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.