Immune System Flashcards
Immunity that everyone is born with characterized by defense mechanisms that help protect the body by acting immediately against all antigens
Innate immunity
Components of innate immunity
Inflammatory response, skin, stomach acid, mucus, phagocytic cells within the body
Type of immunity by which we produce antibodies against specific antigens acquired through the action of B and T cells
Acquired immunity
First stage of inflammatory response
Expect warmth, erythema, edema, And decreased function and/or pain at the site of injury
Second stage of inflammatory response
White blood cells kill off the microorganisms and exudate containing those white blood cells as well as dead tissue cells would accumulate at the site of injury
Third stage of inflammatory response
Damage tissue replaced by scar tissue
Type of immunity by which the body is actively producing antibodies
Active
With _________ immunity, the body produces antibodies and response to exposure to a live pathogen
Active natural
With _________ immunity the body produces antibodies in response to exposure to a vaccine
Active artificial
Immunity by which the body is not making the antibodies, but the antibodies are given to you
Passive immunity
_________ immunity is characterized by the passing of maternal antibodies to baby through the placenta or breastmilk
Passive natural
_________ immunity is obtained through administration of immunoglobulins
Passive artificial
Incubation stage of infection
Pathogen enters the body and begins to multiply, no symptoms during this period
Prodromal stage of infection
Pathogen continues to multiply, onset of general symptoms (malaise, fever, not feeling well)
Illness stage of infection
Onset of specific symptoms related to the particular infection
Convalescent phase of infection
Symptoms subside and eventually disappear, gradual recovery from illness
Symptoms of a systemic infection versus local infection
Systemic: fever, malaise, chills, fatigue, tachypnea, tachycardia
Local: edema, pain, erythema, decreased function and warmth in a particular area of the body
Normal white blood cell count
5000 to 10,000
White blood cell count greater than 10,000
Leukocytosis, indicative of infection
White blood cell count less than 4000
Leukopenia — maybe due to cancer, auto immune disorders, or certain medications/infections; HIGH risk for infection
Normal neutrophil count
2500 to 8000
Neutrophil count less than 2000
Neutropenia
Banded neutrophils or left shift indicate
The body is fighting an overwhelming infection
Normal erythrocyte sedimentation rate (ESR)
Less than 20
ESR above 20 is a strong indicator of
Inflammation in the body
Normal levels of C reactive protein (CRP)
Less than three
Elevated CRP is indicative of
Inflammation in the body
Neutrophils may be elevated in
Acute bacterial infections
Lymphocytes may be elevated in the presence of
Bacterial or viral infections, leukemia, lymphoma
Monocytes may be elevated in the presence of
Bacterial infections, tuberculosis
Eosinophils are elevated with
Allergic reactions, parasitic infections
Basophils are elevated during
Allergic reactions
Chronic inflammatory and autoimmune disorder of the connective tissue resulting in production of antinuclear antibodies (ANA) and widespread inflammation and tissue damage
Systemic lupus erythematosus (SLE)
Lupus risk factors
Women, 20 to 40 years old age of onset, African-Americans, Native Americans, Asians
S/S of systemic lupus
Fatigue, joint pain, fever, butterfly rash across the face, Raynaud’s phenomenon, anemia, pericarditis, lymphadenopathy
Labs associated with lupus
Positive ANA titer, decreased serum complement (C3 and C4), decreased RBCs, WBCs, and platelet counts, increased BUN and creatinine with kidney involvement
Treatment of lupus
NSAIDs, immunosuppressants like prednisone and methotrexate, hydroxychloroquine, topical steroid cream
Nursing care of lupus
Monitor for complications including renal failure, provide important patient teaching: avoid UV and sun exposure to prevent skin damage, avoid infection and sick people, frequent rest periods
Chronic inflammatory and autoimmune disorder of the connective tissue resulting in damage and occlusion to the blood vessels (vasculitis) and overproduction of collagen which causes tissues to become inflamed, fibrotic, and sclerotic
Systemic sclerosis or scleroderma
Scleroderma risk factors
Women, Age of onset typically between 30 and 50 years
Symptoms of scleroderma
Arthralgia, Raynaud’s phenomenon, pitting edema in the hands with taut, shiny skin; with organ involvement — GI dysfunction, reflux, Dysphagia, arrythmias, dyspnea, malignant hypertension
Labs associated with scleroderma
Positive ANA titer, elevated ESR
Scleroderma treatment
Supportive, no cure. Immunosuppressants such as prednisone or methotrexate, ACE inhibitors
Scleroderma patient teaching
Moisturize skin, frequent rest periods, avoid stress and cold (d/t Raynaud’s)
Retrovirus that enters the body through the blood or bodily fluids and targets CD4+ cells causing decreased immunity and increase susceptibility to infections
HIV
HIV risk factors
Unprotected sex, multiple sex partners, perinatal exposure, IV drug use, healthcare workers
Symptoms of HIV
Lymphadenopathy, thrush, weakness, night sweats, fever, weight loss, and rashes
Labs associated with HIV
Decreased WBCC, CD4+ cells (<500)
CD4+ cells below _____ is indicative of AIDS
200
Symptoms of AIDS
Kaposi’s sarcoma (cancer of the skin and soft tissue), tuberculosis, pneumonia, wasting syndrome, candidiasis of the airways, etc.
