Med surge Immune My notes

A client in stage 1 of HIV feels well and questions having the virus. Which response by the nurse is appropriate?

"There is an equal amount of virus and the cells to combat the virus in your body."

cytoxic T cells

(killer T cells) attack the antigen directly by altering the cell membrane, causing cell lysis (disintegration), and releasing cytolytic enzymes and cytokines

Stage 1 of HIV infection

*Acute Infection* -flu-like response to initial contact with the virus

Steps of HIV infection

1) HIV surface glycoprotien - gp120 - attaches to CD4 receptor on T-helper cells 2) Chemokine co-receptor aids in binding of gp120 ccr5/ cxcr4 3) Viral RNA converted into DNA with help from 3 enzymes - Reverse Transcriptase, Integrase, & Protease 4) DNA is inserted and integrated into the T-helper cell. protease matures new HIV virus Basically takes over cell = cell isn't a T-helper cell anymore, so T-helper cell values drop

IgA

15 percent, appears in breast milk, gi prostatic and vaginal secretions, prevents absorption of pathogens from food

A client is infected with human immunodeficiency virus (HIV) after sharing needles with another intravenous (IV) drug abuser. Upon infection with HIV, the immune system responds by making antibodies against the virus, usually within how many weeks after infection?

3 to 12 weeks

midrange

500-5000

high viral load

5000-10000

stage 3

<200

stage 2

<200-499

A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery?

A cell-mediated response

What is the function of the thymus gland?

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.

The spleen

An organ that is part of the lymphatic system; it produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. Red pull is where old ones are destroyed/ white pulp contain lymphocytes

IgD

Attached to B cells Activates B cells

Which of the following cell types are involved in humoral immunity?

B lymphocyte

humoral

B lymphocyte cells (produces immunoglobulins gamde

Aids can also be aquired

By chemo therapy

Cytomegalovirus (CMV)

DNA virus that accounts for many respiratory, ophthalmic, and liver infections can cause blindness

HIV encephalopathy

Disease of the brain (dementia) caused by infection with the human immunodeficiency virus (HIV), which causes AIDS (acquired immunodeficiency syndrome).

hiv test

ELISA and Western Blot tests --> HIV diagnosed only after 2 or more positive ELISA tests are confirmed by positive Western Blot

Which blood test confirms the presence of antibodies to HIV?

Elisa

enzyme antibody

Elisa

Which blood test confirms the presence of antibodies to HIV?

Enzyme immunoassay (EIA)

A client with chronic renal failure has begun treatment with a colony-stimulating factor. What medication does the nurse anticipate administering to the client that will promote the production of blood cells?

Epoetin alfa (Epogen)

When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask?

Have you ever received a blood transfusion?"

DiGeorge syndrome

Hypercalcemia, hypoparathyroidism

Nurse treatment

ID risk / help prevent transmission/ educate about disease/ arts/ monitor labs blood transfusion questions

proliferation stage

Lymphocytes stimulate some of the dormant T and B lymphocytes to enlarge, divide, and proliferate in the lymph nodes causing sore throat and swelling

What type of cytokine will attract neutrophils and monocytes to remove debris?

Lymphokines

More than 50% of individuals with this disease develop pernicious anemia:

More than 50% of clients with CVID develop pernicious anemia. Pernicious anemia is not associated with the other conditions.

NK cell

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. The helper T cells contribute to the differentiation of null and NK cells.

Which type of cells destroys antigens already coated with antibody?

NULL

The nurse is taking the health history of a newly admitted client. Which condition would place the client at risk for impaired immune function?

Organ transplantation requires immunosuppressive drugs, which cause impaired immune function.

The nurse completes a history and physical assessment on a client with acquired immune deficiency syndrome (AIDS) who was admitted to the hospital with respiratory complications. The nurse knows to assess for what common infection (80% occurrence) in persons with AIDS?

Pneumocystis pneumonia

pep

Post-exposure prophylaxis: can reduce the risk of HIV infection immediately AFTER exposure no more than 72 hrs

client is diagnosed with severe combined immunodeficiency (SCID). What would the nurse expect to integrate into the client's plan of care?

Preparation for bone marrow transplantation

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 of immunoglobulins

stage 2 of hiv

Stage 2 occurs when CD4+ T-lymphocyte cells decrease to between 200 and 499 cells/mm3 and had previously been referred to as the symptomatic stage.

A client who is has been HIV positive for 10 years has a CD4+T-lymphocyte count of 2600 cells/L. For which stage of the virus will the nurse provide care when the client is diagnosed with invasive cervical cancer?

Stage 3 because an opportunistic infection has occurred

stage 3 of hiv

Stage 3 is diagnosed when the count drops below 200 cells/mm3 and the person has AIDS.

cellular immunity

Stem cells migrate to thymus and produce T cells

T helper cells

T lymphocytes with CD4 receptors on their cell-surface membranes, which bind to antigens on antigen-presenting cells and produce interleukins, a type of cytokine. Presents ti to a B cell, T cells act alone and they destroy virus cells or cancer changed by mutation

What are the primary participants in the immune system

T- and B- cell lymphocytes

nucleic and p24

TEST FOR VIRUS DIRECTLY

A client is prescribed didanosine as part of a highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client?

Take half hour before or 2 h after meals

HIV 1 emmunoessay

Tests for both HIV-1 and HIV-2 antibodies

humoral response

The branch of acquired immunity that involves the activation of B cells and that leads to the production of antibodies, which defend against bacteria and viruses in body fluids.

