Immune_20Disorders

Nursing Care for Families with Children with Immune Disorders

Nursing Diagnoses for Children with Immune Disorders

• Common Nursing Diagnoses Include:

  • Risk for infection related to altered immune response.

  • Impaired skin integrity related to inadequate lymphocyte protection.

  • Activity intolerance related to chronic illness.

  • Risk for delayed or altered growth & development from chronic immune disorders.

• Nursing Diagnoses for Allergic Responses:

  • Situational low self-esteem related to contact dermatitis effects.

  • Ineffective breathing pattern due to bronchospasm or anaphylaxis.

  • Anxiety related to allergic response.

  • Powerlessness related to difficulty identifying allergy cause.

Outcome Evaluation for Children with Immune Disorders

• High self-esteem is voiced, even if contact dermatitis persists.

• Maintained respiratory rate of 20 breaths/minute with minimal wheezing.

• Child and parents feel capable of coping with anxiety.

• Child lists three actions taken for greater control.

• Developmental milestones achieved within age-acceptable parameters despite chronic illness.

The Immune System

• Composition: Includes various cell types that react to foreign substances (antigens like pathogens, food proteins, pollens).

• Components of Immune Response:

  • Host Defenses: Physical barriers (skin, mucous membranes).

  • Nonspecific Response: Involves complement, phagocytes, natural killer cells.

  • Specific Responses: Antibody production and cellular immunity work in synergy to protect against foreign invasion.

Immune Response Details

• Immune Response Mechanism: Mobilizes leukocytes and antibodies to combat infections.

• Types of Antigens:

  • Antigen: Any foreign substance inciting immune response.

  • Immunogen: Antigen readily destroyed by immune response.

  • Allergen: Antigen causing tissue injury and allergic symptoms.

Major Immune Organs & Cells

• Key Organs: Liver, lymph nodes, bone marrow, thymus, spleen, tonsils.

• Lymphocytes:

  • B Lymphocytes: Produce antibodies/immunoglobulins.

  • T Lymphocytes: Responsible for cell-mediated immunity.

Types of Immunity

• Cell-Mediated Immunity: Involves T lymphocytes.

• Humoral Immunity: Involves antibody production by B lymphocytes (IgG, IgM, IgA, IgD, IgE).

Mechanism of Immunity Response

• Involves differentiation of specific B lymphocytes into plasma cells, leading to antibody production against antigens.

• Memory Cells: Facilitate rapid antibody production upon re-exposure to antigens.

Immunodeficiency Disorders

• Primary Immunodeficiencies:

  • Congenital (e.g., X-linked agammaglobulinemia, CVID).

  • Treatment includes regular immunoglobulin infusions and extended antibiotic courses.

• Secondary Immunodeficiencies:

  • Acquired through infections (e.g., HIV) or environmental factors.

Therapeutic Management of HIV

• Frequent CD4 counts to monitor progression, maintain CD4 > 500 cells/mm³ through antiretroviral therapy.

• Preventative measures include avoiding breastfeeding and cesarean delivery to reduce maternal-transmission risk.

Allergy Assessment

• Common allergic responses are assessed via history, skin testing, and lab tests (e.g., eosinophil count).

Therapeutic Management of Allergies

• Goals:

  • Reduce allergen exposure.

  • Modify responses via medications.

  • Immunotherapy when avoidance isn’t effective.

• Pharmacotherapy: Antihistamines (e.g., cetirizine), intranasal steroids, and decongestants for symptom relief.

Emergency Treatment for Anaphylaxis

• Immediate recognition and treatment necessary for anaphylactic shock.

• Administer epinephrine and bronchodilators, provide oxygen if hypoxia present, and prepare for secondary medications (e.g., corticosteroids).

Conclusion

• Nursing care for families with children having immune disorders requires comprehensive assessment, diagnosis, planning, implementation, and evaluation to provide effective care.