Nursing Tips: Immune

A patient with Systemic Lupus Erythematosus (SLE) has some classic findings including fatigue, joint pain, fever, butterfly rash on the face, Raynaud's phenomenon, and a positive ANA titer.

A patient taking ethambutol for tuberculosis should be educated to have regular vision screenings and report changes in vision to the prescriber.

Assess any skin lesions for potential cancerous changes using ABCDE.

A patient taking oseltamivir to treat Influenza A and B must begin therapy within 48 hours of the onset of symptoms.

A child with Chickenpox (Varicella) is contagious until all lesions have crusted over. Educate families to keep them at home and away from others until this time.

IMMUNIZATIONS IN FIRST 6  MONTHS Birth = "B" Hep B 2 Months = "B. Dr. HIP" Hep B, DTAP, RV, Hib, IPV, PCV 4 months = "Dr. HIP" DTAP, RV, Hib, IPV, PCV 6 months = "B. Dr. HIP" Hep B (6-12 months), DTAP, RV, Hib, IPV (3rd dose: 6-18 months), PCV

Don't get TIPSY when taking your TB meds! Alcohol is contraindicated for these TB meds: Isoniazid, Rifampin, Pyrazinamide, Ethambutol. All carry a risk for hepatotoxicity!

Ciprofloxacin is a fluoroquinolone antibiotic used to treat UTIs. A unique side effect of this medication is "achilles tendon rupture". HINT: If you take CIPRO, you might SLIP due to your achilles tendon rupturing.

Amphotericin B is only used for life-threatening fungal infections, because the side effects will "terrorize" your body.

These side effects include: hepatotoxicity, nephrotoxicity, and bone marrow suppression.

Acyclovir and Ganciclovir are antiviral medications. Both medications have a key side effect of nephrotoxicity. Ganciclovir can also cause bone marrow suppression (anemia, neutropenia, thrombocytopenia).

Innate vs. Acquired Immunity Pathophysiology

Patient teaching for external radiation therapy.

Neutropenia and Thrombocytopenia are key symptoms of hematologic cancers (ex: leukemia, multiple myeloma). Key Nursing priority: Prevent infection and bleeding!

When screening a patient for prostate cancer, be sure to obtain the PSA (prostate specific antigen) before performing a DRE (digital rectal exam).

Mastectomy Care and Patient Teaching:

Nursing Care: Do not administer injections, obtain blood, or take BP in the affected arm.

Patient Teaching: Wear sling when ambulating, wear loose clothing, perform arm/hand exercises to prevent edema and increase ROM.

Doxorubicin is an antitumor antibiotic used to treat cancer. Think "ruby" RED. This medication can cause RED discoloration of sweat, urine, and tears.

Leuprolide is a medication used to treat prostate cancer.
HINT: Dr. Lou lied to me about the side effects of this medication, which include: hot flashes, gynecomastia, decreased libido.

Vincristine is an antimitotic medication used to treat cancer. A key side effect with this medication is peripheral neuropathy.
HINT: Vin = wine in French. If you drink too much wine, you won't feel your arms/legs (like having neuropathy!).

Tamoxifen is a medication used to treat breast cancer. It works by competing with estrogen for binding sites in breasts.

HINT: Tammy is a foxy lady with breast cancer.

Types of immunity: Active natural: Body produces antibodies in response to exposure to a live pathogen. Active artificial: Body produces antibodies in response to a vaccine.  Passive natural: Antibodies are passed from the mom to her baby through the placenta and breastmilk. Passive artificial: Immunoglobuins are administered to an individual after exposure to a pathogen.

Stomatitis is inflammation of the mouth/lips. It is a common side effect of chemotherapy. If your patient has stomatitis, provide the following teaching:

• Do not use alcohol based mouthwash!
• Use a soft toothbrush.
• Avoid acidic, spicy, dry, or crunchy foods.
• Cut food is smaller bites.
• Use a straw.

Gentamicin is an aminoglycoside used to treat SERIOUS bacterial infections. Gentamicin looks like "Gentle", but it is the OPPOSITE of gentle. Key side effects include ototoxicity and nephrotoxicity.

For patients who suffer mucositis (related to chemotherapy): Avoid glycerin or alcohol containing mouthwashes!!