Tabloski ch23 lecture

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THIRD EDITION
CHAPTER
23
The Immune
System
Copyright © 2014, © 2010, © 2006 by Pearson Education, Inc.
All Rights Reserved

Learning Objectives
1. Define the role of the immune system
in the maintenance of health.
2. Describe the three unique
characteristics of the immune system.
3. Identify factors that affect proper
immune system function.
Gerontological Nursing, Third Edition
Patricia A. Tabloski

Learning Objectives
4. Distinguish the similarities,
differences, and interactions between
the humoral immune response and the
cellular immune response.
5. Associate the pathology that underlies
illnesses associated with both
excessive and deficient immune
responses.

Learning Objectives
6. Outline the unique characteristics
associated with HIV infection in the
older person.
7. Relate the care of the patient with a
rheumatoid disorder to the pathology
involved.

Learning Objectives
8. Explain the physiological processes
that increase the susceptibility of the
older person to infections.
9. Identify nursing interventions that can
be effective in improving immune
status in the older person.

Introduction
• Three major biological defense
mechanisms protect the human body
from injurious chemicals, foreign
bodies, microorganisms, and parasites.
• The first line of defense is the physical,
anatomical, and biochemical barriers
provided by our skin and the mucous
membranes that line our digestive,
respiratory, urinary, and reproductive
tracts.

Introduction
• The second line of defense is often
called the “innate” immune system
because it is present from birth in all
animals. It includes mechanical
clearance. The inflammatory response
is also part of the second line of
defense.

Introduction
• The third line of defense is the immune
response or the “adaptive” immune
system, a highly complicated,
integrated system that is controlled by
a complex communication mechanism.

The Immune System
• The immune response has the
capability to confer long-term and,
sometimes, permanent protection
against living organisms such as
bacteria, viruses, and parasites.
• It also protects the body from its own
cancer cells. It is a diverse and
complicated system made up of
interrelated parts, but functions as a
whole.

The Immune System
• Multiple factors affect the individual’s
immune system.
• The internal characteristics of the
individual include factors such as age,
gender, and inherited genetic
sequence.
• External factors also can have a
substantial effect on a person’s immune
system.

Characteristics Unique to the
Immune System
• Three characteristics are unique to the
immune system:
–Self-recognition
–Specificity
–Memory

Characteristics
• In self-recognition (tolerance), the
immune system differentiates between
substances that are normal
constituents of a person’s body and
those that are not.
• Specificity means that the immune
response reacts to only one antigen.

Characteristics Unique to the
Immune System
• Memory means that the immune
system has the capacity to develop
long-lasting protection against specific
invaders.

Cell-mediated Immune Response
• A highly regulated communication
system with a series of positive and
negative feedback systems regulates
and coordinates the immune response
so that normal body tissues are not
injured. These regulatory functions can
be affected by the aging process and
the presence of chronic disease.

Normal Changes of Aging
• Generally, aging is associated with
physiological changes that cause
stiffness or rigidity and decreased
levels of functioning in many systems.
• One of the most important biological
changes occurring during human aging
is a progressive decrease in immune
functioning, or immunosenescence.

Normal Changes of Aging
• A decreased ability to respond to
antigenic stimulation by B lymphocytes
is a common characteristic of the aging
humerol immune system.
• The number of B cells in the circulation
decreases in some individuals. As a
result, tissues are slower to repair and
are more vulnerable to disease,
especially infections.

Factors Affecting Aging of the
Immune System
• Many factors directly or indirectly
associated with aging can affect the
immune system. These factors include
stress, chronic illness, exercise, and
dietary nutrients.
• An increase in the amount of stress
perceived by individuals is generally
associated with poorer cellular
immunity.

Factors Affecting Aging of the
Immune System
• Mood, stress, depression, and mental
illness influence the immune system.

Healthy Aging Tips
• Regular, moderate, exercise 30
minutes a day, five days a week
• Take a multivitamin/mineral
supplement daily.
• Consider vitamin D supplementation.
• Maintain a healthy weight.
• Report increased infections to your
health care practitioner.

Excessive Immune Responses
• Hypersensitivity and autoimmunity are
types of excessive responses.
Overreaction of the immune system is
believed to result from interplay
between environmental factors and the
genetic makeup of the individual.

Hypersensitivity
• Hypersensitivity is either an excessive
response to antigen stimulation or a
normal response that is inappropriate.

Deficient Immune Responses
• Deficient immune responses occur
when there is a functional decrease in
one or more components of the
immune system.

Primary Immunodeficiency
Disorders
• Primary immunodeficiency disorders
are either congenital or acquired, and
are not attributed to other causes.

Primary Immunodeficiency
Disorders
• HIV/AIDS
– Infection with the human
immunodeficiency virus (HIV) and the
resulting acquired immunodeficiency
syndrome (AIDS) is the best example of
a primary immunodeficiency disorder.
The hallmark of this infection is a
decrease in cellular (T cell) immunity.

Susceptibility to Infections
• Infections are one of the most
frequently encountered problems in the
older population. Although specific
relationships between an aging or
compromised immune system and
infection are not clear, the decline in
responsiveness of the immune system
to harmful foreign invaders leads to an
increase in the incidence and severity
of infections.

Pneumonia
• Pneumonia is a common condition in
immune deficient people and is the
leading cause of death in people over
65 years of age.
• The combination of pneumonia and
influenza causes the greatest number
of deaths.

Monoclonal Antibodies
• The scientific community can now mass
produce immune cell secretions, such
as antibodies. The availability of these
products has revolutionized the study
of the immune system and has had a
significant impact not only upon
medicine, but upon agriculture and
industry as well.

Genetic Engineering
• Genetic engineering, recombinant DNA
technology, genetic
modification/manipulation (gm), and
gene splicing are all terms that are
applied to the direct manipulation of an
organism’s genes.

Nursing Assessment
• Multiple factors underlie immune
problems in the older person.
Therefore, a health history and physical
examination are essential.

Nursing Interventions
• The nurse often will engage in teaching
older patients and families about
prevention of infectious disease like
influenza.

Tabloski ch23 lecture

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