Immune Disorders Assignment: APA format 1.5 pages MSN degree 2 references from Walden university library

Due Thursday March 15 at 7pm EST

https://www.onlinenursingpapers.net/immune-disorders-assignment/

Immune Disorders

Two immune deficiency disorders will form the basis of the following text’s discussion, human immunodeficiency virus (HIV) and psoriasis. Pathophysiology, drug therapy, and adverse effects will be discussed. Furthermore, variations in each disease process will also be presented. The purpose of this discussion post is to further understand the disease process of HIV and psoriasis.

Introduction

Since the beginning of the HIV epidemic nearly four decades ago, the world has witnessed an unprecedented transformation of this disease from a debilitating and rapidly fatal syndrome to a chronic condition effectively managed with combination antiretroviral therapy (cART). People living with HIV (PLWH) who receive treatment now have nearly the same life expectancy as HIV-negative people. 1 With the exception of two people who were cured by human stemcell transplantation,2, 3 a broadly applicable cure for HIV remains elusive, and PLWH infection still necessitates lifelong therapy. Although effective cART suppresses viral replication, PLWH continue to experience inflammation and immune activation, which are caused by a combination of HIVdependent and HIVindependent factors. 4 These immune factors contribute to an increase in nonAIDS comorbidities in PLWH, such as cardiovascular disease (CVD), frailty, malignancy, neurocognitive disease, osteoporosis, and renal and liver disease. 4 It is becoming increasingly clear that, as the PLWH population ages, focusing on nonAIDS comorbidities is critical to effectively caring for and treating this population.

Immune Disorders Assignment

CVD is the world’s leading cause of death, accounting for 56.9 million deaths in 2016.

 

5 The relative risk of CVD in PLWH is significantly higher than in HIVnegative controls, with higher rates of acute myocardial infarction6 and an increased risk of ischemic stroke,7 heart failure,8, and sudden cardiac death.

 

9 Indeed, the HIVassociated risk for CVD is thought to be similar to that of traditional risk factors such as smoking, hyperlipidemia, diabetes mellitus, and hypertension. 10 Despite several studies demonstrating a higher risk of cardiovascular events in PLWH, the most difficult challenge has been defining the overarching mechanisms by which HIVmediated immune activation and chronic inflammation increase the risk of CVD. 11 Despite significant efforts, this has made it difficult to identify effective interventions to target and reduce cardiovascular risk in this population.

 

In this review, we look at the effects of HIVassociated inflammation and immune activation on the cardiovascular system, with a focus on atherosclerotic CVD, and we discuss existing and proposed antiinflammatory therapeutic strategies to reduce CVD risk. Figure 1 summarizes the factors that contribute to immune activation and CVD in PLWH.

 

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V. &  Reinhold, J. A.  (Eds.).

(2017). Pharmacotherapeutics  for advanced practice: A practical approach (4th ed.).

Ambler, PA:  Lippincott Williams & Wilkins.

Huether, S. E., & McCance, K. L. (2017). Understanding  pathophysiology (6th ed.). St. Louis,

MO: Mosby.

Renton, C. (2018). Late-onset psoriasis: Diagnosis, assessment and management. British

Journal Of Community Nursing, 23(2), 58-63.

Van Onselen, J. (2013). Managing psoriasis in children and young people. Nurse Prescribing,

11(7), 330-336.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

• Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two-sentence responses, simple statements of agreement, or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

• I discourage overutilization of direct quotes in DQs and assignments at the Masters’s level and deduct points accordingly.
• As Masters’s level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

 

LopesWrite Policy

• For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
• Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
• Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
• Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

HIV Immune Deficiency

Human immunodeficiency virus (HIV) is a virus that infects CD4-positive T cells, which are required for the development of plasma cells and T cells. As a result of this cell depletion, the immune system reacts negatively. The development of acquired immunodeficiency syndrome (AIDS) is possible with immune system suppression (Huether & McCance, 2017), p. 194).

