| Question | Answer |
| Lymphoid Structures | Bone marrow(Illiac sternum)
Thymus gland
Lymph nodes
Spleen(composed of red&white pulp,filters the blood)
Tonsils(Immune for Resp.)
Appendix
Peyer’s patches |
| Immune Cells | Lymphocytes
B-lymphocytes
T-lymphocytes |
| Lymphocytes | B-lymphocytes(bone marrow)
T-lymphocytes(thymus) |
| Types of Immunity | Innate—nonspecific(Natural Immunity,present at birth)
Acquired—specific(happens after you have been exposed to an antigen,immunizations,vaccines) |
| Acquired Immunity | Active Acquired Immunity
Passive Acquired Immunity |
| Active Acquired Immunity | immunization
Takes time to develop but long term |
| Passive Acquired Immunity | immune globulins/gamma-globulins
Immediate but short term(passed through placenta from mother) |
| Hypersensitivity Reactions | Allergies(b-Lymphocytes) Anaphylaxis
Cytotoxic (b-Lymphocytes)
Immune Complex Mediated (b-Lymphocytes)
Delayed Hypersensitivity (t-lymphocytes) |
| Allergic Reactions | Sneezing,itchy eyes,runny/congested nose, swollen sinuses,coughing,wheezing
Common allergens include the waste products from dust mites,proteins found in pet dander,saliva and urine, molds in&out of your home,tree,grass&weed pollen,&roach droppings |
| Other possible substances that can cause allergic reactions include, | venom from insect stings, certain foods, food additives, natural rubber latex, or drugs. |
| Anaphylaxis & Anaphylactic Shock | Occurs suddenly
Check and maintain airway – can go from mild SOB to full blown stridor
Recognize s/s quickly – Rash? Swelling? Itching on chest, throat? |
| Cytotoxic or Cytolytic Reactions | Blood transfusion reactions
ABO incompatibilities
Rh incompatibilities |
| Clinical manifestations of cytotoxic reactions; | Hematuria
Acute renal failure
Bleeding |
| Immune Complex Mediated Reactions | Autoimmune disorders
Rheumatoid Arthritis
Systemic Lupus Erythematousus (SLE)
Plasmapheresis |
| Autoimmunity; Theories of causation | Genetic susceptibility
Initiation of autoreactivity |
| Delayed Hypersensitivity | Cell mediated immune response
Contact dermatitis
Hypersensitivity reactions to bacterial, fungal and viral infections
Transplant rejections
SOME drug sensitivities |
| Factors Affecting Immune Response | Age
Metabolism
Emotional stress
Hormones
Environment/lifestyle
Nutrition |
| Diagnostic Studies | CBC w/WBC diff
Skin tests
RAST(radioallergosorbent test)blood test. RAST can be performed when a skintest(the more common allergy test)cannot be done due to a skin problem.Both are highly specific,but a skintest is less expensive&produces imediate resu |
| Review lab and diagnostic tests for acute injury/inflammation | Erythrocyte Sedimentation Rate (ESR)
C-reactive protein (CRP)
WBC
Differential |
| WBC… what’s the diff? | Neutrophils 50-75%,Basophils 0-2%,Eosinophils 0-6%,Monocytes 1- 10%,Lymphocytes 20-50%,All are decreased in viral infections |
| Neutrophils 50-75% | Increased in infection, inflammation, tissue necrosis, tumor |
| Basophils 0-2% | Increase is rare – happens with allergies |
| Eosinophils 0-6% | Increase with allergies & parasites |
| Monocytes 1- 10% | Increase with acute & chronic infection |
| Lymphocytes 20-50% | Decrease in overwhelming illness, Increase with acute & chronic infection |
| Inflammation | When damage to tissue occurs, the body's immunologic response to the damage is inflammation. |
| Purpose of Inflammation | Isolate, neutralize and remove cause
Clear debris
Initiate healing and repair |
| Inflammatory response | Movement of blood/fluid into injured area promotes healing
Problem when edema impedes tissue perfusion
Anti-inflammatory medications |
| Assessment of the client with an acute injury/inflammation | Redness
Heat
Pain
Swelling
Loss of function |
| Infection | A disease caused by an invasion of the body by pathogenic organisms |
| Basic Infection | Local
Systemic |
| Systemic Infection | Bacteremia
Sepsis |
| Chain of events… | Virulence
Mode of Transmission
Access to host
Direct contact
Inhalation
Ingestion - Gastrointestinal system |
| Mode of Transmission | Direct or indirect contact
Airborne droplets (TB)
Vector (Lyme disease) |
| Access to host | Inhalation
Ingestion
Direct contact
Penetration |
| Direct contact | Some pathogens can live on hard surface
Bedrails
Tables
Person to person contact
Sexually transmitted diseases
Maternal to child transmission during childbirth
Herpes
HIV
Skin breaks - burns, bites, surgery |
| Inhalation - Respiratory tract | Cilia remove microorganisms from lungs
Coughing removes microorganisms from lower respiratory tract
Enzymes & alveolar macrophages destroy most respiratory pathogens
Smoking interferes with action |
| Ingestion - Gastrointestinal system | Contaminated food, water is most common vector
Low gastric pH, enzymes, peristalsis & intestinal flora protect normally GI tract
Medications that decrease gastric acid increase risk of infections |
| Assessment Infection | Vital to check the vital signs when infection is suspected!
Temp, pulse, and respirations may all increase
Mild fever is good defense system
If very young/old or immune system is compromised, need to treat STAT! |
| Factors that Increase Susceptibility to Infection | Age
Nutrition
Medication
Radiation
Burns
Trauma
Surgery
Stress
Cancer
Chronic illness |
| Antibiotics | Bactericidal: kill bacteria
Bacteriostatic: inhibit growth of susceptible bacteria, rather than killing them immediately; will eventually lead to bacterial death |
| Selection of Antibiotics | Identification of the Infecting Organism
Determination of Drug Susceptibility
Gram stain + or - allows best choice of initial therapy
Culture - identification of the actual organism
Sensitivity - what drug will BEST kill the organism |
| Clients with Communicable Disease – Isolation Precautions | Standard Precautions
Airborne Precautions
Droplet Precautions
Contact Precautions |
| Viral Infections | Competent immune system:
Best response to viral infections
A well-functioning immune system will eliminate or effectively destroy virus replication |
| Viral Infections | Immunocompromised patients have frequent viral infections
Cancer patients, especially leukemia or lymphoma
Transplant patients, due to pharmacologic therapy
AIDS patients, disease attacks immune system |
