PrepU Ch 35 Concept of Immunity
A client with lupus erythematosus wants to know why autoimmune disorders are much more common in women. The nurse correctly responds with which of the following statements?
"Estrogen tends to enhance immunity." Autoimmune can be seen as an over-functioning immune system. Androgen tends to be immunosuppressive.
While taking the health history of a newly admitted client, the nurse asks for a list of the client's current medications. Which of the following medication classifications would place the client at risk for impaired immune function?
Antimetabolites Antimetabolites can cause leukopenia, eosinoplilia, aplastic bone marrow, and pancytopenia. The other choices do not directly affect the immune system.
A nurse encourages a client with an immunologic disorder to eat a nutritionally balanced diet to promote optimal immunologic function. Which snacks have the greatest probability of stimulating autoimmunity?
Potato chips and chocolate milk shakes keyword is stimulating autoimmunity, so we're looking for unhealthy stuffs.
An older adult patient who is postmenopausal informs the nurse that she believes she has developed another urinary tract infection (UTI). The nurse understands that postmenopausal females are at greater risk for UTIs. What risk factors do female patients in this age group have? (Select all that apply.)
Residual urine Urinary incontinence Estrogen deficiency
A client has been diagnosed with AIDS. Which of the following statements correctly describes a secondary immune deficiency?
An interference develops in an already developed immune system A secondary immune deficiency results from some interference with an already developed immune system. A primary deficiency results from improper development of immune cells or tissues. A hypersensitivity happens when the body produces an inappropriate or exaggerated response to a specific antigen. Autoimmunity happens when the normal protective immune response pradoxically turns against or attacks the body, leading to tissue damage. It is not an immune deficiency.
A client has breast cancer. The nurse is concerned about a compromised immune system in this client for which of the following reasons?
Antineoplastic drug therapy Antineoplastic drugs cause a compromised immune system. Breast cancer is not associated with an excess of lymphocytes, a deficiency of circulating antibodies, or an excess of hemoglobin.
Which of the following is a medical condition that is an example of a humoral immune response?
Asthma
General role of: Basophil Eosinophil Neutrophil/Monocytes NK cells (Natural Killer)
Basophils = HISTAMINE Eosinophil = COMPLEX PHAGO (helminth) Monocytes/Neutrophil = GENERAL PHAGO NK cells = free-floating policemen cells looking for infected/cancerous cells
The nurse is obtaining information from a client with Crohn's disease about his medication history. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response?
Corticosteroids Corticosteroids suppress inflammatory and immune responses.
A nurse is taking the health history of a newly admitted client and asks for a list of the client's current medications. Which of the following medication classifications would NOT place the client at risk for impaired immune function?
Inotropics Inotropics do not directly affect the immune system.
A 34-year-old client is diagnosed with chronic hepatitis C. Testing reveals that the client is a candidate for treatment. The nurse anticipates that which therapy could be used to treat the client's condition?
Interferon Interferons are used to treat immune-related disorders (e.g., multiple sclerosis) and chronic inflammatory conditions (e.g., chronic hepatitis).
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 of this patient?
Kupuna pt develop depression and suicidal tendencies when faces with chronic illness. The effects of the aging process and psychological stress interact, with the potential to negatively influence immune integrity (Masoro & Austad, 2011). Consequently, continual assessment of the physical and emotional status of older adults is imperative, because early recognition and management of factors influencing immune response may prevent or mitigate the high morbidity and mortality seen with illness in the older adult population (Brunner et al., 2011; Swain & Nikolich-Zugich, 2009).
the immunoglobulins and what they do MAGED immunoglobulins
M - IgM agglutinates antigens and lyses cell walls. (FIRST RESPONDER) A - IgA interferes with the entry of pathogens through exposed structures or pathways. 15% total immunoglobulin. Found in body fluids. Passes to neonate via breastmilk (RESPIRATORY, GASTROINTESTINAL, GENITOURINARY) G - IgG neutralizes bacterial toxins and accelerates phagocytosis. 75% of total immunoglobulin. Crosses placenta. (BLOODBORNE, TISSUE INFECTIONS) E - IgE promotes the release of vasoactive chemicals such as histamine and bradykinin in allergic, hypersensitivity, and inflammatory reaction. D - IgD possibly influences B-Lymphocyte differenciation
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.)
Nutritional status Caloric intake Quality of food ingested Nutritional intake that supports a competent immune response plays an important role in reducing the incidence of infections; patients whose nutritional status is compromised have a delayed postoperative recovery and often experience more severe infections and delayed wound healing.
Which of the following occurs when the antigen-antibody molecule is coated with a sticky substance what also facilitates phagocytosis?
Opsonization In this process, the antigen-antibody molecule is coated with a sticky substance that also facilitates phagocytosis. One antibody can act as a cross-link between two antigens, causing them to bind or clump together. This clumping effect, referred to as agglutination, helps clear the body of the pathogen by facilitating phagocytosis. The portion of the antigen involved in binding with the antibody is referred to as the antigenic determinant. Circulating plasma proteins, known as complement, are made in the liver and other sites and activated when an antibody connects with its antigen.
A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have?
