Infection & Immunity Quiz
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Questions and Answers

What is the primary reason Mrs. A needs to be isolated?

  • She is positive for MRSA. (correct)
  • She is experiencing mild symptoms.
  • She needs routine monitoring.
  • She has contracted a viral infection.

    • What does the term 'antibacterial therapy' refer to?

  • The process of improving immune cell function.
  • The treatment of infections primarily caused by viruses.
  • The use of medications to prevent allergic reactions.
  • The administration of medications to combat bacterial infections. (correct)

    • What complication can arise from infections evading the immune system?

  • Enhanced immune response.
  • Reduced medication efficacy.
  • Increased risk of allergies.
  • The need for additional medications to combat bacteria. (correct)

    • Why are antibiotic-resistant bacteria considered a significant concern?

    <p>They render many common treatments ineffective.</p> Signup and view all the answers

    What type of precautions should be taken for Mrs. A's care given her MRSA positivity?

    <p>Contact precautions.</p> Signup and view all the answers

    What can untreated severe infections potentially lead to?

    <p>Septic shock</p> Signup and view all the answers

    Which laboratory test indicates possible sepsis or multiorgan dysfunction?

    <p>Lactate levels</p> Signup and view all the answers

    Which symptom is NOT a consequence of severe infection?

    <p>Hypoglycemia</p> Signup and view all the answers

    What is an important aspect of primary prevention in infection control?

    <p>Public health initiatives</p> Signup and view all the answers

    Which type of test helps visualize body tissues to assess possible infection?

    <p>Radiographic tests</p> Signup and view all the answers

    What is one of the first steps in managing a patient's fever due to infection?

    <p>Cool the patient using ice packs</p> Signup and view all the answers

    Which blood component indicates bacterial or viral infections through its elevation?

    <p>Lymphocytes</p> Signup and view all the answers

    Which of the following is a secondary prevention strategy for infection?

    <p>Screening for infections</p> Signup and view all the answers

    Which class of antibiotic is specifically designed to kill bacteria?

    <p>Bactericidal</p> Signup and view all the answers

    What is the primary purpose of anthelmintics in anti-infective therapy?

    <p>To target parasitic worms</p> Signup and view all the answers

    Which type of spectrum is used when an antibiotic is effective against a wide variety of organisms?

    <p>Broad Spectrum</p> Signup and view all the answers

    What factor must be considered for antibiotics to be effective?

    <p>The dosage and duration of use</p> Signup and view all the answers

    How do antibiotics differentiate between bacteria and human cells?

    <p>By exploiting differences in cellular structure</p> Signup and view all the answers

    What characterizes an acute infection?

    <p>Lasts a few days to weeks</p> Signup and view all the answers

    In what scenario might an antibiotic not be tolerated well by the host?

    <p>Immune reaction or allergy to the drug</p> Signup and view all the answers

    Which of the following does not describe broad-spectrum antibiotics?

    <p>Only effective on Gram -ve bacteria</p> Signup and view all the answers

    Which of the following describes a pandemic?

    <p>A worldwide increase in infectious cases</p> Signup and view all the answers

    What is the role of lab technicians when a suspected infection is observed?

    <p>To determine the bacteria's Gram classification and shape</p> Signup and view all the answers

    What is a potential outcome during the convalescence stage of infectious diseases?

    <p>The body returns to homeostasis</p> Signup and view all the answers

    Which method of transmission involves the spread of pathogens through respiratory droplets?

    <p>Droplet transmission</p> Signup and view all the answers

    Which of the following statements about sepsis is true?

    <p>It results from pathogens in blood or tissue throughout the body</p> Signup and view all the answers

    What risk factor can lead to an increased susceptibility to infections?

    <p>Malnutrition or dehydration</p> Signup and view all the answers

    Which type of precaution is specifically mandated for contact transmission infections such as MRSA?

    <p>Transmission-based precautions</p> Signup and view all the answers

    What type of pathogen is capable of causing disease and includes unicellular organisms?

    <p>Pathogens including viruses, bacteria, fungi, and protozoans</p> Signup and view all the answers

    Which of these is NOT a recognized method of infectious disease transmission?

    <p>Pathogen transmission</p> Signup and view all the answers

    In the context of infection control, what is Hand Hygiene primarily aimed at?

    <p>Preventing the spread of infectious agents</p> Signup and view all the answers

    What symptom is NOT present in the case of the 80-year-old female patient with cellulitis?

    <p>Numbness in the foot</p> Signup and view all the answers

    Which laboratory tests are specifically ordered for this patient?

