Immunocompromise (HIV and AIDS, Oncology and Chemotherapy, Transplant Patient) for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Immunocompromise (HIV and AIDS, Oncology and Chemotherapy, Transplant Patient) for Certified Emergency Nursing (CEN)
Outline
Immunocompromise (HIV and AIDS, Oncology and Chemotherapy, Transplant Patient)
Definition/Etiology:
Immunocompromise – failure of absence of elements in the immune system.
Can occur as primary or secondary (we usually see secondary in the ER).
Primary – Born with it such as DiGeroge Syndrome
Secondary – Acquired such as HIV/AIDs, organ transplant, oncology with chemo.
Neutropenic – WBCs <1,000
Pathophysiology:
- HIV/AIDs – disease process is to kill CD4 cells (which help with our immunity). HIV becomes AIDs when CD4 count falls below 200.
- Oncology/Chemo – chemo works to kill off fastest growing cells in the body (both good and bad) so also kills off any developing WBCs making the person immunocompromised
- Organ transplant – on immunosuppressant drugs to prevent organ rejection
Clinical Presentation:
- Usually present with secondary infections.
- Fever (maybe)
- Pain
- Low WBCs (less than 1,000)
- If organ transplant, pain at the transplant site.
Collaborative Management:
- Treatment based upon complaint
- Labs
- Neutropenic precautions
- Appropriate hand hygiene shown to be the most effective measure
- Limit the number of people in the room if possible.
Evaluation | Patient Monitoring | Education:
- Monitoring/Educate primary complaint
- In addition, maintain and educate on neutropenic precautions
- No fresh fruits or flowers
Linchpins: (Key Points)
- Immunocompromised with a fever = bad news
- Isolate
- Neutropenic precautions
- “No fresh fruits or flowers”
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Department of Health. AIDS Institute. (2003). Retrieved October 23, 2022, from https://www.health.ny.gov/diseases/aids/
- Haug, S. (2017). Neutropenic Precautions.
- Neutropenia: What it is, types, symptoms & causes. Cleveland Clinic. (2022, May). Retrieved October 23, 2022, from https://my.clevelandclinic.org/health/diseases/21058-neutropenia
- Steigbigel, N. Neutropenic Precautions Demystified.
- Vaillant, A. A. J., & Qurie, A. (2021). Immunodeficiency. In StatPearls [Internet]. StatPearls Publishing.
NCLEX
Concepts Covered:
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