Unit 7 - Immunity Flashcards
Function of immune system:
- protect body from _____ _____
- identify, destroy potentially harmful _____
- remove _____ _____
- protect body from foreign antigens
- identify, destroy potentially harmful cells
- remove cellular debris
_____ is the primary defense
skin
Leukocytes:
- primary cells in both nonspecific, specific _____ _____
- derived from _____ _____ in _____ _____
- attack, destroy anything _____ (to include cancer cells)
- can move through _____ spaces
- normal number =
- leukocytes in presence of infection =
- primary cells in both nonspecific, specific immune responses
- derived from stem cells in bone marrow
- attack, destroy anything foreign (to include cancer cells)
- can move through tissue spaces
- normal number = 4,500 - 10,000 cells/mm^3
- leukocytes in presence of infection = > 10,000/mm^3
Definition:
decrease in number of circulating leukocytes
leukopenia
Leukopenia:
- when bone marrow activity _____
- when leukocyte destruction _____
- suppressed
- increases
3 Types of leukocytes:
- granulocytes
- monocytes
- lymphocytes
Granulocytes:
- _____-_____% of total leukocytes
- derive from _____ _____ _____ of bone marrow
- _____ life span
- key role during _____ _____, infection
- 60-80% of total leukocytes
- derive from myeloid stem cells of bone marrow
- short life span
- key role during acute inflammation, infection
3 types of granulocytes
- neutrophils
- eosinophils
- basophils
describe neutrophils
first responder
Segmented neutrophils (or _____ ) are _____ forms and usually account for approximately _____ of total leukocytes. _____ are immature neutrophils and usually comprise _____ of leukocytes.
segs mature 55% Bands 5%
Increased neutrophils seen in _____ infections
bacterial
a _____ _____ refers to the presence of increased proportions of younger, less well differentiated neutrophils and neutrophil-precursor cells in the blood. This generally reflects early of premature release of _____ _____ from the bone marrow, the site where _____ are generated. A severe neutrophilia with left shifts is referred to as a _____ _____.
Left shift
myeloid cells
neutrophils
leukemoid reaction
How do you measure granulocytes
CBC
Type of granulocyte:
- certain allergic diseases and some asthma patients
eosinophils
Type of granulocyte:
- associated with allergic reactions, also contain some histamine
Basophils
Monocytes:
- _____-_____% of circulation leukocytes
- _____ leukocytes
- derive from _____ _____ of bone marrow
- migrate to _____, mature into _____, remain until activated
- _____cytes
- 2-3% of circulation leukocytes
- largest leukocytes
- derive from myeloid stem cells of bone marrow
- migrate to tissues, mature into macrophages, remain until activated
- histocytes
4 Types of monocytes:
- _____ cells - in the liver
- _____ macrophages
- _____ - in the brain
- activate immune response against _____ infections
- kupffer cells - in the liver
- alveolar macrophages
- micoglia - in the brain
- activate immune response against chronic infections
The client who has only a slight elevated in temperature in response to pneumonia is an example of a _____ in the expected immune response. The other clients are demonstrating an expected immune response as evidence by redness, swelling, and induration.
decline
Human _____ engulf the weakened vaccine virus as if it is dangerous and _____ stimulate the immune system to attack it.
macrophages
antigens
Lymphocytes:
- derive from _____ _____ _____ of bone marrow
- _____-_____% of circulating leukocytes
- _____, _____ cells of specific responses
- constantly circulate, monitoring for _____ _____
- derive from lymphoid stem cells of bone marrow
- 20-40% of circulating leukocytes
- effector, regulator cells of specific responses
- constantly circulate, monitoring for cancerous cells
Lymphocytes:
- _____ cells
- stay _____, sometimes for years
- activate immediately when exposed to _____ _____
- proliferate _____, intense immune response
- responsible for _____ _____
- memory cells
- stay inactive, sometimes for years
- activate immediately when exposed to same antigen
- proliferate rapidly, intense immune response
- responsible for acquired immunity
2 types of lymphocytes
T cells
B cells
T Cells:
- mature in _____
- on contact with _____ (antigen presenting cells), mature into active _____T cells, _____ T cells, or _____ T cells
- mature in thymus
- on contact with APCs (antigen presenting cells), mature into active helper T cells, cytotoxic T cells, or memory T cells
B cells:
- mature in _____ _____
- on contact with _____, activated and mature into _____ cells of _____ cells
- create _____ after antigen encountered
- mature in bone marrow
- on contact with antigen, activated and mature into plasma cells of memory cells
- create antibodies after antigen encountered
Natural Killer cells:
- in _____, lymph nodes, bone marrow, _____
- _____% of circulating lymphocytes
- immune _____, resistance to _____
- destruction of _____ _____ cells
- in spleen, lymph nodes, bone marrow, blood
- 15% of circulating lymphocytes
- immune surveillance, resistance to infection
- destruction of early malignant cells
Antigens: primary immune response
- B cell produces antibodies to _____ _____ _____
- _____ react specifically to that antigen
- takes _____ days
- B cell produces antibodies to eliminate extracellular antigens
- antibodies react specifically to that antigen
- takes ~3 days
Antigens: secondary immune response
- subsequent encounters with an _____ _____ _____ cell
- subsequent encounters with an antigen trigger memory cell
When an antigen is encountered in the body, two major groups of cells—_____ and _____—generate an effective immune response. _____ are recognized by a specific receptor on a lymphocyte, and an immune response is generated by those
lymphocytes. Depending on the antigen itself and the type of immune cell activated by contact with the antigen, two separate but overlapping immune responses may occur. The _____, or humoral branch of the immune system, mainly eliminates extra-
cellular antigens, such as bacteria, bacterial toxins, and free viruses, through the production of _____ (molecules that bind with the antigen and inactivate it). Antibodies are found in serum, body fluids, and certain tissues. When an individual is first exposed to an antigen, the B lymphocyte system begins to produce antibodies that react specifically to that antigen It takes approximately _____ days for this process, known as the _____ _____ _____, to occur. Subsequent encoun-ters with the antigen trigger memory cells, and the result is a secondary immune response within _____ hours.
