8.1.1 Autoimmune and Hypersensitivity Reactions
Open Resources for Nursing (Open RN)
The body’s inflammatory and immune responses are essential defense mechanisms designed to protect us against various threats, such as infections and cancer. These responses involve activation of immune cells, release of signaling molecules, and initiation of inflammatory processes to help eliminate harmful invaders and promote tissue repair.
There are instances when an individual’s immune system becomes overly reactive, resulting in an excessive or prolonged inflammatory response that occurs at an inappropriate time or against harmless substances. This kind of exaggerated reaction can damage normal tissues and cause a range of health issues. Such responses are referred to as hypersensitivity reactions or allergic responses.
Hypersensitivity Reactions
Hypersensitivities reflect a range of exaggerated immune responses triggered by exposure to specific antigens.[1] These immune reactions can vary widely in their intensity, causing a range of effects that span from discomfort to severe and life-threatening conditions. When the immune system perceives an antigen as a threat, it can lead to a heightened and often disproportionate response.
Allergic responses are a specific type of hypersensitivity reactions that arise when the immune system reacts to allergens, substances that are generally harmless to most individuals.[2] Common allergens include pollen, dust mites, pet dander, certain foods, and insect venom. When a person with allergies encounters these allergens, their immune system goes into overdrive, releasing histamines and other inflammatory molecules that trigger symptoms such as itching, sneezing, wheezing, hives, or in severe cases, anaphylactic shock. See Table 4.5 for a summary of hypersensitivity reactions.[3],[4]
Table 4.5. Hypersensitivity Reactions
| Hypersensitivity Type | Description | Mechanism | Examples | Nursing Interventions |
|---|---|---|---|---|
| Type 1 Hypersensitivity (Immediate) | Also known as atopic allergy; this is the most common type of hypersensitivity reaction. It involves rapid and excessive immune responses to harmless antigens (allergens) that lead to allergic reactions. | Upon initial exposure, sensitization occurs, involving the production of IgE antibodies against the allergen. Upon subsequent exposure, the allergen binds to IgE antibodies on mast cells and basophils, triggering the release of inflammatory mediators like histamine. | Inhaled allergens (pollens, animal dander), ingested allergens (foods, drugs), injected allergens (bee venom, drugs), and contacted allergens (latex, environmental proteins).
Anaphylactic reactions can occur, involving widespread blood vessel dilation, decreased cardiac output, and bronchoconstriction. |
Provide antihistamines, short-acting beta agonists, and corticosteroids as prescribed; administer epinephrine for anaphylactic reactions; and educate clients about allergen avoidance. |
| Type 2 Hypersensitivity (Cytotoxic) | This type involves antibodies targeting antigens on cell surfaces, leading to the destruction or dysfunction of the affected cells. | Antibodies (IgG, IgM) bind to antigens on cell surfaces, triggering immune-mediated destruction through complement activation or antibody-dependent cell-mediated cytotoxicity. | Hemolytic transfusion reactions, autoimmune hemolytic anemia, and drug-induced cytotoxic reactions. | Monitor for signs of hemolysis, administer blood product transfusions as needed, implement plasmapheresis as prescribed, and provide supportive care. |
| Type 3 Hypersensitivity (Immune Complex) | Immune complexes formed between antibodies and soluble antigens deposit in various tissues, leading to localized inflammation and tissue damage. | Immune complexes attract neutrophils, causing inflammation and tissue damage at the site of deposition. | Post-streptococcal glomerulonephritis, serum sickness, systemic lupus erythematosus, and rheumatoid arthritis. | Administer anti-inflammatory medications, monitor for signs of tissue damage, provide pain relief, and educate clients on self-care. |
| Type 4 Hypersensitivity (Delayed) | This type involves cell-mediated immune responses mediated by T cells, causing inflammation and tissue damage. | Sensitized T cells recognize antigens presented by antigen-presenting cells, releasing cytokines that recruit inflammatory cells and induce tissue damage. | Contact dermatitis, tuberculin skin test reactions, and graft rejection. | Administer corticosteroids for severe reactions, provide wound care for dermatitis, and monitor graft sites for signs of rejection. |
| Type 5 - Stimulated (Autoimmune Reaction) | The immune system mistakenly attacks the body’s own cells and tissues as if they were foreign antigens, leading to chronic inflammation and tissue damage. | Autoantibodies and autoreactive T cells target self-antigens, causing immune-mediated damage to various tissues and organs. | Rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, and type 1 diabetes. | Administer immunosuppressive medications, manage symptoms, provide emotional support, and educate clients on self-management. |
Read more about “Rheumatoid Arthritis” in the “Musculoskeletal Alterations” chapter, “Diabetes Mellitus” in the “Endocrine Alterations” chapter, and “Multiple Sclerosis” in the “Nervous System Alterations” chapter, and “Systemic Lupus Erythematosus” in the following section of this chapter.
