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Transcript
Chapter 55 Care of the Patient with an Immune Disorder 1 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 1 Nature of Immunity Functions of the immune system 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 3 1 Nature of Immunity Inappropriate responses of the immune system Hyperactive response (allergy) Immunodeficiency disorders (AIDS) Autoimmune disorders (systemic lupus erythematosus) erythematosus) Attacks foreign tissue (organ transplant rejection or transfusion reaction) Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 6 2 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. Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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. Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 9 3 HELPER TT-CELLS ATTACK SPECIFIC CELLS, CANCER CELLS AND VIRUSES. T-CELLS WILL TRIGGER MACROPHAGES AND WBC’ WBC’S TO A SITE Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 10 REVIEW B-CELLS ARE RESPONSIABLE FOR ANTIBODY IMMUNITY TO BACTERIA T-CELLS PROVIDE CELLCELL-MEDIATED IMMUNITY AGAINST VIRUSES AND CANCER CELLS Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 11 Complement System The complement system can destroy the cell membrane of many bacterial species, and this action attracts phagocytes to the area Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 12 4 Genetic Control of Immunity There is a genetic link to both wellwelldeveloped immune systems and poorly developed or compromised immune systems Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 15 5 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 18 6 Disorders of the Immune System Hypersensitivity (continued) Medical management/nursing interventions Symptom management: antihistamines Environmental control: avoidance of the allergen Immunotherapy Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 19 Disorders of the Immune System Anaphylaxis Etiology/pathophysiology Etiology/pathophysiology System reaction to allergens 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 21 7 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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) Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 23 Disorders of the Immune System Primary immunodeficiency disorders B-cell deficiency T-cell deficiency Combined BB-cell and TT-cell deficiency Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 24 8 Disorders of the Immune System Secondary immunodeficiency disorders DrugDrug-induced immunosuppression Stress Malnutrition Radiation Surgical removal of lymph nodes, thymus, or spleen Hodgkin’ Hodgkin’s disease Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. 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 Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 26 The 4 R’ R’s of the Immune Response RECOGNIZE RESPOND REMEMBER REGULATE Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 27 9 Class is excused Move immediately to a faucet and wash your hands vigorously Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 28 10