Gerontological Nursing
THIRD EDITION
CHAPTER
23
The Immune
System
Copyright 2014, 2010, 2006 by Pearson Education, Inc.
All Rights Reserved
Learning Objectives
1.
2.
3.
Define the role of the immune
system in the maintenance of
health.
Describe the three unique
characteristics of the immune
system.
Identify factors that affect proper
immune system function.
Learning Objectives
4.
5.
Distinguish the similarities,
differences, and interactions
between the humoral immune
response and the cellular immune
response.
Associate the pathology that
underlies illnesses associated with
both excessive and deficient
immune responses.
Learning Objectives
6.
7.
Outline the unique characteristics
associated with HIV infection in the
older person.
Relate the care of the patient with a
rheumatoid disorder to the
pathology involved.
Learning Objectives
8.
9.
Explain the physiological processes
that increase the susceptibility of
the older person to infections.
Identify nursing interventions that
can be effective in improving
immune status in the older person.
Introduction
Three major biological defense
mechanisms protect the human body
from injurious chemicals, foreign
bodies, microorganisms, and
parasites.
The first line of defense - physical,
anatomical, and biochemical barriers
provided by our skin, the mucous
membranes of the digestive, urinary,
respiratory, and reproductive tracts.
Introduction
The second line of defense: the
innate immune system meaning,
present from birth in all animals.
It includes mechanical clearance.
The inflammatory response is also
part of the second line of defense.
Introduction
The third line of defense: the
adaptive or immune response
system
A highly complicated, integrated
system that is controlled by a
complex communication mechanism.
The Immune System
The immune response has the ability to
confer long-term and, sometimes,
permanent protection against living
organisms such as bacteria, viruses, and
parasites.
It also protects the body from its own
cancer cells.
It is a diverse and complicated system
made up of interrelated parts, but
functions as a whole.
The Immune System
Multiple factors affect the individuals
immune system.
The internal characteristics of the
individual include factors such as
age, gender, and inherited genetic
sequence.
External factors also can have a
substantial effect on a persons
immune system.
Characteristics Unique to
the Immune System
Three characteristics are unique to
the immune system:
Self-recognition
Specificity
Memory
Characteristics
In self-recognition (tolerance), the
immune system differentiates
between substances that are normal
constituents of a persons body and
those that are not.
Specificity means that the immune
response reacts to only one antigen.
Characteristics Unique to
the Immune System
Memory means that the immune
system has the capacity to develop
long-lasting protection against
specific invaders.
Cell-mediated Immune
Response
A highly regulated communication
system with a series of positive and
negative feedback systems
Regulates and coordinates the
immune response so that normal
body tissues are not injured.
These regulatory functions can be
affected by the aging process and
the presence of chronic disease.
Normal Changes of Aging
Generally, aging is associated with
physiological changes that cause
stiffness or rigidity and decreased
levels of functioning in many
systems.
One of the most important biological
changes occurring during human
aging is a progressive decrease in
immune functioning, or
immunosenescence.
Normal Changes of Aging
A decreased ability to respond to
antigenic stimulation by B
lymphocytes is a common in the
aging humerol immune system.
The number of B cells in the
circulation decreases in some
individuals.
This results in slower tissue repair
therefore increasing vulnerabilitye to
disease, especially infections.
Factors Affecting Aging of
the Immune System
Many factors directly or indirectly
associated with aging can affect the
immune system.
These factors include stress, chronic
illness, exercise, and dietary
nutrients.
An increase in the amount of stress
perceived by individuals is generally
associated with poorer cellular
immunity.
Factors Affecting Aging of
the Immune System
Mood, stress, depression, and mental
illness influence the immune system.
Healthy Aging Tips
Regular, moderate, exercise 30
minutes a day, five days a week
Take a multivitamin/mineral
supplement daily.
Consider vitamin D supplementation.
Maintain a healthy weight.
Report increased infections to your
health care practitioner.
Excessive Immune
Responses
Hypersensitivity and autoimmunity
are types of excessive responses.
Overreaction of the immune system
is believed to result from interplay
between environmental factors and
the genetic makeup of the individual.
Hypersensitivity
Hypersensitivity is either an
excessive response to antigen
stimulation or a normal response
that is inappropriate.
Deficient Immune
Responses
Deficient immune responses occur
when there is a functional decrease
in one or more components of the
immune system.
Primary Immunodeficiency
Disorders
Primary immunodeficiency disorders
are either congenital or acquired,
and are not attributed to other
causes.
Primary Immunodeficiency
Disorders
HIV/AIDS
Infection with the human
immunodeficiency virus (HIV) and the
resulting acquired immunodeficiency
syndrome (AIDS) is the best example of
a primary immunodeficiency disorder.
The hallmark of this infection is a
decrease in cellular (T cell) immunity.
Susceptibility to Infections
Infections are one of the most
frequently encountered problems in
the older population. Although
specific relationships between an
aging or compromised immune
system and infection are not clear,
the decline in responsiveness of the
immune system to harmful foreign
invaders leads to an increase in the
incidence and severity of infections.
Pneumonia
Pneumonia is a common condition in
immune deficient people and is the
leading cause of death in people over
65 years of age.
The combination of pneumonia and
influenza causes the greatest
number of deaths.
Monoclonal Antibodies
The scientific community can now
mass produce immune cell
secretions, such as antibodies. The
availability of these products has
revolutionized the study of the
immune system and has had a
significant impact not only upon
medicine, but upon agriculture and
industry as well.
Genetic Engineering
Genetic engineering, recombinant
DNA technology, genetic
modification/manipulation (gm), and
gene splicing are all terms that are
applied to the direct manipulation of
an organisms genes.
Nursing Assessment
Multiple factors underlie immune
problems in the older person.
Therefore, a health history and
physical examination are essential.
Nursing Interventions
The nurse often will engage in
teaching older patients and families
about prevention of infectious
disease like influenza.