HIV Immune Disorders and Drug Therapy

After HIV is diagnosed, the goal of treatment is to keep the virus under control and prevent it from progressing to AIDS. Drug therapy is intended to accomplish five goals for the patient: to suppress the viral load, to restore immune system function, to maintain quality of life, to prevent HIV-related complications, and to prevent HIV transmission (Arcangelo, Peterson, Wilbur, & Reinhold, 2017, p. 846).

Medication regimens have been developed, and it is important to note that each patient reacts differently. Nucleoside reverse transcriptase inhibitors (NRTI), nonnucleoside reverse transcriptase inhibitors (NNRTI), protease inhibitors (PI), fusion inhibitors, integrase trans transfer inhibitors (INSTI), and CCR5 antagonists are examples of drug regimens.

It is critical to understand that NRTI drugs such as Ziagen, Videx, Emtriva, Epivir, Zerit, and Retrovir prevent RNA transcription into DNA (Arcangelo, Peterson, Wilbur, & Reinhold, 2017, p. 849).

When used in conjunction with NNRTIs such as Rescriptor, Sustiva, Intelence, Viramune, and Edurant, the drug binds to reverse transcriptase and prevents RNA from being converted into DNA. 2017; Arcangelo, Peterson, Wilbur, and Reinhold, p. 851).

Later stages of cell replication are targeted by protease inhibitors. They inhibit the formation of polyproteins, which are required for the replication of HIV RNA. Reyataz, Prezista, Lexiva, Crixivan, Kaletra, Viracept, Norvir, Invirase, and Aptivus are examples of PIs (Arcangelo, Peterson, Wilbur, & Reinhold, 2017, p. 852).

Fusion inhibitors prevent HIV from entering cells by preventing the virus from fusing with the membrane of CD4 T cells. Fuzeon is the only drug in this class that is currently available (Arcangelo, Peterson, Wilbur, & Reinhold, 2017, p. 853).

Trivicy, Vitekta, and Isentress are the INSTIs that are available for use. These drugs prevent HIV DNA from entering the host cell’s genome. They are frequently used in conjunction with NRTI medications (Arcangelo, Peterson, Wilbur, & Reinhold, 2017, p. 853).

The CCR5 Antagonists are the final drug class, and Selsentry is the only medication that is friendly. By blocking the CCR5 receptors on the membrane of CD4 T cells, this medication prevents HIV from entering the cells (Arcangelo, Peterson, Wilbur, & Reinhold, 2017, p. 854).

Each medication regimen is custom-tailored for the patient. Each patient will react differently. It is also important to note that HIV is not curable, as no medication has been shown to completely eradicate the virus.

HIV Immune Disorder in Children

Unfortunately, HIV in children is a topic that needs to be addressed. It can be detected and diagnosed as early as infancy. When infants become infected with HIV, it is usually from their mother during birth. As children grow, their drug therapy treatment evolves. Interactions with food and other medications are possible. As these children are treated, compliance and frequent follow-ups are required. It is critical to provide each child with a life that is full of quality and has few negative consequences (Arcangelo, Peterson, Wilbur, & Reinhold, 2017, p. 855).

Adverse Reactions

The severity of adverse effects varies according to the patient’s medication regimen. When patients take a NRTI, for example, they must be aware of the development of gastrointestinal (GI) symptoms such as nausea, vomiting, and abdominal pain. These symptoms could be caused by lactic acidosis combined with hepatic sweatosis. This unusual side effect may result in death. Patients taking NNRTIs may experience GI symptoms in addition to dizziness, difficulty concentrating, hallucinations, and strange dreams. When taking NNRTIs, there is also a risk of liver function impairment. Gastrointestinal symptoms, as well as liver transmitases, are PI-related side effects. Because fusion inhibitors are administered via subcutaneous injections, irritation at the injection site is a common side effect. Another possibility is a rash and fever. INSTI side effects include headache, diarrhea, decreased renal function, and hypersensitivity. CCR5 antagonists have the potential to cause hepatotoxicity, which can result in a systemic allergic reaction. Because of this side effect, CCR5 antagonists are not recommended as first-line HIV treatment (Arcangelo, Peterson, Wilbur, & Reinhold, 2017, p. 849-854).

