Unit 7 course point 2300 and lecture

A patient develops gastrointestinal bleeding from a gastric ulcer and requires blood transfusions. The patient states to the nurse, "I am not going to have a transfusion because I don't want to get AIDS." What is the best response by the nurse?

"I understand your concern. The blood is screened very carefully for different viruses as well as HIV."

The nurse is instructing a client about safer sexual behaviors. Which client statement indicates a need for additional instruction?

"I will apply baby oil to lubricate the condom.

A nurse is teaching high school students about transmission of the human immunodeficiency virus (HIV). Which comment by a student warrants clarification by the nurse?

"I won't donate blood because I don't want to get AIDS."

The development of a positive HIV antibody test following initial infection generally occurs in which timeframe?

4 weeks

Which client is more at risk of becoming infected with human immunodeficiency virus (HIV)?

A person having casual intercourse with multiple partners

During a mumps outbreak at a school, a teacher is exposed. Because of a previous immunization for mumps, what type of immunity does the teacher possess?

Acquired immunity.

Macrophages

Amoeboid cells that are fixed or roam connective tissue and engulf foreign particles and debris of dead cells.

Which of the following is the most severe form of hypersensitivity reaction?

Anaphylaxis

A client sustained a deep laceration while gardening and requires sutures. The client received a tetanus immunization that allows for the release of what protective agent?

Antibodies

The marks on the lymphocyte are called what?

Antibodies Unique antibodies that win and fight pathogens with great odds.

A client will be receiving a hepatitis B vaccination series prior to employment in a dialysis center. What type of immunity will this provide?

Artificially acquired active immunity

The nurse is caring for a client whose most recent laboratory values reveal a neutrophil level of 21,000 mm3. When preparing to assess the client, the nurse should prioritize what assessment?

Assessing the client for signs and symptoms of infection

When preparing a client with acquired immunodeficiency syndrome (AIDS) for discharge to home, the nurse should be sure to include which instruction?

Avoid sharing such articles as toothbrushes and razors.

Other than abstinence, what is the only proven method of decreasing the risk of sexual transmission of HIV infection?

Consistent and correct use of condoms

The nurse is obtaining the medical history of a client with Crohn's disease. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response?

Corticosteroids

baby does not have their own immunoglobulin

Crosses the placenta Maternal IgG disappears by 6-8 months. IgA presents in breast milk

A client has discussed therapy for his HIV-positive status. What does the nurse understand is the goal of antiretroviral therapy?

Bring the viral load to a virtually undetectable level

Which of the following is a age-related change associated with the immune system?

Decreased antibody production

A school nurse is talking about infection with a high school health class. What would be the nurse's best explanation of the process of phagocytosis?

Engulfment and digestion of bacteria and foreign material

Which blood test confirms the presence of antibodies to HIV?

Enzyme-linked immunosorbent assay (ELISA)

natural vs artificial immunity = Active immunity

N= infection A= vaccination life time immunity Memory cells formed

Passive immunity= natural vs artificial

N= maternal antibodies Artificial= monoclonal antibodies short period of time No memory cells formed

A 20-year-old client cut a hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which cell type to be elevated first in an attempt to prevent infection in the client's hand?

Neutrophils

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.

No memory cells are produced, and the level of the injected antibodies diminishes over a period of several weeks to a few months. This type of immunity is not natural, artificially acquired active immunity, or naturally acquired active immunity.

A 16-year-old has come to the clinic and asks to talk to a nurse. The teen states that she has become sexually active and is concerned about getting HIV. The teen asks the nurse what she can do to keep from getting HIV. What would be the nurse's best response?

Other than abstinence, only the consistent and correct use of condoms is effective in preventing HIV.

The nurse is completing a focused assessment addressing a client's immune function. What should the nurse prioritize in the physical assessment?

Palpation of the client's lymph nodes

A nurse has given an 8-year-old client the scheduled vaccination for rubella. This vaccination will cause the client to develop which expected and desired condition?

Passive acquired immunity

A nurse is exposed to hepatitis C and receives a shot of gamma globulin. What type of immunity does this nurse have?

Passive immunity

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.....

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.

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

A client has been brought to the emergency department by the parents after falling through the glass of a patio door, sustaining a laceration. The nurse caring for this client knows that the site of the injury will have an invasion of which type of cell?

Phagocytic cells

The nurse is aware that during the immune response, pathogens are engulfed by white blood cells that ingest foreign particles. What is this process known as?

Phagocytosis

A client with Crohn's disease, an autoimmune disorder, informs the nurse about not having any symptoms of the disease in 8 months. What does the nurse understand this asymptomatic period is referred to?

