Académique Documents
Professionnel Documents
Culture Documents
I.
II.
WBC
a. Neutrophils- increase in relation to acute bacterial infection and
fungal infection
b. Lymphocytes (T and B cells)- increased in relation to chronic bacterial
or viral infection, viruses such as mononucleosis, mumps, and
measles, bacteria such as hepatitis, lymphocytic leukemia, multiple
myeloma
c. Monocytes- increased in relation to chronic inflammation, protozoal
infections, TB, viral infections like mononucleosis, mumps, and
measles
d. Eosinophils- increase in relation to allergic reaction, parasitic
infection, chronic inflammation, Hodgkins disease
e. Basophils- increase with leukemia
Skin test for allergens
a. Involves the use of intradermal injections or scratching the superficial
layer of the skin with small amounts of suspected allergnes
b. Intradermal runs a higher risk of hypersensitivity reactions and is
usually done if the scratch test is inconclusive
c. Pre
i. Prepare the skin for application of various allergens using soap
and water (clients back or forearm are usually used for
testing)
ii. Alcohol may be used to remove oil
iii. Have equip ready for possible anaphylaxis reaction
iv. Instruct the client to avoid taking cortocsteroids and
antihistamines 5 days before the testing
d. Intra
i. Skin is scratched or pricked with a needle after application of a
drop of an allergen
ii. An assessment of reactions is done after 15-20 minutes
e. Post
i. Assess the skin for areas of reaction, and document the
allergen that is responsible
ii. Remove all solutions from the skin
iii. Inform the client when results will be available
iv. Recommend an antihistamine or topical corticosteroid if the
client experiences itching seco
v. ndary to the testing
vi. Keep for 30 mins after
III.
HIV/AIDs
a. HIV:
i. Manifestations occur within 2-4 weeks of infection
ii. Symptoms are similar to those of influenza and can include a
rash and a sore throat
iii. Rapid rise in HIV viral load, decrease CD4+ cells, and increased
CD8 cells
iv. Lymphadenopathy persists throughout the disease process
v. Chronic asymptomatic infection
1. This stage may be prolonged and clinically silent
2. Client may remain asymptomatic for 10 years or more
3. Anti-HIV antibodies are produced (HIV positive)
4. Over time, the virus begins active replication using the
hosts genetic machinery:
a. CD4+ cells are destroyed
b. The viral load increases
c. Dramatic loss of immunity begins
b. AIDs
i. Lie-threatening opportunistic infections
ii. End stage of HIV infection
iii. Without txt, death occurs within 5 years
iv. All people with AIDS have HIV, but not all people with HIV have
AIDS
c. Standard precautions
d. s/s:
i. chills, rash, anorexia, nausea, weight loss, weakness, fatigue,
HA, sore throat, night sweats
e. Stages
i. Stage 1
1. No defining conditions
2. CD4+ 500 or more
ii. Stage 2
1. No defining conditions
2. CD4+ 200-499
iii. Stage 3
1. One or more of the following:
a. Candidiasis
b. Herpes simplex- chronic ulcers
c. HIV related encephalopathy
d. Disseminated or extrapulmonary histoplasmosis
e. Kaposis sarcoma
f. Burkitts lymphoma
g. Mycobacterium TB of any site
h. Pneumocytisis jirovecii pneumona
i. Recurrent pneumonia
IV.
V.
k. Medications
i. NSAIDs
ii. Corticosteroids
iii. Immunosuppressants
iv. Antimalaraial- hydroxycholoroquine- encourage frequent eye
exams
l. Client education
i. Avoid UV and sun exposure- use sunscreen when outside and
exposed to sunlight
ii. Use mild protein shampoo and avoid harsh hair txts
iii. Use steroid creams for skin rash
iv. Report peripheral and periorbital edema promptly
v. Report s/s of infection
vi. Avoid crowds and those who are sick
vii. Educate client of childbearing age regarding risks of pregnancy
with lupus and txt medications
m. Complications
i. Lupus nephritis (renal failure/glomerulonephritis)
1. Monitor for periorbital and lower extremity swelling
and HTN
2. Monitor renal status
3. Teach importance of taking immunosupressants and
corticosteroids as prescribed
4. Avoid stress and illness
ii. Pericarditis and myocarditis
1. Report chest pain
2. Monitor for chest pain, fatigue, arrhythmias, and fever
3. Teach importance of taking immunosupressants and
corticosteroids as prescribed
4. Avoid stress and illness
Rheumatoid arthritis
a. s/s
i. pain at rest and with movement
ii. morning stiffness
iii. pleuritic pain (pain upon inspiration)
iv. xerostomia (dry mouth)
v. anorexia/wt loss, fatigue, paresthesias
vi. recent illness/stressor
vii. joint pain
viii. lack of function
ix. joint swelling/warmth/erythema
x. finger, hands, wrists, knees, and foot joints are generally
affected
xi. finger joints affected are the proximal interphalangeal and
metacarpophalangeal joints
xii. joints may become deformed merely by completing ADLs
VI.
VII.
Kaposis sarcoma
a. With AIDS
b. Can be found on the ahrd palate, gums, tongue, or tonsils
c. Lesions appear as raised, purple nodules or plaques
Infection
a. Best way to prevent health-care associated infection is for frequent
and effective hand hygiene
b. Standard precautions
i. Applies to all body fluids, non-intact skin, mucous membranes
ii. Hand hygiene before and after gloves and between patients
iii. Clean gloves
iv. Masks, eye protection, face shield if there is a risk of splash
v. Private room is not needed
c. Airborne
i. Measles, varicella, pulmonary, or laryngeal TB
ii. Private room
iii. N95 or high-efficiency particulate air respirator mask
iv. Negative pressure airflow room
d. Droplet
i. Strep pharyngitis or pneumonia, scarlet fever, rubella,
pertussis, mumps, mycoplasma pneumonia, meningococcal
pneumonia/sepsis, pneumonic plague
ii. Private room or room with same infectious disease
iii. Mask for providers and visitors
e. Contact
i. RSV, shingella, enteric disease, wound infections, herpes
simplex, scabies, MRSA, C. diff, impetigo
ii. Private room or room with same infection
iii. Gloves and gowns by caregiver and visitors
iv. Disposal of infectious dressing material into a single,
nonporous bag without touching the outside of the bag
f.