HIV/AIDS treatment
Anti-retroviral therapy (ART) for the rest of life
Preventing infection for patients with HIV/AIDS
Hand hygiene, Bathe daily with anti-microbial soap, avoid raw and undercooked foods and fresh plants, do not clean cat litter boxes, avoid crowds and sick people
Three processes of cancer
Initiation, promotion, progression
Initiation stage of cancer
Damage or mutation to the DNA causes excessive cell division due to excessive oncogene function, but decreased suppressor gene function
Promotion stage of cancer
Mutated cells are exposed to promoters that enhance their growth (estrogen is an example of a promoter)
Progression stage of cancer
Two more cells acquire additional mutations, and their growth rate increases allowing them to metastasize and become resistant to therapy
Cancer risk factors
Older age, genetics, immunosuppression, viruses, smoking, sun exposure, and a high-fat low-fiber diet
General signs and symptoms of cancer
Unexplained weight loss, fatigue, infection, and bleeding
Gold standard for diagnosing cancer
Biopsy
Cancer treatment
Chemotherapy via implanted port or central line (destroys rapidly dividing cells), hormonal therapy, immunotherapy, radiation, surgical removal of tumors
Potential and common complications of cancer
Malnutrition, infection, mucositis (inflammation and ulceration of mucosa in mouth), anemia, thrombocytopenia, alopecia
Cancer that originates in the epithelial tissue
Carcinomas
Cancer that originate in the supportive or connective tissues of the body, including bones, muscle, tendon, cartilage, and fat
Sarcomas
Cancer that originates in the bone marrow
Leukemia
Cancer that originates in the plasma cells specifically in the bone marrow
Myeloma
Cancer that originates in the lymphatic glands or nodes, or an organs such as the thymus or spleen
Lymphoma
Cancer grading refers to
- Comparing the cancer to the tissue of origin
- Grades 1-4.
