Concepts of Immunity and Inflammation

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Questions and Answers

What is the primary role of inflammation in the immune system?

To provide immediate resistance to a broad range of pathogens

To promote healing and tissue repair (correct)

To facilitate the development of adaptive immunity

To eliminate all foreign substances from the body

Which type of immunity is characterized by a quick response to pathogens that a person has never encountered before?

Adaptive immunity

Innate immunity (correct)

Acquired immunity

Passive immunity

At what age do significant changes in immunity typically begin to stabilize in pediatric patients?

6 months

1 year (correct)

5 years

Birth

What is a characteristic of innate immunity?

It includes specific cells such as macrophages. Signup and view all the answers

Which of the following vaccines is classified as a live vaccine?

Measles, mumps, rubella (MMR) Signup and view all the answers

Which type of immunity involves maternal antibodies?

Passive immunity Signup and view all the answers

What differentiates passive immunity from active immunity?

Passive immunity involves immediate protection without prior exposure Signup and view all the answers

What is the significance of the recommended vaccine schedule during the first 5 years of life?

To optimize the infant's ability to respond to future vaccinations Signup and view all the answers

Why are infants and young children more susceptible to infections?

They display a decreased inflammatory response. Signup and view all the answers

Which of the following is an example of artificial active immunity?

Immunization shots Signup and view all the answers

Which of the following describes a key aspect of autoimmune responses?

T cells mistakenly attack the body's own tissues Signup and view all the answers

How does HIV affect the immune system in infants acquired through birth or breastmilk?

It impairs the immune system over time Signup and view all the answers

How does humoral immunity develop in infants?

As the body encounters new diseases. Signup and view all the answers

What role do neutrophils play in the immune response of infants?

They are part of innate immunity and react quickly. Signup and view all the answers

Which immunological function is least developed in newborns?

Humoral immunity Signup and view all the answers

What is a common risk factor for increased infection in infants?

Limited exposure to diseases. Signup and view all the answers

What physiological changes are triggered by the release of endogenous pyrogens in response to infection?

Production of prostaglandins Signup and view all the answers

Which of the following best describes inflammation?

A body's response marked by redness, swelling, warmth, and/or pain Signup and view all the answers

What action should be taken when managing fever in a child?

Assess temperature every 30 to 60 minutes after administering antipyretics Signup and view all the answers

During which developmental stage are children most susceptible to infections transmitted through poor hand hygiene?

Preschool years Signup and view all the answers

What is a common source of immunity transmission in infants?

Transmission of infections in utero or through breast milk Signup and view all the answers

What is a primary reason for a child to experience a fever during an infection?

To inhibit the growth of pathogens Signup and view all the answers

Which of the following practices should be encouraged to manage fever in children?

Keep linens and clothing clean and dry Signup and view all the answers

How does fever affect the body’s response to an infection?

Increases resistance to infections Signup and view all the answers

What is the role of nurses in the vaccine administration process?

Educate patients and prepare vaccines while selecting injection sites Signup and view all the answers

Which of the following groups should not receive the live flu vaccine (Flu Mist)?

Children less than two years of age Signup and view all the answers

What can be considered a barrier to immunization?

Cost and long wait times Signup and view all the answers

Which condition is a specific contraindication for vaccine administration?

History of severe anaphylactic reaction Signup and view all the answers

What is the impact of the HIV virus on the immune system?

It causes gradual suppression of cell-mediated immunity Signup and view all the answers

Which method is NOT a route of transmission for HIV to children?

Saliva exchange during kissing Signup and view all the answers

What is a common symptom associated with HIV/AIDS in infants?

Flu-like symptoms Signup and view all the answers

What is the correct protocol regarding infants born exposed to HIV?

They start antiretroviral medications and may stop after two negative tests. Signup and view all the answers

What is a common intervention for managing Juvenile Idiopathic Arthritis (JIA)?

Medications to reduce inflammation Signup and view all the answers

Which statement correctly describes the assessment of hyper-reactive immune response?

It can range from mild symptoms to severe anaphylaxis. Signup and view all the answers

What is a critical nursing intervention for a child at risk of anaphylactic shock?

Ensure an Epi pen is available at all settings. Signup and view all the answers

Which of the following is a characteristic of highly active antiretroviral therapy (HAART)?

It involves a combination of medications. Signup and view all the answers

What best describes the autoimmune response in conditions like Juvenile Idiopathic Arthritis (JIA)?

