IMMUNITY

Concept 20
Goals for This Concept Presentation
1. Define and describe the concept.
2. Notice risk factors for altered immune
functioning.
3. Recognize when an individual has altered
immune functioning.
4. Provide appropriate nursing and
collaborative interventions to optimize the
immune response and minimize the
complications of an altered immune
response.
Definition
The normal physiologic response to microorganisms
and proteins as well as conditions associated with an
inadequate or excessive immune response.
Altered Immunity
What is meant by altered immunity?

Conditions in which immune responses are either
suppressed or exaggerated
Suppressed responses
are referred to as
immunocompromised
or immunodeficiency
Exaggerated responses
are referred to as
hypersensitive
Scope of Concept
Types of Immune Response
Collaborative Learning #1
In your learning group, define, compare, and
contrast the following immunity terms:
Innate immunity
Active acquired immunity
Passive acquired immunity
Review of Immune Response
Major histocompatibility complex
Organs involved with immune response
Cells associated with immune response
Overview of Immune Response
Suppressed Immune Response
Primary immunodeficiency
Secondary immunodeficiency
Intentional
Adverse effect of treatment
Exaggerated Immune Response
Four types of exaggerated immune response
Type I
Type II
Type III
Type IV
Hypersensitive reactions
Localized effects
Systemic effects

Consequences of Suppressed
Immune Response
The two major types of problems that result
from suppressed immune response are
Infection
Cancer

What is the link between a suppressed
immune response and these consequences?
Consequences of Exaggerated
Immune Response
Acute hypersensitive reaction
Localized effect
Systemic effect
Chronic body-wide system disease
Destruction of body tissue
Abnormal organ growth
Change in organ function
Elements of History
Past medical history
Family history
Genetic history
Current medications
Allergies to medications or other substances
Lifestyle behaviors
Occupation
Social environment
Exaggerated Immune
Functioning*
Symptoms
Allergic symptoms
Pain
Fatigue
Fever
Clinical Findings
Allergic response
Mild allergic response
Severe allergic response
Autoimmune disorders
Can range from vague
findings to findings
associated with organ
failure
*Note: Symptoms of autoimmune disorders tend to be vague. Clinical
findings vary widely based on the severity of the problem.
Suppressed Immune Functioning*
Symptoms
Report of frequent
infections
Report of poor wound
healing
Fatigue
Malaise
Weight loss
Clinical Findings
May appear poorly
nourished or have wasting
syndrome
May have chronic wounds
May have enlarged lymph
nodes
Presence of opportunistic
infection
*Note: Symptoms and clinical findings vary widely based on the severity of
the problem.
Common Diagnostic Tests
Primary Testing
Red blood cell count and
white blood cell count
with differential
Fluorescent antinuclear
antibody
C-reactive protein (CRP)
Erythrocyte
sedimentation rate (ESR)
Other Diagnostic Tests and
Disease-Specific Testing
Allergy testing
Genetic testing
Rheumatoid factors
(RFs)
Western blot test
TORCH antibody panel
Organ function tests
Clinical Management:
Primary Prevention
Immunizations
Avoid high-risk behaviors
Adequate nutrition
Exercise
Infection control measures
Collaborative Care:
Exaggerated Immune Response
Remove exposure (if possible)
Airway support (if anaphylaxis occurs)
Pharmacotherapy
Reduce response
Antihistamine
Sympathomimetic
Mast cell stabilizer
Immunosuppressive therapy
Antiinflammatory agents
Symptomatic relief
Antipruritic
Decongestant
Analgesics

Collaborative Care:
Immunodeficiency
Monitor immune function
Nutrition
Prevent opportunistic infections
Monitor and treat opportunistic infections
Drug therapy
Interrelated Concepts
Collaborative Learning #4
In your learning group, develop a list of the
four most important concepts related to
immunity. Defend your answers. Compare
your list with those of other learning groups. Interrelated Concept Rationale
Immunity
Suppressed Immune Response
Exaggerated Immune Response
Exemplars
Collaborative Learning #5 In your learning group, identify and discuss
common conditions linked to suppressed or exaggerated immune
responses. Write the conditions in the boxes.