Presentation 51.pptx MANGENET OF PATIENT

NURSING MANAGEMNT OF PATIENT WITH IMMUNOLOGICAL ISSUES

1. Adult health nursing - 2  Unit –7 Nursing management of patients with immunological  problems

2. Objectives …. Introduction Review of immune system  Nursing assessment – history and physical assessment  HIV and AIDS - Epidemiology, transmission Prevention of transmission and its mx

3. Objectives        ….. Role of nurse ... NACO  and other agencies                     .................................

4. Introduction  Immune system disorders  Can be abnormally low activity or high activity of immune system ….

5. An immune system disorder - dysfunction of the immune system.  These disorders can be characterized in several different ways: By the components of immune system affected. By whether the immune system is overactive or underactive. By whether the condition is congenital or acquired.

6. Review of immune system ​:- ANATOMY AND PHYSIOLOGY OF IMMUNE SYSTEM IMMUNE SYSTEM

7. IMMUNE SYSTEM :- An immune system is a collection of biological processes within an organism that protects against disease by identifying and killing pathogens and tumor cells.

8. IMMUNITY Immunity is defined as the resistance of an organism to infection, disease or other unwanted biological invasion.

9. immunity is defined as the defense mechanism of the human body produced from the cumulative action of cells and antibodies when a pathogen attacks it. It works relentlessly to protect us from different infections without our conscience. The quick detection of pathogens and the release of defensive antibodies to fight comprise the function of our immune system.

10. Nursing assessment –  history and physical assessment  ​....

11. An assessment of immune function begins with a health history and physical examination.  The history should note the patient's age along with information about past and present conditions and events that may provide clues to the status of the patient's immune system.  Areas to be addressed include nutritional status; infections and immunizations; allergies; disorder and disease states, such as autoimmune disorders, cancer, medications; and blood transfusions. and chronic illnesses; surgery; Physical assessment includes palpation of the lymph nodes and examination of the skin, mucous membranes, and respiratory, gastrointestinal, genitourinary, cardiovascular, and  other systems

12. Nurse has to collect various data by using both objective and subjective because immunology/immunity concerned with almost all systems of the body.  Usually in the baseline data: Patient age, gender, occupation, Address, educational qualifications, Etc..

13. On physical examination:-  the skin and mucous membranes are assessed for lesions, dermatitis,  inflammation, or any discharge.  Any signs of infection are noted.

14. The patient's temperature is recorded, and the patient is observed for chills and sweating. The anterior and posterior cervical, axillary, and inguinal lymph nodes are pal-pated for enlargement; if palpable nodes are detected, the location, size, consistency, and reports of tenderness upon palpation are noted.  Joints are assessed for tenderness and swelling and for limited range of motion.

15. The patient's respiratory, cardiovascular, gastrointestinal, genitourinary, and neurosensory status is evaluated for signs and symptoms indicative of immune dysfunction. The patient's nutritional status, level of stress, and coping ability are also assessed, along with his or her age and any functional limitations or disabilities.

16. Indications of Immune Dysfunction Respiratory System :- Changes in respiratory rate Cough (dry or productive) Abnormal lung sounds (wheezing, crackles) Rhinitis Hyperventilation Bronchospasm

17. Cardiovascular System :-  Hypotension  Dysrhythmia  Vasculitis  Anemia Gastrointestinal System  :- Hepatosplenomegaly Colitis Vomiting Diarrhea

18. Genitourinary System :- Frequency and burning on urination Hematuria Discharge Skin :- Rashes Lesions Dermatitis  Hematomas Edema  Inflammation Discharge

19. Neurosensory System :- Cognitive dysfunction Hearing loss Visual changes Headaches and migraines Ataxia Tetany

20. Diagnostic Evaluation :- A series of blood tests and skin tests and a bone marrow biopsy may be performed to evaluate the patient's immune competence. Specific laboratory and diagnostic tests are discussed in greater de-tail along with specific disease processes in subsequent. Laboratory and diagnostic tests used to evaluate immune competence

21. HIV and AIDS - Epidemiology, transmission ​ Prevention of transmission and its mx ​

22.  HIV / AIDS :- Acquired immuno-deficiency syndrome Fatal illness Caused by a retrovirus HIV It breaks down the body's immune system, leaving the patient vulnerable to a host of life threatening opportunistic infections, neurological disorders or unusual malignancies.

