1. 1. Prepared by :- Taghreed Hamza hawswi BSN-RN CPR instructor, TOT trainer Master student 1st year Management for Immune Defense
2. 2. L E A R N I N G O B J E C T I V E S By the end of the lesson the learner will be able to define The immune defense & immunodeficiency By the end of the lesson the learner will be able to describe the process of body defense against disease By the end of the lesson the learner will be able to enumerat the line of defense mechanism
3. 3. L E A R N I N G O B J E C T I V E S By the end of the lesson the learner will be able to Differentiate between (primary & secondary ) case of Immunodeficiency disease By the end of the lesson the learner will be able to demonstrate nursing management for patient with Immunodeficiency disease
4. 4. Introduction Throughout life, the human body can be invaded by many disease-causing organisms such as bacteria, viruses, fungi and parasites. Collectively, these are known as pathogens and can trigger a specific immune response. Other substances that may trigger such a response include chemicals from the environment, pollen grains or foreign tissue cells.
5. 5. Introduction Any substance that stimulates a specific immune response is called an antigen . This topic explores how the immune system protects the body from harmful antigens and how the latest medical technology is used in the production of vaccines .
6. 6. Section 1 Immune Defense
7. 7. 5 minute
8. 8. Definition Immune defense is the coordinated, complicated interplay of cellular mechanisms and antibodies to fight disease-causing agents, including viruses, bacteria, and other types of infection.
9. 9. Function of Immune system To protect the body from harmful substances, such as pathogens and environmental pollutants.
10. 10. Nonspecific External Barriers skin, mucous membranes If these barriers are penetrated, the body responds with Innate Immune Response phagocytic and natural killer cells, inflammation, fever If the innate immune response is insufficient, the body responds with Adaptive Immune Response cell-mediated immunity, humoral immunity Defense Against Disease
11. 11. Lines of defense The immune system provides three lines of defense. The first and second lines of defense of the human body are nonspecific immune responses The third line of defense, immune system, reacts in specialized ways for various invaders
12. 12. Non-specific defenses are designed to prevent infections by viruses and bacteria. These include: Intact skin Mucus Cilia The Defense
13. 13. Role of skin Dead skin cells are constantly sloughed off, making it hard for invading bacteria to colonize. Sweat and oils contain anti-microbial chemicals, including some antibiotics.
14. 14. Mucus contains lysozymes, enzymes that destroy bacterial cell walls. The normal flow of mucus washes bacteria and viruses off of mucus membranes. Cilia in the respiratory tract move mucus out of the lungs to keep bacteria and viruses out. Role of mucus and cilia
15. 15. Role of phagocytes Phagocytes are several types of white blood cells (including macrophages and neutrophils) that seek and destroy invaders. Some also destroy damaged body cells. Phagocytes are attracted by an inflammatory response of damaged cells.
16. 16. Role of inflammation Inflammation is signaled by mast cells, which release histamine. Histamine causes fluids to collect around an injury to dilute toxins. This causes swelling. The temperature of the tissues may rise, which can kill temperature-sensitive microbes.
17. 17. Third line of defense Specific defenses are those that give us immunity to certain diseases. In specific defenses, the immune system forms a chemical memory of the invading microbe. If the microbe is encountered again, the body reacts so quickly that few or no symptoms are felt.
18. 18. Antibodies Antibodies are assembled out of protein chains. There are many different chains that the immune system assembles in different ways to make different antibodies.
19. 19. Antigen recognition Cells of the immune system are trained to recognize self proteins vs. not self proteins. If an antigen (not self) protein is encountered by a macrophage, it will bring the protein to a helper T-cell for identification. If the helper T-cell recognizes the protein as not self, it will launch an immune response.
20. 20. Role of Antibodies Antibodies released into the blood stream will bind to the antigens that they are specific for. Antibodies may :- 1- Disable some microbes 2-Cause them to stick together (agglutinate). 3- They tag microbes so that the microbes are quickly recognized by various white blood cells.
21. 21. How vaccines work Modern vaccines are created from killed bacteria or viruses, or fragments of proteins from these microbes. 1- The proteins are recognized as antigens by our immune systems. 2-This causes a mild immune response. 3-Memory T-cells and B-cells remain ready to fight off the illness if it is encountered again.
22. 22. How antibiotics work 1- Antibiotics help destroy bacteria (but not viruses). 2- Slowing bacteria reproduction. 3- Interfering with bacterial cell wall formation.
23. 23. Medical science has created to systems for augmenting the human immune system: Antibiotics (NOT the same as antibodies) Vaccines Medical Management
24. 24. Section 1
25. 25. Immunodeficiency defined Decreased or compromised ability to respond to antigenic stimuli by appropriate cellular immunity reaction. May be secondary to loss of immunoglobulin's or an abnormality of B or T cell lymphocytes
26. 26. Immunodeficiency Primaryinborn errors. Can affect lymphocytes, phagocytes, complement system SecondaryMore common and may be related to underlying diseases or the treatment of these diseases.
27. 27. Causes of secondary immunodeficiency Malnutrition Burns Uremia Diabetes mellitus Immunotoxic medications Self-medication of recreational drugs and alcohol AIDS
28. 28. Section 3 Nursing Management
29. 29. Nursing Management for Patient with Immunodeficiency in general Assess for infection 1. Fever 2. White patches in oral cavity 3. Adenopathy 4. Persistent diarrhea 5. Frequency, urgency or pain upon urination 6. Redness, drainage or swelling of skin lesions 7. Persistent vaginal discharge 8. Cough with or w/o sputum
30. 30. Monitor lab values 1. Sputum 2. Urine 3. Blood cultures 4. CBC Monitor vital signs, weight
31. 31. Nursing Assessments Identification of risky sexual practices, drug use (IV) Physical assessment Respiratory status Nutritional status Skin integrity Neurologic status Fluid and electrolyte balance Knowledge level
32. 32. Nursing Diagnoses 1-Diarrhea related to enteric pathogens or HIV infection 2- Risk for infection related to immunodeficiency 3- Ineffective airway clearance related topneumocystis pneumonia (PCP), increased secretions, decreased ability to cough 4- Imbalanced nutrition, less than body requirements 5- Social isolation related to stigma of disease, fear of infecting others
33. 33. Nursing Interventions Improving airway clearance Preventing infections Maintaining thought processes Improving activity tolerance Promoting skin integrity Promoting usual bowel patterns Relieving pain and discomfort Improving nutritional status
34. 34. Nursing Interventions Decreasing sense of isolation Coping with grief Monitoring and managing potential complications-respiratory failure, cachexia, side effects of medications Teach self-care
35. 35. Evaluation Maintains effective airway Maintains usual level of thought processes Resumes usual bowel habits Maintains skin integrity Experiences no infections Maintains adequate level of activity tolerance Maintains adequate nutritional status Progresses through grief process Remains free of complications
36. 36. Summary Viruses and bacteria are everywhere. Some of them want to invade our body. Our body defend itself against viruses and bacteria.
37. 37. Brunner, L., Smeltzer, S., & Bare, B. (2010). Hand Book for Brunner & Suddarths textbook of medical-surgical nursing. Retrieved from http://books.google.com/books?hl=en&lr =&id=SmtjSD1x688C&oi=fnd&pg=PA131 1&dq=Brunner+%26+Suddarth%27s+Te xtbook+of+Medical- Surgical+Nursing&ots=cii4p83QfO&sig= 3-niIms8D7CobiuLjIICoTeTKY8
38. 38. http://www.presentermedia.com/powerpoint-templates/templates/on- the-red-carpet/16565-ppt.html