learning Objectives - Demonstrate skill in providing nursing care to patients with altered immune response.
Hours - 6
Teaching and Learning Activities - Lecture cum discussion Clinical case presentation
Assessment Methods - Short answer Objective type Essay type
Content of the chapter
a) Overview of normal immune system
b) Altered immune response, hypersensitivity
and allergy
c) Assessment of immune system
d) Diagnostic evaluation
e) Allergy disorders:
– Anaphylaxis
– Allergic rhinitis
– Contact dermatitis
– Atopic dermatitis
– Drug reactions
– Food allergy
– Serum sickness
– Latex allergy
f) Approaches to treatallergic diseases
g) Nursing management client with altered
immune response
h) Auto immune disease
– Rheumatoid arthritis
– SLE
– Ankylosing spondylitis
– Graft versus host disease
Altered Immune Response
The immune system protects the body from infections and foreign substances. An altered immune response occurs when the immune system reacts excessively, inadequately, or against the body’s own tissues, leading to allergic, hypersensitivity, or autoimmune disorders.
a) Overview of Normal Immune System
The normal immune system consists of organs, cells, and chemicals that protect the body.
Components of Immune System
- Primary organs: Bone marrow, thymus
- Secondary organs: Lymph nodes, spleen, tonsils
- Cells: Lymphocytes (B cells, T cells), macrophages, neutrophils
- Antibodies: Immunoglobulins (IgG, IgA, IgM, IgE, IgD)
Types of Immunity
- Innate (natural) immunity
- Acquired (adaptive) immunity
b) Altered Immune Response, Hypersensitivity and Allergy
An altered immune response occurs when the immune system fails to maintain balance.
Types of Altered Immune Response
- Hypersensitivity reactions
- Immunodeficiency
- Autoimmune disorders
Hypersensitivity
An exaggerated immune response to an antigen.
Types of Hypersensitivity
- Type I – Immediate (Allergy, anaphylaxis)
- Type II – Cytotoxic
- Type III – Immune complex
- Type IV – Delayed (Contact dermatitis)
Allergy
An abnormal immune response to harmless substances called allergens.
c) Assessment of Immune System
Nursing Assessment Includes:
- History of infections and allergies
- Family history of immune disorders
- Exposure to allergens
- Skin condition
- Presence of fever, fatigue, or swelling
- Response to previous immunizations
d) Diagnostic Evaluation
Common Diagnostic Tests
- Complete blood count (CBC)
- Differential leukocyte count
- Serum immunoglobulin levels
- Allergy skin tests
- Patch testing
- Specific IgE blood tests
e) Allergy Disorders
1. Anaphylaxis
A severe, life-threatening allergic reaction.
Symptoms: Breathlessness, hypotension, urticaria
Management: Epinephrine, oxygen, IV fluids
2. Allergic Rhinitis
Inflammation of nasal mucosa due to allergens.
Symptoms: Sneezing, nasal congestion
Management: Antihistamines, nasal steroids
3. Contact Dermatitis
Skin inflammation due to direct contact with irritants.
Symptoms: Redness, itching, blisters
Management: Avoid irritants, topical steroids
4. Atopic Dermatitis
Chronic allergic skin condition.
Symptoms: Dry, itchy skin
Management: Moisturizers, antihistamines
5. Drug Reactions
Adverse immune response to medications.
Symptoms: Rash, fever, anaphylaxis
Management: Discontinue drug, supportive care
6. Food Allergy
Immune reaction to specific foods.
Symptoms: GI upset, skin rashes
Management: Avoid allergen, emergency medications
7. Serum Sickness
Immune complex reaction following exposure to antiserum.
Symptoms: Fever, joint pain, rash
Management: Antihistamines, corticosteroids
8. Latex Allergy
Allergic response to natural rubber latex.
Symptoms: Skin irritation to anaphylaxis
Management: Latex-free environment
f) Approaches to Treat Allergic Diseases
- Avoidance of allergens
- Antihistamines
- Corticosteroids
- Bronchodilators
- Immunotherapy (desensitization)
- Emergency management for severe reactions
g) Nursing Management of Client with Altered Immune Response
- Assess for allergic history
- Identify and avoid allergens
- Monitor vital signs
- Administer prescribed medications
- Educate patient and family
- Provide emotional support
- Maintain emergency preparedness
h) Autoimmune Diseases
Autoimmune diseases occur when the immune system attacks self-tissues.
1. Rheumatoid Arthritis
Chronic inflammatory joint disease.
Symptoms: Joint pain, stiffness
Management: Anti-inflammatory drugs, physiotherapy
2. Systemic Lupus Erythematosus (SLE)
Multisystem autoimmune disease.
Symptoms: Butterfly rash, fatigue
Management: Immunosuppressive therapy
3. Ankylosing Spondylitis
Inflammatory disease affecting the spine.
Symptoms: Back pain, stiffness
Management: NSAIDs, exercise
4. Graft Versus Host Disease (GVHD)
Immune reaction following transplantation.
Symptoms: Skin rash, diarrhea
Management: Immunosuppressive drugs
Conclusion
Altered immune responses can lead to allergies and autoimmune diseases that require early identification and appropriate nursing care. Nurses play a vital role in assessment, prevention, management, and patient education to improve quality of life and prevent complications.