Immunological Nursing

The Nurse needs to understand the immune system and how it functions; to recognize its importance in understanding disease process; and to apply this knowledge in making appropriate patient care decisions

Definition of terms

Immunology The study of immunity and all the phenomena connected with the defense mechanisms of the body. Immunity - refers to the bodys specific protective response to an invading foreign agent or organism. Active Immunity arises when the bodys own cell produce, and remain able to produce appropriate antibodies following an attack of a disease or deliberate stimulation (Immunization). Passive Immunity which is short-lived, is provided by injecting readymade antibodies in antiserum taken from another person or animal already immune. Immunopathology is the term used to describe the study of disease caused by disorders that affect the immune system. Immuno deficiencies is a state of suppression of the immune response caused by disorders that affect the immune system.

BODY ORGANS INVOLVE IN DEFENSE

A. Skin

covering most of the body is more than 1 mm thick it provides very effective protection against invasion by bacteria and other foreign matter. The thickened skin of the palms and soles protects against the effects of constant trauma that occurs in these areas.

Epidermis

The outermost layer of the skin and is composed of several layers of keratinocytes that change character as they migrate to the surface.

The stratum corneum, outermost layer of the epidermis provides the most effective barrier to epidermal water loss and penetration of environmental factors such as chemicals, microbes and insect bites.

Lipids are naturally occurring molecules which includes fats, waxes, sterols, fatsoluble vitamins monoglycerides, diglycerides, phospholipids, and others Microbes and fungi, are part of the bodys normal flora, cannot penetrate unless there is a break in the skin barrier.

Dermis &Epidermis Junction

a basal layer composed of collagen - ) is a group of

natural proteins

has four functions: it acts as scaffold for tissue organization and template for regeneration - support

has four functions: it provides selective permeability for filtration of serum

allows substance to pass through

a physical barrier between different types of cells It binds the epithelium to underlying cell layers - thin protective layer of tissue

B. Lymph nodes

are body organs (not glands) spread throughout the body. filters out all the dead bacteria, viruses, and other dead tissue from the lymphatic fluid and eliminate it from the body. the place where the white blood cells (lymphocytes) spend much of their time. When immune system is activated it begins producing large numbers of lymphocytes which causes them to swell. about 500-700 lymph nodes spread throughout the body

widely distributed over the body: Sub mental & Sub maxillary nodes (Mouth) Superficial cervical glands (Neck) Superficial cubital nodes (Bend of elbow) Axillary nodes (Under arm) Inguinal nodes (Groin)

Spleen is an organ in the upper far left part of the abdomen, to the left of the stomach. varies in size and shape its commonly fistshaped, purple, and about 4 inches long.

Because it is protected by the rib cage, it cant easily feel unless its abnormally enlarged.

It acts as a filter for blood as part of the immune system. Old red blood cells are recycled in the spleen, and platelets and white blood cells are stored. helps fight diff. kinds of bacteria that cause pneumonia and meningitis.

C. Liver

is a large, meaty organ that sits on the right side of the belly. about 3 pounds, reddish-brown in color and feels rubbery to touch. It can't be feel because it's protected by the rib cage.

it filter the blood coming from the digestive tract, before passing it to the rest of the body. detoxifies chemicals and metabolizes drugs. secretes bile that ends up back in the intestines. makes proteins important for blood clotting and other functions.

two large sections, called the right and the left lobes protects the liver

The gallbladder sits under the liver, along with parts of the pancreas and intestines.
The liver and these organs work together to digest, absorb, and process food.

Bone marrow

soft tissue filling the spongy interiors of bones. Red marrow is the principal organ that forms blood cells. In children, the bones contain only red marrow.

As the skeleton matures, fat-storing yellow marrow displaces red marrow in the shafts of the long bones of the limbs. In adults red marrow remains in the ribs, the vertebrae, the pelvic bones, and the skull. Erythrocytes (red blood cells), platelets, and all but one kind of leukocyte (white blood cell) are manufactured in human red marrow. releases about 10 million to 15 million new erythrocytes every second, while an equivalent number are destroyed by the spleen.

Types of Immunity
a. b.

