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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher Nursing (RN) School Study Aid


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13 - Altered Immune Responses and Transplantation
20 Picmonics to Learn | 32 mins

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Innate Immunity Cellular Response
Characteristics
Natural Killer Lymphocytes Attack Abnormal Cells
Neutrophils in Blood
Infected Cells Release Interferon
Complement Proteins Lyse Pathogens/Infected Cells
Dendritic Cells in Tissue
Macrophages in Tissue
1 min
Immune System Tissues
Characteristics
Bone Marrow
B Cells and T Cells Formed
B Cells Mature
Thymus
T Cells Tested For Self-Response
T Cells Mature
Lymph Nodes
Mature B Cells and T Cells Monitor Lymph For Pathogens
Spleen
Mature B Cells and T Cells Monitor Blood For Pathogens
1 min
Innate Immunity Barriers
Skin Protects Against Pathogens
Normal Flora Outcompete Pathogens
Lysozyme in Saliva, Tears, and Mucus
Mucous Traps Pathogens
Cilia Remove Mucus
Acid and Digestive Enzymes in the Stomach Kill Pathogens
1 min
WBC Differential Lab Value
White Blood Cells (WBC)
5-10 (5,000-10,000)
Leukocyte Differential
Neutrophils (50%-70%)
Bands (2%-5%)
Segs (50%-70%)
Lymphocytes (20%-40%)
Monocytes (4%-8%)
Eosinophils (2%-4%)
Basophils (0.5%-1.5%)
1 min
Cell-mediated Adaptive Immune Response
Characteristics
Macrophages and Dendritic Cells Present Antigens
T Cell Develops Antigen Specificity
Regulatory T Cells Suppress Response
Memory T Cells Cause Faster Secondary Response
Cytotoxic T Cells Lyse Infected Cells
Infected Cells Present Antigen On Surface
1 min
Humoral Adaptive Immunity
Characteristics
B Cell Binds Free Floating Antigen
B Cell Presents Antigen to Helper T Cell
Helper T Cells Help B Cells Develop Antigen Specificity
Plasma B Cells Secrete Antibodies
Memory B Cells Cause Faster Secondary Response
1 min
Erythropoietin
Mechanism
Stimulates RBC Production
Indications
Chronic Renal Failure
Anemia
Side Effects
Increased Risk of Thrombosis
Pelvic and Limb Pain
Hypertension
Considerations
Do Not Shake
Monitor Hemoglobin (Hgb) Weekly
May Accelerate Tumor Progression
1 min
Hypersensitivity Type I
Previous Antigen Exposure
Immediate Reaction
IgE Cross-linking
Presensitized Mast Cells
Histamine Release
Vasodilation
Anaphylaxis
Allergies
Treatment
Epinephrine
1 min
Hypersensitivity Type II
Cytotoxic
IgM or IgG antibody-mediated
Membrane Attack Complex (MAC)
Mechanism
Opsonization
Complement Activation
NK Cells
Testing
Direct Coombs test
Indirect Coombs Test
1 min
Hypersensitivity Type III
Immune Complex
Antigen-antibody (IgG) complex activates complement
Neutrophils release lysozomal enzymes
Examples
Arthus Reaction
Serum Sickness
Systemic Lupus Erythematosus (SLE)
1 min
Hypersensitivity Type IV
Delayed-Type Hypersensitivity
T Cell Mediated
Antibody Independant
Macrophages Activated
Examples
Transplant Rejection
PPD Skin Test
Contact Dermatitis
1 min
Transfusion Reactions
Acute Hemolytic
Febrile, Non-Hemolytic
Mild Allergic
Anaphylactic
Circulatory Overload
Sepsis Reaction
Transfusion-Related Acute Lung Injury (TRALI)
Massive Blood Transfusion
2 mins
Anaphylaxis Intervention
Intervention
Assess Airway and Oxygen Needs
Reassure Patient with Anxiety
Trendelenburg Position
Methylprednisolone (Solu-medrol)
Epinephrine
Diphenhydramine (Benadryl)
Medical Alert Bracelet
1 min
Cromolyn (Mast Cell Stabilizers)
Mechanism
Mast Cell Stabilizer
Indications
Asthma Prophylaxis
Bronchial Inflammation
Allergic Rhinitis
Side Effects
Cough
Bronchospasm
Consideration
Fixed Schedule Administration
1 min
Epinephrine (Adrenaline)
Mechanism
Alpha and Beta Agonist
Indications
Anaphylaxis
Primary Open Angle Glaucoma (POAG)
Bleeding
Cardiac Arrest
Side Effects
Tachycardia
Hypertension
Tremors
Insomnia
Considerations
Multiple Strengths
1 min
Systemic Lupus Erythematosus (SLE) Assessment
Mechanism
Multisystem Inflammatory Disorder
Assessment
Malar Rash
Discoid Rash
Arrhythmias
Arthritis
Hemolytic Anemia
Seizures
Glomerulonephritis
Considerations
Periods of Exacerbation and Remission
Diagnosed by ANA (Anti-nuclear antibody assay)
2 mins
Tacrolimus (Prograf) Overview
Mechanisms
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Transplant Rejection
Atopic Dermatitis
Considerations
Increased Lymphoma Risk
Avoid Grapefruit Juice
1 min
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
1 min
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
1 min
Tacrolimus (Prograf) Side Effects
Nephrotoxicity
Neurotoxicity
GI Distress
Infection
Hypertension
Hyperkalemia
Hyperglycemia
1 min

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