QUESTIONS AND ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
ALREADY GRADED A+
Type of immunity present at birth - Answer-Cell-mediated (T cells)
Type of immunity newborns do not have - Answer-Humoral (B cells that produce
antibodies - except for IgG that can cross placenta)
S/S of SCID - Answer-Absence of both cell and humoral immunity:
Abnormally small thymus on CXR
Oral thrush in infants
Chronic diarrhea
Skin infections
FTT
Treatment for SCID - Answer-IV IgG until stem cell transplant
Hematopoetic stem cell transplant
Nursing considerations with SCID - Answer-~Infection prevention/neutropenic
precautions:
same as for onco patients but more strict
~Skin care (their only defense)
~Proper nutrition, sometimes need a tube
SCID vs WAS - Answer-WAS is less common
WAS= SCID + low platelets
--> same tx (add platelet transusions) and nursing (add bleeding precautions)
HIV/AIDS in pregnant women - interventions - Answer-~ART - zidovudine (25% chance
of transmission without it)
~C section
~No breatfeeding
Lab testing for HIV in kids - Answer-<18 mo: PCR
>18 mo: HIV antibodies
+ CD4 count to determine stage
, Autoimmune disease typically diagnosed in adolescence/early adulthood - Answer-SLE
Autoimmune disease typically diagnosed in toddlers - Answer-JIA
Diagnostic criteria for JIA - Answer->1 joint affected
Persists for >6 months
Concern with JIA - Answer-Higher chance of inflammation of the middle layer of the eye
(uveitis), can cause blindness --> slit lamp eye exam
Nursing considerations with JIA - Answer-~Worse in the morning
~Mainain ROM, move joints but allow rest
~Warm compresses prior to exercise
~Firm matterss
~Arthritis will get worse when these kids get sick
~Routine eye exams important
Chickenpox incubation and transfer periods - Answer-Incubation: 2-3 weeks
Contagious: 1 day before rash appears until after rash resolves
Contraindications for chicken pox vaccine - Answer-Allergy to gelatin, neomycin
Anyone immunocompromised
Pregnancy
Chicken pox vaccine: when - Answer-12-15 months (1 year old visit)
4-6 years (usually at 4 yo)
(given together with MMR)
Measles (Rubeola) transmission precautions - Answer-Airborne/contact
Chickenpox transmission precautions - Answer-Airborne/contact
Measles (Rubeola) incubation and transfer periods - Answer-Incubation: 20 days
Contagious: 4 days before rash till 5 days without it
Prodromal stage of measles: s/s and timing - Answer-~1 week
Koplik spots (before fever)
Fever over 104 starts at day 4
Classic triad (three Cs): cough, conjunctivitis, coryza (runny nose)
Koplik spots are a diagnostic indicator of - Answer-Measles (Rubeola)
Stage 2 of Measles (Rubeola) - Answer-•Maculopapular rash begins on face and
spreads downward
Rubella transmission precautions - Answer-Droplet/contact