Anaphylaxis
Anaphylaxis is a Type I hypersensitivity reaction that occurs rapidly and systemically, and if not promptly treated, it can be fatal. It involves a severe and often sudden immune response triggered by the release of inflammatory mediators in response to an allergen. During an anaphylactic reaction, the body experiences a cascade of symptoms that can affect multiple systems.
Clients experiencing anaphylaxis can have various signs and symptoms. They may experience feelings of uneasiness, apprehension, or a sense of impending doom. Generalized itching and urticaria (hives) can manifest as raised, red, and itchy skin lesions. Erythema and angioedema, characterized by localized swelling often around the eyes, lips, and throat, may occur. Additionally, congestion and rhinorrhea (runny nose) may occur, leading to dyspnea (difficulty breathing) and respiratory distress. In severe cases, anaphylaxis can cause bronchoconstriction and swelling of the throat, leading to obstruction of the airway, a potentially life-threatening condition. Recognition of symptoms and signs of anaphylaxis and prompt intervention are crucial. Treatment typically involves the administration of epinephrine to counteract the systemic effects of anaphylaxis and stabilize the client’s condition.[5],[6]
Interventions for treating anaphylaxis are outlined in the following box.
Interventions for Anaphylaxis[7],[8]:
- Assess respiratory function to monitor for signs of airway obstruction or distress.
- Establish or stabilize the airway if necessary to ensure proper breathing and oxygenation.
- Provide supplemental oxygen to maintain adequate oxygen saturation levels.
- Stay with the client to provide continuous monitoring and support.
- Administer epinephrine (1:1000) as the first-line drug for anaphylaxis; the recommended dose is 0.3-0.5 mL, usually given intramuscularly in the thigh. Epinephrine helps counteract the severe effects of the allergic reaction by increasing heart rate, improving breathing, and reducing blood vessel dilation.
- Administer antihistamines to help relieve itching, hives, and other allergic symptoms.
- Administer a beta-adrenergic agonist (such as albuterol) to help relax bronchial smooth muscles and alleviate bronchoconstriction.
- Administer corticosteroids, either intravenously or orally, to help reduce inflammation and prevent delayed allergic reactions.
- Continuously monitor the client’s vital signs, respiratory status, and overall response to interventions.
- Prepare for potential additional interventions, such as intravenous fluids, if the client’s condition warrants it.
- Provide education and support to the client and family regarding anaphylaxis triggers, emergency action plans, and the proper use of epinephrine auto-injectors if applicable.
