Immune Assessments Flashcards
Function of the immune system
Defense of invasion of microorganisms and prevention of development of infection by attacking pathogens
Homeostasis: damaged cells are digested and removed from the body (uniformity of cells)
Surveillance of foreign/mutated/non-self cells and attack destroy remove.
Immunity
body’s ability to resist disease
Antigen
traces nonself pathogens leave behind
molecules found on the surface of pathogens detected by adaptive
used for recognition on the outside of cells
Antigen elicits an
immune response
Antibody
produced by B cells
attach to antigens
signal macrophages to kill the pathogen
Y shaped
bind to antigens
Complement
works to help the actions of the immune system
- both responses
The immune system is divided into what 2 parts
Innate
Adaptive
Innate is
non-specific, quicker
1st natural defense to any intruder (prevent entry)
-does not differentiate between different pathogens
-skin, mucous lining, tears, acid in stomach
What are 2 physical barriers in innate immunity?
-skin, mucous lining
What are the chemical/biochemical barriers to innate immunity?
tears, acid in stomach, normal flora in gut
After the 1st barriers such as skin, what is the next line of defense?
inflammation by mast cells (histamine molecules)
Leukocytes have an all access pass of the body except to the
brain and spine
What leukocyte belongs to the innate system?
Phagocytes
- patrol like neutrophils
- Stay in areas and wait for cue
Phagocytes
abundant
patrol and breach sites quickly
kill infectious cells and then die to make pus
What is pus?
dead phagocytes after sefl destructing with infection
Macrophages
engulf unwanted pathogens
remain in one place
consume about 100 pathogens before death
detect self-cells going rogue (CA) and kill
give info on antigens
Natural Killer cells
detect rogue cells by sight constant checking
-release chemicals to eliminate
attacks when cells stops producing Major Histocompatibility Complex
Dendritic cells
- contact with the outside environment
Link between innate and adaptive immunity
-Eat then carry info about antigen to adaptive T cells
The adaptive immune system
specific and target cells infected, antigens, and antibodies
Acquired immunity
Adaptive immune system has 2 components
T lymphocytes
B lymphocytes
T cells come
infection has already occurred
brings cell-mediated immune response
B cells come
when the pathogens have entered and have not caused a disease yet
humoral immune response
Helper T cells
Use information from dendritic/macrophage cells
form effector t cells = circulate and call for other WBCs
form memory t cells = record of antigen for future infections
Cytotoxic T cells
perform a mercy killing for the infected and dying cells
- cell-mediated release of Perforin and cause apoptosis
B cells produce
antibodies to fit around antigens
tag them and don’t allow for them to infect anything
B cells also produce what when they encounter an antigen?
memory b cells
Both memory cells jointly maintain
record of all encountered infections and strengthen the immune response to infections
Which immune system reacts 1st?
if out of hand, they call upon the?
innate
adaptive
Order of immunity
Innate
1) Skin barriers
2) Inflammation (histamine)
Adaptive Specific with B and T cells
- Cell-mediated
- Humoral
Inflammatory response lines of defense
vasodilation with increase capillary permeability
- increase blood flow and leukocyte mvmt
interferon
complement
phagocytosis
Adaptive acquired found from
infection tolerance
vaccine
antigen
cytokine
b and T lymphocyte activation
- cell-mediated and humoral
Components of the immune system include
lymphatic
primary/secondary lymphoid organs
hematopoietic stem cell differentiation
thymus (chest)
bone marrow
tonsils
adenoids
peyer’s patches
Thymus is the
the central lymphoid organ which produces the Thymusen stimulates T cells and the development
Bone marrow produces what
B and T lymphocyte cell differentiation occurs
What are the different type of adaptive immune response?
