Page 2180 - Saunders Comprehensive Review For NCLEX-RN

infections.
f. Administer corticosteroids and
cytotoxic agents as prescribed to bring
about remission.
XI. Goodpasture’s Syndrome
A. Description
1. An autoimmune disorder; autoantibodies are made
against the glomerular basement membrane and
alveolar basement membrane.
2. It is most common in males and young adults who
smoke; the exact cause is unknown.

3. The lungs and the kidneys are affected

primarily, and the disorder usually is not diagnosed
until significant pulmonary or renal involvement
occurs.

B. Assessment

1. Clinical manifestations indicating pulmonary and
renal involvement
2. Shortness of breath
3. Hemoptysis
4. Decreased urine output
5. Edema and weight gain
6. Hypertension and tachycardia

C. Interventions

1. Focus on suppressing the autoimmune response with
medications such as corticosteroids and on
plasmapheresis (filtration of the plasma to remove
some proteins and autoantibodies).
2. Provide supportive therapy for pulmonary and renal
involvement.
XII. Lyme Disease
A. Description
1. An infection caused by the spirochete Borrelia
burgdorferi, acquired from a tick bite (ticks live in
wooded areas and survive by attaching to a host)
2. Infection with the spirochete stimulates inflammatory
cytokines and autoimmune mechanisms.
B. Assessment (Box 62-3; Fig. 62-5)
1. The typical ring-shaped rash of Lyme disease does not
occur in all clients. Many clients never develop a rash.
2. If a rash does occur, it can occur anywhere on the
body, not only at the site of the bite.
C. Interventions
1. Gently remove the tick with tweezers, wash the skin

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