RN Recap: Type 1 Hypersensitivity (Immediate) Reaction
View a supplementary YouTube video overview of Type 1 hypersensitivity (immediate) reaction[9]:
RN Recap: Type 2 Hypersensitivity (Cytotoxic) Reaction
View a supplementary YouTube video overview of Type 2 hypersensitivity (cytotoxic) reaction[10]:
RN Recap: Type 3 Hypersensitivity Reaction
View a brief YouTube video overview of a Type 3 hypersensitivity reaction[11]:
RN Recap: Type 4 Hypersensitivity Reaction
View a brief YouTube video overview of a Type 4 hypersensitivity reaction[12]:
RN Recap: Type 5 Autoimmune Reactions
View a brief YouTube video overview of Type 5 autoimmune reactions[13]:
Next- 8.1.2 Systemic Lupus Erythematosus
Media Attributions
- RN Recap Icon
- Immunodeficiency UK. (2018). Allergy and hypersensitivity. https://www.immunodeficiencyuk.org/ ↵
- Immunodeficiency UK. (2018). Allergy and hypersensitivity. https://www.immunodeficiencyuk.org/ ↵
- Immunodeficiency UK. (2018). Allergy and hypersensitivity. https://www.immunodeficiencyuk.org/ ↵
- Justiz, Vaillant, A.A., Vashisht, R., & Zito, P. M. (2023). Immediate Hypersensitivity Reactions. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK513315/ ↵
- Immunodeficiency UK. (2018). Allergy and hypersensitivity. https://www.immunodeficiencyuk.org/ ↵
- Justiz, Vaillant, A.A., Vashisht, R., & Zito, P. M. (2023). Immediate Hypersensitivity Reactions. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK513315/ ↵
- Immunodeficiency UK. (2018). Allergy and hypersensitivity. https://www.immunodeficiencyuk.org/ ↵
- Justiz, Vaillant, A.A., Vashisht, R., & Zito, P. M. (2023). Immediate Hypersensitivity Reactions. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK513315/ ↵
- Open RN Project. (2024, March 25). Health Alterations - Chapter 4 - Type 1 Immediate hypersensitivity reaction [Video]. YouTube. CC BY-NC 4.0https://www.youtube.com/watch?v=KQj7aHVem-0 ↵
- Open RN Project. (2024, March 25).Health Alterations - Chapter 4 - Type 2 Cytotoxic reaction [Video]. YouTube. CC BY-NC 4.0https://www.youtube.com/watch?v=mlkTixljv-0 ↵
- Open RN Project. (2024, June 23). Health Alterations - Chapter 4 - Type 3 Hypersensitivity reaction [Video]. You Tube. CC BY-NC 4.0https://youtu.be/opvj_7lKBWc?si=uFU3dwyAHguJxTFo ↵
- Open RN Project. (2024, June 23). Health Alterations - Chapter 4 - Type 4 Hypersensitivity reaction [Video]. You Tube. CC BY-NC 4.0https://youtu.be/N1bmV6oflhk?si=AHOkqituul2BVfDI ↵
- Open RN Project. (2024, June 23). Health Alterations - Chapter 4 - Type 5 Autoimmune reactions [Video]. You Tube. CC BY-NC 4.0https://youtu.be/VrPq0y3DJ1A?si=Yu5m9GS4oa4t2KAK ↵
Corticosteroids can be prescribed in a variety of routes. Fluticasone is an example of a commonly used inhaled corticosteroid that can be inhaled or used as a nasal spray. Prednisone is an example of a commonly used oral corticosteroid, and methylprednisolone is a commonly used IV corticosteroid. Additional information about corticosteroids and potential adrenal effects is located in the "Corticosteroids" section of the "Endocrine System" chapter.
Mechanism of Action: Fluticasone is a locally acting anti-inflammatory and immune modifier. The nasal spray is used for allergies, and the oral inhaler is used for long-term control of asthma. Fluticasone is also used in a combination product with salmeterol. It decreases the frequency and severity of asthma attacks and improves overall asthma symptoms. See Figures 5.15-17[1],[2],[3] for images of different formulations of fluticasone.
Oral prednisone prevents the release of substances in the body that cause inflammation. It also suppresses the immune system.
Methylprednisolone IV prevents the release of substances in the body that cause inflammation. It also suppresses the immune system. Methylprednisolone comes in powder form and must be reconstituted (mixed) with sterile saline before administration. See Figure 5.17[4] for an image of methylprednisolone.
