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Exam 1 Immunity
Readings:
Aschenbrenner & Venable Drug Therapy in Nursing
o Chapter 13: pages 169-175 (Epinephrine)
o Chapter 45: pages 927-932 (Acyclovir), 934-936 (Oseltamivir)
o Chapter 46: pages 944-950; Classification paragraphs on pages 950, 959,
964, 971 (HAART)
o Chapter 54: pages 1173-1178 (Interferon alfa-2a)
Giddens Concepts for Nursing Practice
o Chapter 20: pages 204-215
Lewis Medical-surgical Nursing
o Chapter 14: pages 209-211 (Type 1: IgE Mediated Reactions), 214
Collaborative Care: Anaphylaxis
o Chapter 15: pages 231-233 (HIV)
o Chapter 24: pages 436 (Herpes Zoster Virus in Table 24-5)
o Chapter 27: pages 503-504 (Influenza)
o Chapter 44: pages 1007-1015 (Hepatitis C only)
Immunity Giddens Chapter 20
Immunity: a physiologic process that provides an individual with protection or defense
from disease
Accomplished through the actions of the immune system, which is a body-wide,
complex, interrelated group of cells, tissues, and organs that work within a
dynamic communication network to protect the body from attacks by foreign
antigens, typically proteins.
Foreign antigens may include microorganisms (bacteria, viruses, parasites, or
fungi), but may also be proteins found in pollens; foods; bee, snake, or spider
venom; vaccines; transfusions; and transplanted tissues.
Innate Immunity = immunity present at birth
o Provides nonspecific response not considered antigen specific
o Has no memory of the encounters, does not remember specific foreign
antigens, and does not provide any ongoing protection against future
infection.
Acquired Immunity = immunity protection that is gained after birth either
actively or passively
o Active Acquired Immunity = develops after the introduction of a foreign
antigen resulting in the formation of antibodies or sensitized T lymphocytes
Ex: active immunity may be obtained artificially through the immune
response to an immunization or it may be obtained naturally through
the immune response to exposure to infectious pathogens such as
varicella-zoster virus
o Passive Acquired Immunity = occurs by the introduction of preformed
antibodieseither from an artificial route, such as a transfusion of
immunoglobulin (Ig), or from a natural route, such as from a mother to her
fetus through placental blood transference or through colostrum transfer
during breastfeeding
Occupation
Social environment = substance abuse
Common Diagnostic Tests
Primary Testing = use first**, then try other methods
o RBC count & WBC count with Differential (CBC)
High WBC possible infection
High RBC hemolytic interactions
Differential count shows count of all WBCs and can show what kind of
problem you are having
o Fluorescent Antinuclear Antibody
Shows if you are having any autoimmune disorder problem
o C-Reactive Protein (CRP)
Shows inflammation pt of immune response, but does not show
where in the body
o Erythrocyte Sedimentation Rate (ESR)
Shows inflammation pt of immune response, but does not show
where in the body
Other Testing = use after primary testing
o Allergy testing
o Genetic testing
o Rheumatoid factors (RFs) = specific test for rheumatoid arthritis (a
autoimmune disorder)
o Western blot test = tests for HIV
o TORCH antibody panel = tests for certain viruses (herpes)
o Organ function tests = kidney, liver
Clinical Management
Prevention
o Immunizations (CDC)
o Avoid high-risk behaviors
o Adequate nutrition
o Exercise
o Infection control measures
Screening
o No routine screening for general public tests are expensive and dont
always give us a great idea of what is going on unless there are s/s to go
along with it
o HIV screening for those with specific risk factors
Interrelated Concepts
Inflammation part of immune response, may or may not be visible
Infection infection precipitates (triggers) inflammation and immune response
Tissue Integrity if skin is intact, you have a good first barrier defense system
Stress alters hormone (cortisol) levels and can possibly weaken immune system
Exaggerated Immune System
Consequences:
o Acute hypersensitive reaction
Mild to severe
Localized to systemic (whole body)
Ex: bee sting pain/itchiness on arm (mild, localized to arm)
Diarrhea
Individualized
Duty to warn
Nervous System
o
o
o
o
Central Nervous
System (CNS) [brain
and spinal cord]
Peripheral Nervous
System (PNS) [neurons
outside brian and spinal
cord]
Efferen
t
Autonomic
nervous system
Sympathetic
nervous sytem
(adrenergic)
Alpha-1
Alpha-2
Beta-1
Afferen
t
Somatic nervous
system
Parasympathetic
nervous sytem
(cholinergic)
Beta-2
Cells
Involved
Products
Memory
Cells
Protection
Examples
Humoral Immunity
B lymphocytes
Antibodies
Present
Bacteria
Viruses (extracellular)
Respiratory and GI
pathogens
Anaphylactic shock
Atopic diseases
Transfusion reaction
Bacterial infections
Cell-Mediated Immunity
T lymphocytes,
macrophages
Sensitized T cells, cytokines
Present
Fungus
Viruses (intracellular)
Chronic infectious agents
Tumor cells
Tuberculosis
Fungal infections
Contact dermatitis
Graft rejection
Destruction of cancer cells