1. The Child with an Immunologic Alteration
Chapter 42
The Child with an
Immunologic Alteration
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2. Nonspecific Immune Function
Chemical barriers
Inflammation
Increased capillary permeability
Vasodilation
Phagocytosis
Elimination of cellular waste products
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3. Specific Immune Function
Humoral response
Cell-mediated response
Development of immunity
Actively acquired
Passively acquired
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4. Immunologic Imbalance
Under function
Increased susceptibility to infection
Over function
Produces antibodies against cells of the body
Allergies
Autoimmune disease
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5. Acquired or Congenital Immunodeficiency
Increased vulnerability to viral or bacterial infections
Appropriate hand hygiene and infection control practices
Three guiding principles
Prevent contact was organisms.
Create barriers if contact is unavoidable.
Kill organisms if contact is made.
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6. The Child Taking Oral Corticosteroids
Both immunosuppressive and antiinflammatory properties
During cessation of therapy, gradually taper the dose to allow for a gradual return of adrenal function.
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7. Immune Complex and Autoimmune Disorders
Kawasaki disease
Glomerulonephritis
Autoimmune disorders
Systemic lupus erythematosus (SLE)
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8. Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc.

9. Types of Allergic Reactions
Type I: immediate (anaphylactic) hypersensitivity
Examples: allergic rhinitis, acute anaphylaxis, hives, eczema, asthma
Type II: cytotoxic hypersensitivity
Examples: transfusion reaction after receiving incompatible blood
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10. Types of Allergic Reactions (cont.)
Type III: arthus hypersensitivity (immune complex)
Examples: serum sickness, glomerulonephritis
Type IV: delayed cell-mediated hypersensitivity
Examples: contact dermatitis (poison ivy)
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11. Initial Symptoms of Impending Anaphylaxis
Sneezing
Tightness, tingling of mouth or face, with subsequent swelling of lips and tongue
Severe flushing, urticaria, and itching, especially on head and upper trunk
Rapid development of erythema
Sense of impending doom
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12. Managing Anaphylactic Shock
Ensure an adequate airway, possibly by endotracheal intubation.
Administer epinephrine.
Administer oxygen if available.
Administer corticosteroids and antihistamines as ordered.
Keep the child warm and lying flat or with feet slightly elevated.
Start an intravenous (IV) line.
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13. Question
Which intervention is a priority for a nurse caring for a child with anaphylaxis?
Providing supplemental oxygen
Ensuring an adequate airway
Initiating IV access
Administering corticosteroids
Answer: B
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