Indications: Fluticasone inhalers are used to prevent asthma attacks. Fluticasone nasal spray is used to reduce inflammation of sinus passages. In respiratory conditions, oral prednisone is used to control severe or incapacitating allergic conditions, severe asthma, and acute exacerbations of COPD. Oral prednisone is also used to relieve contact dermatitis, atopic dermatitis, serum sickness, and drug hypersensitivity reactions. Methylprednisolone IV is used to rapidly control these same conditions.
Nursing Considerations: Fluticasone is safe for children aged 4 years and older. Prednisone and methylprednisolone are safe for all ages.
Side Effects/Adverse Effects: Fluticasone inhalers can cause hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis. Fluticasone nasal spray can cause dry nasal passages and epistaxis (nosebleeds). Clients should rinse their mouths after using corticosteroid inhalers to prevent candidiasis (thrush).
Prednisone and Methylprednisolone: See more information about adverse effects of corticosteroids in the in the "Corticosteroids" section of the "Endocrine System" chapter. Cardiovascular symptoms can include fluid retention, edema, and hypertension. Imbalances such as hypernatremia (↑Na), hypokalemia (↓K+), and increased blood glucose with associated weight gain can occur. CNS symptoms include mood swings and euphoria. GI symptoms can include nausea, vomiting, and GI bleed. In long-term therapy, bone resorption occurs, which increases the risk for fractures; the skin may bruise easily and become paper thin; wound healing is delayed; infections can be masked; and the risk for infection increases. Long-term corticosteroid therapy should never be stopped abruptly because life-threatening adrenal insufficiency may occur.[5]
Health Teaching & Health Promotion: Instruct clients to rinse their mouths after inhaler use to prevent candidiasis (thrush). Advise clients that corticosteroids are not used to treat an acute asthma attack. They can cause immunosuppression, suppress signs of infection, and cause an increase in blood glucose levels. Clients may experience weight gain, swelling, increased fatigue, bruising, and behavioral changes. These occurrences should be reported to one’s health care provider.[6]
Now let's take a closer look at the medication grid for fluticasone, prednisone, and methylprednisolone in Table 5.12.[7],[8],[9]
Table 5.12 Fluticasone, Prednisone, and Methylprednisolone Medication Grid
Class/Subclass |
Prototype/Generic |
Nursing Considerations |
Therapeutic Effects |
Side/Adverse Effects |
|---|---|---|---|---|
| Corticosteroids | fluticasone | Rinse mouth after use
Do not use inhaler as a quick-relief medication for asthma attacks |
Nasal spray: Used for management of the nasal symptoms of perennial nonallergic rhinitis
Inhaler: Used to improve the control of asthma by reducing inflammation in the airways |
Nasal spray: Dry nasal passages and epistaxis (nosebleed)
Inhalers: Hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis
|
| Corticosteroids | prednisone | Do not use if signs of a systemic infection
When using more than 10 days, the dose must be slowly tapered May increase blood glucose levels |
Used to control severe or incapacitating allergic or respiratory conditions | CV: Fluid retention, edema, and hypertension
Electrolytes: ↑Na, ↓K+, ↑Ca, and ↑BG CNS: Mood swings and insomnia in high doses GI: Nausea, vomiting, and GI bleed MS: Bone resorption Skin: Acne, paper thin, bruises, infections, and delayed healing Increased appetite and weight gain Adrenal suppression Increased risk for infection, and infections can be masked Long-term use may result in Cushing's syndrome |
| Corticosteroids | methylprednisolone | May increase blood glucose levels | Used to rapidly control severe or incapacitating allergic or respiratory conditions, in sepsis to reduce systemic inflammation, and to treat adrenal insufficiency | Same as prednisone |
Next- 3.2.12 Leukotriene Receptor Antagonists
Montelukast is a leukotriene antagonist medication with a distinctly-shaped square tablet. See Figure 5.19.[10]
Mechanism of Action: Montelukast blocks leukotriene receptors and decreases inflammation.
