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Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
Decreased Immune Response Infection Immunity
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Decreased Immune Response Infection Immunity

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  • Infections or disease occur
  • If infections are not treated or adequately treated patient can develop:SepticemiaSeptic ShockDisseminated intravascular coagulation (DIC)POOR HAND HYGIENE APPLIES TO ALL
  • Handwashing and alcohol based hand rubs are two methods of hand hygieneCDC bans artificial figernails for healthcare professionaal when they are caring for patients at high risk for infection
  • Transcript

    • 1. Decreased Immune Response: Susceptibility to Infection<br />C Washington RN, MSNEd<br />
    • 2. Infection<br />Host organism’s <br />response to a <br />pathogen or disease causing substance<br />
    • 3. Infection<br />Tissue destroying microorganisms enter & multiply in the body<br />
    • 4. Invasion of the body by pathogenic organisms that multiply and produce injurious effects<br />
    • 5. Four types of microorganisms can enter the body & cause infection<br />
    • 6. Harmless Organisms<br />Resident flora <br /> -E Coli (intestine)<br /> -Staph aureus (skin)<br />Colonization<br /> -microorganisms<br /> become resident<br /> flora<br />Intestinal flora help synthesize vitamin K<br />
    • 7. Harmful Actions of Microorganisms<br /># of organism present<br />Ability of organism to cause disease<br />Person’s immune system<br />Length of contact between person & organism<br />
    • 8. Climate for Infection<br />Poor nutrition<br />Stress<br />Humidity<br />Poor sanitation<br />Crowded living conditions<br />Pollution<br />Dust<br />Medications<br />
    • 9. Opportunistic infections<br />Risk for Infection<br />Inhalation<br />
    • 10. Risk for Infection<br />Direct contact<br />
    • 11. Ingestion<br />Insect or animal bite<br />
    • 12. Controlling Microorganism <br />Medical Asepsis <br /><ul><li>Clean technique
    • 13. Limit #, growth, & transmission of microorganisms
    • 14. Handwashing
    • 15. Barrier techniques
    • 16. Environmental cleaning </li></ul>Surgical Asepsis <br />Sterile technique<br />Completely free of microorganisms<br />
    • 17.
    • 18. The Spread of Infection<br /><ul><li>An elderly pt, admitted with a GI disorder, is on bedrest and requires assistance with ADLs.
    • 19. Frequent uncontrolled diarrhea stools; the nurse provided excellent care to maintain cleanliness & comfort.
    • 20. After one episode of cleaning the pt & changing the bed linen, the nurse went over to a second pt to adjust foleycath tubing.
    • 21. The nurse’s hands were not washed before assisting the second patient.</li></li></ul><li>Breaking the Chain<br />A patient assigned for morning care has an open wound on her left lower leg. <br />The wound is draining & when last cultured, the organism MRSA was identified. <br />What steps would you take to break the chain of infection while changing the patients bed.<br />
    • 22. Nosocomial Infections<br />Drug Resistant Organisms<br />Vancomycin-resistant enterococcus (VRE)<br />
    • 23. Methicillin-resistant Staph aureus (MRSA)<br />
    • 24. Clostridium difficile (C Diff) <br />
    • 25. Nosocomial Infections<br />Pneumonia<br /> -Pseudomonas<br /> -Improper suctioning<br /> technique<br />
    • 26. Nosocomial Infections<br />Bloodstream<br /> -Staph aureus<br /> -Improper IV site care<br />
    • 27. Nosocomial Infections<br />Surgical Site<br /> -Enterococcus<br /> -Improper dsg <br /> change<br />
    • 28. Nosocomial Infections<br />Urinary Tract<br /> -E Coli<br /> -Poor cath care<br />
    • 29. Preventing Nosocomial Infections<br />
    • 30. Transmission Based Precautions<br />Droplet precautions (pneumonia, meningitis)<br /> -Private room/mask &lt;3 ft from pt<br />
