Interrelated Concepts
These age-related immune system changes —
Reduced cell-mediated response
Decreased specific antibody production
Increased susceptibility due to compromised immunity
Greater severity of illness, depending on host response and location
— all contribute to a higher risk of this outcome in older adults.
What is IMMUNITY
What is T-cell
These B cells carry unique surface receptors (BCRs) that bind only one specific antigen. They circulate in blood and lymph until they encounter their matching antigen. Once bound, they internalize the antigen, process it, and present it on MHC II molecules to helper T cells for full activation. For example, they first respond when you’re exposed to measles for the very first time.
What are naïve B cells?
This is the body’s first line of defense, present at birth. It includes barriers like skin, mucous membranes, phagocytes, and inflammation. For example, stomach acid killing ingested microbes is part of this type of immunity.
What is innate immunity
Definition: IgE-mediated reaction; mast cells and basophils release histamine after exposure to an allergen. Rapid onset.(Immediate / Allergic)
Type I Hypersensitivity
Definition: The most abundant antibody in the blood and extracellular fluid (~70–80%).
Functions:
Provides long-term immunity after infection or vaccination
Crosses the placenta to give newborns passive immunity
Activates complement and opsonizes pathogens for phagocytosis
Example: Immunity after measles infection; maternal antibodies protecting a newborn
What is IgG
This type of stress negatively impacts homeostasis and can wear down the body over time.
what is chronic stress
This level of prevention stops infection before it starts by strengthening immunity. Examples include the flu vaccine, practicing hand hygiene, eating a balanced diet with vitamin D and zinc, exercising, and getting 8 hours of sleep.
What is primary prevention
In this step, the nurse identifies actual or potential health problems and writes nursing _____. For example, “acute pain related to tissue injury.”
What is diagnosis
: This condition causes runny nose, watery eyes, and sneezing and is the most common Type 1 reaction.
What is allergic rhinitis
This organ produces albumin, bile, and clotting factors
This organ stores glycogen and vitamins A, D, and K
the liver
This condition weakens the immune system and contributes to chronic illness. It can be identified by:
Inadequate dietary intake and low energy levels
Recent weight changes
A compromised immune system
Interventions may include:
Multivitamins and mineral supplements
Improved dietary intake
IV antibiotics if infection is present
Regular exercise to support recovery
What is Nutrition
These T cells, also called CD4+ cells, “help” coordinate the immune response by activating B cells and macrophages. They are the target of HIV, which weakens immunity by destroying them.
What is Helper T-Cell
These B cells remain after infection or vaccination. They don’t actively secrete antibodies but “remember” the antigen. On re-exposure, they rapidly activate and differentiate into plasma cells, creating a faster and stronger antibody response—this is the basis for long-term immunity. For example, after a flu shot, they provide rapid protection if you’re exposed to influenza months later.
What are Memory B-cells
This type of immunity develops after exposure to specific antigens and involves T cells and B cells. It provides memory for future protection. For example, fighting off chickenpox and then being protected for life.
What is adaptive immunity
Definition: Conditions where part of the immune system is missing or not functioning properly, leading to increased risk of infection. Can be congenital (primary) or acquired (secondary).
Examples:
Primary: Severe Combined _______(SCID), IgA deficiency
Secondary: HIV/AIDS, chemotherapy-induced immunosuppression
what is immunodeficiency
Definition: Found mostly in secretions (tears, saliva, mucus, breast milk); 2nd most abundant antibody overall.
Functions:
Protects mucosal surfaces (respiratory, GI, urogenital tracts)
Prevents pathogen adherence to epithelial cells
Provides passive immunity to infants through breast milk
Example: Secretory IgA in breast milk protecting infant GI tract from infection
what is IgA
Definition: Body’s response to stress in three stages: alarm, resistance, exhaustion.
Example: College exams → initial panic (alarm), study routine (resistance), burnout after weeks (exhaustion).
What is general adaption Syndrome
This immune response stays confined to one area and produces redness, heat, swelling, pain, and loss of function. Examples include a swollen cut on the finger, an abscess in the skin, or pneumonia affecting one lung.
