Exam (elaborations)
Management of Patients with Immunodeficiency Disorders(SOLVED ).
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Management of Patients with Immunodeficiency Disorders(SOLVED ).
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Management ofPatients with
Immunodeficienc
y
Disorders(SOLVE
D)
A teenager is diagnosed with cellulitis of the right knee
and fails to respond to oral antibiotics. He then develops
osteomyelitis of the right knee, prompting a detailed
diagnostic workup that reveals a phagocytic disorder. This
patient faces an increased risk of what complication?
A) Thrombocytopenia
B) HIV/AIDS
C) Neutropenia
D) Hemophilia - answer C
,(Feedback:
Patients with phagocytic cell disorders may develop
severe neutropenia. None of the other listed health
problems is a common complication of phagocytic
disorders.)
A patient is admitted for the treatment of a primary
immunodeficiency and intravenous immunoglobulin (IVIG)
is ordered. What should the nurse monitor for as a
potential adverse effect of IVIG administration?
A) Anaphylaxis
B) Hypertension
C) Hypothermia
D) Joint pain - answer A
(Feedback:
Potential adverse effects of an IVIG infusion include
hypotension, flank pain, chills, and tightness in chest,
terminating with a slightly elevated body temperature and
anaphylactic reaction. Hypertension, hypothermia, and
joint pain are not usual adverse effects of IVIG.)
A nurse is admitting a patient with an immunodeficiency
to the medical unit. In planning the care of this patient,
the nurse should assess for what common sign of
immunodeficiency?
A) Chronic diarrhea
,B) Hyperglycemia
C) Rhinorrhea
D) Contact dermatitis - answer A
(Feedback:
The cardinal symptoms of immunodeficiency include
chronic or recurrent severe infections, infections caused
by unusual organisms or organisms that are normal body
flora, poor response to treatment of infections, and
chronic diarrhea. Hyperglycemia, rhinorrhea, and contact
dermatitis are not symptoms the patient is likely to
exhibit.)
A young couple visits the nurse practitioner stating that
they want to start a family. The husband states that his
brother died of a severe infection at age 6 months. He
says he never knew what was wrong but his mother had
him undergo "blood testing" as a child. Based on these
statements, what health problem should the nurse
practitioner suspect?
A) Severe neutropenia
B) X-linked agammaglobulinemia
C) Drug-induced thrombocytopenia
D) Aplastic anemia - answer B
(Feedback:
There is no evidence of drug-induced thrombocytopenia or
aplastic anemia. The child would have only suffered from
, severe neutropenia if there was evidence of bacterial or
fungal infections. The fact the mother of this individual
had him tested for gamma-globulin as a child would
indicate that his sibling had X-linked
agammaglobulinemia. More than 10% of patients with X-
linked agammaglobulinemia are hospitalized for infection
at less than 6 months of age. Since the condition is X-
linked it is important for the couple to undergo genetic
testing.)
The parents of a 1-month-old infant bring their child to the
pediatrician with symptoms of congestive heart failure.
The infant is ultimately diagnosed with DiGeorge
syndrome. What will prolong this infant's survival?
A) Stem cell transplantation
B) Long-term antibiotics
C) Chemotherapy
D) Thymus gland transplantation - answer D
(Feedback:
Transplantation of fetal thymus, postnatal thymus, or
human leukocyte antigen (HLA)-matched bone marrow has
been used for permanent reconstitution of T-cell immunity
in infants with DiGeorge syndrome. Antibiotics and
chemotherapy do not address the etiology of the infant's
disease. Stem cell transplantation is not a common
treatment modality.)
A patient who has received a heart transplant is taking
cyclosporine, an immunosuppressant. What should the
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