Chapter 11: Care of Patients with Immune and Lymphatic Disorders (with HIV and AIDS) deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The nurse is caring for a pediatric patient recently diagnosed with severe combined immunodeficiency (SCID) disease. The nurse determines that teaching has been effective after the parent makes which statement? a. “This disease is like a pediatric version of AIDS.” b. “My child must be careful not to fall to avoid bleeding.” c. “My child should not attend day care.” d. “This problem happened because of chemotherapy treatments.” ANS: C There are two forms of immune deficiency: primary and acquired. In primary immune deficiency disorders (PIDD), the cause is an inherited genetic mutation and some of PIDD are detected during infancy or early childhood. Patients with this type of disorder experience repeated infections that clearly increase their risk of morbidity and mortality as well as the cost of health care. AIDS is an example of acquired immune deficiency and affects pediatric patients as well as adults. Hemophilia is a disorder in which patients can suffer life-threatening bleeds from a fall. Chemotherapy recipients may develop an acquired immune disorder, but chemotherapy would not cause any type of immune disorder in the child. PTS:1 DIF: Cognitive Level: Application REF: 217, Box 11-1 OBJ:1 TOP: Primary Immune Deficiency KEY: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 2. After an influenza immunization, the patient complains of shortness of breath, breaks out in hives, and begins to twitch. Which ordered medication should the nurse give first? a. Epinephrine injection b. Oxygen via mask at 5 L/min c. Corticosteroid injection d. Bronchodilators per nebulization ANS: A Epinephrine is the initial line of defense to reverse anaphylaxis, followed by high-flow oxygen, bronchodilators, and corticosteroid injection as necessary. PTS:1 DIF: Cognitive Level: Application REF: 249 OBJ: 6 (clinical) TOP: Anaphylaxis KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. The nurse is educating a patient with systemic lupus erythematosus (SLE). Which information is most important for thenurse to include in the teaching plan? a. Train with weights to increase strength. b. Avoid glycerin-based soaps. c. Use an SPF 15 sunblock when outdoors. d. Apply fragrance-free lotions to dry areas twice daily.