Download Immunity

IMMUNITY
RNSG 2572
Health Care Concepts 2
Concept – IMMUNITY
Concept Definition
A physiologic process that provides an individual with protection or defense from disease.
Exemplars
Vaccines
Otitis Media
Urinary Tract Infection
Cellulitis
Pneumonia
Appendicitis
Trauma-Sprain
Objectives
Part 1 – Alterations in Immunity Exemplars
1. Explain the correlation between otitis media, urinary tract infection, cellulitis,
pneumonia, appendicitis, and trauma-sprain and the concept of Immunity (including
compromised antecedents, deficit measurement in attributes, a list of negative
consequences, and the interrelated concepts which may be involved).
2. Identify conditions that place an individual at risk for imbalance leading to
compromised Immunity resulting in otitis media, urinary tract infection, cellulitis,
pneumonia, appendicitis, and trauma-sprain.
3. Apply the nursing process with collaborative interventions for individuals
experiencing otitis media, urinary tract infection, cellulitis, pneumonia, appendicitis,
and trauma-sprain.
Part 2 – Immunizations (Vaccines)
1. Correlate the administration of Immunizations (Vaccines) to the concept of
Immunity to include:
a. A description of the antecedents of active and passive immunity
b. The promotion of attributes of immunity by immunizations,
c. The positive outcome of protection from microorganisms with
immunizations
d. The relationship of the subconcepts of Immune response and Infectious
response with immunizations.
2. Identify conditions that place an individual at risk for a compromise in immunity that
can be resolved with immunizations.
3. Apply the nursing process with collaborative interventions for individuals receiving
immunizations.
Concept Analysis Diagram
Note: Diagram on separate page
Explanation of Immunity Diagram:
The Immunity Concept Analysis Diagram begins with the definition of the concept, as
based on the attributes and antecedents. The attributes - normal WBC and differential counts,
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IMMUNITY
negative bacterial and viral cultures, soft, non-tender lymph nodes, recognition of self and
recognition of foreign proteins - are the defining characteristics of immunity or what
constitutes immunity. The antecedents are events or incidents that must be in play in order for
immunity to exist. The antecedents for immunity consist of intact non-specific defenses or
barriers, a functional lymphatic system, an optimal innate immune response, a functional
inflammatory response, and appropriate adaptive (acquired) immune response—active and
passive. With these attributes and antecedents, immunity is a physiologic process that provides
an individual with protection or defense from disease.
There are interrelated concepts that impact immunity throughout the lifespan. These
interrelated concepts include tissue integrity, cellular regulation, thermoregulation, comfort,
coping, nutrition, mobility and functional ability. There are also sub-concepts that are major
components of the immunity concept – inflammatory response, infectious response, and
immune response. The sub-concepts are manifested when immunity is challenged.
Consequences, positive or negative, are reliant upon the performance of the immune
system. If any of the antecedents fail, for example, the result would be a negative outcome,
such as infection-localized or systemic, cancer, immune suppression, immune deficiency, and
chronic inflammatory response or exaggerated immune response that may lead to an allergic,
cytotoxic or autoimmune reaction. If the immune system is healthy, positive outcomes will
result; in that, damaged tissue and cells are replaced with repaired or functional tissue (i.e.,
healing), recognition and removal of cell mutations that have demonstrated abnormal cell
growth and development is effected, and protection of the body from invasion of
microorganisms and other antigens occurs.
Last, but not least, nursing care may or may not be required, as indicated by the dotted
directional lines on the diagram. Nursing care may/may not be needed to keep immunity intact,
or assist with negative consequences.
Assignments
Prior to class:
1. Review definitions of inter-rated concepts on concept analysis diagram.
2. Review concept analysis diagram.
3. Review the following content from previous courses
 Immunity Concept Analysis Diagram
 Oxygenation Concept Analysis Diagram
 Gas Exchange Concept Analysis Diagram
 Tissue Integrity Concept Analysis Diagram
 Thermoregulation
4. Assigned reading:
 Giddens, J.F. (2013). Concepts for nursing practice. St. Louis. MO: Mosby
Elsevier.
 Chapter 20: Immunity
 Chapter 22: Infection
 Lewis, S.L., Heitkemper, M.M., Dirksen, S.R., O’Brien, P.G., & Bucher, L.
