pathophysiology case study

I am going to be a senior in nursing school next year and am taking pathophysiology this summer. My teacher has us do a discussion every week, but I honestly find them to be SO over my head that I'm not learning a thing. My mother has been an ICU nurse for 31 years and she thinks they are ridiculous as well. I'm not looking for someone to answer this question for me, but does anyone have any ideas about this particular case study? In particular I am struggling with numbers 6,7, and 8 on the first case study and numbers 3,7, and 8 on the second case study. I do not feel like these are answers I can look up in a book or research, I don't think I have the clinical knowledge or critical thinking skills because we have been exposed to very little in clinicals. Any help would be appreciated!

You are working in the ED when a patient comes in having an allergic reaction to bee pollen she has eaten. She brought the jar of bee pollen with her. Your nurse colleague, curious as to how bee pollen tastes, injests a small amount. A few minutes later your colleague begins to experience itching in her throat and ears, hives and mild respiratory distress. The respiratory distress rapidly progresses to audible wheezing. You notice that your colleague appears to be in distress.

1. What do you think is wrong with your colleague?

2. Given that your colleague is having a possible allergic reaction, what actions would you take (list 6)?

3. What is the rationale behind giving the medications you identified in answer 2 above? Indicate their usual dosages.

4. List the 4 types of allergy reactions.

5. Identify 3 nursing diagnoses for your first client.

6. The nurse colleague begins to improve. She states that the itching has subsided and the hives are fading. She reports that she no longer has acute shortness of breath. On auscultation of her lungs, you note that the wheezing has resolved. She wants to return to work. Is it appropriate to allow her to return to duty? Why?

7. A decision is made to discharge the nurse to her home. What issues should you address in discharge teaching of this nurse( list 3)?

8. Should you allow the nurse to drive herself home? Why?

You are now scheduled to work at the student health center for a local university. TQ a 19-year-old male student, visits you. He informs you of his immunodeficiency problem. He gives you a letter from his attending physician, a vial of his gamma globulin, and asks you if you would give him his "shot". The letter, written by TQ'S physician, states that he has an adequate number of B-cells but inadequate numbers of immunoglobulin. TQ has a history of chronic sinus and upper respiratory tract infections and occassional GI tract infections. He is maintained on 0.66 ml/kg gamma globulin IM every 3 weeks. TQ responds well to his treatment and has suffered no side effects from gamma globulin other than occassional redness at the injection site. TQ has no other known allergies or illnesses and is on tetracycline for acne. TQ is 5 foot 11 inches and weighs 190 pounds, has several pustular lesions on his face and neck, and his VS are 134/78, 84, 20, 98.8.

1. What actions will you take first?

2. What should you do while the physician is verifying information?

3. Would you give TQ his own medication?

4. What other assessments should you make before TQ leaves?

TQ is very knowledgeable about his condition. After receiving his injection, he makes an appointment to return to the health department in 3 weeks. TQ complains of a stuffy nose on his next appointment.

5. How should you respond to TQ's complaints?

6. If TQ is developing a sinus infection, what signs are you likely to encounter upon examining TQ?

7. TQ's nares do not appear swollen or red, although he does have some clear mucus drainage. His temperature is normal at 98.4. TQ is due for his next gamma glubulin. Should you give the medication or ask him to return when he is no longer having nasal stuffiness? Why or why not?

8. Should any adjustments be made in TQ's class schedule or activities because of his condition?

9. How do primary immunodeficiencies differ from secondary immunodeficiencies?

10. Explain why TQ is at greater risk for the development of infections than his classmates.

11. How do injections of gamma globulin help TQ fight off infections?

12. What are the major side effects that could occur from injections of gamma globulin?

13. Given the nature of and any side effects associated with gamma globulin, how long should TQ wait at the health department before leaving?