What is localized effects
This step sets patient-centered goals and expected outcomes, such as “Patient will verbalize two stress-reduction techniques before discharge.”
What is planning
This severe reaction involves vasodilation, bronchoconstriction, and a sense of impending doom (HSI)
What is anaphylaxis
Acute hepatitis is this type of liver inflammation
what is sudden liver inflammation
This rapid activation of biochemical and cellular processes can be either acute or chronic:
Acute: allergies; WBCs arrive on site; short-term response
Chronic: rheumatoid arthritis, systemic lupus; months to years of pain and swelling
Innate responses include:
↑ Blood flow → redness, heat, swelling, and pain
↑ Vasodilation
Neutrophils and macrophages engulf pathogens
Prevents initial spread of infection
Removes damaged tissue and sets the stage for repair
What is Inflammation
Also known as CD8+ cells, these T cells directly kill virus-infected or cancerous cells. For example, they destroy cells infected with influenza or target tumor cells.
What is Cytotoxic T-cell
These are the most abundant white blood cells and the first to arrive at the site of infection. They engulf and destroy bacteria through phagocytosis. For example, they rush to a cut infected with Staphylococcus aureus.
What is Neutrophils
This occurs when the body produces its own antibodies after infection. For example, immunity that develops after recovering from measles.
What is active Natural immunity
(Cytotoxic)
Definition: IgG or IgM antibodies bind to antigens on a cell’s surface, activating complement and leading to cell destruction.
Examples: Hemolytic transfusion reaction (wrong blood type), hemolytic disease of the newborn, autoimmune hemolytic anemia
What is type II hypersensitivity
Definition: The first antibody produced in response to infection; largest in size (pentamer).
Functions:
Provides early defense before IgG is produced
Strong activator of the complement system
Indicator of a recent/acute infection when present in high levels
Example: High ____ in acute hepatitis B infection
What is IgM
Definition: Body can no longer adapt to chronic stressors → disease results.
Example: Long-term stress causing migraines, anxiety, depression, or infections.
What is exhaustion stage
This level of prevention manages chronic immune conditions to reduce complications. Examples include antiretroviral therapy for HIV, biologics for rheumatoid arthritis, long-term immunosuppressants for transplant patients, and rehabilitation after sepsis.
what is tertiary prevention
This step involves collecting both subjective and objective data, such as patient history, physical exam findings, psychosocial cues, and lab results. For example, noting that a patient reports fatigue and has a fever of 101°F.
What is assessment
This medication is first-line treatment in anaphylaxis, even before bronchodilators (HSl)
What is epinephrine
RUQ discomfort, jaundice, and anorexia are symptoms of this chronic condition lasting >6 months
what is chronic hepatitis
This aspect of immunity is considered the body’s first line of defense, maintaining tissue integrity through physical and chemical barriers.
Includes skin, mucous membranes, and normal flora
Provides a protective physical barrier against the external environment
If impaired (cuts, burns, breakdown), pathogens can enter
Initiates inflammation and activates the immune response
Supports wound healing and prevents infection
What is tissue integrity
These T cells maintain self-tolerance by suppressing overactive immune responses. A malfunction in them may lead to autoimmune diseases such as type 1 diabetes.
What is regulatory T-Cells
These large phagocytes develop from monocytes and engulf pathogens, dead cells, and debris. They also act as antigen-presenting cells to activate T cells. For example, alveolar _____ in the lungs protect against tuberculosis bacteria.
What is Macrophages
This immunity develops after receiving a vaccine, which stimulates the body to make antibodies without causing disease. For example, the tetanus shot.
What is active Artificial immunity
(Delayed, T-cell Mediated)
Definition: T cells (not antibodies) cause tissue injury through cytokine release and macrophage activation. Occurs hours to days after exposure.
what is Type IV Hypersensitivity
Definition: The least abundant antibody in circulation.
Functions:
Binds to allergens, causing mast cells and basophils to release histamine (allergic reactions)
Provides defense against parasitic worms (helminths)
Example: IgE elevation in asthma, hay fever, peanut allergy, or parasitic infections
What is IgE
Definition: Body chooses most effective way to respond; decrease in fight-or-flight symptoms.
Example: Using deep breathing and exercise to manage ongoing work stress.
