diagnostic Testing:

  • Tests involving HIV virus antibodies, CD4+ count, and viral load are crucial for monitoring health.

HIV Interventions and Management

• Regular monitoring of vital signs, weight, and lab results (CD4+, viral load).

• Promote adherence to ART, provide nutrition and emotional support.

• Teaching points include avoiding high-risk behaviors and understanding treatment regimens.

Hypersensitivity Reactions

• Types of Reactions:

  • Type I: Immediate (IgE) - Anaphylaxis; requires fast intervention (Epinephrine).

  • Type II: Cytotoxic (IgM) - Hemolytic reactions; stop transfusion protocols.

  • Type III: Immune Complex (IgG) - SLE and rheumatoid arthritis.

  • Type IV: Delayed (cell-mediated) - Poison Ivy or TB tests; 24-48 hours response.

Cancer Overview

• Most common cancers: Lung, breast, colorectal, prostate, skin, stomach.

• Key factors in carcinogenesis include environmental and genetic influences.

• TNM Staging System:

  • Stage 0: Cancer in situ

  • Stage I: Localized tumor

  • Stage II: Limited local spread

  • Stage III: Extensive spread

  • Stage IV: Metastasis

Cancer Treatment Modalities

• Surgical Options: Tumor resection, debulking, reconstruction.

• Radiation Therapy: External and internal forms (Brachytherapy).

• Chemotherapy: Important for systemic treatment of cancer, including immunotherapy and targeted agents.

Patient Care Incorporating Knowledge of Cancer and Immune Disorders

• Interventions for Superior Vena Cava Syndrome: Elevate the head of the bed to facilitate blood flow and alleviate symptoms.

• Dietary Considerations: High protein diets support healing for patients undergoing treatments.

• Managing Chemotherapy Effects: Utilize scheduled antiemetics to combat nausea.

Summary of Important Questions and Answers

• Understanding HIV Patterns: Untreated infection follows a predictable progression; late chronic HIV equals AIDS.

• Antiretroviral Drug Purpose: Primarily to decrease viral load, not to cure the infection but to manage it.

• Education for Expectant Mothers: Most infants born to HIV-positive mothers are not infected if ART is used during pregnancy.

• Rapid HIV Testing Protocol: Positive results necessitate a follow-up blood test for confirmation.

Hypersensitivity Reactions and Nursing Interventions

• When a patient is stung and has a concern about severe reactions, assess their history of past reactions before providing advice.

• Tuberculosis Testing Reaction Type: Positive reactions are characterized by Type IV hypersensitivity.

Early Warning Signals of Cancer (CAUTION)

• Change in bowel or bladder habits

• Non-healing sore, unusual bleeding, thickening/lump

• Indigestion or swallowing issues, changes in warts/moles, nagging cough