    <p>CBC, biochemistry, and blood cultures</p> Signup and view all the answers

    What vital sign is notable for the 80-year-old female patient?

    <p>Blood pressure of 121/79 mmHg</p> Signup and view all the answers

    What immediate action is being considered regarding antibiotic treatment?

    <p>Begin antibiotics before obtaining culture results</p> Signup and view all the answers

    Which of the following is a common characteristic of cellulitis?

    <p>Localized redness, warmth, and swelling</p> Signup and view all the answers

    In the assessment of the patient's leg, what observation was made?

    <p>Blister forming and leaking exudate</p> Signup and view all the answers

    For which specific purpose is an ultrasound ordered for the patient?

    <p>To check for fractures or soft tissue injury</p> Signup and view all the answers

    Which of the following factors could complicate the diagnosis of cellulitis in an elderly patient?

    <p>Chronic immune suppression</p> Signup and view all the answers

    Which cephalosporin is specifically mentioned as being contraindicated for patients with a bleeding disorder?

    <p>Ceftriaxone</p> Signup and view all the answers

    What is the primary mechanism of action for macrolides like erythromycin and azithromycin?

    <p>Inhibit bacterial protein synthesis</p> Signup and view all the answers

    What potential serious side effect is associated with macrolides?

    <p>QT prolongation</p> Signup and view all the answers

    Which antibiotic class is primarily indicated for patients with a penicillin allergy?

    <p>Cephalosporins</p> Signup and view all the answers

    Which side effect is associated with the use of tetracyclines such as doxycycline?

    <p>Photosensitivity</p> Signup and view all the answers

    What nursing consideration is crucial when administering aminoglycosides like gentamicin?

    <p>Assess for hearing impairment</p> Signup and view all the answers

    Which of the following is a contraindication for fluoroquinolones like ciprofloxacin?

    <p>Age under 18 years</p> Signup and view all the answers

    How do sulfonamides like trimethoprim/sulfamethoxazole primarily inhibit bacterial growth?

    <p>By inhibiting folic acid synthesis</p> Signup and view all the answers

    Which of the following side effects is associated with the use of tetracyclines specifically in children?

    <p>Teeth discoloration</p> Signup and view all the answers

    What type of bacterial resistance occurs naturally without external influences?

    <p>Innate resistance</p> Signup and view all the answers

    What serious risk is enhanced when cephalosporins are used in conjunction with anticoagulants?

    <p>Increased risk of bleeding</p> Signup and view all the answers

    What is a key side effect that patients should be monitored for when taking fluoroquinolones?

    <p>Tendon rupture</p> Signup and view all the answers

    Which of the following antibiotics is typically used for serious systemic infections due to its narrow spectrum?

    <p>Gentamicin</p> Signup and view all the answers

    What common side effect is associated with sulfonamides in newborns?

    <p>Kernicterus</p> Signup and view all the answers

    Study Notes

    Infection & Immunity

    • Infection is the invasion and multiplication of harmful microorganisms in the body, leading to illness.
    • Infections can be acute (lasting days to weeks) or chronic (lasting longer than 12 weeks).
    • Infections can be localized (limited to a specific area) or systemic (affecting the entire body).
    • Sepsis is a life-threatening systemic infection with pathogens in the blood or tissues.
    • An epidemic involves more cases of infection than usual, while a pandemic is a worldwide epidemic.
    • Immunity is a physiological process that provides protection against diseases.
    • Immunity is accomplished through the actions of the immune system.
    • The immune system protects the body from foreign antigens (typically proteins).
    • Microorganisms, like bacteria, viruses, parasites, and fungi, are common foreign antigens.

    Student Learning Objectives

    • Describe the general concept of immunity and infection.
    • Explain the pathophysiological mechanisms and impact of altered immune responses and infection.
    • Describe the principles, practices, and processes related to health assessment of impaired immune responses and infections using specific examples.
    • Apply pharmacokinetics, pharmacodynamics, and pharmacotherapeutics of therapies targeting altered immune responses and infections, using specific examples (e.g. Penicillins, Cephalosporins).
    • Apply the principles, practices, and processes of non-pharmacological therapies targeted to altered immune response and infection.
    • Apply nursing process/clinical judgment to patients experiencing altered immune responses and infections.

    Immunity

    • Immunity involves the body's protection or defense from diseases.
    • This function is achieved through the actions of the immune system.
    • The immune system protects against foreign antigens.
    • Common foreign antigens include microorganisms like bacteria, viruses, parasites, and fungi, as well as pollens, foods, venoms, vaccines, and transplanted tissue.

