The document discusses the immune system and its defense against disease. It defines the immune defense and immunodeficiency. It describes the body's lines of defense including physical barriers, phagocytes, inflammation, and the adaptive immune system of antibodies and memory cells. It differentiates between primary and secondary immunodeficiency. The nursing management of patients with immunodeficiency focuses on infection prevention and treatment, nutritional monitoring, education, and managing complications.

1. Prepared by :-
Taghreed Hamza hawswi
BSN-RN
CPR instructor, TOT trainer
Master student 1st year
Management for
Immune Defense

2. L E A R N I N G O B J E C T I V E S
By the end of the lesson the learner will be able to define
The immune defense & immunodeficiency
By the end of the lesson the learner will be able to
describe the process of body defense against
disease
By the end of the lesson the learner will be able to
enumerat the line of defense mechanism

3. L E A R N I N G O B J E C T I V E S
By the end of the lesson the learner will be able to
Differentiate between (primary & secondary ) case of
Immunodeficiency disease
By the end of the lesson the learner will be able to
demonstrate nursing management for patient with
Immunodeficiency disease

4. Introduction
Throughout life, the human body can be
invaded by many disease-causing organisms
such as bacteria, viruses, fungi and
parasites.
Collectively, these are known as pathogens
and can trigger a specific immune response.
Other substances that may trigger such a
response include chemicals from the
environment, pollen grains or foreign tissue
cells.

5. Introduction
Any substance that stimulates a specific immune
response is called an antigen .
This topic explores how the immune system protects
the body from harmful antigens and how the latest
medical technology is used in the production of
vaccines .

6. Section 1
Immune Defense

7. 5 minute

8. Definition
Immune defense is the coordinated, complicated interplay of
cellular mechanisms and antibodies to fight disease-causing
agents, including viruses, bacteria, and other types of infection.

9. Function of Immune system
To protect the body from harmful substances, such as
pathogens and environmental pollutants.

10. Nonspecific External Barriers
skin, mucous membranes
If these barriers are penetrated,
the body responds with
Innate Immune Response
phagocytic and natural killer cells,
inflammation, fever
If the innate immune response is insufficient,
the body responds with
Adaptive Immune Response
cell-mediated immunity, humoral immunity
Defense Against Disease

11. Lines of defense
The immune system
provides three lines of
defense.
The first and second lines of
defense of the human body
are nonspecific immune
responses
The third line of defense,
immune system, reacts in
specialized ways for various
invaders

12. Non-specific defenses are designed to prevent infections by
viruses and bacteria. These include:
Intact skin Mucus Cilia
The Defense

13. Role of skin
Dead skin cells are constantly sloughed off, making
it hard for invading bacteria to colonize.
Sweat and oils contain anti-microbial chemicals,
including some antibiotics.

14. Mucus contains lysozymes,
enzymes that destroy bacterial
cell walls.
The normal flow of mucus
washes bacteria and viruses off
of mucus membranes.
Cilia in the respiratory tract
move mucus out of the lungs to
keep bacteria and viruses out.
Role of mucus and cilia

15. Role of phagocytes
Phagocytes are several types of white blood cells
(including macrophages and neutrophils) that seek and
destroy invaders. Some also destroy damaged body cells.
Phagocytes are attracted by an inflammatory response of
damaged cells.

16. Role of inflammation
Inflammation is signaled by mast cells, which
release histamine.
Histamine causes fluids to collect around an injury
to dilute toxins. This causes swelling.
The temperature of the tissues may rise, which can
kill temperature-sensitive microbes.

17. Third line of defense
Specific defenses are those that give us immunity
to certain diseases.
In specific defenses, the immune system forms a
chemical “memory” of the invading microbe.
If the microbe is encountered again, the body
reacts so quickly that few or no symptoms are felt.

18. Antibodies
Antibodies are assembled out of protein chains.
There are many different chains that the immune system
assembles in different ways to make different antibodies.

19. Antigen recognition
Cells of the immune system are “trained” to recognize
“self” proteins vs. “not self” proteins.
If an antigen (“not self”) protein is encountered by a
macrophage, it will bring the protein to a helper T-cell for
identification.
If the helper T-cell recognizes the protein as “not self,” it
will launch an immune response.