The immune system mistakenly attacks the body's own cells. Signup and view all the answers

Study Notes

Concept of Immunity

Immunity is a complex process that protects the body from foreign substances to prevent infection
Two primary types of immunity: innate and adaptive
- Innate immunity involves cells and proteins like macrophages, neutrophils, and killer cells that identify and react to foreign organisms
- Adaptive immunity is comprised of lymph system components that determine “self” versus “non-self”, it adapts and remembers previous exposure to microorganisms
  - Adaptive immunity breaks down further into natural and artificial immunity
    - Natural immunity:
      - Passive: Maternal antibodies
      - Active: Exposure to infection
    - Artificial immunity:
      - Passive: IVIG (artificial antibodies)
      - Active: Immunizations

Inflammation

Inflammation is the body's natural response to injury, irritation, or infection
Characterized by redness, swelling, warmth, and pain
Occurs due to the accumulation of immune cells and substances around the site of injury or infection

Fever

Infection triggers the release of endogenous pyrogens
Pyrogens act on the hypothalamus and stimulate prostaglandin production, leading to an increase in the body's set temperature
This triggers the cold response (shivering, vasoconstriction, decreased peripheral perfusion) to decrease heat loss and reset body temperature
Fever occurs as a result of these changes

Managing Fever in Children

Assess temperature at least every 4-6 hours and 30-60 minutes after antipyretic administration
Use the same temperature measurement site and device, age- and unit-specific
Administer antipyretics as appropriate
Notify the physician of temperature changes per institution or specific order guidelines
Encourage oral intake or administer intravenous fluids as needed (PRN)
Keep linens and clothing clean and dry

Changes to the Immune System Throughout Development

Infants and young children have immature immune responses making them more susceptible to infection
Newborns have decreased inflammatory responses contributing to an increased risk of infection
Cellular immunity is generally functional at birth, but humoral immunity develops with exposure to new diseases
Infants are at higher risk for infection because they have limited disease exposure and are losing passive immunity acquired from maternal antibodies
Children less than a year old should not receive MMR or varicella (both live vaccines) as they still have maternal passive immunity
Children less than 2 years of age should not receive the live flu vaccine (Flu Mist)

Vaccine Administration and Nursing Role

Educate patients/caregivers about vaccinations prior to administration and provide the Vaccine Information Sheet (VIS)
Obtain consent for vaccination
Prepare the vaccine
Select appropriate injection site (for injectables)
- IM - preferred site, age-dependent
Provide pain relief and/or distraction as needed

Immunizations

Barriers to immunizations include:
- Long wait times
- Expense
- Language barriers
- Lack of knowledge about immunizations
- Misinformation
Contraindications (vaccine-specific) - History of severe anaphylactic reaction - History of encephalopathy within days of DTaP administration - History of Guillain-Barré syndrome
Moderate to severe acute illness with or without fever

Scope of the Immunity Concept

Suppressed immune response: Illnesses like Human Immunodeficiency Virus (HIV)
Hypersensitive response: Food and environmental allergies
Autoimmune response: Juvenile Idiopathic Arthritis (JIA)

Perinatally Acquired Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)

HIV virus leads to AIDS. HIV causes reverse transcription, suppressing cell-mediated immunity
This weakens the immune system and ability to fight infection
HIV is transmitted through direct contact with infected body fluids, secretions, or blood.
Transmission to children:
- Infants: Infected mother during pregnancy, delivery, or breastfeeding
- Adolescents: Unprotected sex with an infected partner or injection drug use
- Any age: Transfusion of HIV-infected blood products
Manifestations: Flu-like symptoms, swollen lymph nodes, pneumonia, very low CD4 cell count
Diagnosis: HIV testing
Treatment: Highly active antiretroviral therapy (HAART), nutritional support, rest, medication adherence, emotional support, education
Nursing interventions: Prevention of transmission, identification of disease progression, and when to seek treatment

Perinatal Transmission and Nursing Care

Babies born exposed to HIV will test positive at birth
Infants begin antiretroviral medications to prevent transmission
Repeat HIV testing at regular intervals depending on the risk of transmission
Most babies test negative by 6 months of age
Infants can stop medication once they have two negative HIV tests
Nursing responsibilities: monitoring infant health, administration of medications, education of the family, and providing emotional support

Hyper-reactive Immune Response

Overreaction of the immune system to an antigen
Triggers can be environmental, food, or medication
Ranges from mild (sneezing) to severe (anaphylaxis)
Increase in the number of children with severe allergies
Epi pens should be available for children with known anaphylaxis history or risk factors

Anaphylactic Shock

Serious allergic reaction that can be life-threatening
Symptoms: Swelling, hives, difficulty breathing, and low blood pressure
Nursing interventions: recognize signs and symptoms, administer epinephrine, monitor vital signs, provide supportive care, and educate patients and families

Autoimmune Response

The immune system fails to recognize “self ” from foreign invaders and attacks the body's own tissues
Juvenile Idiopathic Arthritis (JIA) : Chronic inflammation of the joints with varying degrees of severity and number of joints affected.

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Description

Explore the complex mechanisms of immunity, including innate and adaptive immunity, along with natural and artificial components. Additionally, understand the body's response to injury through inflammation. This quiz covers essential concepts crucial for understanding immune responses and healing processes.