    • 31. Transmission Based Precautions<br />Airborne precautions (measles, TB)<br /> -Private neg airflow room 6 air exchanges/hr<br />
    • 32. Transmission Based Precautions<br />Contact precautions<br /> -Direct (kissing, bathing, toughing)<br /> -Indirect (instruments, needles, dressing)<br />
    • 33. Transmission Based Precautions<br />Protective Precautions<br />
    • 34. What might you NOTICE (subjective & objective) if the patient has inadequate protection as a result of infection or infectious disease?<br />
    • 35. What should you ASSESS for a patient with inadequate protection as a result of infection or infectious disease?<br />
    • 36. How should you INTERVENE for a patient with inadequate protection as a result of infection or infectious disease?<br />
    • 37. What should you EVALUATE when a patient is being treated for an infection or infectious disease<br />
    • 38. 2 days post-op below-the-knee amputation<br />Reports feeling hot and sweaty<br />VS 100-98-30 156/88<br />What is your best action at this time<br />
    • 39. Adm from nursing home<br />H/O Stroke<br />MRSA urine<br />Incontinent of urine & stool<br />No private room available<br />Semi private bed with older pt with fractured leg<br />
    • 40. Immune Response<br /> <br />recognize foreign substances<br /> neutralize, eliminate, or metabolize them with or without injury to the body&apos;s own tissues.<br />
    • 41. Functions of the Immune System<br /><ul><li>Defense: protection against antigens
    • 42. Homeostasis: removal of worn out or damaged components (e.g., dead cells)
    • 43. Surveillance: ability to perceive or destroy mutated cells or nonself cells. </li></li></ul><li>Alterations in Immune Functioning<br /><ul><li>Immune Function: Defense
    • 44. Hypofunction: Immunosuppression with increased susceptibility to infection (neutropenia, AIDS, immunosuppression
    • 45. Hyperfunction: Inappropriate and abnormal response to external antigens; an allergy</li></li></ul><li>Alterations in Immune Functioning<br /><ul><li>Immune function: Homeostasis
    • 46. Hypofunction: No known effect
    • 47. Hyperfunction: Abnormal response where antibodies react against normal tissues and cells; an autoimmune disease</li></li></ul><li>Alterations in Immune Functioning<br /><ul><li>Immune function: Surveillance
    • 48. Hypofunction: Inability of the immune system to perceive and respond to mutated cells, suspected mechanism in cancer
    • 49. Hyperfunction: No known effect</li></li></ul><li>Immune Response: Inflammation <br />Reaction of the tissues of the body to injury in order to destroy or dilute an injurious agent<br />prevent the spread of injury <br />promote repair of damaged tissue<br />
    • 50. Inflammatory Response: Cause<br />Physical irritants (e.g., trauma or a foreign body) <br />Chemical irritants (e.g., strong acids or alkalis) <br />Microorganisms (e.g., bacteria and viruses) <br />
    • 51.
    • 52. Inflammatory Response: Local<br />Pain<br />Swelling<br />Heat<br />Redness<br />impaired function of part <br /> *five cardinal signs of inflammation<br />
    • 53. Inflammatory Response: Systemic<br />appear with moderate to severe response<br />Fever<br />Leukocytosis<br />Chills<br />sweating <br />Anorexia<br />weight loss<br />general malaise<br />
    • 54. Types of Immunity<br />
    • 55. Test Yourself<br />A baby is born temporarily immune to the<br />diseases to which the mother is immune. <br />The nurse understands that this is an example of which type of immunity?<br />
    • 56. Test Yourself<br />A mother brings her children into the clinic & they are diagnosed with chicken pox<br />The mother had chicken pox as a child and is not concerned with contracting the disease when caring for her children<br />What type of immunity does this mother have?<br />
    • 57.
