NURS 301 MEDSURG TEST3 STUDY GUIDE | RATED 100%: LIBERTY UNIVERSITY
7 views 0 purchase
Course
NURS 301 (NURS301)
Institution
Liberty University
NURS 301 MEDSURG TEST3 STUDY GUIDE | RATED 100%: LIBERTY UNIVERSITYNURS 301 MEDSURG TEST3 STUDY GUIDE | RATED 100%: LIBERTY UNIVERSITYNURS 301 MEDSURG TEST3 STUDY GUIDE | RATED 100%: LIBERTY UNIVERSITY
nurs 301 medsurg test3 study guide | rated 100 liberty university
Written for
Liberty University
NURS 301 (NURS301)
All documents for this subject (15)
Seller
Follow
kuglin
Reviews received
Content preview
1
NURS 301 Test 3 Study Guide
Ch 14: Immunology
Immunity Is
Organized series of actions by the body in order to protect itself against a pathological
organism resulting in destruction or neutralization of the organism
Immunity= A state of responsiveness to foreign substances such as microorganisms and tumor
proteins
Functions of the Immune System
1. Homeostasis- recognize and destroy damaged cells; damaged cells are digested and
removed
2. Defense- Protect against antigens
3. Surveillance- Destroy damaged (mutated) cells; don’t destroy good tissue
Foreign Substances (Antigens)
Bacteira, viruses, fungi, prions, parasites
Haptens vs Antigens
1. Antigen= Anything that triggers an immune response
2. Hapten= “signature” of the antigen
Antigens have protein markers that allow body to attack them with right machine
Properties of Immune Response
Specificity- when foreign substance enters body, cellular changes occur. Form antibodies on
lymphocytes
Memory- Allows for quicker response to antigen for subsequent exposures
Self recognition- immune system’s ability to recognize self vs non-self
o If body is unable to recognize self, antibodies against self lead to tissue destruction
o Self recognition prevents auto-immune disorders
Self limitation- once antigen is removed, the response decreases to prevent damage to body’s
own cells
Specialization- different organisms and foreign material are attacked in the correct way to stop
them
Cells Involved with Immune System (The Major Players)
Mononuclear Phagocytes= Monocytes and macrophages engulf pathogens and take it to the
right response system based on surface proteins
o Humoral- attacked by B lymphocytes
o Cell Mediated- attacked by T lymphocytes
Lymphocytes:(produced in bone marrow, then differentiate into B and T cells)
1. B Lymphocytes- differentiate into plasma cells when activated which produce antibodies
(immunoglobulins)
2. T Lymphocytes
a) T cytotoxic cells (CD8) Cell mediated; attack the antigen
, 2
b) T helper cells (CD4) Cell mediated and Humoral
3. Natural Killer Cells- cell mediated; no prior sensitization required. Immune surveillance
for malignant cell changes
Dendritic Cells- activate cell mediated response
Cytokines- messengers between cell types
Two Types (Ways) of Immunity
1. Innate Immunity
a) Natural Innate Immunity
▪ Exists w/o former contact with antigen
▪ “Born with it” (human specific immunity)
▪ Includes natural barriers (skin, mucous membranes) and inflammatory response
▪ Primary role= First Line Defense
▪ Neutrophils & NKC’s remove anything “abnormal;” no specificity! Just engulf and
remove
2. Acquired Immunity
a) Active Acquired Immunity
▪ Occurs when body responds to the presence of pathologic organism and produces
antibodies against them
▪ Comes FOLLOWING an invasion and results in sensitized antibodies
▪ When reinvaded by organism, response is faster!
▪ Can take a while to develop, but lasts a long time
▪ Invaded, then reinvaded! The army is already built up!
▪ Examples of Artificial Active Acquired:
• Vaccine- body produces antibodies because of immunization/inoculation
• Tetanus Vaccine
▪ Examples of Natural Active Acquired:
• Disease- body produces antibodies because of pathogen
• Getting chicken pox from your cousin
b) Passive Acquired Immunity
▪ Temporary!
▪ Receives antibodies to antigen “passively” instead of making them
▪ Quick and strong, but it doesn’t last long! Temporary because there are no memory
cells specific to antigen
▪ May or may not have prior exposure
▪ Comes from someone else! Either mother or a nurse
▪ Examples of Artificial Passive Acquired:
• Injection of gamma-globulins (serum antibodies)
• Rabies immunoglobulin injection
▪ Examples of Natural Passive Acquired:
• Immunoglobulin from mother to fetus via placenta
Types of Immune Response
• Each has unique properties and actions based on antigens involved; both form antibodies!
