PN 190 Ch. 33 Introduction to the Immune System
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? An 80-year-old man who is debilitated from Clostridium difficile-related diarrhea A 68-year-old woman who is being treated for chronic myeloid leukemia (CML) A 60-year-old man with motor and sensory deficits resulting from an ischemic stroke A 36-year-old woman who is in danger of developing sepsis after suffering full-thickness burns
A 68-year-old woman who is being treated for chronic myeloid leukemia (CML) (prepu) Explanation: IFNs are cytokines. They have antiviral and antitumor properties and can consequently be used in the treatment of neoplasms such as CML. Bacterial infections and neurological deficits are not responsive to interferon therapy.
IgM (immunoglobulin M) function
Agglutinates (clusters) antigens and lyses (dissolves) cell walls (pg 553 table 33-2)
IgD (immunoglobulin D) function
Binds to antigens; promotes secretion of other immunoglobulins (pg 553 table 33-2)
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 blood chemistry complete blood count (CBC) liver enzyme studies
CBC with differential (prepu) Explanation: The differential count measures the different types of white blood cells and compares their amounts to the total count. It is usually done by a machine (automated differential) but it can be done by a technologist who hand-counts the cells using a microscope (manual differential). This test would be ordered if the provider suspects something abnormal in the immune system.
This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte.
Cytotoxic T cell (prepu)
IgA (immunoglobulin A) function
Interferes with entry of pathogens through exposed structures or pathways (pg 553 table 33-2)
IgG (immunoglobulin G) function
Neutralizes bacterial toxins; accelerates phagocytosis (pg 553 table 33-2)
IgE (immunoglobulin E) function
Promotes release of vasoactive chemicals such as histamine and bradykinin in allergic, hypersensitivity, and inflammatory reactions (pg 553 table 33-2)
Interleukins carry messages between leukocytes and tissues that form blood cells. Some interleukins enhance the immune response, whereas others suppress it (Martini & Bartholomew, 2016). Examples of interleukin activity include:
Promotion of inflammation and fever Formation of scar tissue by fibroblasts Growth and activation of NK cells and additional T cells Production of mast cells Growth of B cells, formation of plasma cells, and production of antibodies Formation of new blood vessels, known as angiogenesis Stimulation of the anterior pituitary gland to secrete corticotrophin (545)
A nurse is explaining how the humoral and cellular immune responses should be seen as interacting parts of the broader immune system rather than as independent and unrelated processes. What aspect of immune function best demonstrates this? The movement of B cells in and out of lymph nodes The interactions that occur between T cells and B cells The differentiation between different types of T cells The universal role of the complement system
The interactions that occur between T cells and B cells (prepu) Explanation: T cells interact closely with B cells, indicating that humoral and cellular immune responses are not separate, unrelated processes, but rather branches of the immune response that interact. Movement of B cells does not clearly show the presence of a unified immune system. The differentiation between types of T cells and the role of the complement system does not directly suggest a single immune system.
A gardener sustained a deep laceration while working and requires sutures. The date of the client's last tetanus shot was over 10 years ago. Based on this information, the client will receive a tetanus immunization which will allow for the release of what?
antibodies (prepu)
A nurse is monitoring a client who developed facial edema after receiving a medication. Which white blood cells stimulated the edema?
basophils (prepu)
A client has undergone treatment for urosepsis and received high doses of numerous antibiotics during the course of treatment. When planning the client's subsequent care, the nurse should be aware of what potential effect on the client's immune function? Bone marrow suppression Uncontrolled apoptosis Thymus atrophy Lymphoma
bone marrow suppression (prepu) Explanation: Large doses of antibiotics can precipitate bone marrow suppression, affecting immune function. Antibiotics are not noted to cause apoptosis, thymus atrophy, or lymphoma.
