Chapter 51 Management of Patients With Immunodeficiency

Immunodeficiency Disorders Primary Genetic May affect phagocytic function, B cells and/or T cells, or the complement system Secondary Acquired HIV/AIDS Related to underlying disorders, diseases, toxic substances, or medications

Primary Immunodeficiencies Usually seen in infants and young children Manifestations: vary according to type; severe or recurrent infections; failure to thrive or poor growth; and positive family history Potential complications: recurrent, severe, potentially fatal infections; related blood dyscrasias and malignancies Treatment: varies by type; treatment of infection; pooled plasma or immunoglobulin; GM-CSF or GCSF; thymus graft, stem cell, or bone marrow transplant See Table 51-1

Nursing Management Monitor for signs and symtoms of infections Symptoms of inflammatory response may be blunted Monitor lab values Promote good nutrition Address anxiety, stress, and coping Strategies to reduce risk of infection Handwashing and strict aseptic technique Patient protection and hygiene measures: skin care, promote normal bowel and bladder function, and pulmonary hygiene

Patient Teaching Signs and symptoms of infection Medication teaching Prevention of infection Handwashing Avoid crowds and persons with infections Hygiene and cleaning Nutrition and diet Lifestyle modifications to reduce risk Follow-up care