Indications: Montelukast is used for the long-term control of asthma and for decreasing the frequency of asthma attacks. It is also indicated for exercise-induced bronchospasm and allergic rhinitis.
Nursing Considerations: The medication is safe for children 12 months and older. It is available in granule packets and chewable tablets, as well as regular tablets.
Boxed Warning: Serious mental health side effects, including suicidal ideation. Should be avoided for treating mild asthma unless conventional treatment is ineffective.
Side Effects/Adverse Effects: Montelukast can cause headache, cough, nasal congestion, nausea, hepatotoxicity, and suicidal ideation.
Health Teaching & Health Promotion: Clients should be instructed to take medications at the same time each day and at least two hours prior to exercise. They should not discontinue medications without notifying the health care provider.[11]
Now let's take a closer look at the medication grid on montelukast in Table 5.13.[12],[13],[14],[15]
Table 5.13 Montelukast Medication Grid
Class/Subclass |
Prototype/Generic |
Nursing Considerations |
Therapeutic Effects |
Side/Adverse Effects |
|---|---|---|---|---|
| Leukotriene Inhibitor | montelukast | Use as directed; not to be used as a quick relief medication for asthma attacks
Typically, 3-7 days to reach effectiveness Boxed warning for serious mental health side effects, including suicidal ideation. Should be avoided for treating mild asthma unless conventional treatment is ineffective |
Prevention and treatment of asthma and exercise-induced bronchoconstriction | Headache
Cough Nasal congestion Nausea Hepatotoxicity Suicidal ideation |
Next- 3.2.12 Xanthine Derivatives
Montelukast is a leukotriene antagonist medication with a distinctly-shaped square tablet. See Figure 5.19.[16]
Mechanism of Action: Montelukast blocks leukotriene receptors and decreases inflammation.
Indications: Montelukast is used for the long-term control of asthma and for decreasing the frequency of asthma attacks. It is also indicated for exercise-induced bronchospasm and allergic rhinitis.
Nursing Considerations: The medication is safe for children 12 months and older. It is available in granule packets and chewable tablets, as well as regular tablets.
Boxed Warning: Serious mental health side effects, including suicidal ideation. Should be avoided for treating mild asthma unless conventional treatment is ineffective.
Side Effects/Adverse Effects: Montelukast can cause headache, cough, nasal congestion, nausea, hepatotoxicity, and suicidal ideation.
Health Teaching & Health Promotion: Clients should be instructed to take medications at the same time each day and at least two hours prior to exercise. They should not discontinue medications without notifying the health care provider.[17]
Now let's take a closer look at the medication grid on montelukast in Table 5.13.[18],[19],[20],[21]
Table 5.13 Montelukast Medication Grid
Class/Subclass |
Prototype/Generic |
Nursing Considerations |
Therapeutic Effects |
Side/Adverse Effects |
|---|---|---|---|---|
| Leukotriene Inhibitor | montelukast | Use as directed; not to be used as a quick relief medication for asthma attacks
Typically, 3-7 days to reach effectiveness Boxed warning for serious mental health side effects, including suicidal ideation. Should be avoided for treating mild asthma unless conventional treatment is ineffective |
Prevention and treatment of asthma and exercise-induced bronchoconstriction | Headache
Cough Nasal congestion Nausea Hepatotoxicity Suicidal ideation |
Next- 3.2.13 Xanthine Derivatives
Theophylline is a xanthine derivative.
Mechanism of Action: Theophylline relaxes bronchial smooth muscle by inhibition of the enzyme phosphodiesterase and suppresses airway responsiveness to stimuli that cause bronchoconstriction.
Indications: Theophylline is used for the long-term management of persistent asthma that is unresponsive to beta-agonists or inhaled corticosteroids.
