Immunity (NRS 325)

immunity definition

a physiological process that results in resistance to infections or toxins

immunity attributes

- specific

- adaptive

- protective

- resistance

immunity scope

- suppressed immune response

- optimal immune response

- exaggerated immune response

innate immunity consists of

- anatomical barriers

- phagocytic barriers

- blood proteins

- cytokines

acquired immunity consists of

passive and active immunity

passive immunity consists of

naturally acquired and artificially acquired

active immunity consists of

naturally acquired and artificially acquired

innate

- non specific

- fast response (0-4 hours)

adaptive

- specific

- slow response (4-14 days)

suppressed immune response risk factors

- advanced age

- fewer t and b lymphocytes

- chronic illness (cancer, HIV)

- chemotherapy/radiation treatments

- organ transplant

- immunosuppressive medications

- pregnancy

- other

exaggerated immune response

- exposure to allergens which trigger immune response

- exposure to environmental factors which produce allergic reactions

- autoimmune disease

antigen

- trigger immune responses

- bacteria, viruses, or fungi that cause infection and disease

antibody

- also called immunoglobulins

- y-shaped molecules

- proteins manufactured by the body

- helps fight against foreign substances (antigens)

what is an antigen?

is a molecule or particle that triggers an immune response

what is an antibody?

or t-cell receptor is specific, meaning it only binds a particular antigen

diagnostic tests for immunity: laboratory tests

- skin test

- CBC

- CD4/CD8 cell count

- serological tests to detect specific antibodies or viruses

- antigen testing

- antibody testing (POC)

- antibody titer (lab) (aka "titer")

- PCR

diagnostic tests for immunity: other tests

- autoimmune disease specific testing

- comparison of covid tests

clinical management: primary prevention

- immunizations

- adequate nutrition (decreases)

- exercise (increase)

- sleep, rest (increase)

- stress (decreases) uncomfy

- hand wash exposure (decreases)

- family history

clinical management: secondary prevention

no routine secondary prevention for general population

- human immunodeficiency virus (HIV) screening for those with specific risk factors

- allergy screening if indicated

clinical management: collaborative interventions --> suppressed immune response

- airway

- remove exposure (ex: bee sting)

- antihistamines

- corticosteroids

- allergy shots/protocols

- oral immunotherapy

- biologics (target specific responses)

- *stem cell and gene therapies

clinical management: collaborative interventions --> exaggerated immune response

- nutrition - nutrient rich/dense foods, easy to digest

- skin and oral hygiene and care- moisturized, teeth brushed, oral cavity intact

- psychological support

- early intervention with new infections

- stem cell transplants/ bone marrow transplant's

- pharmacological support and monitoring: (chronic illness and autoimmune disease management)

pharmacology: antirivals

• specific antivirals are used for specific viruses:

  • herpes, shingles, chicken pox

    • acyclovir

    • valacyclovir

• influenza

  • osteltamivir

• Do not destroy virus --> Inhibit their development

pharmacology: antivirals --> assessment (nursing considerations)

is the med appropriate?

pharmacology: antivirals --> caution use (nursing considerations)

impaired renal function

pharmacology: antivirals --> implementation/ patient teachings (nursing considerations)

Acyclovir/Valacyclovir:

- slows the growth and may lesson symptoms of the infection. NOT A CURE.

Oseltamivir:

- blocks the action of influenza virus (A and B types). Only works in the first 48 hours after symptom onset

pharmacology: antivirals --> evaluation

how do we know it's working?

HIV and antiretrovirals

- used heavily in the management of HIV/AIDs

-- taken in combination of 2-3 drugs

-- lots of side effects

-- very expensive

-- must be taken exactly as prescribed

-- risk of virus developing resistance

- promote strategies of adherence

-- pre-exposure prophylaxis (PrEP)

-- post-exposure prophylaxis (PEP)

suppressed immune response

- they don't have enough WBC

- can't fight off --> ex: pathogens & bacteria

- low immune system

- low antibodies

hypersensitivity

- anaphylactic response

- not just local fully systemic

- extreme reactions

type 1 mediator

IgE- Mediated

type 2 mediator

IgG or IgM cytotoxic

type 3 mediator

immune complex-mediated

type 4

t-cell mediated

types of white blood cells

neutrophil, eosinophil, basophil, monocyte, b-lymphocyte, t-lymphocyte

neutrophil

lifespan: 7 hours

function: immune defenses

eosinophil

lifespan: 8 to 12 days

function: defense against parasites & allergies (skin)

basophil

lifespan: a few hours to a few days

function: inflammatory response & histamines

monocyte

lifespan: 3 days

function: immune surveillance (looking out)

b-lymphocyte

lifespan: memory cells may live for years

function: antibody production

t-lymphocyte

lifespan: memory cells may live for years

function: cellular immune response

innate immunity

your body's defenses against any pathogen (born with it)

acquired immunity

acquired from somewhere else

active immunity natural

infection; contact with pathogen

active immunity artificial

vaccinations

passive immunity natural

maternal antibodies

passive immunity artificial

monoclonal antibodies

red blood cells (RBCs)

3.6-5.4

hemoglobin (Hgb)

12-17.4 g/dL

hematocrit (Hct)

36% - 48 %

white blood cells (WBCs)

4.5 - 10.5 cells/mm3

platelets

1.4 - 4.0 uL and 140 - 400 L