    Immunity and Interrelated Concepts

    • Immunity is influenced by factors such as nutrition, glucose regulation, stress and coping, inflammation, tissue integrity, and fatigue.
    • Infection also has an impact on immunity.

    Immunity Protection

    • Innate immunity: protection present at birth.
    • Acquired immunity: protection gained after birth through active or passive immunity.
    • Natural active immunity develops through exposure to an antigen.
    • Artificial active immunity results from immunizations.
    • Artificial passive acquired immunity involves receiving specific immunoglobulins.
    • Natural passive immunity is temporary, passing antibodies from a mother to a fetus.

    Normal Physiological Process

    • The body protects itself from microorganisms and harmful antigens.
    • Damaged or dead tissues and cells are removed.
    • The body identifies and removes abnormal cell growth and development.
    • The immune response can be categorized as suppressed, optimal, or exaggerated.

    Risk Factors for Changes in Immunity

    • Older age
    • Low socioeconomic status (SES)
    • Non-immunized status
    • Chronic illnesses
    • Chronic drug therapies (e.g., corticosteroids, chemotherapy)
    • Substance use disorders
    • Unhealthy lifestyles
    • Genetic risk for excessive or decreased immunity

    Three Lines of Defense

    • Skin surfaces form a barrier against infection.
    • Mucous membranes, enzymes, and natural microbial flora.
    • Complement proteins.
    • Activities of T lymphocytes, granulocytes, and macrophages.
    • Antibodies produced by T and B lymphocytes for acquired specific immunity.

    Cells of the Immune Response

    • White blood cells (leukocytes): Granulocytes (Neutrophils, Eosinophils, Basophils), Agranulocytes (Lymphocytes, Monocytes)
    • B lymphocytes mature in the liver
    • T lymphocytes develop in the thymus gland
    • Natural killer cells assist in specific immune responses

    Organs of the Immune System

    • Lymphoid organs are scattered throughout the body (e.g., spleen, thymus gland, bone marrow, adenoids, tonsils, appendix).
    • Lymphocytes form, grow, mature, and are released.
    • Lymphatic system connects tissues and organs via blood.

    Overview of Immune Response

    • Production of various types of cells by the bone marrow like T cells and B cells.
    • Cells are capable of reacting with and responding to antigens.
    • Cells can produce antibodies.

    Clonal Selection

    • Cellular Immunity: T lymphocytes (CD8 cells) attack infected cells, fight intracellular viruses, tumors and fungi. Helper T cells (CD4 cells) regulate immune responses. Suppressor T cells prevent excessive responses.
    • Humoral Immunity: B lymphocytes mature after exposure to an antigen forming plasma cells and memory cells to generate antibodies.

    Normal Specific Immune Response

    Illustrative diagram of cell interactions as specific components of the immune response (e.g., virus, macrophages, T-helper cells).

    Phagocytes and the Complement System

    • Phagocytes (e.g., macrophages, neutrophils) recognize and ingest foreign antibodies.
    • They help with the proliferation and differentiation of T and B cells.

    Antibody-Mediated Process

    • Illustrative diagram outlining the steps in antibody production and interaction with antigens. Illustrative diagram of antibody production and subsequent interaction.

    Antibodies (or Immunoglobulins)

    • Nine types of antibodies: IgG, IgD, IgM, IgA, IgE
    • These antibodies have different functions and locations in the body.

    Primary and Secondary Immune Responses

    Illustrative diagram showing the different antibody responses in primary and secondary immune responses to an antigen.

    • In utero-maternal alloantigen: immune cells immature, but provide innate immunity
    • Infants and children: exposure to antigens and vaccinations
    • Aging: declining immunity, increased risks of infections, reduced vaccine effectiveness, autoimmune conditions become more prevalent.

    Suppressed Immune Response

    • Primary Immunodeficiency (PI): The immune system is inadequately developed, and some components are missing.
    • Secondary Immunodeficiency: Loss of immune function after treatment or illness (e.g., treatment for organ transplant, cancer).

    Assessment (SLO #5)

    • History: details about previous infections, allergies, treatments, etc.
    • Clinical findings: physical examination for signs of infection.
    • Diagnostic tests: to help discriminate between infections, and whether the response is local or systemic.
    • Laboratory tests: e.g., CBC, biochemistry, blood/wound/urine cultures.
    • Screening tests: e.g., CRP, ESR.
    • Disease-specific testing: identify specific pathogens.

    Hypersensitivity Reactions (SLO #4)

    • Four types of hypersensitivity reactions: Type I (allergic), Type II (tissue-specific), Type III (immune complex), and Type IV (cell-mediated hypersensitivity).
    • Each type has unique characteristics and potential outcomes.