Nursing Considerations: Nurses should remind patients that xanthine derivatives are not quick relief medications for asthma attacks. Due to potential CNS stimulation, administer this medication in the morning when possible.
Side Effects/Adverse Effects: Theophylline can cause nausea, vomiting, CNS stimulation, nervousness, and insomnia.[22]
Health Teaching & Health Promotion: Patients should be sure to take medications as prescribed at appropriate intervals. They should avoid irritants, caffeine, and drink fluids to help thin secretions. Patients will need serum blood levels tested every six to twelve months.[23] Due to potential CNS stimulation, suggest taking this medication in the morning.
Now let's take a closer look at the medication grid on theophylline in Table 5.14.[24],[25],[26]
Table 5.14 Theophylline Medication Grid
Class/Subclass |
Prototype/Generic |
Nursing Considerations |
Therapeutic Effects |
Side/Adverse Effects |
|---|---|---|---|---|
| Xanthine | theophylline | Avoid caffeine
Requires evaluation of therapeutic blood level to prevent toxicity Administer this medication in the morning, if possible, due to potential CNS stimulation |
Long-term treatment of chronic asthma and COPD unresponsive to other treatment | GI: Nausea and vomiting
CNS stimulation Nervousness and insomnia |
Next- 3.2.14 Learning Activities
Light Bulb Moment
Let's apply what you have learned in the respiratory unit.
Case Study 1 Asthma Scenario
An adult client presents to the emergency department with complaints of shortness of breath and increased work of breathing. The client is alert and oriented times 3; skin is pink, warm and dry; BP 148/88; T 98; P92; R 24; and pulse oximetry 91% on room air. Assessment of the lung reveals expiratory wheezing throughout the lung fields. The client has a past medical history of asthma, hypertension, and diabetes.
- The nurse anticipates which of the following medications will be initially administered to the client?
a) Theophylline
b) Montelukast
c) Albuterol
d) Salmeterol
2. List the steps the nurse should take to safely administer the medication.
3. What assessments should the nurse plan to complete after administering the medication?
4. The nurse plans on teaching the client about using the albuterol inhaler at home. What information should be included?
5. What is the best method for the nurse to use to ensure that the client is correctly using an inhaler?
Case Study 2 Allergy Scenario
A pediatric client presents to the emergency department with complaints of shortness of breath, increased work of breathing, and a cough. The client is alert and oriented times 3; skin is pink, warm and dry; BP 112/68; T 99; P106; R 32; and pulse oximetry 90% on room air. Assessment of the lung sounds reveals diminished lung sounds throughout all lung fields. The client has a past medical history of peanut allergy. The mother tells you that they were at a birthday party and after consumption of a cupcake, the symptoms started.
- The nurse anticipates that which of the following medications will be likely ordered for this client?
a) Diphenhydramine
b) Epinephrine
c) Cetirizine
d) Guaifenesin
Case Study 3 Rheumatoid Arthritis Scenario
A 67-year-old female client diagnosed with rheumatoid arthritis and type 2 diabetes has been prescribed prednisone for the management of her symptoms. She has been taking prednisone 10mg daily for the past two weeks. The client is complaining of insomnia, increased thirst, and weight gain.
- What are the common side effects of prednisone use?
- How can the nurse help manage the client's insomnia?
- What measures can be taken to help the client manage her increased thirst?
- What teaching should the nurse provide the client regarding prednisone use?
Note: Answers to the Light Bulb Moment can be found in the "Answer Key" section at the end of the book.
