Immune, Pain, Infections, Headache NUR 226 .docx - Definition S\/S Hypersensitivity Overly aggressive immune response Type I Immediate

Immune, Pain, Infections, Headache NUR 226 .docx -...

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Definition S/S DX/TX Hypersensitivity Overly aggressive immune response Type I: Immediate Hypersensitivity -rapid action to antigen (anaphylaxis) -does not occur on 1st exposure to antigen -1st exposure: B cells attach to mast cells to produce IgE -2nd exposure: causes this antibody to react w/antigen immediately -mast cells secrete histamine which act w/in seconds to cause itching, vasodilation, inflammation,& edema-> shock, airway obstruction (d/t laryngeal edema) -mast cells also secrete leukotrienes (act w/in mins to cause smooth mm. constriction leading to bronchospasm) -allergic rhinitis: hayfever, runny nose -hives -asthma -mediates allergy (over response to an exogenous antigen) ->doesn’t occur w/ 1st exposure Can lead to-> Anaphylaxis shock =severe life-threatening -systemic hypersensitivity rxn -↓BP caused by histamine release -airway obstruction -severe hypoxia -can be caused by: latex, insect stings, nuts/shellfish, or various drugs -generalized itching/tingling, esp.oral cavity -coughing -difficulty breathing -feeling weak -dizziness/fainting -sense of fear or panic -edema around eyes, lips, tongue, hands, feet -hives -collapse w/LOC TX: -require 1st aid response (epipen if ava./ call 911) -Tx in ER: epinephrine, glucocorticoids, antihistamines, O2, stabilize BP -skin tests: to determine cause -desensitization tx giving injections very small amts of antigen to create a blocking antibody Type II: Cytotoxic hypersensitivity =autoimmune rxn -antibody recognizes as self protein as nonself and attaches to cell membrane -antibody kills cells or interferes w/cell fxn eg.: transfusion rx, thrombocytopenia, organ transplant rejection, drug rxns Type III: Immune complex =autoimmune rxn -antibody attaches to antigen forming a complex -Eg. Systemic lupus erythematosus, Hep B -produces an inflammatory response locally/circulates & induces inflammation in distant tissues (kidney, joints, heart, microvasculature) -mediates autoimmune disease (immune system mistakes an endogenous substance as foreign) Type IV: Delayed -mediated by T lymph -macrophages attachto antigen & present it to T lymph, activating them to become cytotoxic T cells -when antigen on skin- >inflammation (eg. poison ivy, -cause autoimmune disease when killer T cells attack healthy tissue w/ similar antigen
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contact dermatitis) -deeper tissue: a cluster of macrophages & T cells forms around antigen, creating granuloma (eg. TB in lung) Systemic lupus erythematosus (SLE) =Type III autoimmune -antibodies to many tissues, which form immune complexes -immune complexes are deposited in connective tissue anywhere in the body Complications : -brain, kidney, joints, blood vessels and & blood cells Risk factors : -♀20-40 yo -specific cause not established multifactoral -genetics/ estrogen lvls -pregnancy, infection, physical or emotional stress -chronic disease w/ exacerbations & remissions -”butterfly” rash over the cheeks & bridge of the nose is photosensitive -fatigue, mm aches -swollen, painful joints -photosensitivity TX: certain drugs frequently prednisone, supportive only DX: need at least more symptoms involved Nursing interventions:
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