chapter 15 care of the patient with an immune disorder mosby, inc. items and derived items...

Chapter 15

Care of the Patient with an Immune Disorder

Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.


Care of the Patient with an Immune Disorder 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


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


Effects of Aging on the Immune System Decline in the immune system High incidence of tumors in older adults 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


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


Origin and Processing of B & T Cells

(Figure 15-3)


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


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


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


Immunodeficiency Disease Immunodeficiency disease – involves altered

and failed immune response– Primary immunodeficiency –

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


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 self-antigens) are activated

– Rheumatoid arthritis


Nursing Diagnoses 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

chapter 15 care of the patient with an immune disorder mosby, inc. items and derived items...

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