(2011). Medical surgical nursing (8th ed). St. Louis: Mosby Elsevier.
 Chapter 24: Integumentary Problems; Cellulitis; pg. 454
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
Chapter 22: Visual and Auditory Problems; Otitis Media; pg.
425-426
 Chapter 28: Lower Respiratory Problems; Pneumonia; pg. 546553.
 Chapter 43: Lower Gastrointestinal Problems; Appendicitis;
pg. 1020-1022
 Chapter 46: Renal and Urologic Problems; Urinary Tract
Infection; pg. 1122-1127
 Chapter 63: Musculoskeletal Trauma and Orthopedic Surgery;
Sprain; pg. 1584-1586
 McKinney, E, James, S., Murray, S., Nelson, K., & Ashwill, J. (2013).
Maternal-child nursing (4th ed). St. Louis: Elsevier Saunders.
 Chapter 41: The Child with an Infectious Disease; pg. 10071028
 Chapter 45: The Child with a Respiratory Alteration; Otitis
Media; pg. 1151-1156
5. Internet Resources:
Otitis Media
 http://www.mayoclinic.com/health/ear-infections/DS00303
Urinary Tract Infection
 http://www.cdc.gov/ncidod/dbmd/diseaseinfo/urinarytractinfecti
ons_t.htm
Cellulitis
 http://www.medicinenet.com/cellulitis/article.htm
 http://www.bing.com/images/search?q=cellulitis&qpvt=cellulitis
&FORM=IGRE
Pneumonia
 http://www.lung.org/lung-disease/pneumonia/
Appendicitis
 http://digestive.niddk.nih.gov/ddiseases/pubs/appendicitis/
Immunizations
 CDC: 2013 Combined Immunization Schedule Birth through 18
Years
http://www.cdc.gov/vaccines/schedules/downloads/child/018yrs-schedule.pdf
 Adult Immunization Schedule 2013
http://www.cdc.gov/vaccines/schedules/hcp/adult.html
 Overview of VAERS (Vaccine Adverse Effects Reporting System)
http://www.youtube.com/watch?v=a9bXB3R2qP8&feature=yout
u.be
6. Review the following Nursing Diagnoses:
Otitis Media
 Pain
 Hyperthermia
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 Fatigue
 Deficient knowledge
Urinary Tract Infection
 Pain
 Impaired urinary elimination
 Deficient knowledge
 Ineffective health maintenance
Trauma—sprain
 Acute Pain
 Impaired physical mobility
 Deficient knowledge
Pneumonia
 Ineffective breathing pattern
 Ineffective airway clearance
 Impaired gas exchange
 Activity intolerance
 Anxiety
 Sleep disturbance
 Acute pain
Cellulitis
 Ineffective Health
 Acute Pain
 Ineffective peripheral tissue Perfusion
 Impaired Tissue integrity
 Risk for vascular Trauma: Risk factor: infusion of antibiotics
 Imbalanced nutrition: Less than body requirements
Appendicitis
 Dysfunctional gastrointestinal
 Acute Pain
 Risk for infection
 Disturbed Body image
 Ineffective Breathing pattern
 Deficient Fluid volume
 Imbalanced Nutrition: less than body
Immunity
 Risk for infection
 Effective therapeutic regimen management
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Concept content outline:
Concept:
Immunity
Sub Concepts: Inflammatory Response
Infectious Response
Immune Response
Risk Factors: Applies to each exemplar
Genetic predisposition
Age
Socioeconomic status
Lack of knowledge about infection prevention
Presence of other illness
Drugs and medical treatment
Environmental factors
Assessment: Comprehensive history
Physical assessment
Cultural, behavioral, social assessment
Physical and psychological clinical manifestations
Diagnostic tests
Positive Outcomes:
Replaces damaged tissue with repaired or functional tissue
Recognizes and removes cell mutations
Negative Outcomes:
Physiological
Psychological
Clinical Management:
Nursing interventions
Collaborative interventions
Pharmacological therapy
Non Pharmacological therapy
Procedural therapy
Diagnostic studies
Exemplars:
Vaccines
Otitis Media
Urinary Tract Infection
Cellulitis
Pneumonia
Appendicitis
Trauma-Sprain
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