Chapter 35 Assessment of Immune Function
What does cellular membrane damage result from?
Activation of complement, arrival of killer T cells, and attraction of macrophages
How do biologic response modifiers (BMRs) affect the immune response?
BMRs suppress antibody production and cellular immunity
What is complement, how is it formed, and how does it function?
Complement is a term used to describe circulating plasma proteins that are made in the liver activated when an antibody couples with an antigen. Complement defends the body against bacterial infection, bridges natural and acquired immunity, and disposes of immune complexes and byproducts associated with inflammation.
Describe four ways that disorders of the immune system occur.
Disorders arise from excesses or deficiencies of immunocompetent attack on self-antigens, and inappropriate or exaggerated responses to specific antigens.
Distinguish between natural and acquired (active and passive) immunity.
Natural immunity, which is nonspecific, is present at birth. Acquired immunity us more specific and develops throughout life. Active acquired immunity refers to defenses developed by the person's own body. Passive acquired immunity is a temporary immunity transmitted from another source that has developed immunity through previous disease or immunization
A patient arrives at the clinic and reports a very sore throat as well as a fever. A rapid strep test returns a positive result and the patient is given a prescription for an antibiotic. How did the streptococcal organism gain access to the patient to cause this infection? a. Through the mucous membranes of the throat b. Through the skin c. Breathing in airborne dust d. From being outside in the cold weather and decreasing resistance
a
A patient who has developed kidney failure is discussing options with the healthcare provider for treatment. What does the nurse understand that kidney failure is associated with? a. A deficiency in circulating lymphocytes b. A deficiency in phosphorus c. Decreased amount of WBCs d. Increased amount of macrophages
a
An older adult patient who is postmenopausal informs the nurse that she believes she has developed another urinary tract infection (UTI). What risk factors do female patients in this age group have to increase the incidence of UTIs? (select all that apply) a. Residual urine b. Urinary incontinence c. Estrogen deficiency d. Decreased function of the thyroid gland e. Dry mucous membranes of the vagina
a, b, c
The nurse is caring for a patient in the hospital who is receiving a Vitamin D supplement. What does the nurse understand is the importance of supplementation with this vitamin? (select all that apply) a. Vitamin D deficiency is associated with increased risk of common cancers b. Vitamin D deficiency is associated with increased risk of autoimmune disease. c. Vitamin D deficiency is associated with increased with risk of congenital anomalies d. Vitamin D deficiency is associated with increased risk of inflammatory disorders e. VitaminD deficiency is associated with increased risk of celiac disease
a, b, d
The nurse is caring for a female patient who has an exacerbation of lupus erythematosus. What does the nurse understand is the reason that females tend to develop autoimmune disorders more frequently than men? a. Androgen tends to enhance immunity b. Estrogen tends to enhance immunity c. Testosterone tends to enhance immunity d. Leukocytes are increased in females
b
The nurse is obtaining a history from a patient with severe psoriasis. What question would be the most important to ask this patient to determine a genetic predisposition? a. "How did you know you developed this disease"? b. "Does anyone in your family have more than one autoimmune disease"? c. "How many children do you have"? d. "Does your spouse or significant other have an autoimmune disease"?
b
An older adult has developed a sacral pressure ulcer. What should the nurse assess in order to ensure adequate wound healing and prevent poor outcomes for this patient? (select all that apply) a. The patient's ability to perform self wound care b. Nutritional status c. Caloric intake d. Quality of food ingested e. The amount of carbohydrates the patient ingests
b, c, d
White blood cells (WBCs) involved in immunity are primarily produced in the ______________________________.
bone marrow
The immune system is essentially composed of ________________________, ______________________, and _____________________________.
bone marrow, lymphoid tissue, white blood cells
A patient developed an infection while on vacation in Central America and is now taking the antibiotic chloramphenicol. What should the patient be monitored for when taking this drug? a. Eosinophilia b. Neutropenia c. Aplastic anemia d. Hypoprothrombinemia
c
Granulocytes, which fight invasion by releasing histamine, do not include ______________________________.
lymphocytes
The primary cells responsible for recognition of foreign antigens are ____________________________.
lymphocytes
WBCs that function as phagocytes are called ____________________________.
monocytes
A deficient immune system response that is congenital in origin would be classified as a ________________________ disorder.
natural deficiency
The leukocytes that arrive first at a site where inflammation occurs are ______________________.
neutrophils
The body's first line of defense is the _______________________.
phagocytic immune response
During the _______________________ stage of an immune response, lymphocytes interfere with disease by picking up specific antigens from organisms to alter their function.
proliferation
Antibodies are believed to be a type of _____________________________.
protein
T lymphocytes, descendants of stem cells, mature in the _______________________.
thymus
Describe how effector T cells destroy foreign organisms.
By altering the antigen's cell membrane, causing cellular lysis, and producing lymphokines, which destroy invading organisms.
The nurse is caring for an older adult patient hospitalized with cellulitis of the right lower extremity. Why is it imperative that the nurse continually assess the physical and emotional status us this patient? a.Older patients are at risk of developing dementia b. The patient will not respond to the antibiotic treatment as well as a younger patient would c. Early recognition and management of factors influencing immune response may decrease morbidity and mortality d. Older adult patients develop depression and suicidal tendencies when they are faced with chronic illness
c
