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Immunological Nursing

The Nurse needs to understand the immune systemand how it functions; to recognize its importance inunderstanding disease process; and to apply this

knowledge in making appropriate patient caredecisions

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Immunology The study of immunity and all the phenomena connected withthe defense mechanisms of the body.

Immunity - refers to the bodys specific protective response to an invading

foreign agent or organism.Active Immunityarises when the bodys own cell produce, and remainable to produce appropriate antibodies following an attack of a diseaseor deliberate stimulation (Immunization).

Passive Immunity which is short-lived, is provided by injecting ready-made antibodies in antiserum taken from another person or animalalready immune.

Immunopathology is the term used to describe the study of disease causedby disorders that affect the immune system.

Immuno deficiencies is a state of suppression of the immune responsecaused by disorders that affect the immune system.

Definition of terms

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Epidermis The outermost layer of the

skin and is composed ofseveral layers ofkeratinocytes that change

character as they migrate tothe surface.

The stratum corneum,outermost layer of theepidermis provides the most

effective barrier to epidermalwater loss and penetrationof environmental factorssuch as chemicals, microbesand insect bites.

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Lipids are naturallyoccurring moleculeswhich includesfats,waxes, sterols, fat-

soluble vitaminsmonoglycerides,diglycerides,phospholipids, andothers

Microbes and fungi, arepart of the bodysnormal flora, cannotpenetrate unless thereis a break in the skinbarrier.

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Dermis &Epidermis Junction a basal layer composed

of collagen - ) is a group of

naturalproteins

has four functions:

- it acts as scaffold for

tissue organization andtemplate forregeneration - support

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has four functions:

- it provides selective

permeability forfiltration of serum allows substance to passthrough

- a physical barrierbetween differenttypes of cells

- It binds the

epithelium tounderlying cell layers- thin protective layer of tissue

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B. Lymph nodes- are body organs (not glands)

spread throughout the body.- filters out all the dead bacteria,

viruses, and other dead tissuefrom the lymphatic fluid andeliminate it from the body.

- the place where the white bloodcells (lymphocytes) spend muchof their time.

- When immune system isactivated it begins producinglarge numbers of lymphocytes

which causes them to swell.- about 500-700 lymph nodes

spread throughout the body

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- widely distributedover the body:

Sub mental &Sub maxillary

nodes(Mouth)

Superficialcervicalglands (Neck)

Superficialcubital nodes(Bend ofelbow)

Axillary nodes

(Under arm) Inguinal

nodes (Groin)

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It acts as a filter forblood as part of theimmune system.

Old red blood cellsare recycled in thespleen, and platelets

and white bloodcells are stored.

helps fight diff.kinds of bacteria

that causepneumonia andmeningitis.

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C. Liver is a large, meaty organ

that sits on the rightside of the belly.

about 3 pounds,reddish-brown in colorand feels rubbery totouch.

It can't be feel because

it's protected by the ribcage.

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it filter the blood comingfrom the digestive tract,before passing it to therest of the body.

detoxifies chemicals andmetabolizes drugs.

secretes bile that endsup back in theintestines.

makes proteinsimportant for bloodclotting and otherfunctions.

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two large sections, calledthe right and the left lobesprotects the liver

The gallbladder sits underthe liver, along with parts

of the pancreas andintestines.

The liver and these organswork together to digest,absorb, and process food.

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Bone marrow soft tissue filling the

spongy interiors ofbones.

Red marrow is the

principal organ thatforms blood cells.

In children, the bonescontain only red

marrow.

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As the skeleton matures, fat-storingyellow marrow displaces redmarrow in the shafts of the longbones of the limbs.

In adults red marrow remains in theribs, the vertebrae, the pelvicbones, and the skull.

Erythrocytes (red blood cells),platelets, and all but one kind of

leukocyte (white blood cell) aremanufactured in human redmarrow.

releases about 10 million to 15million new erythrocytes every

second, while an equivalent numberare destroyed by the spleen.