Interactive Activity
"Respiratory Medication Quiz” by E. Christman for Open RN is licensed under CC BY 4.0
Interactive Activity
“Respiratory Flashcards” by E. Christman for Open RN is licensed under CC BY 4.0
Interactive Activity
“Respiratory Branching Scenario” by E. Christman for Open RN is licensed under CC BY 4.0[27]
Test your clinical judgment with this NCLEX Next Generation-style bowtie question: Respiratory Assignment 1.[28]
Test your clinical judgment with this NCLEX Next Generation-style bowtie question: Respiratory Assignment 2.[29]
Next- 3.3 Additional Module Materials
Additional Module Materials
Read:
Watch:
Types of pulmonary diseases (11:51)
https://www.youtube.com/watch?v=-oHlcuS7AeU
Asthma Pathophysiology (7:46)
https://youtu.be/ZKvatbn4a_I
Asthma short term treatment (5:08)
https://youtu.be/aUUi1DrghQc
Asthma long term treatment (6:41)
https://youtu.be/lEXuBpu8jys
Next- 3.4 Glossary
Allergies: Allergies occur when the immune system reacts to a foreign substance and makes antibodies that identify a particular allergen as harmful, even though it isn't.
Anaphylaxis: A severe, potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you're allergic to, such as peanuts or bee stings.
Asthma: condition in which airways narrow and swell, causing wheezing and difficulty breathing
Chronic bronchitis: long-term inflammation of the bronchi, causing severe coughing spells
Chronic obstructive pulmonary disease (COPD): a group of diseases that cause airflow blockage and breathing problems; includes emphysema and chronic bronchitis; also known as chronic obstructive pulmonary disorder
Cyanotic: A bluish or purplish discoloration (as of skin) due to deficient oxygenation of the blood.
Diffusion: spontaneous exchange of gases between the alveoli, capillaries, and lungs
Emphysema: gradual damage of alveoli that causes shortness of breath
Gas exchange: The process at the alveoli level where blood is oxygenated and carbon dioxide, the waste product of cellular respiration, is removed from the body.
Histamine: compound released by cells in response to allergy or inflammatory reactions
Hypoxemia: lack of oxygen in the tissues and organs
Laryngitis: inflammation of the larynx
Olfactory: relating to the sense of smell
Oxygenation: process that involves the absorption of oxygen throughout the body
Pallor: A deficiency of color especially of the face; paleness.
Paradoxical effect: An effect that is opposite to what is expected.
Perfusion: blood flow to tissues and organs
Pharyngitis: inflammation of the pharynx; also known as a sore throat
Pulmonary function tests (PFTs): noninvasive tests that show how well the lungs are working
Respiratory rate: The total number of breaths, or respiratory cycles, that occur each minute. A child under 1 year of age has a normal respiratory rate between 30 and 60 breaths per minute, but by the time a child is about 10 years old, the normal rate is closer to 18 to 30. By adolescence, the normal respiratory rate is similar to that of adults, 12 to 18 breaths per minute.
Rhinitis: inflammation and swelling of mucous membranes in the nose
Sinus cavities: four air-filled, interconnected cavities located between the eyes and nose; produce and circulate mucus
Sinusitis: infection of the lining of the sinuses
Sputum: Matter expectorated from the respiratory system and especially the lungs that is composed of mucus but may contain pus, blood, fibrin, or microorganisms (such as bacteria) in diseased states.
Ventilation: process of moving air into and out of the lungs
Welcome!
This book is for students enrolled in the University of Wyoming's ReNEW and RN to BSN nursing program taking Nursing 4650, Foundational Patho-Pharmacology for Nursing.
Each module section contains much of the required reading for the week. Please refer to WyoCourses for any additional assigned reading.
Learning Objectives
On completion of this course, the student will meet the following outcomes:
- Distinguish clinical manifestations of selected disease processes in care of clients across the lifespan. (PLO 2; AACN 1.2a, 1.3a-c, 2.3e)
- Link the concepts of genetics, age, and gender to pharmacokinetics and pharmacodynamics. (PLO 2; AACN 1.2a, 1.3a-c)
- Relate medication safety to the role of the nurse as an active participant within the interprofessional healthcare team. (PLO 1, 2, 6; AACN 2.4e, 2.5a, 2.9c, 2.9e, 5.1a, 5.1b, 5.2a-e, 6.1d, 6.2c)
- Integrate clinical reasoning to ensure safe medication interventions for clients with a diversity of conditions. (PLO 1, 2, 4; AACN 1.3a-c, 2.5c-e, 2.6d, 2.7b, 5.2b, 8.3b)
- Extrapolate select principles of anatomy and physiology as applicable to the pathophysiology of acute, chronic, and complex conditions. (PLO 2; 1.3a-c, 2.3e)
- Include the client as an active partner in medication safety, knowledge, and adherence. (PLO 2, 3, 5; AACN 2.2e, 2.5b, 2.8a-e, 7.2e, 9.1f)
Resources from:
Attribution Statement
Nursing Pharmacology-2e Copyright © 2023 by WisTech Open is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.
