Chapter 35: Assessment of Immune Function
"White blood cells are produced in the bone marrow." White blood cells (leukocytes) are produced in the bone marrow. They are not produced in the plasma, thymus gland, or the lymphatic tissue.
A client is informed that his white blood cell count is low and that he is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse?
Passive immunity transferred by the mother Passive immunity develops when ready-made antibodies are given to a susceptible person. The antibodies provide immediate but short-lived protection from the invading antigen. Newborns receive passive immunity to some diseases for which their mothers have manufactured antibodies. Naturally acquired active immunity occurs as a direct result of infection by a specific micro organism. An example is the immunity to measles that develops after the initial infection. Not all invading microorganisms produce a response that gives lifelong immunity. Artificially acquired immunity is obtained by receiving a killed or weakened microorganism or toxoid.
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?
Potato chips and chocolate milk shake A diet containing excessive fat, such as that found in potato chips and milk shakes, seems to contribute to autoimmunity — overreaction of the body against constituents of its own tissues. Raisins, carrot sticks, fruit, mineral water, applesauce, and saltine crackers are snacks containing adequate amounts of vitamin A, zinc, and carotene, which are beneficial for the body.
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?
"These tissues filter bacteria from tissue fluid." Tonsils and adenoids filter bacteria from tissue fluid. Because they are exposed to pathogens in the oral cavity, they can become infected and locally inflamed. The spleen acts as an emergency reservoir of blood and removes blood and bacteria, not the tonsils
A parent of a child who has been having frequent bouts of tonsillitis brings the child back to the clinic for another sore throat. The parent asks the nurse, "What are tonsils good for anyway?" What is the best response by the nurse?
Impaired ciliary action from exposure to environmental toxins Impaired ciliary action from exposure to smoke and environmental toxins contributes to impaired clearance of pulmonary secretions and an increased incidence of respiratory infections in the elderly. Failure of the immune system to differentiate "self" from "non-self" leads to an increase incidence of autoimmune diseases. Decreased phagocytosis by the liver's Kupffer cells leads to increased incidence and severity of hepatitis B. Decreased sensation and slowing of reflexes leads to increased risk of skin injury, skin ulcers, abrasions, burns, and other trauma
An elderly client is diagnosed with a respiratory infection. While reviewing age-related changes in the immune system, the nurse identifies which of the following as having contributed to this client's infection?
Cytotoxic T cells Cytotoxic T cells (killer T cells) attack the antigen directly by altering the cell membrane and causing cell lysis (disintegration) and by releasing cytolytic enzymes and cytokines. Lymphokines can recruit, activate, and regulate other lymphocytes and white blood cells (WBCs). These cells then assist in destroying the invading organism.
An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack the antigen directly by altering the cell membrane and causing cell lysis. Which cells should be isolated?
Effector T cells Explanation: Effector T cells are killer (cytotoxic) cells.]
During the immune response, cytotoxic cells bind to invading cells, destroy the targeted invader, and release lymphokines to remove the debris. Which type of T-cell lymphocyte is cytotoxic?
Neutropenia Motrin causes leukopenia and neutropenia. Phenylbutazone causes pancytopenia. Cefuroxime sodium (Ceftin) causes thrombocytopenia and hemolytic anemia.
Ibuprofen (Motrin) has which effect on the immune system?
Interferons. Interferons are biologic response modifiers with nonspecific viricidal proteins. Antibodies are protein substances developed by the body in response to and interacting with a specific foreign substance. Antigens are substances that induce formation of antibodies. Complement refers to a series of enzymatic proteins in the serum that, when activated, destroy bacteria and other cells.
Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as
Antigens Antigens, which are protein markers on cells, are substance capable of inducing a specific immune response and of reacting with the products of that response
The immune system is a complicated and intricate system that contains specialized cells and tissues that protect us from external invaders and our own altered cells. Which of the following is the term used to define any substance capable of inducing a specific immune response and of reacting with the products of that response?
The injection area swells if the client has developed antibodies against the antigen. The injection area swells if the client has developed antibodies against the antigen. The client is not necessarily actively infectious if the test results are positive. Although a productive cough is one of the symptoms of active tuberculosis, it may also indicate other diseases and disorders. The area should not be painful, and the client should not break out with a rash.