20. Role of Antibodies
Antibodies released into the blood stream will bind to
the antigens that they are specific for.
Antibodies may :-
1- Disable some microbes
2-Cause them to stick together (agglutinate).
3- They “tag” microbes so that the microbes are
quickly recognized by various white blood cells.

21. How vaccines work
Modern vaccines are created from
killed bacteria or viruses, or
fragments of proteins from these
microbes.
1- The proteins are recognized as
antigens by our immune systems.
2-This causes a mild immune
response.
3-Memory T-cells and B-cells
remain ready to fight off the illness
if it is encountered again.

22. How antibiotics work
1- Antibiotics help destroy bacteria (but not viruses).
2- Slowing bacteria reproduction.
3- Interfering with bacterial cell wall formation.

23. Medical science has created
to systems for augmenting the
human immune system:
Antibiotics (NOT the same
as antibodies)
Vaccines
Medical Management

24. Section 1

25. Immunodeficiency defined
Decreased or compromised ability to respond to antigenic
stimuli by appropriate cellular immunity reaction.
May be secondary to loss of immunoglobulin's or an
abnormality of B or T cell lymphocytes

26. Immunodeficiency
• Primary—inborn errors. Can affect lymphocytes,
phagocytes, complement system
• Secondary—More common and may be related to
underlying diseases or the treatment of these diseases.

27. Causes of secondary
immunodeficiency
Malnutrition
Burns
Uremia
Diabetes mellitus
Immunotoxic medications
Self-medication of recreational drugs and alcohol
AIDS

28. Section 3
Nursing Management

29. Nursing Management for Patient
with Immunodeficiency in general
Assess for infection
1. Fever
2. White patches in oral cavity
3. Adenopathy
4. Persistent diarrhea
5. Frequency, urgency or pain upon urination
6. Redness, drainage or swelling of skin lesions
7. Persistent vaginal discharge
8. Cough with or w/o sputum

30. Monitor lab values
1. Sputum
2. Urine
3. Blood cultures
4. CBC
Monitor vital signs, weight

31. Nursing Assessments
Identification of risky sexual practices, drug
use (IV)
Physical assessment
Respiratory status
Nutritional status
Skin integrity
Neurologic status
Fluid and electrolyte balance
Knowledge level

32. Nursing Diagnoses
1-Diarrhea related to enteric pathogens or HIV infection
2- Risk for infection related to immunodeficiency
3- Ineffective airway clearance related topneumocystis
pneumonia (PCP), increased secretions, decreased ability
to cough
4- Imbalanced nutrition, less than body requirements
5- Social isolation related to stigma of disease, fear of
infecting others

33. Nursing Interventions
Improving airway clearance
Preventing infections
Maintaining thought processes
Improving activity tolerance
Promoting skin integrity
Promoting usual bowel patterns
Relieving pain and discomfort
Improving nutritional status

34. Nursing Interventions
Decreasing sense of isolation
Coping with grief
Monitoring and managing potential
complications-respiratory failure, cachexia, side
effects of medications
Teach self-care

35. Evaluation
Maintains effective airway
Maintains usual level of thought processes
Resumes usual bowel habits
Maintains skin integrity
Experiences no infections
Maintains adequate level of activity tolerance
Maintains adequate nutritional status
Progresses through grief process
Remains free of complications

36. Summary
Viruses and bacteria are everywhere.
Some of them want to invade our body.
Our body defend itself against viruses and bacteria.

37. Brunner, L., Smeltzer, S., & Bare, B.
(2010). Hand Book for Brunner &
Suddarth’s textbook of medical-surgical
nursing. Retrieved from
http://books.google.com/books?hl=en&lr
=&id=SmtjSD1x688C&oi=fnd&pg=PA131
1&dq=Brunner+%26+Suddarth%27s+Te
xtbook+of+Medical-
Surgical+Nursing&ots=cii4p83QfO&sig=
3-niIms8D7CobiuLjIICoTeTKY8

38. http://www.presentermedia.com/powerpoint-templates/templates/on-
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