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2-Med Sur
Ch. 10 Immune & Lymphatic
| Question | Answer |
|---|---|
| This sys protects againgst microscopic threats | Immune and Lymphatic sys |
| this syst. makes white blood cells that fight against infection and rid body of foreign invaders | Hematologic Sys. |
| when is the natural immune sys. activated? | when the external barrier is penetrated(skin, nasal mem. and urinary tract) |
| this immunity is present in body even before the body is exposed to any outside Antigens | Natural Immune System(nonspecific) |
| where are the defensive cells, proteins and chemicals of innate(natural) immune sys. located? | In the blood |
| when there is damage to tissue due to trauma, infection, or chemicals what occurs? | there will be swelling, redness, & warmth at the site do to chemicals being sent to the site of injury |
| when chemicals are sent to the affected site what occurs? | blood flow increases to site, and upstream blood vessels dilate causing warmth and redness |
| what other event occurs from chemicals being sent to the site of injury? | vasoconstriction of downstream blood vessels occurs and causes swelling and pain |
| What is it called when there is redness, swelling and pain due to injury to the tissue called? | Inflammatory response |
| What are Complement Sys. Proteins? | these are protective protein enzymes that that implant themselves in the membrane of the attacking microbe as a result of initiation of the Inflammatory response |
| what is needed for distruction of microbe? | break in cell wall-due to presence of complement-binding sites after they attach to antigens; flow of Na and water into microbe cell which causes swelling and bursting of microbe. |
| what are foreign agent that enter the body called? 216 | Antigens |
| which Systems play a major part in the Immune Response? | Lymphatic sys. , Thymus, Spleen, Lymph Nodes, Bone Marrow, & the Peyer's Patches located in the small Intestine. |
| what triggers the Immune Rspone in the body? | when the body recognizes something as foreign or nonself. |
| What is it called when the body does not exhibit the right respone to foreign objects? | Immune Deficiency 216 |
| What is it called when the body exhibits a defective cellular immune respone to it own cells and tissues and makes antibodies against itself? | Autoimmune Disease |
| what can cause the body to have no immune response? | Massive Trauma and Chronic illnesses |
| What is produces when the body detects a foreign substance is present? | a protein called an Antibody |
| what is the 1st immediate immune respone called when these proteins are made?217 | A Humoral Response(any fluid or semifluid) |
| what is the 2nd delayed immunity response called that uses sensitized Lymphocytes to attack bacteria and virus called? | Cell-mediated Response |
| what are the kinds of living Antigens? | cells of bacteria, viruses, fungi, infectious organisms and the toxins they produce |
| what are the nonliving kinds of Antigens? | pollen, dust, chemicals in deterents and some foods |
| what 2 cells are needed for a normal Immune Response? | T cells and B cells 217 |
| what must happen 1st before B cells can become Plasma and Memory cells | they must 1st interact with helper T cells |
| What controls the amount of Antitbody that B cells make? | the suppressor T cells |
| which lymphocytic cells aid in the Humoral Immunity and make Antibodies? where do they come from? | Lymphocytic B cells; stem cells in the bone marrow |
| What do Lymphocytic B cells secrete in response to comming in contact with Antigens? what is this resonse called? | make immunoglobulins called Antibodies; antibody-mediated or Humoral Immunity(Primary)217 |
| what happens to the antigen stimulated B cells | some of the B cells become memory cells and will later reactivate the plasma cells if they incounter the same type of antigen a 2nd time |
| these proteins are made by plasma cells and form a bond with specific Antigens? | Antibodies also called Immunoglobulins(5 classes) |
| These proteins are found in the serum of blood,urine, saliva, tears, breast milk, interstitial fluid, lymph nodes and in the spleen | Anitbodies |
| how do antibodies prepare the antigen for ingestion by Phagocytosis? | it causes Lysis in which the antibody breakes the membrane on the antigen cell causing it to rupture , thus allowing its inner contents to be digested. |
| this antibody is cabable of neutralizing a poisonos(toxin) chemical made by the bacteria or viral cell | Antitoxin |
| what happens when the bacterium or Antigen enters the body? | it meets w/B Lymphocyte, lymphocyte becomes plasma cell and secretes IgM(antibody) |
| what is the time frame for which a B lymphocyte can make immunoglobulin to attack the bacterium after the 1st incounter? | takes 4-8 days(1-2days for 2nd encounter) |
| what is the primary function of the humoral Anitgen-antibody response? | protection against Acute rapidily growing bacteria and viral diseases; also for Allergies and transfusion reactions. |
| the secondary cellular response occurs where? what cells does it involve? | occurs out in the tissues, T Lymphocytes |
| the cells(see above question) that provide secondary cellular immunity(cell-mediated) pass through which organ | T Lymphocytes pass through the Thymus then on to lymph tissue and from there to all parts of the body(where they encounter and destroy specific foreign Antigen). |
| which cells provide defense against viral Infections? | T cells; 4 groups(killer t cells, helper t cells, supressor t cells, memory t cells) |