Passive immunity transferred by the mother Passive immunity develops when ready-made antibodies are given to a susceptible person. (Mom's breastmilk) Naturally acquired active immunity occurs as a direct result of infection by a specific microorganism. (measle immunity after getting measles) Artificially acquired immunity is obtained by receiving a killed or weakened microorganism or toxoid. (Vaccines)
Immune Response Stages ProRecResEff
Proliferation phase - circulating lymphocytes containing the antigenic message return to the nearest lymph node. Once in the node, the sensitized lymphocytes stimulate some of the resident dormant T and B lymphocytes to enlarge, divide, and proliferate. (HEY, SOMETHING IS FISHY, LETS GO CHECK IT OUT) Recognition stage - the immune system distinguishes an invader as foreign, or non-self. (YOU'RE RIGHT IT WAS FISHY OR NO IT WAS OK) Response stage - the changed lymphocytes function either in a humoral or cellular fashion. (LET US FIX THE FISHY, WHAT DO WE NEED?) Effector stage - either the antibody of the humoral response or the cytotoxic T cell of the cellular response reaches and couples with the antigen on the surface of the foreign invader. (ANTIBODIES NOW TAKING CARE OF THE FISH)
A client has a suspected immune system disorder. What test would be ordered if a deficiency or excess of immunoglobulins was suspected?
Protein electrophoresis
Which adverse effect should the nurse closely monitor in a client who takes immunosuppressive drugs?
Respiratory or urinary system infections When taking drugs to suppress the immune system, the client is vulnerable to an increased risk of infection, especially in the respiratory or urinary systems.
A patient tells the nurse, "I can't believe I have ineffective immune function and am getting sick again. I exercise rigorously and compete regularly." What is the best response by the nurse?
Rigorous exercise can cause negative effects on immune response (you can never have too much of a good thing) Although factors that are not consistent with a healthy lifestyle are predominantly responsible for ineffective immune function, positive lifestyle factors can also negatively affect immune function and require assessment. For example, rigorous exercise or competitive exercise— usually considered a positive lifestyle factor—can be a physiologic stressor and cause negative effects on immune response (Walsh, Gleeson, Shephard, et al., 2011).
A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which of the following reasons?
Use of anti-rejection drugs These drugs cause a compromised immune system. Renal transplant is not associated with excess lymphocytes, deficient circulating antibodies, or excess hemoglobin.
A 38-year-old client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. Which is the most important factor related to the client's assessment?
Use of other drugs These data will help her to assess the client's susceptibility to illness because certain past illnesses and drug use, such as corticosteroids, suppress the inflammatory and immune responses. The client's age, home environment, and diet do not have any major implications during assessment because they do not indicate the client's susceptibility to illness.
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.)
Vitamin D deficiency has been associated with increased risk of: >common cancers >autoimmune diseases >inflammatory disorders
A client undergoing a skin test has been intradermally injected with a disease-specific antigen on the inner forearm. The client becomes anxious because the area begins to swell. Which technique may be used to decrease anxiety in this client?
Assure the client that this is a normal reaction When disease-specific antigens are injected, the injection area swells as a result of the client developing antibodies against the antigen that is introduced. The nurse should also keep in mind that the client is not necessarily actively infectious if the test result is positive. Rubbing the area gently or even applying ice packs may only aggravate the swelling. The swollen area should be left open to heal by itself. The nurse should await the physician's instructions before advising the client to use any prescribed analgesics.
The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following?
Serum, which depletes the body's store immunoglobulins Major burns cause impaired skin integrity and compromise the body's first line of defense. Loss of large amounts of serum occurs with burn injuries and depletes the body of essential proteins, including immunoglobulins. Loss of serum or plasma does not deplete the body of catecholamines (adrenal gland), calcitonin (thyroid gland), or glucagon (pancreas).
A nurse is taking the health history of a newly admitted client. Which of the following conditions would NOT place the client at risk for impaired immune function?
Surgical removal of the appendix Appendix hardly do shet.
The nurse is beginning the physical examination of a client with a complaint of fatigue. What documentation will the nurse provide to describe this general appraisal of the client's health?
The client appears mildly ill, listless, and disheveled. Step 1 is always inspection. Then you obtain vitals and conduct a more comprehensive exam.
Define: Interferons Antibodies Antigens Complement
interferons Interferons = proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system (THEY /INTERFERE/ WITH RESPONSES) Antibodies = protein substances developed by the body in response to and that interact with a specific foreign substance. (TARGET; COMBAT ALIEN SUBSTANCE) Antigens = substances that induce formation of antibodies. (TARGET STIMULUS; THE ALIEN SUBSTANCE) Complement refers to a series of enzymatic proteins in the serum that, when activated, destroy bacteria and other cells.
Define the responses: Cell-mediated response Complement system Colony-stimulating factors Naturally Acquired Active Immunity
Cell-mediated response = occurs when T cells survey proteins in the body, actively analyze the surface features, and respond to those that differ from the host by directly attacking the invading antigen. An example of a cell-mediated response is one that occurs when an organ is transplanted. The complement system cooperates with antibodies to attract phagocytes and coat antigens to make them more recognizable for phagocytosis and stimulate inflammation and is not related to the surgery. Colony-stimulating factors prompt the bone marrow to produce, mature, and promote the functions of blood cells. Naturally acquired active immunity is a direct result of infection by a specific microorganism.