The nurse is administering a skin test for detection of exposure to tuberculosis. How would the nurse determine if the client was exposed to tuberculosis?
A 65-year-old client who had chicken pox when he was 12 years old Half of individuals living to age 65 years have had or will develop shingles and may not understand the potential seriousness and risk for complications. Nurses as client advocates should determine and provide health information regarding the shingles vaccine. The other clients are not candidates for the vaccine
The nurse is instructing client's about the importance of taking the shingles vaccine. Which client would benefit from this vaccine?
Corticosteroids The nurse obtains a history of immunizations, recent and past infectious diseases, and recent exposure to infectious diseases. He or she reviews the client's drug history because certain drugs, such as corticosteroids, suppress the inflammatory and immune responses. Advil is a nonsteroidal anti-inflammatory medication and does not suppress the inflammatory and immune responses. An ACE-I prevents the conversion of angiotensin I to angiotensin II and does not suppress the inflammatory or immune response. Diuretics also do not suppress the immune response but help reduce excess fluid from the kidneys.
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?
Programs T lymphocytes to become regulator or effector T cells. The thymus gland is located in the neck below the thyroid gland. It extends into the thorax behind the top of the sternum. The thymus gland produces lymphocytes during fetal development. It may be the embryonic origin of other lymphoid structures such as the spleen and lymph nodes. After birth, the thymus gland programs T lymphocytes to become regulator or effector T cells. The thymus gland becomes smaller during adolescence but retains some activity throughout the life cycle. Options A, B, and C are incorrect
What is the function of the thymus gland?
IgE igE promotes the release of vasoactive chemicals such as histamine and bradykinin in allergic, hypersensitivity, and inflammatory reaction. IgG neutralizes bacterial toxins and accelerates phagocytosis. IgA interferes with the entry of pathogens through exposed structures or pathways. IgM agglutinates antigens and lyses cell wall
What type of immunoglobulin does the nurse recognize that promotes the release of vasoa ctive chemicals such as histamine when a client is having an allergic reaction?
Decreased renal function Decreased renal circulation, filtration, absorption, and excretion contribute to the risk for urinary tract infections. The antibody production decreases, skin become thinner, and the incidence of autoimmune disease increases with age
Which of the following is associated with impaired immunity in the aging patient?
Natural killer cells NK cells are a class of lymphocytes that recognize infected and stressed cells and respond by killing these cells and by secreting macrophage-activating cytokine. Natural killer cells defend against microorganisms and some type of malignant cells.
Which type of cells is capable of recognizing and killing infected or stressed cells and producing cytokines?
Obtain a written consent from the client It is important that the nurse obtain written consent from the client before performing an HIV test and keep the results of HIV test confidential. The nurse may not ask the client to avoid excess fluid intake or abstain from intercourse before the tests. The client also need not take off ornaments and metallic objects worn unless they are likely to interfere with the test results.
You are the clinic nurse caring for a client with a suspected diagnosis of HIV. You are preparing to draw blood for a confirmatory diagnostic test on this client. What is the most important action that the nurse should perform before testing a client for HIV?
mpaired ciliary action as a result of exposure to environmental toxins mpaired ciliary action from exposure to smoke and environmental toxins contributes to impaired clearance of pulmonary secretions and an increased incidence of respiratory infections in the elderly. Failure of immune system to differentiate "self" from "non-self" leads to an increased incidence of autoimmune diseases. Decreased phagocytosis by the liver's Kupffer cells leads to increased incidence and severity of hepatitis B. Decreased sensation and slowing of reflexes leads to increased risk of skin injury, skin ulcers, abrasions, burns, and other trauma.
The nurse is caring for an elderly client with a respiratory infection. While reviewing age-related changes in the immune system, the nurse identifies which of the following as having contributed to this client's infection
Opsonization n the process of opsonization, the antigen-antibody molecule is coated with a sticky substance that also facilitates phagocytosis. Apoptosis is programmed cell death that results from the digestion of DNA by endonucleases. Agglutination is the clumping effect occurring when an antibody acts as a cross-link between two antigens. Immunoregulation is a complex system of checks and balances that regulates or controls immune responses
Which of the following is a process in which the antigen-antibody molecule is coated with a sticky substance that facilitates phagocytosis?
