Case Study 2: Management of Patients With Immune Deficiency

Disorders
1. The nurse educator for an oncology unit is preparing an in-service
presentation for new nurses about the care of patients with
immunodeficiencies. Patients with cancer who are receiving chemotherapy,
as well as those with bone marrow transplants, are immunocompromised and
require special attention to assess for signs of infection. The nurse educator
focuses on special care needs of this patient population.

a. What is the rationale for assessing the pulse and respiratory rates for
1 full minute in a patient with immunodeficiency?

b. What special precautions about dietary restrictions and food

preparation should be included in the teaching for a patient with
immunodeficiency?

c. What nursing actions should be implemented to decrease the risk of

infection in the patient with immunodeficiency?

2. Josh Parsons, a 36-year-old patient diagnosed with leukemia, is

immunocompromised. The patient’s absolute neutrophil count is 750. The
patient has a moderate risk for infection. The nurse provides patient and
family education on ways to decrease the risk for infection.

a. What should the nurse include in the teaching session with the patient
and family?

3. The nurse is planning to provide education on HIV infection transmission

and prevention strategies at a local senior center.

a. What should the nurse include in the session considering the needs of
the older population?

4. Sallie Jefferies, 28-year-old patient, is at the obstetric clinic for a

pregnancy visit. The physician informs the patient that her HIV screen test is
positive. The patient has no evidence of AIDS. The nurse provides patient
education regarding what HIV is and what the clinical management entails.

a. What clinical management is recommended for the patient during the

pregnancy to help decrease the risk of transmitting HIV to the unborn
child?
b. The patient asks the nurse how zidovudine (Retrovir) will help her
unborn child from getting HIV. How should the nurse respond?

c. What explanation about Retrovir should the nurse provide?

d. The patient asks the nurse if it will be safe to breast-feed her infant
after the delivery. The nurse should provide what explanation?

e. The patient asks the nurse what testing schedule for the HIV antibody
is needed after her baby is born. How should the nurse respond?