lymphocytes APCs APCs B cell antibodies 3 primary immune response 24
5 Classes of antibodies (immunoglobulins)
IgM IgG IgA IgD IgE
Which antibody:
responsible for primary immunity
IgM
Which antibody:
major immunoglobulin
igG
Which antibody:
protects mucous membranes
igA
Which antibody:
role unknown
igD
Which antibody:
increases during allergic reactions, anaphylaxis
igE
In regard to newborn and infant immunity, _____ is the only immunoglobulin that crosses the placental barrier. Because of this, a newborn’s level of IgG is similar to that of the mother. The maternal IgG disappears by the time the infant is _____ months old. IgA and IgE (are, are not) present at birth. Infants and children have differing amounts of some immunoglobulins.
IgG
6-8
are not
Nursing interventions to support antibiotic therapy include encouraging an adequate fluid intake, monitoring for manifestations of an allergic reaction, assessing renal and hepatic function, and assessing vital signs. A baseline _____ is appropriate for _____ medication.
electrocardiogram
antimalarial
_____ carry messages for immune system function
cytokines
Cytotoxic T lymphocytes:
- attack _____ cells
- responsible for rejection of _____
- attack malignant cells
- responsible for rejection of transplants
Immunosuppressive agents _____ T cell development and activation. They are given concurrently with _____ and in combination with other immunosuppressants, and inhibit immune system activity and organ rejection. Nursing responsibilities include monitoring BUN and creatinine for evidence of _____ (kidney damage). The client should _____ grapefruit juice, which can raise cyclosporine levels by 50% to 200% and increase the risk of _____. Fluids should be _____ to maintain good hydration and urinary output. Ibuprofen is acceptable for immunosuppressive medications, but should not be taken with _____ agents.
inhibit glucocorticoids nephrotoxicity avoid toxicity increased cytotoxic
Lymphoid system:
- recover _____ for vascular system
- protects bloodstream from _____ _____
- recover proteins for vascular system
- protects bloodstream from invading organism
Lymph nodes:
- most numerous elements of _____ system
- filter foreign products of _____
- house, support ____ and _____
- most numerous elements of lymphoid system
- filter foreign products of antigens
- house, support lymphocytes and macrophages
Spleen:
- ______ lymphoid organ
- filters _____
- _____ kinds of tissue
- _____ pulp: lymphoid proliferation, immune surveillance
- _____ pulp: blood filtration
- largest lymphoid organ
- filters blood
- two kinds of tissue
- white pulp: lymphoid proliferation, immune surveillance
- red pulp: blood filtration
Thymus gland:
- stimulates _____
- during fetal life, childhood, site for maturation differentiation of _____ lymphoid cells
- stimulates lymphopoiesis
- during fetal life, childhood, site for maturation differentiation of thymic lymphoid cells
Bone marrow:
- produces, stores _____ stem cells
- produces, stores hematopoietic stem cells
Lymphoid tissues:
- _____ collections of lymphocytes, plasma cells, phagocytes
- _____ _____: largest collection of immune cells
- diffuse collections of lymphocytes, plasma cells, phagocytes
- peyer patches: largest collection of immune cells
Tonsiles and adenoids:
- protect from inhaled, ingested _____ _____
- protect from inhaled, ingested foreign agents
How can voiding create Barrier Protection?