Natural / Innate Immunity Acquired Develop Immunity

TYPES OF IMMUNITY

Natural/Innate Immunity

is a non specific immunity present at birth provides a non specific response to any foreign invader, regardless of the composition of the invader the basis of natural defense mechanism is the ability to distinguish between self and non self natural mechanisms include physical and chemical barriers

Physical barriers

intact skin and mucous membranes, prevents pathogens from gaining access to the body the cilia of the respiratory tract with ciliary action propels foreign matter out of the respiratory tract

coughing and sneezing propels foreign maters out of the respiratory tract
nasal hairs has filtration actions that traps particles and organisms

the flushing action of saliva and urine prevents the buildup of organisms the eyelids and eye lashes protects the eyes from dirt particles and organisms, that does gain entrance to the eyes tends to be washed out by tears the peristaltic action of the GIT provide constant movement of foods thus preventing buildup of foreign organisms or toxic waste products vomiting and diarrhea are active mechanisms that remove harmful products from the GIT

Chemical barriers

the acetic acid and salt concentration of perspiration is toxic to many pathogenic organisms the stomach acidity (approximately pH 2) of the gastric juices kills many organisms and detoxifies certain potentially toxic substances the upper intestine is generally freed of organism by the action of bile and proteolytic enzymes

vaginal secretions allow certain harmless acidproducing bacteria to colonize the vagina and create an acidic environment thus reducing the chances of pathogens colonizing the area the enzyme lysozyme (present in mucus, tears, saliva, skin and internal fluid of cells) is capable of lysing (splitting) the bacterial cell wall of many gram-positive organisms and causing their destruction

the bacterial flora in the different areas of the body competes for space and nutrients with pathogenic organisms and release anti-microbial substances to retard the growth of foreign organisms seeking to occupy the same site

Acquired/Developed Immunity

consist of immunologic responses that are not present at birth but are acquired during life

most acquired immunity develops as a result of contracting a disease or generating a protective response through immunization

Naturally Acquired Natural Acquired Active Immunity Passive immunity (antibodies in the breast (contracting a milk) disease) acquired by the fetus or - occurs when the newborn from the person is exposed to mother via the placental a live pathogen, transfer of antibodies during pregnancy and develops the disease, via breast milk. and becomes immune/safe from dse. as a result of the - This type of immunity is short-lived, lasting the primary immune first six months of the response.
newborn's life.

Artificially acquired active immunity

-

(vaccination/immunization)

Artificially acquired passive immunity - is a short-term immunization by the injection of antibodies

can be induced by a vaccine, a substance that contains the antigen. A vaccine stimulates a primary response against the antigen without causing symptoms of the disease

GENERAL IMMUNE RESPONSES

1. Phagocytic Immune Response

The cells move to the point of attack to engulf and destroy the foreign agents

the first line of defense the Leukocytes or White Blood Cells (WBC) ingest foreign particles

WBC is consist of:

Neutrophils (55 to 70%)

essential in preventing or limiting bacterial infection via phagocytosis

enters tissue as macrophage(WBC); - highly phagocytic against fungus; - immune surveillance

Macrophage Cell

Monocytes (2 to 8%)

involved in allergic reactions (neutralizes histamine) - digests foreign proteins

Eosinophil (1 to 4%)

Basophil (0.5 to 1%)

Blood Cell

contains histamine that produces allergic reaction - integral part of hypersensitivity reactions

Lymphocyte (20 to 40%)

integral component of the immune system - types: T lymphocyte functions in cell-mediated immunity - has receptor (T cell receptor) on the cell surface ( a nerve ending that is sensitive to stimuli
& can convert them into nerve impulse)

B lymphocyte respond to pathogens by producing large quantities of antibodies which then neutralize foreign objects Plasma Cells Secretes immunoglobulin (Ig, antibody); most mature form of B lymphocyte

2. Humoral or Antibody Response

begins with the B lymphocytes which transform into plasma cells that manufactures antibodies B lymphocytes transform to dormant memory cells (after infection) it is the antibodies, which are highly specific proteins that are transported into the bloodstream and have the ability to disable the invaders

3. Cell Mediated Immune Response

involves B lymphocytes, which in addition to transforming themselves into plasma cells, can also turn into special Cytotoxic T cells (killer T lymphocytes) that can attack the microbes themselves

Killer T lymphocytes / Killer T cells Suppressor T lymphocytes / Suppressor T cells Helper T lymphocytes / Helper T cells

THE END