    • 58. Factors Influencing Immunity<br />Age<br />Sex<br />Nutritional Status<br />Stress<br />Treatment Modalities<br />
    • 59. Nursing History<br />Present illness<br /><ul><li>Associated symptoms
    • 60. Location
    • 61. Radiation
    • 62. Intensity
    • 63. Duration
    • 64. Frequency
    • 65. Precipitating & alleviating factors</li></ul>Chief complaint<br />Lack of energy<br />Light-headedness<br />Frequent infections<br />Bruising<br />Slow wound healing<br />
    • 66. Nursing History<br />Medical history<br /><ul><li>Changes in overall health
    • 67. Allergies
    • 68. Childhood diseases
    • 69. Recurrent infections
    • 70. Innumizations
    • 71. Rashes
    • 72. Visual disturbances</li></ul>Present illness<br />Prescription drugs<br />Over the counter drugs<br />Herbal remedies<br />Vitamins & nutritional supplements<br />Alternative therapies<br />
    • 73. Nursing History<br />Medical history<br />Fever<br />Changes in elimination<br />h/o immune disorders<br />Menstural patterns<br />Family history<br />Recurrent infections<br />Allergies<br />Cancer<br />
    • 74. Nursing History<br />Social history<br /><ul><li>Work
    • 75. Exercise
    • 76. Diet
    • 77. Recreational drugs & alcohol
    • 78. Hobbies
    • 79. Stress
    • 80. Support systems
    • 81. Coping mechanisms</li></li></ul><li>Physiologic Responses Immunologic Dysfunction<br />Urticaria<br />Hives (wheals)<br />
    • 82. Physiologic Responses Immunologic Dysfunction<br />Angioedema<br /> Generalized swelling<br />
    • 83. Physiologic Responses Immunologic Dysfunction<br />Conjunctivitis<br />Inflammation of membranes of eyelids<br />
    • 84. Physiologic Responses Immunologic Dysfunction<br />Bronchoconstriction<br />Swelling of airway <br />
    • 85. Physiologic Responses to Immunologic Dysfunction<br />Pruritis<br />Associated with erythema & urticaria<br />Hypotension<br />
    • 86. Physiologic Responses Immunologic Dysfunction<br />Leukocytopenia<br />Abnormal decrease in WBCs<br />
    • 87. Physiologic Responses Immunologic Dysfunction<br />
    • 88. Hypersensitive Immune Responses<br />Allergies<br />Anaphylaxis<br />Transfusion reactions<br />Transplant rejection<br />Latex allergy<br />
    • 89. Allergies<br />Allergic disorders are the result of a hypersensitivity (excessive reaction to a stimulus) of the immune system to allergens (a type of antigen commonly found in the environment).<br />
    • 90.
    • 91. Allergies<br />A pt has allergic rhinitis. <br />If the pt does not remain compliant with the treatment regime, the patient is at risk for developing an infection <br />Such as Sinusitis<br />
    • 92. Anaphylaxis<br />A systemic reaction to allergens and the most serious type of allergic reaction.<br />Foods, drugs, hormones, insect bites, blood, and vaccines are all associated with anaphylactic reactions.<br />
    • 93. Anaphylaxis<br />
    • 94. Anaphylactic Reaction<br />A patient is being given PCN via IVPB.<br />Develops an anaphylactic reaction<br />What would you do first?<br />What symptom may the pt be experiencing?<br />What is the medication of choice for anaphylaxis?<br />
    • 95. Transfusion Reactions<br /><ul><li>Any client receiving blood products that are homologous or from a donor may develop a transfusion reaction.
    • 96. Five types: febrile nonhemolytic; allergic urticarial; delayed hemolytic; acute hemolytic; and anaphylactic.</li></li></ul><li>
    • 97. Transplant Rejection<br />Even with the use of immunosuppressive medications, 10% to 15% of transplanted organs fail.<br />
    • 98. Latex Allergy<br /><ul><li>Since 1987, when universal precautions (now called Standard Precautions) were mandated, exposure to latex by health care workers has dramatically increased.
    • 99. By June, 1996, 28 latex-related deaths had been reported to the FDA.</li></li></ul><li>Latex in our lives<br />A combination of exposures to proteins found in latex products and certain foods may be the cause of a rise in latex allergies <br />
    • 100. Latex in our lives<br />Assess for allergies to avocados, bananas, kiwi or chestnuts for cross sensitivity to latex<br />
    • 101. Latex Allergies: Signs & Symptoms<br />Contact dermitis<br />Facial swelling<br />Itching<br />Hives<br />Rhinitis<br />eye symptoms<br /><ul><li>Bronchospasms
    • 102. generalized edema
    • 103. difficulty breathing
    • 104. cardiac arrest</li></ul>Latex cart at bedside<br />
    • 105. Latex Allergy Precautions<br /><ul><li>Mrs. Smith tells you she has allergic reactions when she eats bananas, seafood, eggs
    • 106. Based on this information what would you ask Mrs. Smith