Humoral Immunity- Think “Bacteria” (also extracellular viruses)
o The antigen that invades causes B-cells to divide and become plasma cells (differentiated
B-cells) which produce antibodies (immunoglobulin) that travel in the bloodstream to
communicate with other cells
o B lymphocytes produce:
1. Antibodies
2. Memory cells
o “Humor” is Latin word for “liquid”
, 3
o **Primary Immune Response takes 4-8 days after initial exposure
o **Secondary Immune Response takes 1-3 days; it is stronger and longer lasting!
o Cells Involved
o B-lymphocytes
o Products
o Antibodies (Immunoglobulins)
o Memory Cells:
o **Present
o Protection
o Bacteria
o Extracellular viruses
o Respiratory and GI pathogens
Cell-Mediated Immunity- Think “Viruses”
o When T-cells recognize antigen and start immune response
o Production of sensitized T-Lymphocytes to kill and destroy pathologic organisms
o Does NOT deal with bacteria! Only INTRACELLULAR VIRUSES such as HIV
Exception: Few mycobacteriums that have to live within cell are the only bacteria
attacked by cell mediated
o Primary Uses:
Protection primarily against cancer cells, virus-infected cells, and fungal infections
**Rejection of transplanted tissue**
Contact hypersensitivity reactions
Tumor Immunity
o Cells Involved
1. T-lymphocytes (CD4 Helper and CD8 Cytotoxic)
2. Macrophages
3. NK cells
o Products
Sensitized T cells
Cytokines
o Memory Cells:
**Present
o Protection
Funguses
Intracellular viruses
Chronic infectious agents
Tumor cells
Immunological Effects of Aging
• Decreased immune system function (immunosenescence)
• Increased susceptibility to infection
• Decreased number of T cells
• Increased incidence of tumors (primary clinical evidence is high incidence of malignancy!)
• Immunity because of vaccines may not be as strong
• Immunological escape becomes more opportunistic
Altered Immune Response
• Overacting Immune Response (Hypersensitivity Reactions)
o Over reactive against antigens
o Can’t practice self limitation
o Four Classifications:
▪ Type I: IgE Mediated (most common; “allergies”)
▪ Type II: Cytotoxic Reaction (blood transfusion)
▪ Type III: Immune-Complex Reaction
▪ Type IV: Delayed Hypersensitivity Reaction (transplant reaction)
, 4
o Examples:
▪ Allergies
▪ Autoimmune disease (attacks self)
• Under Responsive Immune System
o Severe infections
o Immunodeficiency diseases
o Malignancies
o Patients on Chemo
Type I IgE Mediated Reaction
• Chemical mediators released from Mast Cells:
o Histamine, serotonin, leukotriene, eosinophil chemotactic factor, kinins, bradykinin
• Symptoms associated with Type I:
o Increased mucosal secretions, itching, increased vascular permeability
o Response of IgE can range from sniffles to anaphylaxis!
• **Know that IgE response is r/t allergies!
o IgE attaches to mast cells (which contain histamine) for transportation, then they attach to
antigen and mast cell explodes! All the histamine is released!
• Anaphylaxis- Medical Emergency!
o Shock can occur d/t kinins (Bradykinin) decreasing BP
o Treatment:
▪ Epinephrine
▪ Maintain Airway and oxygen support… ALWAYS first think airway!!!
• Smooth muscle is clamping down on airway
• Intubation is the best rapid response to keep airway open
▪ Vital signs
▪ Maintain circulatory volume and BP
▪ Keep warm; other drugs
Type II Cytotoxic (IgG or IgM) Reaction
• Target cells (those destroyed during type II reaction) are usually RBCs, WBCs, and platelets
• Commonly antigens involved are ABO blood group, Rh factor, and drugs
• Associated with Blood Transfusion Reaction!
o Instant reaction; no delay!
o Altered airway leads to stridor
o Febrile, anxious, SOB
• If a patient is transfused with incompatible blood:
o Antibodies immediately coat the foreign RBC’s
o RBC’s agglutinate (clump)
o Life threatening! Cellular lysis and possible renal failure secondary to hemaglobinuria
o First Thing: STOP the transfusion! Then, protect airway
Collaborative Care of Hypersensitivity Reactions
• After allergy is diagnosed,
o **Most Important: Avoid triggers/allergens!
o Treat symptoms
o If needed, desensitization through immunotherapy (allergy shots)
• Document allergies
• Drug therapy
Drug Therapy for Chronic Allergies
• Antihistamines- Best to treat allergic rhinitis and urticaria
• Sympathomimetic/Decongestant Drugs
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller kuglin. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
