Immune Slides

7/28/2019 Immune Slides

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AUTOIMMUNE DISORDERS

INFLUENCED BY GENETIC, HORMONAL,

VIRAL OR ENVIRONMENTAL FACTORS

FORMATIONS OF ANTIBODIES AGAINST

SELF-TISSUES MAY INVOLVE

T-CELLS AND B-CELLS OR BOTH

ORGAN SPECIFIC ALSO NON-ORGAN SPECIFIC


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NURSING TREATMENT AND

MANAGEMENT OF

AUTOIMMUNE DISORDERS

CORTICOSTEROID THERAPY

CYTOTOXIC DRUGS EMOTIONAL SUPPORT

EDUCATION

RX SPECIFIC TO TYPE OFAUTOIMMUNE DISORDER


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CHRONIC FATIGUE SYNDROME

LASTING FATIGUE 6 MONTS OR MORE

MAY FOLLOW COLD, FLU, MONO

MUSCLE WEAKNESS / JOINT DISEASE

HEADACHE, LOSS OF CONSCIOUS

ETIOLOGY UNCLEAR

TREATED SOMETIMES WITH ANTI-VIRAL

AGENTS, ANTIDEPRESSANTS, NSAIDS NO CURE


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Pernicious Anemia

Rheumatoid Arthritis

Guillain-Barre

Scleroderma

Ulcerative colitis

Myasthenia Gravis

Multiple Sclerosis

Systemic Lupus Erythmatosis


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SCLERODERMA

Cause unknown

18 20 people per million, per year(rare)

Remissions and exacerbations

Starts with skin involvement

Then skin undergoes fibrotic changes -

loss of elasticity and movement

Becomes non-functional


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GOUT

A heterogenous group of conditions

related to a genetic defect in purine

metabolism that results in hyper uricemia.

Over secretion of of uric acid

Or a renal defect resulting in decreased

excretion of uric acid or a combination of

both occur


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Faulty Uric Acid Metabolism

1. Severe dieting or malnutrition

2. Excessive diet of foods high in purines(shellfish, organ meats)

3. Secondary to increase in cell turnover and cellbreakdown

( leukemia, multiple myeloma, some types ofanemia, psoriasis)

4. Altered renal tubular function - Pharmacological

agents ( diuretics such as thiazides andfurosemide, saliciylates (low dose), ethanol

5. Increase in alcohol intake


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Metatarsophalangeal joint of big toe the

most common site (90%)

May cause renal stones and damage


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RX

Test of synovial fluid of joint involved

Acute attack

Colchicine

Indomethethacin NSAID

Corticosteroids

After Acute Attack Subsides

Urososuric Agents Benemid these correcthyperuricemia and dissolve deposited urate


10/18

If at risk for renal insufficiency or kidney

stones

Allopurinol, a xanthine oxidase inhibitor is

also effective


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FIBOMYALGIA

Fibromyalgia is a common syndrome

fatigue

2% of population affected

More common in women


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Treatment

No specific symptoms

Trycyclic antidepressants

Serotonin reuptake inhibitors

Anticonvulsants


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Osteoarthritis

Degenerative Joint Disease

Wear and Tear Syndrome

Most common and most frequently

over treated or under treated

Idiopathic in nature


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SYSTEMIC LUPUS

ERYTHEMATOSUS (SLE) A result of disturbed immune regulation

that causes an exaggerated production ofauto-antibodies.

Chronic connective tissue diseaseinvolving multiple organ systems.

Deposit of antigen or antibody complexes

that affect the connective cells throughoutthe body.


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CAUSES OF SLE

Unknown

Genetic

Autoimmune

Viral

Drug induced: procainamide (Pronestyl) andhydralazine (Apresoline)


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Home Care Instructions

Stop smoking

Lupus foundation

Identify ways to reduce stress S & S Renal failure

Avoid people with infections

Monitor self for infection, fatigue, jointpain, renal complications


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Diagnostic Tests

Hematology

Rheumatoid factor

*LE cell preparation

*Urine chemistry Blood chemistry

*ANA

*Skin Biopsy

*Key findings


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Complications of SLE

Necrosis of glomerular capillaries

Inflammation of cerebral and ocular blood vessels

Necrosis of lymph nodes

Vasculitis of GI tract and pleura

Degeneration of the skins basal layer

Heart failure

Seizures

Depression

Infection

Peripheral neuropathy

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