When the body is invaded or attacked by bacteria, viruses, or other pathogens, it has three means of defense:

The phagocytic immune response The humoral or antibody immune response The cellular immune response

The nursing instructor is discussing the development of human immunodeficiency disease (HIV) with the students. What should the instructor inform the class about helper T cells?

They are activated on recognition of antigens and stimulate the rest of the immune system.

Which is a major manifestation of Wiskott-Aldrich syndrome?

Thrombocytopenia

Post exposure prophylaxis

Treatment administered to an individual after exposure to an infectious disease to prevent the disease

Epstein-Barr virus (EBV)

acute infection which causes sore throat, fever, fatigue, and enlarged lymph nodes; also called mononucleosis (white patches on tongue)

IRIS (Immune Reconstitution Inflammatory Syndrome)

an exaggerated inflammatory reaction to a disease-causing microorganism that sometimes occurs when the immune system begins to recover following treatment with antiretroviral (ARV) drugs ;; mycobacteria, fungi, herpes types: 1. "unmasking" = flare-up of an underlying, previously undiagnosed infection 2. "paradoxical" = worsening of a previously treated infection *can be life-threatening

3 types of test

antibody, antigen/antibody, nucleic acid

Which assessment should be completed if immune dysfunction is suspected in the neurosensory system?

ataxia

anti body test can be found in

blood , urine , saliva

A client is diagnosed with severe combined immunodeficiency (SCID). What would the nurse expect to integrate into the client's plan of care?

bone marrow transpl

infections a person with aids can get

candidiasis

even if cd4 increase

cannot be made less stage

Which is usually the most important consideration in the decision to initiate antiretroviral therapy?

cd4 ct

the complement system

circulating proteins that assist antibodies in the destruction of pathogens, made int he liver when an antibody connects to its antigen

prevention

dont drink water from foreign eat foods that are not raw or un pasteurized avoid risky activities keep vax up to date exposure to animal feces should be limited need to take art- helps immune strong

Protease inhibitors

ends invir

HIV/1-HIV-2 antigen/antibody combination immunoassay

ests for both virus (antigen) and antibody for both HIV-1 and HIV-2

IgE

for allergic reactions, and parasitic infections

HIV patients should avoid

fresh fruits everything should be thourughlt cookws

Cryptococcus neoformans

fungus that causes neurological disease fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures.

stage 1

greater than 500

supressor T cells

have the ability to decrease B-cell production, thereby keeping the immune response at a level that is compatible with health (e.g., sufficient to fight infection adequately without attacking the body's healthy tissues).

Testing preformed for people with

hepatitis, tb stds

Which of the following protective responses begin with the B lymphocytes?

humoral

uninfected T cells

in lymph nodes, and cell death occurs, this time pyroptosis due to inflammation , interluekin 1 betta , they get showered with interleukin one and all t ells cd4 gets destroyed, and end up in chronic inflamation (chain reaction)

A nurse is teaching the parents of an infant about primary immunodeficiencies. Which statement verifies that the parents understand the teaching?

infancy

A client has had a splenectomy after sustaining serious internal injuries in a motorcycle accident, including a ruptured spleen. Following removal of the spleen, the client will be susceptible to:

infections

A client is taking a corticosteroid for the treatment of systemic lupus erythematosus. When the nurse is providing instructions about the medication to the client, what priority information should be included?

infections

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

interferons

IgM

intravascular, first response to pathogen of viral and bacterial infections

cellular response

involves the T lymphocytes, which can turn into special cytotoxic (or killer) T cells that can attack the pathogens.

Interferons

is a nonspecific viricidal protein that is naturally produced by the body and capable of activating other components of the immune system.

Low HIV viral load

les that 75

highest reservoir of his

lymphatic system In GI

kaposi sarcoma

malignant, vascular, neoplastic growth characterized by cutaneous nodules. KS is caused by human herpesvirus-8 (HHV-8); affects eight times more men than women; and may spread through sexual contact. It involves the epithelial layer of blood and lymphatic vessels.

IgG antibodies

most abundant, crosses placenta, enhances phagocytosis

A 25-year-old client receives a knife wound to the leg in a hunting accident. Which type of immunity was compromised?

natural

Which immunity type becomes active as a result of infection by a specific microorganism?

naturally acquired active immunity

A client receiving antiretroviral therapy reports "not urinating enough." What is the nurse's bestaction?

nephron urea/ creatine

Mycobacterium avium complex (MAC)

opportunistic infection caused by mycobacterial organisms that commonly causes a respiratory illness but can also infect other body systems

Apoptosis

process of programmed cell death specific

compliment components

prostaglandins,leukotrines etc

B cells and T cells

respond to antigen, when they encounter specific antigen they bind in a lock and key manner

adenosine

reverse transcription inhibitor

A client on antiretroviral drug therapy informs the nurse about sometimes forgetting to take the medication for a few days. What should the nurse inform the client can occur when the medications are not taken as prescribed?

rsistance

Helper T cells (type of lymphocyte) there are 3

secrete cytokines that enhance immune response, which attract and activate B cells

Telangiectasia

skin lesion due to permanently enlarged and dilated blood vessels that are visible

What organ is considered lymphoid tissue?

spleen

prolonged chronic stage

stage 1

A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?

stool

cellular

t lymphocyte (helper t - memoryt - cytoxic t)

phagocytic immune response

the immune system's first line of defense, involving white blood cells that have the ability to ingest foreign particles

bone marrow

the white blood cells (WBCs) involved in immunity are produced in the bone marrow

Kaposi sarcoma (KS)

type of skin cancer often seen in patients with AIDS; consists of brownish-purple papules that begin in skin and spread to internal organs <200

intergrase

valtagovir