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Understanding Immunity: Agents, Responses, and Nursing Considerations

This chapter explores the various agents that influence immune system functions, including the recognition and elimination of foreign materials like bacteria, viruses, and fungi. It discusses the roles of essential immune cells such as mast cells, PMNs, and macrophages in mounting immune responses. The chapter also addresses the concepts of active and passive immunity, the importance of nursing considerations when administering vaccines, and the role of immunosuppressant agents in preventing organ rejection. Proper monitoring and education on side effects are crucial for patient safety.

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Understanding Immunity: Agents, Responses, and Nursing Considerations

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  1. Chapter 38 Agents That Affect Immunity

  2. Immune System Functions • Recognize and dispose of foreign material such as: • -Bacteria -Worms • -Viruses -Drugs • -Fungi -Food • -Protozoa -Transplanted organs

  3. Immune System • Responds to foreign agents (antigens) • Forms antibodies • Recognizes and destroys antigens • Reason for an allergic reaction

  4. The Immune System • Mast cells • Large tissue cells • promotes inflammation • increases permeability of blood vessels • PMN’s • ’scavenger’ white blood cells • contains powerful antibacterial enzymes • Macrophages • -large tissue cells • -removes damaged cells, bacteria, and other debris

  5. Immune Responses • Exposure to environmental antigens • Immune system may overreact • Results in an allergic response • Can be decreased by desensitization • Body may reject own tissue • Autoimmune response • Rheumatoid arthritis or systemic lupus erythematosus (SLE) • Organ graft

  6. Immune Responses • Normal response requires a series of interactions • Defects cause decreased effectiveness of immune system • Increases susceptibility to infection • Causes could include: • -genetic defects • -aging • -immunosuppressant drug use • -HIV/AIDS

  7. Types of Immunity • Active immunity • Administration of an antigen, a weakened or killed vaccine • Stimulates your immune system to form antibodies against the disease • Lasts for many years

  8. Types of Immunity • Passive Immunity • Administration of preformed antibodies • IgG antibodies • Provides instant protection • Short duration

  9. Nursing Considerations • Obtain a full history, including allergies, pregnancy, immune status, medical condition, and past response to immunizations, prior to giving the vaccines • Follow directions for administration and storage of the vaccines • Have emergency equipment available • Deltoid muscle or vastus lateralis muscle for IM injection sites

  10. Nursing Considerations • Ibuprofen or Tylenol for premedication • Observe the patient after the vaccine administration for any distress • Keep accurate records • Educate patients on side effects of vaccines and symptoms to report

  11. Interferons and Interleukins • Synthetic IM injection • Stimulate the immune and inflammatory response • Assist with communication between the cells of the immune (and other) system(s)

  12. Interferons and Interleukins (cont’d) • They are used to: • Treat cancer • Stimulate T cell production • Promote blood cell formation • Treat several inflammatory diseases

  13. Immunosuppressant Agents • Examples: Azathioprine/Imuran, Cyclosporine/Sandimmune, CellCept • Prevent organ rejection after transplant • Used in combination with corticosteroid therapy • Combined with corticosteroids • Total mechanism of action is unclear • They suppress T lymphocytes

  14. Immunosuppressant Agents • Must be taken every day- no missed doses • Compliance necessary • Side effects/Adverse effects: • Nephrotoxicity, tremor, HTN, gum hyperplasia, nausea…

  15. Immunosuppressant Agents • Many Drug-Drug interactions • Medication changes should be cleared through the transplant physician Clients need to avoid infections -Instruct to wear a mask if going out Immunosuppressant agents are expensive -Cost $50,000/year or more

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