Passive
Active
Active Adaptive Immunity
Invasion of foreign substance (natural or artificial)
Body forms long-lasting immunity
Ex: Chicken pox, mumps, measles
Passive Adaptive Immunity
Receive antigen instead of create their own (natural or artificial)
Body immunity is short duration
Ex: Mom to baby via placenta or colostrum
Gamma globulin injections
Cellular mediated is
Tcells
- activated to defend against intracellular microorganisms
- survive inside cells (viruses, fungi, and some bacteria
Humoral mediated is
Bcells
- occurs in reaction to an antigenic challenge - antibodies to the substance
- anaphylactic shock, transfusion gone wrong, and bacterial infections
If a pathogen gets by the innate immune system they are taken care of by
adaptive immune system
Types of Acquired Specific Immunity
Natural
- Passive: mother to child
- Active: natural contact through actual infection
Artificial
- Passive: inject antibodies from one to another person without antibodies
- Active: vaccinations
Hypersensitivity Reaction Types
1) Allergic
2) Cytotoxic
3) Immune complex deposition
4) Delayed
Hypersensitivity Reaction
1) Allergic
IgE
Quick onset after exposure
Hay fever environmental
Hypersensitivity Reaction
2) Cytotoxic
antibody-mediated
specific cell has an antigen stuck to it - organ and tissue specific
hemolytic - RBC destruction, good pasture syndrome, hyperacute graft rejection
Hypersensitivity Reaction
3) Immune Complex Deposition
IgG/IgM mediated
complex formed in circulatory system and into vessel wall
highly pathogenic
hypersensitivity pneumonitis
Lupus
Polyarteritis nodosa
serum sickness
Hypersensitivity Reaction
4) Delayed
cell-mediation slow onset 24-48 hours
edema and inflammation not by antibodies
-topical-
chronic graft rejections, +PPD test, Latex, Nickel, poison ivy
Assess Immune system - H&P
Current problem
Age & allergies (severity)
Nutrition (tolerance of activity)
Med-Surg history
Immunization
Immune deficiencies (chemo, immunosuppressants, antibiotics
Family history
Look, LISTEN, FEEL
Assessment of the current problem
Constitutional (overall body - fever)
Neurologic (dizzy, memory)
Respiratory (cough, sneeze, patterns)
GI system (loss of appetite, N/V/D)
Lymph nodes (bleeding and characteristics)
Mobility & pain (gait, joints, stiffness, swelling, uni and bilateral)
Age-associated with Immunological
impact susceptibility to infection
regulation of inflammation
Immunosenescence = low innate and adaptive
What type of t cells occur more near the end of the life?
mature
along with tissue inflammation and suseptibility to infection
Immune competence is what as we age
decreased
- lowers innate and adaptive
Immunoessence
gradual deterioration of the immune system brought on by the natural aging process
- host capability to respond to infections and long term immune therapy (vax)
Frequency and severity of infections are increased in elderly related to:
decrease ability to respons to invading organisms (flu, pneumo.)
decrease production and function of T and B lymphocytes (cell-mediated and humoral)
The ability to distinguish self from non-self lowers as the pt gets
older
-fail to recognize abnormal cells
-thymus gland shrinks (increase in viral)
-more memory than fighter t cells
-immune competence decreases
The older age to immunity
decreases function and less effective (increase infections from secondary)
increase autoantibodies (increase autoimmune disorders)
malignant cells not destroyed (leads to CA)
Older age what organs are connected to
Thymus
What suppresses immune function via nutrition
vitamins and trace elements
- DNA and protein synthesis reglate cell repilcation and maturation
Fatty acids
- structural of membrane, precursor to vitamins and cholestrol
What increases suseptibility to infections via nutrition?
atrophy of lymph
depress antibody
reduce circulating T cells
phagocytic function impaired
Allergies need to be said when
Every time you give a MED BEFORE!!!!
- occurrence and severity
testing and tx
effectiveness
Autoimmune disorders have a
genetic link
common in females
Neoplastic disease
immunocompromised pt
Ca (hematological)
from chemo and radiation
What causes renal failure in immune systems
reduce lymhoctes and uremai
What causes DM in immune systems
↑ infections, vascular insufficiency, & neuropathy.
What causes COPD in immune systems
recurrent respiratory tract infections → ineffective airway clearance.
What causes SURGERY in immune systems
Removal of spleen, lymph nodes, thymus, organ transplantation.
What causes burns, injuries, and infections in immune systems
Impaired skin integrity & compromised first line of defense.
Loss of large amounts of serum in burn patients → depletes body of immunoglobulins.
Hx and immunizations
Childhood/recent immunizations & diseases.
TB: Exposure
Recent exposure to infections.
Past & present infections.
Multiple persistent infections, FUO
Lesions/sores, any type of drainage.
Social Hx
Smoking
Alcohol consumption
Dietary intake & nutritional status
Amount of perceived stress
IV drug use
Sexual practices
Occupational or residential exposure to radiation or pollutants
Under a normal response, the immunity
does not act
Autoimmune diseases
-age, genetic is risk
viral infection triggers
cluters of diseases
The nurse associates which of the following findings to immunosenescence in a 68-year-old woman? Select all that apply.
A. Pneumonia
B. Shingles
C. Cervical dysplasia
D. Cancer
A. Pneumonia
B. Shingles
D. Cancer
The nurse includes which of the following in the past medical history evaluating the immune response? Select all that apply.
A. Recurrent infections
B. Chronic illness
C. Dietary history
D. History of fractures
E. Medication history
A. Recurrent infections
B. Chronic illness
C. Dietary history
E. Medication history
What functions of the immune system can be found the older adult?
Select all that apply
a
Decreased formation of antibodies
b Thymus enlargement
c Decreased surveillance for malignant cell changes
d Decreased delayed hypersensitivity reactions
e Increased response of T and B cells
a = Decreased formation of antibodies
b = Thymus enlargement
c= Decreased surveillance for malignant cell changes
e= Increased response of T and B cells