    Hypersensitivity Type I

    • Illustrative diagram showing the cascade of events from allergen exposure to the response of chemical mediators from mast cells.
    • Allergic reactions can range from mild to severe anaphylactic shock.

    Altered Immune Response

    Different body systems that can be affected with abnormal immune responses are illustrated.

    Allergy Assessment (SLO #5)

    • History: past allergic reactions
    • Allergy testing: skin prick tests, blood tests (IgE levels)
    • Skin test: identify allergen-specific responses

    Management (SLO #6)

    • Primary prevention: vaccination, modifying risk factors.
    • Secondary prevention: screening for infections.
    • Treating problems: administering antimicrobials (antibiotics, antivirals, antifungals, antiparasitics).
    • Immunosuppression (e.g., corticosteroids, NSAIDs) if necessary.
    • Easy-to-read instructions, and easy-grip body for epinephrine auto-injectors (e.g. EpiPen).

    Meet Mr. Hayes (Case study)

    • A 50-year-old male undergoing gallbladder removal surgery.
    • Complains of abdominal pain, receives morphine.
    • Develops urticaria and angioedema (swelling of the lips).
    • States a history of receiving morphine.
    • Develops severe hypersensitivity reaction requiring emergency treatment as a result of the interaction between previous exposure to an antigen and the current administration of morphine.
    • The case demonstrates acute allergic response to a drug.
    • Further diagnostics and treatment are needed.

    Management of Exaggerated Immune Response (Anaphylaxis)

    • Support airway, breathing and circulation.
    • Administer epinephrine, bronchodilators (e.g., albuterol).
    • Provide circulatory support to maintain blood pressure.
    • Treat underlying conditions via immunosuppression with corticosteroid therapy or NSAIDs

    Mr. Hayes (follow-up)

    • Mr. Hayes stabilizes, and morphine is discontinued by the physician.

    Vaccines

    • Vaccines are preventative measures that improve the immune response to infectious agents.
    • Dosage, number of doses and timing are important considerations for vaccine administration.
    • Common vaccines include those for diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, varicella, hepatitis B, pneumonia, etc.
    • Recommendations for vaccination schedules for various age groups may be found from governmental health organizations.

    Vaccination

    • Antigens trigger an immune response, so the body reacts more effectively next time to that triggering antigen.
    • Effective vaccinations may require booster/follow-up doses.
    • Bacterial and viral vaccines can be categorized into inactivated, killed, or live attenuated type.
    • The type of vaccine used can influence the immune response it produces and the longevity of the protection.

    Infections (SLO #2)

    • Infection is the invasion and multiplication of harmful microorganisms.
    • Different types of infections (bacterial, viral, fungal, parasitic) exist.
    • Infections can be localized or systemic, and have a variety of transmission methods.

    Chain of Infection

    • The components of this process include an infectious agent, a reservoir, a portal of exit, a mode of transmission, a portal of entry, and a susceptible host.

    Methods of Transmission

    • Contact transmission: direct or indirect physical contact.
    • Droplet transmission: transmission via large respiratory droplets.
    • Airborne transmission: transmission of pathogens through smaller, airborne particles.

    Infection Control and Prevention

    • Hand hygiene measures are essential to prevent infection transmission.
    • Standard precautions and transmission-based precautions are used in healthcare settings to prevent infectious agents from spreading.
    • Isolation precautions may be implemented for patients with certain infectious conditions.

    4 Moments of Hand Hygiene

    • Specific times for performing hand hygiene.

    Stages of Infectious Diseases

    • Incubation, Prodromal, Illness, Convalescence
    • Incubation period precedes the appearance of the symptoms
    • Prodromal period precedes the period of illness.
    • Illness period is marked by the presence of specific symptoms characteristic of the infection.
    • Convalescent stage is the recovery from the disease and return to homeostasis without symptoms.

    Risk Factors for Infection

    • Factors like compromised immune systems, age, malnutrition, underlying health conditions, and lifestyle choices can increase risk for infections.
    • Pathogens have various ways to cause infection including bypassing body’s defenses, and having high reproductive speed.
    • Opportunistic pathogens take advantage of a weakened immune system for successful infection.

    Clinical Manifestations of Infection

    • Local signs: redness, pain, swelling, exudates (pus).
    • Systemic signs: fever, fatigue, headache, anorexia, nausea, malaise, muscle pain.