    • 107. What actions would you take?</li></li></ul><li>Nursing Diagnosis<br />Ineffective airway<br />Clearance (obstructed airway)<br />Facial edema<br />Bronchospasms<br />Laryngeal edema<br />Decreased cardiac output<br />(Histamine release)<br /><ul><li>Peripheral vasodilation
    • 108. Increased capillary permeability</li></li></ul><li>Nursing Diagnosis<br />Risk for Injury<br />Hypersensitivity responses high<br />Blood transfusions<br />
    • 109. Components of Immune Response<br />Located throughout the body <br />Organs include thymus, bone marrow, lymph nodes, spleen, tonsils, appendix, Peyer&apos;s patches of small intestine. <br />
    • 110. Components of Immune Response<br />Main cell types are WBCs (especially lymphocytes, plasma cells, and macrophages)<br />all originate from the same stem cell in bone marrow, then differentiate into separate types <br />
    • 111. Components of Immune Response<br />Granulocytes <br />Eosinophils: increase with allergies and parasites <br />Basophils: contain histamine and increase with allergy and anaphylaxis<br />Neutrophils: involved in phagocytosis <br />
    • 112. Components of Immune Response<br />Monocytes (macrophages) (e.g., histiocytes, Kupffer cells): involved in phagocytosis<br />Lymphocytes (T cells and B cells): involved in cellular and humoral immunity <br />
    • 113. Immune System Response<br />Infection<br />WBCs released from bone marrow into blood<br />Bone marrow increases production of additional leukocytes<br />
    • 114. White Blood Cell Count & Differential<br />
    • 115. Leukocytes (WBC) <br /><ul><li>4,500 to 10,000 cell per cubic millimeter
    • 116. Transports themselves to site of inflammatory or immune response
    • 117. Detect, attack, & destroy anything foriegn
    • 118. Locates damaged tissue & infection by responding to chemicals released by other leukocytes & damaged tissue</li></li></ul><li>WBC <br />Leukocytosis<br />Leukopenia<br /><ul><li>WBC greater than 10,000/mm3
    • 119. Infection or inflammation
    • 120. Leukemia
    • 121. trauma or stress
    • 122. tissue necrosis
    • 123. bone marrow depression
    • 124. overwhelming infection
    • 125. viral infection
    • 126. Immunosuppression
    • 127. autoimmune disease
    • 128. dietary deficiency </li></li></ul><li>Differential WBC<br />Granulocytes<br /><ul><li>Play key role in protecting body from harmful microorganisms during acute inflammation & infection</li></ul> -neutrophils<br /> -eosinophils<br /> -basophils<br />
    • 129.
    • 130. Neutrophils (55% to 70%)<br />Neutrophilia<br />Acute infection<br />Stress response<br />Myelocytic leukemia<br />Inflammatory disorders<br />Metabolic disorders<br />Neutropenia<br /><ul><li>Bone marrow depression
    • 131. Overwhelming bacterial infection
    • 132. Viral infection
    • 133. Addison’s disease</li></li></ul><li>Eosinophils (1% to 4%)<br />Eosinophilia<br />Eosinopenia<br />Parasitic infections<br />Hypersensitivity reactions<br />Autoimmune disorders<br />Cushing’s syndrome<br />Autoimmune disorders<br />Stress<br />Certain drugs<br />
    • 134. Basophils (0.5% to 1%)<br />Basophilia<br />Basopenia<br /><ul><li>Hypersensitivity responses
    • 135. Chronic myelogenous leukemia
    • 136. Chickenpox/smallpox
    • 137. Splenectomy
    • 138. hypothyroidism</li></ul>Acute stress<br />Hypersensitivity reactions, hyperthyroidism<br />
    • 139. Monocytes (monos)<br />Monocytosis<br />Monocytopenia<br /><ul><li>Chronic inflammatory disorders
    • 140. Tuberculosis
    • 141. Viral infections
    • 142. Leukemia
    • 143. Hodgkin’s disease
    • 144. Multiple myeloma</li></ul>Bone marrow depression<br />Corticosteroid therapy<br />
    • 145. Lymphocytes (lymphs)<br />Lymphocytosis<br />Lymphocytopenia<br />Chronic bacterial infection<br />Viral infections<br />Lymphocytic leukemia<br /><ul><li>Bone marrow depression
    • 146. Immunodeficiency
    • 147. Leukemia
    • 148. Cushing’s disease
    • 149. Hodgkin’s disease
    • 150. Renal failure</li></li></ul><li>Autoimmune Diseases<br />Systemic lupus erythematosus<br />Rheumatoid arthritis<br />Myasthenia gravis<br />Multiple Sclerosis<br />AIDS<br />
    • 151. Systemic Lupus Erythematosus (SLE)<br />A chronic, progressive, incurable autoimmune disease affecting multiple body organs.<br />T cells attack the skin, kidneys, and other organs <br />Characterized by periods of remission and exacerbation.<br />
    • 152. Rheumatoid Arthritis<br />A chronic, systemic autoimmune disease characterized by joint stiffness<br />T cells attack the linings of joints <br />
    • 153. Myasthenia Gravis<br />
    • 154.
    • 155. Acquired Immune Deficiency Syndrome<br />

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