Question

Case Study, Chapter 36, Management of Patients with HIV Infection and AIDS 1. The nurse is planning to provide education on HIV infection transmission and prevention strategies at a local senior center. (Learning Objectives 1 and 4) a. What should the nurse include in the session considering the needs of the older population? Case Study, Chapter 37, Assessment and Management of Patients with Allergie Disorders 1. William Peterson is preparing to go a camping trip with some of his colleagues. Due to an allergy to bees, he comes to the clinic to get an EpiPen. The last time he was on vacation in the mountains, he was stung by a bee and was rushed to the local emergency department due to an anaphylactic reaction. Because of this experience, he always keeps an EpiPen with him. (Learning Objective 4) a. What is the pathophysiology of an anaphylaxis reaction? b. What are clinical manifestations of anaphylactic reactions? What is the rationale of Mr. Peterson carrying an EpiPen with him at all times Case Study, Chapter 38, Assessment and Management of Patients with Rheumatic Disorders 2. Julie Walker, a 22-year-old patient, is newly diagnosed with systemic lupus erythematosus (SLE). She presented with extreme fatigue; muscle and joint aching and swelling: a butterfly shaped, flat, red rash across the bridge of the nose: patchy alopecia; a low-grade fever; and loss of appetite. Further workup revealed a positive antinuclear antibodies (ANA) titer, anemia leucopenia, and mild thrombocytopenia. She has an abnormal lipid profile, proteinuria and hypertension. The liver and renal profiles are within normal range. The physician ordered over the-counter ibuprofen as needed for joint discomfort, but not to exceed 1.200 moldava hydroxychloroquine sulfate (Plaquenil) before meals at the same time each day; and prednisone

Answer 1

1) a) HIV infection transmission and prevention:

Anyone can be infected by HIV either old ones or adults. People whi are diagnosed with HIV in young age are getting older. Antiretroviral therapy can help these patients to an extent. This will help these people live longer. There is no specific HIV treatment for older people. The treatment regimens for them is based on the person’s individual needs. Age related factors should be considered by the health care provider while treating thise patients. Some may have kidney or liver disease or any non communicable diseases like diabetes, hypertension etc. Age related thinning and drying of genital areas in female patients are at high risk.

Always use treatment as prevention and use post exposure prophylaxis.

2) a) pathophysiology Of anaphylactic reaction: Anaphylaxis is a potentially fatal reaction caused by the release of chemical mediators from mast cell and basophils. This involves the prior sensitization toan allergen in an individual with later reexposure produces symptoms through immunological mechanisms.

b) Clinical manifestation of anaphylactic reaction: anaphylaxis commonly affects the cutaneous, respiratory, cardiovascular and gastrointestinal systems. Also the skin and mucous membranes get affected in many. Urticaria, erythema pruritis and angioedema is seen in majority of adult patients.

c) Epipen will help to constrict the blood vessel to increase the blood pressure and helps to relax the smooth muscles in lungs to reduce wheezing and this improves breathing. It may stimulate the heary and increase heart rate that works to reduce the swelling around face and lips.