Inflammation, Wound Healing, Immune Response, Allergic Disorders, Autoimmunity Flashcards
acute inflammation
healing occurs in 2-3 weeks, usually leaving no residual damage; neutrophils are predominant cell type at site of inflammation
subacute inflammation
has same features as acute inflammation, but persists longer
chronic inflammation
· may last for years; injurious agent persists or repeats injury to site.
o Predominant cell types involved are lymphocytes and macrophages
o May result from changes in immune system (autoimmune disease)
healing process
final phase of the inflammation process is healing; consists of two major components: regeneration and repair
regeneration
· the replacement of lost cells and tissues with cells of the same type
repair
is health with connective tissue replacing lost cells and usually results in scar formation
Clinical Manifestations (Local response to inflammation)
· Redness
· Heat
· Pain
· Swelling
· Loss of function
Clinical Manifestations (Systemic response to inflammation)
· Increased WBC count with a shift to the left
· Malaise
· Nausea and anorexia
· Increased pulse and respiratory rate
· Fever (patient then experiences chills and shivering)
acute intervention for inflammation
· Observation
· Vital signs
o Temperature may rise, pule and respirations may increase
· Fever management
o Antipyretic use should be considered
· RICE (rest, ice, compression, elevation
drug therapy for inflammation
· Aspirin
· Acetaminophen
· NSAIDs
Corticosteroids
immunity
body’s ability to resist disease
· Serves three functions: defense homeostasis and surveillance
innate immunity
present at birth, first-line of defense against pathogens
acquired immunity
Immunity that is present only after exposure and is highly specific, developed immunity
active immunity
results from the invasion of the body by foreign substances such as microorganisms, with each reinvasion of the microorganisms, the body responds more rapidly and vigorously to fight off the invader. May result naturally from a disease or artificially through immunization with a less virulent antigen. Immunity takes time to develop but is long lasting.
passive immunity
implies that the host receives antibodies to an antigen rather than synthesizing them. May take place naturally through the transfer of immunoglobulins across the placental membrane from mother to fetus. Artificial passive acquired immunity occurs through injection with gamma globulin (serum antibodies). The benefit of this immunity is its immediate effect. Immunity is short lived because the person does not synthesize the antibodies and consequently does not retain memory cells for the antigen.
antigens
substances the body recognizes as foreign that elicit an immune response, most are composed of protein
antibodies
immune globulins produced by lymphocytes in response to antigens
Central (primary) lymphoid organs
bone marrow and thymus
The thymus gland ____ with age.
shrinks
· Peripheral lymphoid organs: Lymph nodes
§ Tonsils
§ Spleen
§ Lymphoid tissues associated with gut, genitals, bronchi, and skin
§ WBCs, and platelets
· Mononuclear phagocytes
o Include monocytes in blood and macrophages found throughout body
o Capture, process, and present antigens to lymphocytes to initiate an immune response
o Capture antigens by phagocytosis
· Lymphocytes
o Produced in bone marrow
o Eventually migrate to peripheral organs
o Differentiate into B and T lymphocytes
- T Cytotoxic cells
- T Helper cells
Immunocompetence
body’s immune system can identify and inactive or destroy foreign substances
Anaphylaxis
can occur when mediators are released systemically (e.g., after injection of a drug, after an insect sting). The reaction occurs within minutes and can be life threatening because of bronchial constriction and subsequent airway obstruction and vascular collapse.
autoimmunity
an immune response against self in which the immune system no longer differentiates self from non-self
· Examples of autoimmune disease: RA, SLE, IBD, MS, Type 1 diabetes
Allergic rhinitis
can occur year round or may be seasonal, causes include pollens, dust, and molds
Angioedema
localized cutaneous lesions involving deeper layers of the skin, swelling is usually seen in the face
Clinical Manifestations of Anaphylaxis
· Edema
· Itching at site of exposure to the allergen
· Wheal-and-flare reaction: a pale wheal containing edematous fluid surrounded by a red flare from the hyperemia
· Shock: rapid, weak pulse, hypotension, dilated pupils, dyspnea, possible cyanosis
Clinical manifestations of allergic rhinitis
· Nasal discharge
· Sneezing
· Tearing
· Mucosal swelling with airway obstruction
· Pruritis around eyes, nose, throat and mouth
Clinical manifestations of asthma
· Dyspnea
· Wheezing
· Coughing
· Tightness in the chest
· Thick sputum
Clinical manifestation of Urticaria (hives)
· Transient wheals (pink, raised, edematous, pruritis areas)
· Pruritis
Anaphylactic Shock Management
· Ensure patient airway, intubation if evidence of impending obstruction
· Remove insect stinger if present
· Establish IV access
· Epinephrine
· Give high-flow O2 via face mask as needed
· Nebulized albuterol for bronchospasm resistant to epinephrine
· Diphenhydramine IV for urticaria and itching
· Corticosteroids: Methylprednisone IV
· For hypotension: place recumbent and elevate legs, IV NS rapid bolus of 1-2 L
Ongoing monitoring: VS, O2 Sat, LOC, cardiac rhythm, UO
Automatic Epinephrine Injectors
· Fill the prescription at once and keep at least 2 doses available
· Always keep at least 1 autoinjector with you
· Keep and autoinjector in a place where others an easily find it
· Keep in original case in room temperature away from cold and heat extremes
· Mark on calendar when autoinjector expires and replace id discolored or contains particles
· Use device if you see signs of anaphylaxis
· Inject to top of thigh slightly on outside at 90-degree angle, hold in place for 2-3 seconds
· You can inject through clothes, avoid pockets and seams where fabric is thick
After use call 911 and get to nearest hospital, take autoinjector with you