Pharmacology for Nurses. Copyright © 2024 by OpenStax is licensed under Creative Commons Attribution License v4.0
Access for free at https://openstax.org/books/pharmacology/pages/1-introduction
Pathophysiology and Pharmacology Basics for Nurses Copyright © by Raquel Bertiz, PhD, RN, CNE, CHSE-A is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.
Next- Module 1
Welcome!
This book is for students enrolled in the University of Wyoming's ReNEW and RN to BSN nursing program taking Nursing 4650, Foundational Patho-Pharmacology for Nursing.
Each module section contains much of the required reading for the week. Please refer to WyoCourses for any additional assigned reading.
Learning Objectives
On completion of this course, the student will meet the following outcomes:
- Distinguish clinical manifestations of selected disease processes in care of clients across the lifespan. (PLO 2; AACN 1.2a, 1.3a-c, 2.3e)
- Link the concepts of genetics, age, and gender to pharmacokinetics and pharmacodynamics. (PLO 2; AACN 1.2a, 1.3a-c)
- Relate medication safety to the role of the nurse as an active participant within the interprofessional healthcare team. (PLO 1, 2, 6; AACN 2.4e, 2.5a, 2.9c, 2.9e, 5.1a, 5.1b, 5.2a-e, 6.1d, 6.2c)
- Integrate clinical reasoning to ensure safe medication interventions for clients with a diversity of conditions. (PLO 1, 2, 4; AACN 1.3a-c, 2.5c-e, 2.6d, 2.7b, 5.2b, 8.3b)
- Extrapolate select principles of anatomy and physiology as applicable to the pathophysiology of acute, chronic, and complex conditions. (PLO 2; 1.3a-c, 2.3e)
- Include the client as an active partner in medication safety, knowledge, and adherence. (PLO 2, 3, 5; AACN 2.2e, 2.5b, 2.8a-e, 7.2e, 9.1f)
Resources from:
- Barbour-Taylor, T., Mueller (Sabato), L., Paris, D., & Weaver, D. (2024). Pharmacology for Nurses. OpenStax. https://openstax.org/books/pharmacology/pages/1-introduction
- Bertiz, R., Sharpe-Mason, C., Sohrabi, T., Wright, J. S., Magerer, D., Agostini, M., & Kefelegn, M. (n.d.). Pathophysiology and Pharmacology Basics for Nurses. Montgomery College Pressbooks. (n.d.) https://pressbooks.montgomerycollege.edu/pathophysiologyandpharmacology/front-matter/montgomery-college-nursing-program-open-textbook-on-pathophysiology-and-pharmacology/
- Ernstmeyer, K., & Christman, E. (Eds.). (2023). Nursing Pharmacology-2e (2nd ed.). WisTech Open. https://wtcs.pressbooks.pub/pharmacology2e/
Attribution Statement
Nursing Pharmacology-2e Copyright © 2023 by WisTech Open is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.
Pharmacology for Nurses. Copyright © 2024 by OpenStax is licensed under Creative Commons Attribution License v4.0
Access for free at https://openstax.org/books/pharmacology/pages/1-introduction
Pathophysiology and Pharmacology Basics for Nurses Copyright © by Raquel Bertiz, PhD, RN, CNE, CHSE-A is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.
