chapter 33

immunoglobulins may hinder antigens physically by

(1) neutralizing their toxins; (2) linking them together in a process called agglutination; and (3) causing them to precipitate, or become solid. Second, antibodies can facilitate the destruction of antigens with other mechanisms—for example, those performed by nonantibody proteins such as the complement system and cytokines.

Lymphoid tissues

, such as the thymus gland, tonsils and adenoids, spleen, and lymph nodes, play a role in the immune response and prevention of infection

antigens

, which are protein markers on cells, and form additional T-cell clones that stimulate B-cell lymphocytes to produce antibodies against foreign antigens

A nurse is aware of the important role that interferons (IFNs) perform in the normal function of the immune system. As well, the nurse has provided care for patients who have benefited from interferon therapy. IFN therapy is most likely to be effective in the treatment of which of the following patients?

A 68-year-old woman who is being treated for chronic myeloid leukemia (CML)

A client who has developed kidney failure is discussing options with the health care provider for treatment. What does the nurse understand that kidney failure is associated with?

A deficiency in circulating lymphocytes

An infection control nurse is presenting an in-service reviewing the immune response. The nurse describes the clumping effect that occurs when an antibody acts like a cross-link between two antigens. What process is the nurse explaining?

Agglutination

A nurse is reviewing the immune system before planning an immunocompromised client's care. How should the nurse characterize the humoral immune response?

Antibodies are made by B lymphocytes in response to a specific antigen.

humoral immunity

B cells

A client's health care provider suspects the client has developed an immune system disorder. What will most likely be the first test ordered?

CBC with differential

A client with cystic fibrosis has received a double lung transplant and is now experiencing signs of rejection. What is the immune response that predominates in this situation?

Cellular

A client is fighting an active infection. What function will cytokines perform in this immune response?

Determining whether the immune response will be the production of antibodies or a cell-mediated response

A client's natural immunity is enhanced by processes that are inherent in the physical and chemical barriers of the body. What is a chemical barrier that enhances natural immunity?

Gastric secretions

Our bodies contain a variety of immunoglobulins. Which of these immunoglobulins is found in sweat, tears, mucus, and bile?

IgA

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?

Interferons

What specific drug group has both antiviral and anti-proliferative actions?

Interferons

Lymphocytes

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

markers

Molecules on the surfaces of cells Composed of proteins and/or sugars Evaluated by cells of the immune system

Which medication classification is known to inhibit prostaglandin synthesis or release?

NSAIDS Nonsteroidal anti-inflammatory drugs in large doses

Which type of cell is capable of directly killing invading organisms and producing cytokines?

Natural killer cells

A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a storm door. The fall resulted in a 6 cm laceration of the right antecubital. The nurse caring for this patient knows that the site of the injury will have an invasion of what?

Phagocytic cells

thymus gland programs

T lymphocytes to become regulator or effector T cell

Histocompatibility

The immunologic similarity between an organ donor and a transplant recipient

A client is responding to a microbial invasion and the client's differentiated lymphocytes have begun to function in either a humoral or a cellular capacity. During what stage of the immune response does this occur?

The response stage

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.

Interferons

They enable cells to resist viral infection and slow viral replication. They have been used as adjunctive therapy in the treatment of AIDS

immune response

a target-specific system of defense, primarily involves the lymphocytes, which are specialized cells that are located in blood and lymphoid tissue.

lymphokines

a type of cytokine (discussed later in this chapter), attract neutrophils and monocytes to remove the debris.

Tumor necrosis factor (TNF)

a type of cytokine, was first discovered, it showed promise as a means of shrinking tumors.

Cytokines

are chemical messengers released by lymphocytes, monocytes, and macrophages

Colony-stimulating factors (CSFs)

are cytokines that prompt the bone marrow to produce, mature, and promote the functions of blood cells.

Helper T cells

are especially important in fighting infection

Natural killer (NK) cells

are lymphocyte-like cells that circulate throughout the body looking for virus-infected cells and cancer cells. NK cells can identify atypical markers on the membranes of these cells without the help of T-cell or B-cell lymphocytes.

T cell lymphocytes

are manufactured in the bone marrow and travel to the thymus gland where they mature to become either regulator T cells or effector T cells

Cytotoxic T cells

bind to invading cells, destroy the targeted invader by altering their cellular membrane and intracellular environment, and stimulate the release of chemicals called lymphokines.

Immunoglobulins (antibodies)

bind with antigens and promote the destruction of invading cells in one of two ways.

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

blood transfustion

A patient is being treated in the intensive care unit for sepsis related to ventilator-associated pneumonia. The patient is on large doses of three different antibiotics. What severe outcome should the nurse monitor for in the lab studies?

bone marrow suppression

Antibodies

chemical substances that destroy foreign agents such as microorganisms. Helper T cells are also called T4 cells or CD4 cells.

Agglutination

clumping

lymphatic system

consists of vessels similar to capillaries that drain tissue fluid, called lymph

memory cells

convert to plasma cells on reexposure to a specific antigen.

Naturally acquired active immunity

develops after exposure to antigens in environment

The thymus gland, a lymphoid tissue, programs T lymphocytes to become regulator or effector T cells. In which part of the life cycle does the thymus gland produce lymphocytes?

fetal development

A nurse has admitted a client who has been diagnosed with urosepsis. What immune response predominates in sepsis?

hummoral

complement cascade

initiation, amplification and cascade, polymerization, and membrane attack

white blood cells

leukocytes are produced in the bone marrow.

Interleukins

proteins that stimulate the growth of B and T lymphocytes

effector T cells

release cytokines (killer cells)

Immunocompetence

the ability of the immune system to respond to attack the ability to cooperatively protect a person from external invaders and the body's own altered cells.

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 any other durgs

Artificially acquired active immunity

vaccination

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

Lymphocytes

white blood cells

Passive immunity: Natural

• Mother to baby (placenta, colostrum and breast milk)

The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger promotes inflammation, fever, and angiogenesis?

interleukins

Suppressor T cells

limit or turn off the immune response in the absence of continued antigenic stimulation.

adenoids are

located behind the nose on the posterior wall of the nasopharynx.

complement system

proteins in the blood that help antibodies kill their target

Monocytes, also called

macrophages

Regulator T cells

made up of helper and suppressor cells

tonsils

masses of lymphatic tissue in the back of the oropharynx

B-cell lymphocytes

mature into plasma cells to secrete antibodies

Interleukins carry

messages between leukocytes and tissues that form blood cells.

Neutrophils also called

microphages

Neutrophils and monocytes are

phagocytes,

Interleukins

proteins (cytokines) that stimulate the growth of B and T lymphocytes