Remission

A client at the walk-in clinic reports exposure to human immunodeficiency virus (HIV). The client wants to know the precise sources through which the HIV infection is transmitted. What is the nurse's best response?

Semen

A new nursing graduate is working at the hospital in the medical-surgical unit. The preceptor observes the nurse emptying a patient's wound drain without gloves on. What important information should the preceptor share with the new graduate about standard precautions?

Standard precautions should be used with all patients to reduce the risk of transmission of bloodborne pathogens.

What are the primary participants in the immune system?

T- and B- cell lymphocytes

Lymphocytes, which are either T-cell or B-cell lymphocytes, comprise 20% to 30% of all leukocytes.

T-cell and B-cell lymphocytes are the primary participants in the immune response. Therefore options A, C, and D are incorrect.

The anatomy and physiology instructor is explaining a cell-mediated response to the pre-nursing students. What actions would the instructor explain occur in a cell-mediated response?

T-cell lymphocytes survey proteins in the body and attack the invading antigens.

passive immunity

Temporary Results from transfer of source outside of the body that has developed immunity through previous disease or immunization

The nurse is teaching the client with HIV about therapy. Which elements are essential for the nurse to include in the teaching plan? Select all that apply.

The CD4 count is the major indicator of immune function and guides therapy. Antiretroviral therapy targets different stages of the HIV life cycle.

humoral immune 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 the blood and lymph systems.

A client has received the results of a HIV antibody test, which is positive. What is the best explanation for the nurse to give to the client?

The client has been infected and has produced antibodies.

The client should use only water-soluble lubricant, such as K-Y jelly or glycerin. Baby oil can cause the condom to break.

The client should use a new condom for each sexual activity and hold onto the condom so that it does not come off when pulling out. Manual-anal intercourse should be avoided.

A client has been diagnosed with AIDS and tuberculosis (TB). A nursing student asks the nurse why the client's skin test for TB is negative if the client's physician has diagnosed TB. The nurse's correct reply is which of the following?

The client's immune system cannot mount a response to the skin test

A client suspected of having human immunodeficiency virus (HIV) asks the nurse what causes AIDS. What is the best response by the nurse?

The human immunodeficiency virus

Where can we find the humoral fluid in?

The interstitial space between your cells

The CD4 count is the major indicator of immune function. Antiretroviral therapy in HIV targets different stages of the HIV life cycle.

Therapy does not prevent opportunistic infections. Medication therapy is effective, and most clients respond well to it.

natural killer cells (NK cells)

They can kill your own cells if they are infected with viruses or have become cancerous

Helper T cells can't kill but they can activate cells that do, and they help.

They help call the shots for the whole adaptive immune response. cytotoxic cells are the ones that actually do the killing. They clone themselves into memory T cells They also produce a whole mess of T cells

Warmth felt over a wound is part of the healing process.

This is from inflammatory chemicals such as prostaglandins, kininogen, plasma proteins...

A client 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 client is given a prescription for an antibiotic. How did the streptococcal organism gain access to the client to cause this infection?

Through the mucous membranes of the throat.

Why would it be important for the nurse to question the client about sexual practices, history of substance use disorder, and the client's lifestyle during the interview process?

To determine if the client has practices that the client at risk for acquired immunodeficiency syndrome (AIDS)

The most severe form of hypersensitivity reaction or immune-mediated reaction is anaphylaxis. Type II, or cytotoxic, hypersensitivity occurs when the system mistakenly identifies a normal constituent of the body as foreign.

Type III, or immune complex, hypersensitivity involves immune complexes that are formed when antigens bind to antibodies. Type IV, or delayed-type hypersensitivity, occurs 24 to 72 hours after exposure to an allergen.

Cell-immediated immune response

When a B or T cell responds to a specific bacteria or infection

A client is informed of having a low white blood cell count and that the client 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?

White blood cells are produced in the bone marrow.

specific, systemic, has memory

adaptive immune response

Type 1 allergic reaction

anaphylaxis/ food allergies bee stings

Passive immunity injection

antibodies injection produced by another host (artificial)

Live vaccines are contraindicated in a patient who:

are immunocompromised people going through chemotherapy

AIDS (acquired immune deficiency syndrome)

attacks the helper T cells

without cytokines doing it's job, it's easy to acquire what?

auto immune disorders like MS or diabetes

Neutrophils (polymorphonuclear leukocytes [PMNs]) are the first cells to arrive at the site where inflammation occurs. Eosinophils and...

basophils, other types of granulocytes, increase in number during allergic reactions and stress responses.

