A patient who is immunosuppressed asks the nurse why he is ...

[genevieve1028]

A patient who is immunosuppressed asks the nurse why he is experiencing so many illnesses. How should the nurse respond?
 
  1. You are unable to develop immunity to common bacteria, so you experience more illnesses.
  2. Your body takes longer to develop an immune response.
  3. Your body thinks everything is foreign matter and responds with an illness.
  4. You are under severe stress, which is causing the illnesses.

Question 2

A patient is prescribed an immunosuppressive agent. Which statement indicates the patient needs additional instruction from the nurse about this drug?
 
  1. I should drink a lot of fruit juices, such as grapefruit juice.
  2. I know to call the physician if I start experiencing a lot of bruising.
  3. I should drink plenty of water to keep from getting dehydrated.
  4. If I experience any joint pain, I should take ibuprofen for the pain as needed every 4 hours.

[LVPMS]

Answer to Question 1

Correct Answer: 1

Patients with immunodeficiency disorders demonstrate an unusual susceptibility to infection. When the antibody-mediated response is primarily affected, the patient is at particular risk for severe and chronic bacterial infections. Patients with a defect of cell-mediated immunity tend to develop disseminated viral infections such as herpes simplex and cytomegalovirus. Overwhelming bacterial infections may occur. Patients with combined immunodeficiency are susceptible to all varieties of infectious organisms, including those not normally considered pathogens. The patient's body does not take longer to develop an immune response or think everything is foreign matter. Severe stress is not causing the illnesses.

Answer to Question 2

Correct Answer: 1

Immunosuppressive agents inhibit T cell development and activation. They are given concurrently with glucocorticoids and in combination with other immunosuppressants, and inhibit immune system activity and organ rejection. Nursing responsibilities include monitoring blood urea nitrogen levels and creatinine for evidence of nephrotoxicity. The patient should avoid grapefruit juice, which can raise cyclosporine levels by 50 to 200 and increase the risk of toxicity. Fluids should be increased to maintain good hydration and urinary output. Ibuprofen is acceptable for immunosuppressive medications, but should not be taken with cytotoxic agents. The physician should be notified about any bruising.