| why are viruses so difficult to get rid of? | because they inject themselves into the host cells and reproduce themselves. |
| how do T cells workd? | they respond to foreign or abnormal molecules on the surface of the cell |
| what are Lymphokines? | these are substances made by T cells and Macrophages that help destroy foreign Antigens. |
| what are the 2 Lymphokines that secrete chemicals into the membrane of the target cell and kill the Antigen(called killer activity)219? | Interleukin-2 & T-cell growth factor |
| where are the complement proteins, that work with antibodies to destroy Antigens made? | made in the Liver |
| The T Lymphocyte cells are defensive cells that guard or watch over what? | potrol the blood and the tissues |
| what must a transplant patient have inorder for the tissue from the donor not be rejected. | pt needs to have similar surface antigens as the donor or host tissue |
| 2 kinds of Immunity to specific disease are? | Innate(natural), Acquired(adaptive immunity) |
| this immunity is present at birth | innate immunity |
| this immunity is acquired from actively making antibodies when the body has been exposed to pathogens | Acquired immunity |
| this immunity is passed from mother to baby | passive (natural) immunity |
| how are antibodies passed to baby? | passed in utero(when blood from mothers bloodstream passes through placenta & mixes with fetus blood) or after birth in breast milk |
| what will limit the benefit of passive natural immunity to the baby? | if the mother has a depressed Immune system function |
| what is used to boost the immune system in humans? | Human immune globulin(gamma globulin) |
| Human immune globulin(gamma globulin)contains what? | antibodies that protect against many infectious diseases |
| how is the antitoxin against Tetanus prepared? | by getting serum from the blood of a horse that has had increasinly strong injection of the antigen for tetanus. |
| why should injections that provide passive injections be given as early as possible? | because they provide protection against further tissue damage , but don't protect against damage already done.(only good for a specific time frame) |
| this immunity occurs when person contracts disease and survives it | Active naturally Acquired Immunity |
| this immunity occurs when person is given an vaccination or immunization? | Active Artificial Acquired Immunity(pathogenic microorganism is grown in lab and the Attenuated-weakened, or killed to simulate production of antibodies)(short lived, will need booster) |
| name one of the resons why there may be a alteration in immune function that is not caused by pathogenic factors? | these dysfunctions may be a result of Iatrogenic or conditions caused by a particular treatment(of a disease or condition) |
| examples of therapies that suppress or attenuate the body's natural immune response? | treatment of Asthma, inflammatory disorders, autoimmune disorders and organ transplants |
| why is the helpful effect of supressing the primary conditions of a disorder bad for patients in the long run? | because it makes the patient more succeptible to infections and hinders the body's ability to fight infections |
| why is the elderly patient at risk for immune problems? | they have decreased nutrutional intake, are prone to chronic illiness, and are closer to other that can pass their illness to them |
| What initiates the Immune Response? | Inflammation( supressing this respone by using OTC meds like pain pills can hinder the body's ability to fight infection) |
| Alcohol does what to the body's ability to launch an Immune Response? | it impairs ability of B Lymphocytes to make antibodies, can affect T-cell activity; alters Liver function and impair nutrition, also altering Immune function. |
| Which patients are considered Immunocompromised until proven otherwise? | those that are chronic substance abusers |
| what is an primary intervention the nurse may practice in reguards to public health? | they can provide education in reguards to importance of immunizations. |
| under what circumstance would immunizations need to be postponed? | if patient has a fever, is pregnant, immune deficient, taking immunosupressive therapy, has gotten serum ummune globulin, plasma or whole blood transfusion 6-8 wks before needed nimmunization. |
| what should be done before giving immunization shots? | ensure as far as possible that patient isn't allergic or hypersensitive to the components of the agent:usually made from chicken embroys,horse serum. |
| whic Immunizing agents are most often known to produce an anaphylaxis reaction in patients? | Tetanus antitoxin, Diptheria antitixin, rabies antitixin, and Antilymphocyte globulin |
| which common food or spice/herb is know to assist in the Immune respone? | Garlic, patients on Anticoagulants need to know that it can prolong or extend the action of the meds they are taking. |
| why are skin test done before giving any serum systemically? | this test will show if there will be a local reaction to a minute amout of immunizating agent. if there is a rxn , chances are there will be a more severe reaction if agent is given systemically |
| what precautions should be taken when administering immunizations? | keep pt in dr office for 15-20 min post immunization, and have available emergency equipment ready and at hand to treat any reaction that present |
| Signs & Symptoms of Immune deficiency or a depressed or inadequate immune response?223 | pt has known infection but exhibits no signs or symptoms; pt has recurrent infections or infection of common organisms to which individuals with normal immune systems are not usually susceptilbe. |