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Types of Immunity

a. Natural / Innate Immunity

b.Acquired Develop Immunity

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TYPES OF IMMUNITY

Natural/Innate Immunity is a non specific immunity present at birth

provides a non specific response to anyforeign invader, regardless of the compositionof the invader

the basis of natural defense mechanism is the

ability to distinguish between self andnon self

natural mechanisms include physical andchemical barriers

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the flushing action of saliva and urineprevents the buildup of organisms

the eyelids and eye lashes protects theeyes from dirt particles and organisms,that does gain entrance to the eyes tendsto be washed out by tears

the peristaltic action of the GIT provideconstant movement of foods thuspreventing buildup of foreign organisms ortoxic waste products

vomiting and diarrhea are activemechanisms that remove harmful productsfrom the GIT

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Chemical barriers

the acetic acid and salt concentration ofperspiration is toxic to many pathogenicorganisms

the stomach acidity (approximately pH 2) ofthe gastric juices kills many organisms anddetoxifies certain potentially toxic substances

the upper intestine is generally freed oforganism by the action of bile and proteolyticenzymes

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vaginal secretions allow certain harmless acid-producing bacteria to colonize the vagina and createan acidic environment thus reducing the chances ofpathogens colonizing the area

the enzyme lysozyme (present in mucus, tears, saliva, skin andinternal fluid of cells)is capable of lysing (splitting) thebacterial cell wall of many gram-positive organismsand causing their destruction

the bacterial flora in the different areas of the bodycompetes for space and nutrients with pathogenicorganisms and release anti-microbial substances toretard the growth of foreign organisms seeking to

occupy the same site

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Acquired/Developed Immunity consist of immunologic responses that are not

present at birth but are acquired during life

most acquired immunity develops as a resultof contracting a disease or generating a

protective response through immunization

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Naturally AcquiredActive Immunity(contracting adisease)

- occurs when theperson is exposed to

a live pathogen,develops the disease,and becomesimmune/safe from

dse. as a result of theprimary immuneresponse.

Natural AcquiredPassive immunity(antibodies in the breast

milk)

- acquired by the fetus ornewborn from themother via the placental

transfer ofantibodiesduring pregnancy andvia breast milk.

- This type ofimmunity isshort-lived, lasting thefirst six months of thenewborn's life.

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Artificially acquiredactive immunity(vaccination/immunization)

- can be induced by avaccine, a substancethat contains theantigen.

- A vaccine stimulatesa primary responseagainst the antigen

without causingsymptoms of thedisease

Artificially acquiredpassive immunity

- is a short-termimmunization by theinjection of

antibodies

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GENERAL IMMUNE RESPONSES

1. Phagocytic Immune Response

The cells move to the point ofattack to engulf and destroy theforeign agents

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

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WBC is consist of: Neutrophils(55 to 70%)

essential in preventing or limiting bacterialinfection via phagocytosis

Monocytes(2 to 8%) enters tissue as macrophage(WBC);- highly phagocytic against fungus;- immune surveillance

Eosinophil(1 to 4%) involved in allergic reactions (neutralizes

histamine)- digests foreign proteins

Basophil(0.5 to 1%) contains histamine that produces allergic reaction- integral part of hypersensitivity reactions

Macrophage Cell

Blood Cell

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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 cellsurface( a nerve ending that is sensitive to stimuli

& can convert them into nerve impulse)

B lymphocyte

respond to pathogens by producing largequantities ofantibodies which then neutralize

foreign objects

Plasma Cells Secretes immunoglobulin (Ig,antibody); most mature form of B lymphocyte

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2. Humoral or Antibody Response

begins with the B lymphocytes which

transform into plasma cells thatmanufactures antibodies

B lymphocytes transform to dormantmemory cells (after infection)

it is the antibodies, which are highly

specific proteins that are transportedinto the bloodstream and have theability to disable the invaders

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3. Cell Mediated Immune Response

involves B lymphocytes, which inaddition to transformingthemselves into plasma cells, canalso turn into special Cytotoxic T

cells (killer T lymphocytes) thatcan attack the microbesthemselves

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

Helper T lymphocytes / Helper T cells

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THE END