Comprehensive Nursing Pharmacology Q 133
Nurse Susan administered intravenous gamma globulin to an 18 month-old child with AIDS. The parent asks why this medication is being given. What is the nurse’s best response?
A. “It will slow down the replication of the virus.”
B. “This medication will improve your child’s overall health status.”
C. “This medication is used to prevent bacterial infections.”
D. “It will increase the effectiveness of the other medications your child receives.”
Correct Answer: C. “This medication is used to prevent bacterial infections.”
Intravenous gamma globulin is given to help prevent as well as to fight bacterial infections in young children with AIDS. Gamma globulin injections seem to lower the number of certain infections among children with AIDS but do not cure the lethal ailment.
Option A: The main immunological abnormality in human immunodeficiency virus (HIV)-infected patients, and particularly those with the acquired immune deficiency syndrome (AIDS), is a deficiency in cellular immunity. However, symptomatic HIV-infected children also have evidence of deficiency of specific antibody synthesis, and intravenous immune globulin (IVIG) preparations in doses of 0.2-0.4 g/kg every 2-4 weeks have been shown to reduce the incidence of respiratory infections.
Option B: IVIG therapy may also reduce the mortality and incidence of bacterial infections in adults but further studies are required. In addition, high-dose IVIG therapy (1-2 g/kg over 2-5 days) produces increased platelet counts in patients with idiopathic thrombocytopenic purpura (ITP) associated with HIV infection. Finally, IVIG therapy may have a role in HIV-infected patients suffering from severe parvovirus B19 or measles infection, or in patients suffering from autoimmune disorders where high-dose IVIG therapy has been shown to be efficacious.
Option C: Doctors said that although the gamma globulin treatment did not cure AIDS it seemed to ”enhance the quality” the lives of the children in the study group because it freed them from the constant infections that added to their suffering. Such episodes of sepsis are often a result of bacterial infection. The gamma globulin contains antibodies to many common bacteria, including ones that often kill children whose immune systems have been paralyzed by the AIDS virus.