    Consequences of Infection

    • Severe, poorly responsive infections can lead to septic shock and multi-organ dysfunction syndrome (MODS).
    • Complications like various symptoms, such as hypotension, tachycardia, tachypnea, oliguria, anuria, hypoxia, hypercapnia, potentially leading to coma and death, may also occur.

    Assessment (SLO #5)

    • History taking is essential to understand various symptoms, and possible triggers.
    • Physical examination for local signs of infection and general systemic symptoms.
    • Diagnostic testing to ascertain probable pathogens.
    • Laboratory and/or imaging tests to confirm the diagnosis.

    Clinical Management

    • Methods of managing infections like use of antimicrobials, primary and secondary prevention strategies.
    • Control measures that limit exposure and spread of infection should be practiced in healthcare settings.

    Lab Values for Infection

    • Biochemistry (e.g., electrolytes, creatinine).
    • Complete blood counts for WBC counts and differential (e.g., neutrophils, lymphocytes, eosinophils).
    • Culture and sensitivity tests to identify the specific pathogen and its sensitivities to drugs.

    Growing Bacteria

    • Bacteria grow under controlled conditions.

    Collaborative Interventions

    • Antimicrobial drug therapy, fluids and electrolytes, rest, nutrition, fever management (e.g., antipyretics).

    Anti-Infective Therapy (SLO #6)

    • Treatment of various infections via antibiotics, antivirals, antifungals, and antiparasitics.
    • These medications are used to combat pathogens specific to their origin.

    Anti-infective agents

    • Antibiotics treat bacterial infections.
    • Antivirals treat viral infections.
    • Antifungals treat fungal infections.
    • Antiparasitics treat parasitic infections.

    Classification of Antibiotic Drugs

    • Classification by susceptible organisms (narrow or broad)
    • Classification by mechanism of action (bacteriostatic or bactericidal).

    How Antibiotics Work

    • Bacteriostatic antibiotics slow the multiplication of bacteria.
    • Bactericidal antibiotics kill bacteria.

    Suspected Infection, Nurse/Physician Orders, Samples

    • Orders, samples, and testing procedures when infection is suspected.

    Gram Stain

    • Gram-positive bacteria stain a certain color, while gram-negative bacteria stain a different color.

    Antibiotics

    • Antibiotics target the differences between bacteria and human cells, to be selectively toxic on bacteria.
    • Effective antibiotics must be taken at the appropriate dose and for the appropriate duration.
    • The use of antibiotics can result in side effects and/or complications when used improperly.
    • Adverse drug effects may include allergic responses, liver and kidney damage.

    Administering Antibiotic Therapy (nurse considerations)

    • Identifying the bacteria/type of microorganism impacted by the administered treatment,
    • Mechanism of action of the administered antibiotic
    • Spectrum of activity of the administered antibiotic (narrow, broad),
    • Adverse effects of the administered antibiotic
    • Nursing considerations for patient teaching and monitoring.

    Penicillins, Cephalosporins, Macrolides

    • Properties and characteristics that differentiate these groups of antibiotics
    • Their mechanism of action, spectrum, interactions, and common side effects.

    Aminoglycosides, Sulfonamides, Tetracyclines, Fluoroquinolones

    • MOA, spectrum, possible side effects, and situations where these antibiotics are used.
    • The categories of drugs, properties, potential toxicity, and relevant nursing considerations.

    Antibiotic Resistant Bacteria

    • Resistance is when bacteria evolve to survive in the presence of antibiotics.
    • Factors for resistance evolution include that antibiotics are taken improperly or are present in excessive doses.
    • Bacteria may develop resistance by altering the structure of drug target molecules or by inactivating the drug.

    Resistance-Selection

    • Selection and survival of resistant strains in the presence of excessive antibiotic use.
    • Infections that develop in hospitals (nosocomial infections) are often resistant to antibiotics owing to extensive antibiotic use within healthcare settings.

    Suppressed Immune System Exemplar: MRSA

    • MrSA as a case example of a bacterial infection that can be problematic if the immune system is weakened.
    • Exemplar of a condition in which, the patient may be prone to infection.

    Mrs. A (Case Study, continued)

    • Provides patient vital signs and clinical characteristics when first evaluating.
    • Outlines treatment protocol, results of clinical tests, resulting diagnosis, treatment, and outcomes.

    Summary (review)

    • Immunity is a diverse system of defense mechanisms against pathogens.
    • Antibiotic therapy can be quite helpful to treat infections caused by various invading bacteria, however, this approach can lead to antibiotic resistant strains.
    • Patient health outcomes are related to factors such as the severity of infection, patient immune response, and treatment.

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