Immune Disorder of Psoriasis

Psoriasis immune immune disorders is a skin, scalp, or nail inflammatory process in which cell replication is faster than normal. The epidermis, for example, sheds in a 14-20 day cycle. The epidermis sheds in 3-4 days when you have psoriasis. During the inflammatory process, macrophages, fibroblasts, dendritic cells, natural killer cells, T helper cells, and regulatory T cells interact in a conflicting manner. Inflammatory mediators are produced as a result of this interaction. Furthermore, the epidermis and dermis thicken above normal due to cellular hyperproliferation, kerotinocyte changes, and expanded dermal vasculature. Skin cells stop maturing and keratinizing, instead thickening and plaque formation begins. Because cell metabolism is increased, blood flow to the skin increases. This results in inflammation and redness. Depending on the triggering factors, the inflammatory process waxes and wanes (Huether & McCance, 2017, p. 1062).

When most people hear the word psoriasis, they immediately think of skin. It is also critical that health care providers receive psoriatic arthritis education. It usually appears later in life, but it is possible that children will experience it as well. Joint pain or stiffness is one of the signs and symptoms (Van Onselen, 2013).

Medication Therapy

Medications used to treat psoriasis immune disorder target the inflammatory mediators. The treatment aims to restore skin moisture, reduce cell turnover, and control pruritus. Each patient’s treatment is unique and is determined by the severity of their condition. Topical corticosteroids, moisturizing creams, Vitamin D analogs, and keratolytic agents are used in mild cases. Ultraviolet light therapy with a narrow band is also used. A more systemic treatment approach is required in severe cases. Methotrexate, acitretin, and cyclopsporine were among the medications that were approved. As the pathophysiology of psoriasis is better understood, new therapies are being developed. Biologics are one type of treatment. This drug class’s safety and efficacy are still being studied (Huether & McCance, 2017, p. 1062-1063).

Pediatrics

The pathophysiological process of developing psoriasis in children and adults is the same. It is more common in adults than in children. There is some genetic link to psoriasis, but the specifics are unknown. Environmental and systemic triggers will still typically initiate the initial presentation. Infection, skin trauma, medications, hormonal changes, smoking, or alcohol are all potential triggers (Vam Onselen, 2013).

Emollients are commonly used in the treatment of children with psoriasis to help with skin dryness. Emollients also have anti-inflammatory properties, making them an excellent first-line treatment for children. Topical corticosteroids, Vitamin D analogues, ditheranol, tar, topical calcineurin inhibitors, and photosynthesis treatment are some other treatment options. When treating psoriasis, both the child and the parents must be thoroughly educated. Allowing the child to put on his or her own cream may be a beneficial activity. While the child is being treated, psychological support may be required (Van Onselen, 2013).

Psoriosis Immune Disorder Side Effects Reduction

Immune disorders’ side effects can be managed and reduced by seeking medical advice as soon as symptoms appear. Side effects can be reduced by completing thorough education, encouraging follow-up, and avoiding triggering agents. Patients frequently believe that nothing can help them. It is critical to recommend dermatology consultations when necessary and to encourage each patient to be open to new therapies. Treatments do not always work the same way for every patient. Furthermore, patients must be taught how to adhere to their treatment regimen (Renton, 2018).

Immune Disorders in HIV and Psoriasis

Immune disorders can be extremely aggravating for patients. Depending on how they contracted HIV, the patient may experience feelings of inner guilt or embarrassment. Outsiders may never know they have HIV, but the patient will believe that everyone knows and is talking about them. Furthermore, patients with psoriasis may feel embarrassed, but this is due to the physical manifestations of the disease. These people may find it difficult to wear shorts or go swimming without feeling self-conscious. It is critical to respect and support patients who are experiencing maladaptive and physiological responses. Positive outcomes for those with these immune disorders are more likely if these patients have a positive outlook.

Late Policy

• The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
• Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
• If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
• I do not accept assignments that are two or more weeks late unless we have worked out an extension.
• As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

• Communication is so very important. There are multiple ways to communicate with me: 
  • Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
  • Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.