chapter 15 care of the patient with an immune disorder mosby, inc. items and derived items...
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Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc. Immunity Quality of being insusceptible to or unaffected by a particular disease or condition – Innate (natural) – body’s first line of defense provides physical and chemical barriers to invading pathogens and protects against the external environment – Adaptive (acquired) – body’s second line of defense provides a specific reaction to each invading antigen and can remember the antigen causing the attackTRANSCRIPT
Chapter 15
Care of the Patient with an Immune Disorder
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Care of the Patient with an Immune Disorder In response to attack, the body exhibits a wide array
of adaptations designed to provide a defense and protect the body from external and internal harmful agents
The immune system has three functions:– Protect the body’s internal environment against
invading organisms– Maintain homeostasis by removing damaged cells
from the circulation– Serve as a surveillance network for recognizing and
guarding against development and growth of abnormal cells
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Immunity Quality of being insusceptible to or
unaffected by a particular disease or condition– Innate (natural) – body’s first line of
defense provides physical and chemical barriers to invading pathogens and protects against the external environment
– Adaptive (acquired) – body’s second line of defense provides a specific reaction to each invading antigen and can remember the antigen causing the attack
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Effects of Aging on the Immune System Decline in the immune system High incidence of tumors in older adults Greater susceptibility to infections such
as influenza and pneumonia Bone marrow is relatively unaffected Delayed hypersensitivity response is
frequently decreased or absent, results in an increased risk of cancer mortality
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Immune Response There are two ways of assisting the body
to develop immunity:– Immunization – controlled exposure to
a disease-producing pathogen develops antibody production while preventing disease
– Immunotherapy – a special treatment of allergic responses that administers increasingly large doses of the offending allergens to gradually develop immunity
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Origin and Processing of B & T Cells
(Figure 15-3)
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Failure of the Immune Response Severity of altered immune response disorders
range from mild to chronic to life threatening:– I – Hypersensitivity disorder – involves
allergic response and tissue rejection– II – Immunodeficiency disease – involves
altered and failed immune response– III – Autoimmune disease – involves
extensive tissue damage resulting from an immune system that seemingly reverses its function to one of self-destruction
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Hypersensitivity Disorder Hypersensitivity disorder – involves allergic
response and tissue rejection– Treatment:
Symptom management with medications Environmental control Immunotherapy
– Nursing Diagnosis Risk for injury, related to exposure to allergen Activity intolerance, related to malaise Risk for infection, related to inflammation of
protective mucous membrane
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Hypersensitivity Disorder Anaphylaxis or Systemic Reaction
– Most severe allergic reaction - reaction may be fatal very rapidly within seconds to a few minutes
Transfusion reaction– Hypersensitivity to mismatched blood
Delayed Hypersensitivity– Reactions may occur 24 – 72 hours after exposure
Transplant Rejection– Immune response to foreign protein
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Immunodeficiency Disease Immunodeficiency disease – involves altered
and failed immune response– Primary immunodeficiency –
Phagocytic B cell deficiency T cell deficiency Combined b cell and t cell deficiency
– Secondary immunodeficieny Drug – induced (most common) treatment for
prevention of transplant rejection Stress, hypofunctional state, malnutrition, radiation,
Hodgkin’s
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Autoimmune Disease Autoimmune disease – involves
extensive tissue damage resulting from an immune system that seemingly reverses its function to one of self-destruction– Unknown reasons – immune cells that
are normally unresponsive (tolerant to self-antigens) are activated
– Rheumatoid arthritis
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Nursing Diagnoses Risk for injury,
related to exposure to allergen
Activity intolerance, related to malaise
Risk for infection, related to inflammation of protective mucous membranes
Breathing patterns, ineffective, related to edema, bronchospasm and increase secretions
Cardiac output, decreased, related to increased capillary permeability and vascular dilation