Med-Surg Ch 33-35 Unit 9

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Terms in this set (...)

anergy
inability to mount an immune response
antibodies
chemical substances that destroy foreign agents such as microorganisms
antigens
protein markers on cells, marking them foreign
artificially acquired active immunity
administration of a killed or weakened microorganism or toxin in order to manufacture cells that will remember the substance and fight it next time it is recognized
immune response
target-specific system of defense, involving lymphocytes
immunocompetence
the ability for the system to cooperatively protect the person from outside invaders an the body's own altered cells. anergy is common with this or AIDS
naturally acquired active immunity
directly acquiring an infection and building antibodies against it so it can be fought next time it is recognized
passive immunity
ready made antibodies given or passed ont a susceptible person, short lived, will not recognize agent when seen again. markers to newborns
Cell-mediated response
When T cells survey proteins in body, actively analyze the surface features and respond to those that differ from host by directly attacking invading antigen
Thymus
Programs T lymphocytes to become regulator or effector T cells
Tonsils and Adenoids
Filter bacteria from tissues fluid
Lymphoid tissues
Play role in immune response and prevention of infection
Artificial immunity
Results from administration of a killed or weakened microorganism or toxoid ex influenza vaccine
Active immunity
The body had to do something. life long immunity, the body worked to build specific immunity based on exposure to antigen
Natural immunity
Occurs as a direct result of infection from a specific microorganism Ex measles
Naturally given from mom born with
What is the primary test for immune system disorders?
CBC with differential
Where are WBCs produced?
Bone marrow, stem cells
How does a TB test screen for TB?
If the person has been exposed they will have antibodies (B memory cells) that will attack the small injected around in the arm, making it swollen and red. Check 48-72 hours
Natural killer cells (effector T)
Lymphocyte-like cells that circulate throughout the body looking for virus-infected cells and cancer cells (Seek and destroy)
Allergic disorder and response
Characterized by a hyperimmune response to weak antigens that are usually harmless Ex rhinitis, edema, SOB
Allergens cause an allergic reaction
Why do allergic reactions usually not happen on the first exposure?
It does not produce symptoms (Sensitization)
Sensitization
Process by which cellular and chemical events occur after a 2nd or subsequent exposure to antigen
What do you do if a patient says they are allergic to something?
Document allergy, list specific reactions, later reconcile and ask more questions if needed, allergy bracelet, check every med administration
What are the symptoms of food allergies?
Cramping, vomiting, diarrhea
What is the typical tx of allergies?
Corticosteroids, benadryl, epinephrine
What is prick testing?
Skin testing with extracts of various substances (antigens)
What is a nursing intervention for someone on desensitization therapy?
Watch closely for reactions with initial dose and when increasing
What is the symptoms management of anaphylaxis?
Epinephrine ASAP
How do you get a ring off a client's finger when their hands are swollen without damaging the ring?
Try soap and oil first, then do the string method
Autoimmune disorder
Killer T cells and autoantibodies attack or destroy natural cells
How does being on an immunosuppressant drug drug affect getting a vaccine?
Possibility of getting sick, don't have tools to fight off infection
What are colony-stimulating factors?
Agent that helps stimulate production of cells
What do colony-stimulating factors do?
RBCs produce epogen
WBCs produce Neupogen/Nulasta
What are the txs of autoimmune disorders?
Drug therapy
Corticosteroids (prednisone)
Antineoplastics-lower immune response, risk for infection
What do autoimmune disorders put people at risk for?
Infections
Pt teaching for autoimmune disorders?
Take medications even when in remission
Report symptoms of infection ASAP
Avoid crowds
Diet for an autoimmune disorder?
Encourage well balanced diet (Supplements not necessary)
Why do clients with autoimmune disorders sometimes take chemo drugs?
Lower the immune response
What does it mean to have exacerbations and remission of autoimmune disorders and why is it important to keep taking the meds?
To avoid another acute exacerbation
How does HIV attack the body and why does it affect the immune system? ***** Short answer
Impairs the ability of infection T4 cells to recognize foreign antigens and stimulate B cell lymphocyte
What opportunistic infections HIV/AIDS pts susceptible to?
Cryptosporidosis and Candidiasis
Cryptosporidosis
Diarrhea leads to dehydration and electrolyte imbalance (Protozoan)
Candidiasis
Yeast infection Tx-nystatin, vaginal tablets, suppositories
What is the best way to prevent HIV/AIDS?
Use condom with or spermicide (Nonoxynol-9)
Bank autologous blood (Self donated) or directed donor blood
What puts someone at high risk for HIV/AIDS?
Unprotected sexual intercourse, multiple partners, sharing needles, nanaulologous transfusion, infected mother to infant transmission
What should a healthcare worker do if stuck by a contaminated needle?
Report immediately to supervisor
Practice safe sex until negative testing confirmed for 6 months
What is ADC?
AIDS dementia complex
Degeneration of brain, affects mood cognition, and motor function
When does HIV become AIDS?
Markedly decrease T4 cells count (normal 800-1200)
Development of certain cancers, opportunistic infections
What should you always do before testing a client for HIV?
Obtain consent
What are the drug therapy goals of AIDS?
Keep CD4 cell count above 350/mm3-undetectable viral load level
How do you reduce occupational risks?
Safe handling of needles and sharp instruments
Delayed hypersensitivity response
Type IV
May develop over several hours or days
Corticosteroids
Anti-inflammatory hormones
Block the synthesis of prostaglandins and leukotrienes
Acquired immunity
Lymphocytes
Picked up along the way
Active
Lasts as long as the system works
Makes T and B cells
What makes T and B cells?
Acquired immunity
Innate immunity
Passive
Born that way
Doesn't last long
Makes bloodborne and physical barriers
What makes bloodborne and physical barrieres?
Innate immunity
T cells
Produced from bone marrow
Hangs out in the thymus
Wait until its told to become Regulator T or effector T cells
What makes Regulator T and effector T cells?
T cells
Regulator T cells make?
Helper T and Suppressor T
Desensitization
When you try to lower your response to allergens
Helper T cells
Detect antigens
Stimulates B cells to make antibodies to antigens
Police cells
What cells stimulate B cells to make antibodies to antigens?
Helper T cells
Suppressor T cells
Turns off immune response when done
Effector T cells
Has killing cells
Calls in the troops of other nonspecific WBC
Seek and destroy
Plasma cells
Antibodies
Specific fighters
Memory cells
Make memory of antigen and are activated when re-exposed
Bloodborne
Immunity passed from placenta
Breast milk
Some vaccines
Generic cells-Monocytes, microphages, macrophages
Physical barriers
1st line of defense
Skin
Mucous membranes
Tears
Stomach acid
Fevers
Inflammation