What organ is the location to which phagocytes brain lung liver kidney blood joint
brain- microglial cells lung- alveolar macrophages liver- kupffer cells kidney- mesangial phagocytes blood- monocytes joint- synovial A cells (552 fig 33-3 Location of phagocytes)
Colony-stimulating factors (CSFs) are ___________________________________________________________
cytokines that prompt the bone marrow to produce, mature, and promote the functions of blood cells
humoral response
formation of antibodies (549)
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? Eosinophils Neutrophils B cells Monocytes
neutrophils (prepu) Explanation: 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.
What is an example of cell-mediated response
organ transplant
Interferons are chemicals that ________________________________________. Interferon is administered parenterally because digestive enzymes destroy its protein structure.
primarily protect cells from viral invasion by stimulating NK-cell activity. (545)
A nurse is admitting a client who exhibits signs and symptoms of a nutritional deficit. Inadequate intake of what nutrient increases a client's susceptibility to infection? Vitamin B12 Unsaturated fats Proteins Complex carbohydrates
proteins (prepu) Explanation: Depletion of protein reserves results in atrophy of lymphoid tissues, depression of antibody response, reduction in the number of circulating T cells, and impaired phagocytic function. As a result, the client has an increased susceptibility to infection. Low intake of fat and vitamin B12 affects health, but is not noted to directly create a risk for infection. Low intake of complex carbohydrates is not noted to constitute a direct risk factor for infection.
Which medication classification is known to inhibit prostaglandin synthesis or release? Nonsteroidal anti-inflammatory drugs in large doses Antibiotics (in large doses) Adrenal corticosteroids Antineoplastic agents
NSAIDs (prepu) Explanation: Nonsteroidal anti-inflammatory drugs (NSAIDs), in large doses, inhibit prostaglandin synthesis or release. NSAIDs include aspirin and ibuprofen. Antibiotics in large doses are known to cause bone marrow suppression. Adrenal corticosteroids and antineoplastic agents are known to cause immunosuppression.
Everyone's body cells are coded with distinct__________________
histocompatibility (tissue cell) markers (549)
A gerontologic nurse is caring for an older adult client who has a diagnosis of pneumonia. What age-related change increases older adults' susceptibility to respiratory infections? Atrophy of the thymus Bronchial stenosis Impaired ciliary action Decreased diaphragmatic muscle tone
impaired ciliary action (prepu) Explanation: As a consequence of impaired ciliary action due to exposure to smoke and environmental toxins, older adults are vulnerable to lung infections. This vulnerability is not the result of thymus atrophy, stenosis of the bronchi, or loss of diaphragmatic muscle tone.
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 enables cells to resist viral replication and slow viral replication? interferons interleukins tumor necrosis factor colony-stimulating factor
interferons (prepu) Explanation: Interferons are chemicals that primarily protect cells from viral invasion. They enable cells to resist viral infection and slow viral replication. They have been used as adjunctive therapy in the treatment of AIDS. Interferons also have been used to treat some forms of cancer such as leukemia because they stimulate NK cell activity. Interferon is administered parenterally because digestive enzymes destroy its protein structure.
A client's current immune response involves the direct destruction of foreign microorganisms. This aspect of the immune response may be performed by what cells? Suppressor T cells Memory T cells Cytotoxic T cells Complement T cells
cytotoxic T cells (prepu) Explanation: Cytotoxic T cells (also called CD8 + cells) participate in the destruction of foreign organisms. Memory T cells and suppressor T cells do not perform this role in the immune response. The complement system does not exist as a type of T cell.
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? Macrophages Helper T cells B cells Cytotoxic T cells
cytotoxic t cells (prepu)
T/F Vaccines against vital disorders are less effective in younger adults than older adults.
false, less effective in older adults than younger adults (555 Gerontologic considerations)
Which of the following occurs when the antigen-antibody molecule is coated with a sticky substance what also facilitates phagocytosis? Opsonization Agglutination Antigenic determinant Complement
opsonization (prepu) Explanation: Some antibodies assist in removal of offending organisms through 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.
