Download Immunization

Chapter 15
Care of the Patient with an Immune
Disorder
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Care of the Patient with an Immune
Disorder
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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
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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
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Effects of Aging on the Immune
System

Decline in the immune system

High incidence of tumors in older adults
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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
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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
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Origin and Processing of B & T Cells
(Figure 15-3)
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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
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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
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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
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Immunodeficiency Disease

Immunodeficiency disease – involves
altered and failed immune response
– Primary immunodeficiency –
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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
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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 selfantigens) are activated
– Rheumatoid arthritis
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Nursing Diagnoses


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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
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