Concept Immunity Topic Question & Answer Guide (With Explanation)
Understanding this question requires applying core subject principles.
What This Question Is About
This question relates to concept immunity topic and requires a structured academic response.
How to Approach This Question
Break the problem into smaller parts and analyze each logically.
Key Explanation
This topic involves concept immunity topic. A strong answer should include explanation, application, and examples.
Original Question
CONCEPT: IMMUNITY TOPIC: Systemic Lupus Erythematosus (SLE) Ms. O is a 34-year-old married woman with two children under 5 years of age. She saw her provider 6 months ago with intermittent fatigue, joint pain, low-grade fever, and unintentional weight loss. Her provider noted small, patchy areas of vitiligo and a scaly rash across her nose, cheeks, back, and chest at that time. Laboratory studies showed Ms. O had a positive antinuclear antibody (ANA) titer, positive anti-dsDNA test, positive anti-Sm test, elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and decreased C3 and C4 serum complement. Joint xray films showed joint swelling without joint erosion. Ms. O was diagnosed with systemic lupus erythematosus (SLE). Initial treatment consisted of hydroxychloroquine (Plaquenil), prednisone, and naproxen sodium, and ice packs. Ms. O responded well and the steroid was tapered and stopped. She was told she could follow-up every 6 months unless her symptoms become acute. Using the mnemonic BRAIN SOAP MD, how is SLE diagnosed? B R A I N S O A P M D 24 months after diagnosis. Ms. O seeks out her provider, saying that she has increased fatigue and puffy hands and feet. Ms. O reports that she has been working longer hours because of the absence of her two co-workers who are on maternity leave. Chart View Basic Metabolic Panel (BMP) and Urinalysis Na 128 mEq/L K 4.3 mEq/L Cl 120 mEq/L CO2 21 mEq/L Glucose 132 mg/dL Blood urea nitrogen (BUN) 38 mg/dL Creatinine 2.5 mg/dL Urinalysis +2 protein, +2 hematuria Interpret Ms. Y’s admitting basic metabolic panel results and urinalysis. What is the significance of all those abnormal laboratory test results based on her current illness? The provider orders cyclophosphamide 100 mg/m2/day orally in tow divided doses. What key points should you include in a teaching plan about cyclophosphamide therapy? Ms. O is seen in the rheumatology clinic twice monthly during the next 3 months. Although her condition does not worsen, her BUN and creatinine remain elevated. While at work, one afternoon, Ms. O begins to feel dizzy and develops a severe headache. She reports to her supervisor, who has her lie down. When Ms. O becomes disoriented, her supervisor calls 911 and she is taken to the nearest hospital. Ms. O is admitted for probable lupus cerebritis related to acute exacerbation of her disease. What other findings indicative of central nervous system involvement should you assess for Ms. O? The provider orders pulse therapy with methylprednisolone 125 mg IV every 6 hours and plasmapheresis once daily. What major complications associated with corticosteroid therapy will you need to monitor for? (List at least 7). A. B. C. D. E. F. G. Vital Signs BP 82/53 mm Hg pulse rate 121 beats/min respiratory rate 20 breaths/min temperature 97.4oF (36.3oC) Mr. O returns to the floor after the plasmapheresis. The assistive personnel (AP) reports Ms. O’s vital signs to you. Based solely on her vital signs, what could be happening to Ms. O? What is plasmapheresis? Based solely on her vital signs, what could be happening to Ms. O? You need to call the provider regarding Ms. O’s status. Using SBAR, what would you report to the provider? S B A R Reference: (with modifications, from Clinical Reasoning Cases in Nursing by Mariann Harding and Julie Snyder, 7th ed.) PART 2: INTEGRATION WEEK 1-4 CLINICAL CASES Cases Assessment Findings: Diagnostic: Lab Tests and Procedure Nursing Management Complications/Psychosocial Considerations: Colon Cancer Lab Tests/Procedure: Priority Nursing Actions: Discuss End-of-Life Care and Colostomy Care Discuss Screening for Colorectal Cancer Lymphoma Lab Tests/Procedure: Priority Nursing Actions: Discuss Stem Cell Transplant and Radiation Therapy HIV/AIDS Lab Tests/Procedure: Priority Nursing Actions: Discuss Stigma and Medication/Treatment Adherence Discuss Opportunistic Infections and Prevention of HIV/AIDS SLE Lab Tests/Procedure: Priority Nursing Actions: Discuss Complications related to Renal Failure Discuss Complications Related to the Use of Immunosuppressive Therapy
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