| what should be included in history of patient that is suspected of having immune deficiency? | sexual history, diases affcting Immune sys., allergies, nutritional status, smoking history and exposure to enviromental pollutants |
| Key thing to check when doing physical assessment of immune deficient patient? | ck skin for any potential entry ways for organisms(be sure to asses areas that have cathers,tubes, or other medicaldevices that bypass the skin barrier(palpate lymph nodes for swelling and tenderness, which indicate that the immune response is activated |
| 2 test used to measure immunity and identify those people witha dormant infection disease? | Schick test(for Diptheria), Mantoux test( for TB) |
| what is a scratch or prick test? | skin test for indentifying allergens |
| what lab test are done on blood and serum that tell the status of the immune system? | CBC(circulating WBC's), Differential(% of total WBC count is accounted for by different cells) |
| Immuunoscintigraphy | procedure that injects radioactive isotope tagged antibodies into the bloodstream. the isotopes emitt gamma rays that can be picked up by imaging equipment. |
| what are the other test used to evaluate the Thymus gland and other tissue structures of the Immune sys.? | CT scan, MRI, PET positron emission tomography. |
| what are a few Nursing interventions for caring for a patient with Immune issues? | used methods to prevent further infection, use strict standard precautions like hand washing, may need to use protective isolation, promote adequate balance nutrition, stress reduction |
| how can you tell if expected outcomes for patient with immune issues are working? | check physical data, look at lab values, ck temp and vital signs, ck patient general wellness |
| what is the normal immune response to infection and why is it helpful? | respone will be a Fever and it is helpful because it helps the body fight off the invaders by promoting a hostile enviroment in which they won't be able to thrive |
| what are the positive and negative effects of decreasing a patients fever? | +it makes the patient more comfortable ,-it may decrease the effectiveness of the body's efforts to eliminate microorganisms. |
| Hyperpyrexia | excessive high fever, it is treated with Antipyretics and cooling measures. |
| when trying to decrease body temp what is contrindicated and why? | Sponging patient with cold water, because it will cool th body to quickly and will induce shivering which will in turn drive the body temp right back up |
| when trying to lower the body temp where can ice bag(wraped in cloth) be placed to help decrese the temp? | Place in the arm pits and the groin areas because there is good blood circulation there that will decrease the total core temp of the body. |
| what is the ideal treatment of fever? | address the cause of the fever |
| what is used to treat allergic inflammatory responses? | Corticosteroids |
| what are the anti-inflammatory meds used to lower the body temp.? | Aspirin, Ibuprofen, and acetaminophen |
| what is the condition that often accompanies fever, infection, and the use of antibiotics when patients are sick? | Anorexia-alteration in desire for food |
| why is it important for sick patients to have adequate fluids when sick? | because there is a increase in cellular metabolism that uses more water than under mormal circumstances. |
| which patients are immunosupressed either from the disease process or the treatment of the disease itself? | pt's using Corticosteroids for Asthma or following organ transportation; those with Diabetes or patient on chemotherapy. |
| which patients need additional precautions to control infection? | those patients that have neutropenia(less than normal amounts of white blood cells) |
| what are the types of isolation used for Neutropenia patients? | Reverse, protective, and neutropenia precautions |
| what foods are restricted for immunosupressed patients? | fresh veggies, fruit and flowers |
| what are additional precautions used to prevent tr amission of potentially infective agents to patients that are immunosupressed? | use of postive air flow, cking water purity, and monitoring air conduits for presence of microorganisms. |
| 214- where do the B-lymphocytes made and mature? | in bone marrow |
| where do the T-lymphocytes matures and where are they released? | mature in the Thymus gland and from there are released into the the bloodstream |
| lymph nodes and vessels circulate what fluids? | fluid called Lymph which contains proteins, glucose, monocytes and lymphocytes |
| which lymph tissues guard the airway from inhaled microbes? | the tonsils and the adenoids |
| which organ filters blood and filters out damaged or old red blood cells, recycling the hemoglobulin in the production of bilirubin? | the Spleen |
| what is the lymphoid tissue that is located in th small intestine and helps defend againsts ingested pathogens called? | the Peyer's Patches |
| what are the 2 things that work in the Hemotalogic system that assists the immune sys by using phagocytosis when an antigen enters the body? | they are the Neutorphils and Macrophages |
| where does humoral and cellular immunity carried out and which type of cell does the work? | takes place in the specialized white blood cells that start in the bone marrow, they are the lymphocytic cells |
| which Immunoglobulin makes up 75-85% of total voulme | IgG which is the major antibody in primary and secondary immune responses, it inactivates antigens,makes up 5-10 % of totla volume |
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Created by:
VRoberts
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