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Chapter 55
Care of the Patient with an
Immune Disorder
1
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Slide 1
Nature of Immunity
 Functions of the immune system
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Protect against invading organisms
Removing damaged cells from the circulation
Serve as a surveillance network for
recognizing and guarding against the
development and growth of abnormal cells
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc.
Slide 2
Nature of Immunity
 Immununity competence
 The immune system responds appropriately
to a foreign stimulus
 Immunity
 The quality of being unaffected by a particular
disease or condition
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Slide 3
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Nature of Immunity
 Inappropriate responses of the immune
system
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Hyperactive response (allergy)
Immunodeficiency disorders (AIDS)
Autoimmune disorders (systemic lupus
erythematosus)
erythematosus)
 Attacks foreign tissue (organ transplant
rejection or transfusion reaction)
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Slide 4
Nature of Immunity
 Innate (natural) immunity
 First line of defense
 Provides PROTECTION to invading
pathogens
 Composed of the skin, mucous membranes,
cilia, stomach acid, tears, saliva, sebaceous
glands, and secretions and flora of the
intestines and vagina
 NonNon-specific immunity
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Slide 5
Nature of Immunity
 Adaptive (acquired) immunity
 Second line of defense
 Protects the internal environment
 Composed of thymus, spleen, bone marrow,
blood, and lymph
 Produces antibodies in the cells after an
infection or vaccination
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Slide 6
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Figure 5555-3
(From Thibodeau, G.A., Patton, K.T. [1996]. Anatomy and physiology. [3rd ed.]. St. Louis: Mosby.)
Origin and processing of B and T cells.
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Slide 7
Nature of Immunity
 Macrophages (phagocytes)
 Engulf and destroy microorganisms that pass
the skin and mucous membrane
 Carry antigen to the lymphocytes
 Lymphokine
 One of the chemical factors produced and
released by T cells that attracts macrophages
to the site of infection or inflammation
 Antigen
 A substance recognized by the body as
foreign that can trigger an immune response
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Slide 8
B-CELLS
 B-CELLS PRODUCE ANTIBODIES IN
LARGE NUMBERS THAT ATTACK
BACTERIA
 MEMORY BB-CELLS PROVIDE THE
RECOGNITION OF THE PREVIOUS
BACTERIA INVADER.
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Slide 9
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HELPER TT-CELLS
 ATTACK SPECIFIC CELLS, CANCER
CELLS AND VIRUSES.
 T-CELLS WILL TRIGGER
MACROPHAGES AND WBC’
WBC’S TO A SITE
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Slide 10
REVIEW
 B-CELLS ARE RESPONSIABLE FOR
ANTIBODY IMMUNITY TO BACTERIA
 T-CELLS PROVIDE CELLCELL-MEDIATED
IMMUNITY AGAINST VIRUSES AND
CANCER CELLS
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Slide 11
Complement System
 The complement system can destroy the
cell membrane of many bacterial species,
and this action attracts phagocytes to the
area
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Slide 12
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Genetic Control of Immunity
 There is a genetic link to both wellwelldeveloped immune systems and poorly
developed or compromised immune
systems
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Slide 13
Effects of Normal Aging on the
Immune System
 Aging causes a decline in the immune
system
 Higher incidence of tumors
 Greater susceptibility to infections
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Slide 14
Immune Response
 Immunization
 A controlled exposure to a diseasedisease-producing
pathogen which triggers antibody production
and prevents disease
 Provides protection for months to years
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Slide 15
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Immune Response
 Immunotherapy
 Treatment of allergic responses that involves
administering increasingly large doses of the
offending allergens to gradually develop
immunity
 Preseasonal,
Preseasonal, coseasonal,
coseasonal, or perennial
 Severe side effect: anaphylaxis
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Slide 16
Immune Response
 Hypersensitivity
 An abnormal condition characterized by an
excessive reaction to a particular substance
 Hypersensitivity reaction
 Harmless substances such as pollens,
danders,
danders, foods, and chemicals are recognized
as foreign
 Exposures may occur by inhalation,
ingestion, injection, or touch
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Slide 17
Disorders of the Immune
System
 Hypersensitivity (continued)
 Clinical manifestations/assessment
 Pruritus
 Nausea
 Sneezing
 Excessive nasal secretions and tearing
 Inflamed nasal membranes
 Skin rash
 Diarrhea
 Cough; wheezes; impaired breathing
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Slide 18
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Disorders of the Immune
System
 Hypersensitivity (continued)
 Medical management/nursing interventions
 Symptom management: antihistamines
 Environmental control: avoidance of the allergen
 Immunotherapy
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Slide 19
Disorders of the Immune
System
 Anaphylaxis
 Etiology/pathophysiology
Etiology/pathophysiology
 System reaction to allergens
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Venoms
Drugs—
Drugs—penicillin
Contrast media dyes
Insect stings
Foods
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc.
Slide 20
Disorders of the Immune
System
 Anaphylaxis (continued)
 Medical management/nursing interventions
 Epinephrine
 Benadryl
 IV access
 Oxygen
 Teaching: avoid allergen; use medicmedic-alert ID;
administration of epinephrine
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Slide 21
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Disorders of the Immune
System
 Latex allergies
 Allergic reaction when exposed to latex
products
 Caused by the chemicals used in the
manufacturing process of latex gloves
 Dryness; pruritus;
pruritus; fissuring and cracking of
the skin followed by erythema,
erythema, edema, and
crusting
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Slide 22
Disorders of the Immune
System
 Immunodeficiency
 An abnormal condition of the immune system
 May cause recurrent infections, chronic
infections, severe infections, and/or
incomplete clearing of infections
 Can be induced (chemotherapy)
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Slide 23
Disorders of the Immune
System
 Primary immunodeficiency disorders
 B-cell deficiency
 T-cell deficiency
 Combined BB-cell and TT-cell deficiency
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Slide 24
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Disorders of the Immune
System
 Secondary immunodeficiency disorders
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DrugDrug-induced immunosuppression
Stress
Malnutrition
Radiation
Surgical removal of lymph nodes, thymus, or
spleen
 Hodgkin’
Hodgkin’s disease
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Slide 25
Autoimmune Disorders
 Autoimmune
 The development of an immune response
to one’
one’s own tissues
 Body is unable to distinguish “self”
self” protein
from “foreign”
foreign” protein
 Examples of disorder: pernicious anemia;
GuillainGuillain-Barré
Barré syndrome; scleroderma;
systemic lupus erythematosus
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Slide 26
The 4 R’
R’s of the Immune Response
 RECOGNIZE
 RESPOND
 REMEMBER
 REGULATE
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Slide 27
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Class is excused
 Move immediately to a faucet and wash
your hands vigorously
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Slide 28
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