23. Signs and symptoms :- The symptoms of HIV vary depending on the stage of infection. The disease spreads more easily in the first few months after a person is infected, but many are unaware of their status until the later stages.  In the first few weeks after being infected people may not experience symptoms . Others may have an influenza-like illness including: Fever and sore throat  headache rash

24. T he infection progressively weakens the immune system. This can cause other signs and symptoms: swollen lymph nodes weight loss fever Loose motions cough.

25. Without treatment, people with HIV infection can also develop severe illnesses :- tuberculosis (TB) cryptococcal meningitis severe bacterial infections cancers such as lymphomas and Kaposi's sarcoma. HIV causes other infections to get worse, such as hepatitis C, hepatitis B ETC....

26. Epidemiology  Males>females  Occurs in all ages and ethnic groups  All areas of the country are affected  AIDS is now the second leading cause of death for all men aged 25-44 years (Unintended injuries is #1 and heart disease is #3 for this age group)

27. Prevalence of HIV in different states Manipur - 1.15% Mizoram - 0.80% Nagaland - 0.78% Andhra Pradesh - 0.66% Karnataka - 0.53% Tamilnadu - 0.28% ETc … 

28. Transmission ​​ :- HIV-Agent It is a RNA virus  Which replicates in actively dividing T4 lymphocytes. Unique ability to destroy T4 Helper cells  Reservoir- Once a person gets infected virus remains in his body lifelong. And the person is a symptomless carrier for years before the symptoms actually appear.

29. Source The virus is found in great concentrations in blood, CSF and semen.  Lower concentrations have been found in tears, saliva, breast milk, urine, cervical and vaginal secretions. •  isolated from brain tissue, lymph nodes, bone marrow cells and skin. •  However only blood and semen are known to transmit the virus.

30. HIV Transmission  HIV enters the bloodstream through: Open Cuts  Breaks in the skin  Mucous membranes & Direct injection

31. Routes of Transmission of HIV :-  Sexual Contact & Blood Exposure Male-to-male Male-to-female or vice versa Female-to-female Injecting drug use/needle sharing Occupational exposure or Transfusion of blood products Perinatal: Transmission from mother to baby Breastfeeding

32. Occupational Transmission , Health care worker/ hospital staff Laboratory workers Other routes Organ transplantation Artificial insemination Needle-prick

33. Prevention of transmission and its mx ​

34. Prevention of transmission

35. HIV is a preventable disease. Reduce the risk of HIV infection by: using a male or female condom during sex being tested for HIV and sexually transmitted infections having a voluntary medical male circumcision using harm reduction services for people who inject and use drugs

36. Doctors may suggest medicines and medical devices to help prevent HIV, including:​ antiretroviral drugs (ARVs), including oral  PrEP  and long acting products​ ( pre-exposure prophylaxis ( PrEP ) dapivirine  vaginal rings​ injectable long acting cabotegravir.​ ARVs can also be used to prevent mothers from passing HIV to their children.​ People taking antiretroviral therapy (ART) and who have no evidence of virus in the blood will not pass HIV to their sexual partners.  Access to testing and ART is an important part of preventing HIV.​

37. Treatment There is no cure for HIV infection. It is treated with antiretroviral drugs, which stop the virus from replicating in the body. Current antiretroviral therapy (ART) does not cure HIV infection but allows a person’s immune system to get stronger. This helps them to fight other infections. Currently, ART must be taken every day for the rest of a person’s life.

38. ART lowers the amount of the virus in a person’s body.  This stops symptoms and allows people to live a full and healthy life.  People living with HIV who are taking ART and who have no evidence of virus in the blood will not spread the virus to their sexual partners.​ Pregnant women with HIV should have access to and take ART as soon as possible. This protects the health of the mother and will help prevent HIV from passing to the fetus before birth, or to the baby through breast milk.​

39. Role of nurse ... ​

40. NACO  and other agencies ​ ​.........

41. National AIDS Control Program The Government forming the National AIDS committee (NAC) headed by the union health secretary. → The National AIDS Control Program was Launched in the year (1987)

42. National AIDS Control Organization National AIDS Control Organization (NACO) 1992 is a organization of Government of India under the Ministry of Health and Family welfare with the primary objective to control the epidemic in India.  NACO also aims at facilitating and improving access to treatment for HIV+ people and also be Phase to promote and protect their human rights.

43.   Ever since its establishment, NACO has been working to create awareness about HIV/AIDS, giving accurate and reliable information on the menace, clearing existing myths and misconceptions and providing practical skills that can be implemented at the individual's level so as to lead to  behaviour   changes that minimize the risk of HIV infection.