Immunodeficiency disorders weaken the body's ability to fight infections. Primary disorders stem from genetic mutations, while secondary ones develop later due to external factors. Both types leave patients vulnerable to various health issues and require specialized care.

Nurses play a crucial role in managing immunodeficient patients. This includes administering treatments, preventing infections, providing nutritional support, and offering psychosocial care. Proper infection control measures are essential to protect these vulnerable individuals from harmful pathogens.

Primary and Secondary Immunodeficiency Disorders

Primary vs secondary immunodeficiencies

• Primary immunodeficiency disorders stem from genetic mutations affecting immune function present at birth or early life (X-linked agammaglobulinemia, DiGeorge syndrome)
• Secondary immunodeficiency disorders develop later due to external factors or medical conditions may be temporary or permanent (HIV/AIDS, chemotherapy-induced)

Pathophysiology of primary immunodeficiencies

• Severe Combined Immunodeficiency (SCID) involves genetic defects impair T and B lymphocyte development leading to compromised cellular and humoral immunity
  • Clinical manifestations include recurrent severe infections, failure to thrive, chronic diarrhea, opportunistic infections (Pneumocystis pneumonia, Candida albicans)
• Selective IgA Deficiency results from impaired IgA production while other immunoglobulins remain normal
  • Symptoms manifest as recurrent respiratory and gastrointestinal infections, allergies, autoimmune disorders (celiac disease, lupus)

Secondary Immunodeficiency and Patient Care

AIDS as secondary immunodeficiency

• HIV infection progressively depletes CD4+ T lymphocytes compromising immune function
• Nursing management encompasses:
  1. Administering antiretroviral therapy and supporting adherence
  2. Preventing and treating opportunistic infections
  3. Providing nutritional support
  4. Offering psychosocial care and counseling
  5. Managing pain
  6. Delivering palliative care in advanced stages

Infection control for immunodeficient patients

• Hand hygiene involves proper handwashing techniques and using alcohol-based sanitizers
• Personal protective equipment includes gloves, gowns, masks, eye protection
• Environmental cleaning and disinfection reduces pathogen transmission
• Patient isolation precautions encompass standard and transmission-based measures (contact, droplet, airborne)
• Vaccinating healthcare workers and patients boosts overall immunity
• Educating patients, families, visitors on infection prevention enhances compliance
• Antimicrobial stewardship promotes judicious use of antibiotics
• Surveillance and monitoring of healthcare-associated infections guides prevention strategies