Immune System Modification & Hematopoietic Disorders

Question 1

Hematopoiesis

Answer 1

Formation and maturation of blood cells in the bone marrow

• erythrocytes (RBC)
• leukocytes (WBC)
• thrombocytes (platelets)

Question 2

Immunity

Answer 2

The ability to resist and fight infection

Requires help from WBCS and lymph system

Question 3

Antigens

Answer 3

Foreign or non self substances that trigger immune system

Question 4

Active immunity

Answer 4

Immune system is stimulated to produce antibodies by a pathogen or its vaccine
(Generates memory B cells)

Question 5

Passive immunity

Answer 5

When antibodies are transferred or donated from one person to another. Protection is short lived (do not generate B cells)
-Maternal antibodies BF/Placenta
-Gamma globulin given after exposure to hepatitis
Sera to treat botulism/tetanus and rabies
Anti-venom for snake bite

Question 6

Immunomodulator

Answer 6

General term referring to any drug or therapy that affects the body’s defenses.
SOme ar used to stimulate the body defenses so that microbes or cancer cell can be attacked (immunostimulant)
Some are used to suppress body defenses to prevent organ transplant rejection

Question 7

Vaccines or Immunizations

Answer 7

Injection of a killed or weakened organism that produces immunity against that organism
Booster - follow up vaccination to provide sustained protection
Tiger- Amount of antibody detected after vaccine has been administered. If low booster is needed

Question 8

Attenuated

Answer 8

Microbes a lover BUT weakened so unable to produce the disease. Can cometiems cause subclinical symptoms
EX: MMR, Varicella, Oral Polio,

Question 9

Inactivated

Answer 9

Microbes are unable to replicate or cause disease

EX; Flu, hep A vaccine

Question 10

Toxoid

Answer 10

Contains bacterial toxins that have been chemically modified to be incapable of causing disease. Usually need booster with these
EX: diphtheria, tetanus toxoid

Question 11

Recombinant

Answer 11

Contain partial organisms or bacterial proteins that are generated in a lab using biotechnology
EX: Hep B vaccine

Question 12

Vaccines Adverse Effects and Contraindications

Answer 12

Discomfort, redness at site, aches, fever

Illness, pregnancy, immunocompromised clients

Question 13

Biological Response Modifiers

Answer 13

Cytokines secreted in response to antigens. Used to enhance body’s responses
-Stimulate the immune system to work more effectively
-Can be produced in lab by recombinant DNA
-Used to treat certain viral infections, autoimmune disease and cancers
EX: Interferons, interleukins, BCG (vaccine for bladder cancer), Granulocyte Colony Stimulating Factors/filgrastim (stimulate WBC production)

Question 14

Interferon

Answer 14

Type of cytokines infected with virus - THINK INTERFERE
Antiviral, anti cancer, anti inflammatory properties Slow. The spread of viral infections and enhance. Activity or leukoctyes
Some serious adverse effects

Question 15

Interferon Alfa-2b

Answer 15

Thera: Immunostimulant
Pham: Interferon,, BRM

Indications: Certain. Cancers ((hair cell leukemia, melanoma, non-Hodgkis)
MOA: suppresses cell proliferation, enhances phagocytic activity, augments cytotoxicity of lymphocytes
Adverse: Flu like symptoms, depression,, suicidal ideation, hepatotoxicity, immunosuppressive
BLACK BOX: neuropsychiatric, autoimmune, ischemic,, and infectious disorders.
Implications, give at night. Avoid using with others

Question 16

Interelukins

Answer 16

Interleukins are cytokines secreted by. Lymphocytes monocytes and macrophages

Play important role in immune cell differentiation. And activation
Can have. Pro. inflammatory and anti inflammatory effects
IL-2 (proleuking)
IL-11 (neumega)

Question 17

Immunosupppressants

Answer 17

Suppress the. Immune system by. Affecting. Lymphocyte function

Used to prevent rejection. After organ/bone marrow transplant. And for treatment of sever autoimmune disease (lupus,, psoriasis, rheumatoid arthritis)
May put clients at risk for serious infections. (Important to minimize exposures), may require anti-infective
Increases risk for developing cancer

Question 18

Commons categories for Immunosuppressants

Answer 18

Corticosteroids ((prednisone, methyprednison)
Antimetabolites (sirolimus, azathisprine)
Calcineurin Inhibitors (cyclosporine, traclomos))
Monoclonal Antibodies (end in MAB)

Question 19

Nursing Implications for Immunosuppresants

Answer 19

• Be aware that these drugs have. Specific. Instructions for administration and monitoring. Of drug levels
• Monitor for signs of infections (susceptible to infection that. Healthy people are not). Often do not show typical signs, watch for fever. (Rednes/pus may not happen)
• Monitor for. Adverse effects (neurological,, renal impairment, abnormal lab values)
• Client education–stress importance of regular visits with provider.

Question 20

Common side effects of chemotherapy

Answer 20

Chemo kills every cell that rapidly reproduces
Temporary hair loss
Sores and dryness in lips//throat/mouth
Red, dry, itchy skin. Sensitive to sunlight
Reduction in production of RB, WBC, Platelets
N/V
Fewer blood cells result in. Fatigue
Fewer WBC result in increased infection risk
Fewer platelets result in increased risk of bleeding

Question 21

Epoetin ALfa ((Epogen)

Answer 21

Growth factor that Stimulates RBCs

HTN, risk for Cv event

Question 22

Filgrastim (Neupogen)

Answer 22

Growth factor that Stimulates neutrophils
(Bone pain, flu-like. Symptoms)

Usually IV piggy back or SQ

Question 23

Oprelvekin (Neumega)

Answer 23

Growth factor that Stimulates platelets

Fluid retention, visual changes

Question 24

Treatment for Anemia

Answer 24

Choice depends on cause

• -Cyanocobalamin (B12): pernicious anemia, strict vegetarians. Patients do not have intrinsic factor
• -folic acid: insufficient dietary intake,ETOH abus
• -ferrous sulfate: iron deficiency is most common type of anemia, vegetarians at risk,GI bleeds. Vitamin C enhances absorption. Usually taken on empty stomach