- Grade 1: cancer is well differentiated and resembles the tissue of origin
- Grade 4: cancer has no similarity to the tissue of origin
TNM cancer staging
Tumor (T): T1, T2, T3, T4 — based on size and extend of tumor
Node (N): N0, N1, N2, N3 — number of regional lymph nodes involved/affected
Metastasis (M): M0 (no metastasis) or M1 (indicated metastasis to other areas of body)
Brachytherapy precautions
Keep door to pts room closed at all times, place warning sign on door, limit visitors to 30 min and stay at least 6 ft from patient, nurse should wear lead apron and dosimeter badge (tracks radiation exposure), always face patient so that lead apron can protect from radiation
External radiation patient education
Do NOT wash off markings (indicates area undergoing radiation), be gentle with area of skin being treated with radiation (wash with gentle soap, pat dry), DO NOT apply lotions, powders, or ointments over area unless prescribed, wear loose and soft clothing, avoid sun and heat exposure to area receiving radiation
Nursing care for malnutrition related to chemotherapy
Provide antiemetics 30 min prior to therapy, administer appetite stimulant (megestrol), teach patient to: avoid drinking liquids with their meals, room temp or cool foods may be indicated for nausea, may need supplements to ensure adequate calories and nutrients
Nursing care for mucositis
Provide meticulous oral care before and after meals, teaching: avoid mouthwash containing glycerin or alcohol, rinse mouth with saline solution 2x/day, use soft toothbrush, avoid foods that cause pain and damage to mucosa (instead, opt for soft foods like scrambled eggs)
Nursing care for neutropenia
Implement neutropenic precautions, carefully monitor temp, restrict ill visitors, no fresh plants or flowers, keep dedicated equipment in room, Filgastrim to boost neutrophil count, teaching: take temp daily and report temp over 100 F to provider, avoid crowds and sick people, do NOT consume raw foods, avoid yard work or gardening, do NOT change cat litter box, wash dishes in hot water, wash toothbrush in dishwasher daily or use bleach solution
Nursing care for anemia
Administer epoietan Alfa and ferrous sulfate, education: increase intake high in iron, folate, and B12, take extra rest periods
Nursing care for thrombocytopenia
Monitor for blood in stool, urine, and vomit, avoid injections, hold prolonged pressure over venipunctures, education: use electric razor, soft toothbrush, avoid blowing nose vigorously, avoid NSAIDs, prevent falls
Prevention of skin cancer
Avoid midday sun, wear sunscreen and protective clothing, perform regular skin checks (annual dermatology appts)
Most common type of skin cancer that appears waxy nodules with pearly boarder
Basal cell carcinoma
Skin cancer that originates in the upper layer of the epidermis and presents as an oozing , crusting lesion
Squamous cell carcinoma
Cancer that arises from melanocytes and is the most deadly form of skin cancer as it is highly metastatic. Lesions are highly irregular with color changes.
Melanoma
ABCDE skin cancer assessment
Asymmetry, borders (irregular), color (multiple colors), diameter (>6mm), Evolving (change in appearance over time)
Skin cancer treatment
Excision, topical chemo (5-FU), Mohs surgery (take one layer off at a time and send to lab), cryotherapy (freezing of lesion)
Hodgkin’s lymphoma will have the presence of
Reed-Sternberg cells (large cells with more than one nucleus)
Hematologic blood cancer increase the patient’s risk for
Anemia, thrombocytopenia, and neutropenia
Cancer of the inner lining of the uterus
Endometrial cancer
Key risk factor for endometrial cancer
Prolonged exposure to estrogen without progesterone
Key symptom of endometrial cancer
Postmenopausal bleeding
Key symptom of cervical cancer
Painless, vaginal bleeding
HPV vaccine
Prevents HPV and cervical cancer, three injections over a six month period of time
Symptoms of ovarian cancer
Vague; GI disturbances
Breast cancer risk factors
Genetics, early menarche, late menopause, long-term use of oral contraceptives, hormone replacement therapy, smoking, obesity
Signs and symptoms of cancerous breast tumor
Firm, Immobile, non-tender lump, dimpling over skin of breast, nipple retraction, nipple discharge, nipple ulceration
Breast cancer treatment
Hormone therapy such as tamoxifen, chemotherapy, radiation, surgical removal of tumor (lumpectomy) or breast (mastectomy)
Nursing considerations and patient education for mastectomy
Do NOT administer any injections, draw blood or take blood pressure on affected side; education: wear sling when ambulating, wear loosed clothing, perform arm and hand exercises to prevent edema and increase ROM
S/S of prostate cancer
Urinary retention, hesitancy and frequency. Frequent bladder infections, hematuria, nocturia
Treatment for prostate cancer
Hormone therapy such as a leuprolide, chemotherapy, radiation, prostatectomy, orchiectomy (removal of testes)
Screening tools for colorectal cancer
Fecal occult blood test (FOBT), colonoscopy (starting at age 50 every 10 years), sigmoidoscopy (every 5 years)
Colorectal cancer risk factors
Older age, high fat and red meat diet, genetics, smoking, obesity, alcohol, physical inactivity
Symptoms of colorectal cancer
Rectal bleeding, change in bowel color, shape, or consistency
Symptoms of lung cancer
Cough, blood tinged sputum, chest pain, shortness of breath, weight loss, fatigue, and a dull chest percussion