Voiding a sufficient quantity of urine is a form of barrier protection that helps the body to defend itself against microorganisms. The act of voiding flushes those organisms that might try to enter the body through the _____ _____. Intact skin is also a physiological barrier that helps defend the body against microorganisms. Occasional smoking does not defend the body from microorganisms; it destroys the _____ in the nose that helps to filter organisms. _____ the skin and a surgical _____ can both allow microorganisms to enter the body.
urinary meatus
cilia
Moisturizing
incision
Child’s igG increases gradually until _____ years
7-8
_____ is present in breastmilk, concentrated in colostrum
igA
T/F: a newborn’s level of igG is similar to that of the mother
T, because igG is the only immunoglobulin that crosses the placental barrier
Are igA and IgE present at birth?
No
As a person grows older, there is an overall _____ in the speed and strength of the immune response. The immune system does not quit working totally. There is a decrease in the number of _____ in circulation.
decrease
B cells
4 types of allergic/hypersensitivity reactions:
- immediate hypersensitivity
Type 1
4 types of allergic/hypersensitivity reactions:
- cytotoxic hypersensitivity
Type 2
4 types of allergic/hypersensitivity reactions:
- immune complex reaction
Type 3
4 types of allergic/hypersensitivity reactions:
- delayed-type hypersensitivity
Type 4
Autoimmune diseases:
- immune system loses ability to…
- attacks…
- examples: _____ (SLE), _____, _____
- immune system loses ability to distinguish self from others
- attacks own body
- examples: lupus (SLE), Rheumatoid arthritis, HIV
Transplant reactions:
occurs minutes, hours after trasnplantation
hyperacute rejections
Transplant reactions:
occurs in weeks after transplantation
acute rejection
Transplant reactions:
occurs months after transplantation
chronic rejection
Transplant reactions:
- secondary deficiencies caused by trauma, cancer therapies
- AIDS
impaired immune response
Hypersensitivity reactions:
Can also affect bone marrow transplants, the new bone marrow can attack the _____ _____
host cells
Prevalence:
- Estimated _____-_____% of schoolchildren worldwide sensitized to one or more allergens
- Prevalence _____ in U.S.
- About _____% of U.S. population affected by autoimmune disease
- Majority are _____
- _____ is the most common
- Estimated 40–50% of schoolchildren worldwide sensitized to one or more allergens
- Prevalence increasing in U.S.
- About 8% of U.S. population affected by autoimmune disease
- Majority are female
- Lupus is the most common
T/F: Restricting fluids could cause respiratory secretions to thicken and hinder the client’s ability to maintain a clear airway. Fluids should be encouraged.
T
If drugs are discontinued, that can ______ the risk of organ rejection
increase
_____ immune deficiencies are more prevalent than _____
secondary
primary
T/F: children are at greater risk of allergies if parents have allergies
T
_____ _____ have higher rates of transplant rejection
African Americans
_____ _____ have increased prevalence of autoimmune disease
African Americans
Influenza vaccine is administered annually to healthy individuals and should not be given to those with an allergy to _____. The pneumococcal vaccine is administered _____. Revaccination is only recommended in persons with _____ _____, those who have had _____, those with malignancies, and those with _____/_____.
eggs once renal failure splenectomies HIV/AIDS
Is a vaccine active or passive immunity
active
is an injection of antibodies produced by another host active or passive imminuty
passive
Receiving an immunization for rabies is an example of _____ _____ _____ _____. Receiving tetanus and immunoglobulin are also examples but would not be used in the case of an animal bite. Mother’s breast milk is another example of _____ immunity, but would not be used in the case of an animal bite.
artificially acquired passive immunity
passive
When the client has the disease, the body stimulates the process of _____ _____ _____. Receiving injections for rabies, tetanus, and gamma globulin are examples of _____ _____ _____ _____.
acquired active immunity
artificially acquired passive immunity
Definition:
life threatening allergic reaction
anaphylaxis
If the nurse observes a _____ reaction, the client will exhibit manifestations including temperature, increased pulse, tachypnea, and leukocytosis. Erythema, warmth, pain, edema, and functional impairment indicate a _____ reaction.
systemic
local
Can you use live virus immunizations (ex. rubella) during pregnancy
No!
A patch test assesses a 1-inch area impregnated with the _____, which is applied for 48 hours. Absence of a response indicates a _____ result. Positive responses are graded from mild (erythema in the exposed area) to severe (papules, vesicles, or ulcerations). Direct Coombs’ test detects _____ in the client’s RBC that damage and destroy the cells. This is used following a suspected transfusion reaction to detect antibodies coating the _____ _____. This is also part of the crossmatch of a blood type and crossmatch. Indirect Coombs’ test detects the presence of circulating antibodies against _____. The eosinophil count is 1% to 4%, which is within normal range.
allergen negative antibodies transfused RBCs RBCs
Nonsteroidal anti-inflammatory drugs (NSAIDS) are _____; keeping the client well hydrated will help prevent kidney damage. Taking the medication (with/without) food will decrease gastrointestinal (GI) irritation, but preventing kidney damage is more of a priority. Taking the medication on an empty stomach will _____ gastrointestinal (GI) irritation. Constipation (is/is not) an issue with NSAIDs.
nephrotoxic
with
increase
is not