The nurse is caring for an older client admitted to the health-care facility with a new onset of confusion and a low-grade fever. Which age-related changes might contribute to decreased functioning of the immune system?

decreased kidney function

type 4 allergy reaction

diabetes/ Guillain-Barre syndrome

Phagocytes: Macrophages

first on the scene

What types of cells are a targeted with a healthy immune system?

foreign cells, infectious cells cancer cells.

B lymphocytes

form in the bone marrow and release antibodies that fight bacterial infections learns self tolerance where it doesn't attack the body's own cells. Friend and foe

Type 2 allergic reaction

hemolytic transfusion reaction/fetus and newborn

herd immunity

immunity in most of a population

active immunity

immunity produced by exposure to an antigen, as a result of the immune response Immunologic defenses developed by person's own body lasts a lifetime-- longterm

A decrease in circulating white blood cells (WBCs) is referred to as

leukopenia

A client has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, the client has an inability to fight infection because bone marrow is unable to produce a sufficient amount of:

lymphocytes

What wbc goes under apoptosis?

neutrophils They are the pus you see from a wound.

histamines increase permeability of capillaries meaning plasma leaks into tissue fluid (pain and swelling);

protein rich fluids are released

Artificial immunity: Specific against foreign antigen

result of prior exposure to an antigen Active or passive

Type 3 allergy

serum sickness

Toxoid vaccines

stimulate active immunity of parts of the germ not actually the germ to fight it off. Diphtheria and Tetanus

DNA technology

techniques for sequencing and manipulating DNA Insulin and growth hormone using it to attack cancers or tumors

Active immunity

vaccines (artificial)

Leukocytes

white blood cells, fight infection

acquired and innate immunity

your body's adaptive system that has learned to build up pathogens that are more complex and foreign pathogens. great memory defense mechanism Vaccines are important due to this system.

The nurse is aware that the phagocytic immune response, one of the body's responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents?

Macrophages

LUPUS is the most common autoimmune disorder/ 8% in US

Majority of autoimmune diseases are women who have it.

Monoclonial Antibodies

Man made Very specific Work in conjunction with our own immune system Fewer side effects Name ends in "mab" made to battle cancer

natural immunity

Infection: White blood cell action to fight off infection Inflammatory response: physical barriers, such as intact skin, chemical barriers, and acidic gastric secretions.... tears and saliva

Which of the following is the most common HIV-related malignancy?

Kaposi's sarcoma

A client asks a nurse, "What can I use to decrease my risk of exposure to HIV?" What will the nurse include as effective in reducing the risk of HIV exposure? Select all that apply.

Latex male condoms Sexual abstinence Dental dams

Which blood cell type is matched correctly with its function?

Leukocyte: Fights infection

Cause inflammation activate macrophages get other T cells fired up Regulate much of the immune response

Lymphocyte T cells jobs

T lymphocytes (T cells)

Lymphocyte that matures in the thymus and acts directly against antigens in cell-mediated immune responses.

A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby:

Lymphocytes migrate to areas of the lymph node

The nursing students are learning about the immune system in their anatomy and physiology class. What would these students learn is a component of the immune system?

Lymphoid tissues

internal innate system

Fever Chemical signals Inflammation

lymphocyte antibodies

Find, bind to, and mark a particular antigen. They don't kill, they just mark for death.-----> phagocytes, macrophages They can turn antigens into neutral bodies and make it so they can't disturb other cells.

Monocytes migrate to injury sites and function as phagocytic cells, engulfing, ingesting, and destroying greater numbers and quantities of foreign bodies or toxins than granulocytes. This occurs in response to the foreign bodies that have invaded the laceration from the dirt on the broken glass. Interferon, one type of biologic response modifier, is a nonspecific viricidal protein that is naturally produced by the body and is capable of activating other components of the immune system......

Helper T cells are activated on recognition of antigens and stimulate the rest of the immune system. When activated, helper T cells secrete cytokines, which attract and activate B cells, cytotoxic T cells, NK cells, macrophages, and other cells of the immune system. Cytokines are the various proteins that mediate the immune response. These do not migrate to injury sites.

Types of vaccines: Killed (inactive) virus

Hepatitis A, Flu (influenza) shot, polio (shot) Rabies

mast cells send out histamine molecules

Histamines cause vasodilation, which creates redness and heat at the site of the injury

After teaching a client with immunodeficiency about ways to prevent infection, the nurse determines that teaching was successful when the client makes which statement?

I should avoid being around other people who have an infection."

A nurse is caring for a client diagnosed with human immunodeficiency virus (HIV). The client wants to know when medication for the disease will begin. What is the nurse's best response?

If the client has a CD4 T-cell count less than 350 cells/mm3.

Psychoneuroimmunology factor

If you are happy, you are less likely to be sick. Thinking good thoughts helps more than you know.