What is resistance stage
This level of prevention detects immune problems early and prevents them from worsening. Examples include an HIV test, a TB skin test, routine CBC to check white blood cells, and giving antibiotics at the first signs of strep throat.
What is secondary prevention
This final step determines if outcomes were met. For example, the patient reports pain decreased from 8/10 to 3/10 after an intervention.
What is evaluation
This heparin-related condition causes platelets to fall below 150,000 and increases clot risk (cytotoxic HSII)
What is Heparin-Induced Thrombocytopenia (HIT)
A TB skin test and poison ivy cause this type of reaction
delayed hypersensitivity reaction
This condition is often linked to a compromised immune system and can be influenced by multiple stressors:
Lack of proper sleep
Cancer and Hodgkin’s lymphoma
Chronic fatigue syndrome (CFS): brain inflammation, ↑ inflammatory cytokines
Chronic illness and long-term inflammatory states
Malnutrition or poor dietary intake
Psychological stress and depression
Autoimmune disorders (e.g., lupus, rheumatoid arthritis)
Effects:
Worsens susceptibility to infection
Reduces energy for healing and immune response
Creates a cycle of illness → fatigue → further immune compromise
What is fatigue
These long-lived T cells “remember” past infections, allowing a faster, stronger immune response when exposed again — for example, after a chickenpox infection or vaccination.
what is Memory T-cells
This is a collection of immune cells, mainly macrophages, that form when the immune system tries to wall off substances it can’t eliminate. For example, granulomas are seen in tuberculosis or sarcoidosis.
What is a Granuloma
This type of immunity is passed from mother to baby through the placenta or breast milk, providing short-term protection. For example, maternal antibodies protecting a newborn.
What is Passive natural immunity
(Immune Complex-Mediated)
Definition: Antigen–antibody complexes form in the blood and deposit in tissues, triggering inflammation and tissue damage.
Examples: Systemic lupus erythematosus (SLE), post-streptococcal glomerulonephritis, rheumatoid arthritis
what is Type III Hypersensitivity
Definition: Found in small amounts in the blood and mainly on the surface of immature B cells.
Functions:
Acts as a B cell receptor to help activate B cells
Role in initiating the early stages of the immune response
Example: IgD on naïve B cells, preparing them for antigen recognition
What is IgD
Definition: Activation of sympathetic nervous system (fight or flight).
Example: Heart racing and sweating when nearly hit by a car
What is alarm stage
This immune response spreads throughout the body, causing fever, fatigue, anorexia, and an increased white blood cell count. Examples include influenza causing muscle aches, rheumatoid arthritis producing widespread inflammation, and sepsis spreading infection in the blood.
What is systemic effects
In this step, the nurse carries out interventions like administering medications, providing education, coordinating care, or teaching energy-conservation strategies. For example, teaching deep-breathing exercises to reduce anxiety.
What is implementation
The intervention for HIT is to stop heparin and switch to this type of anticoagulant(HSII)
what is non-heparin anticoagulant
Steroids are the main treatment for this type of hypersensitivity
what is hypersensitivity IV
This metabolic process directly impacts immune function and infection risk when dysregulated:
Immune cells require glucose for energy to mount a protective response
Chronic hyperglycemia → low-grade inflammation, impaired immune response
Increased infection risk due to slowed neutrophil and macrophage function
Delayed wound healing from excess glucose in tissues
Increased blood pressure and vascular damage over time
Diabetes mellitus strongly linked to impaired immunity
Hypoglycemia can also stress the body and weaken immune defense
Stress hormones (cortisol, epinephrine) raise blood glucose, further altering immunity
What is Glucose regulation
These cells are the bridge between innate and adaptive immunity. Dendritic cells and macrophages engulf pathogens by phagocytosis, while B cells bind antigens with their receptors. All of them process the antigen and display fragments on MHC molecules to activate T cells.
What is antigen-presenting cells
These substances, often released by bacteria or immune cells, trigger the hypothalamus to raise body temperature and cause fever. For example, interleukin-1 (IL-1) released by macrophages during infection acts as a ______
What is pyrogens
This occurs when antibodies are given directly, rather than produced by the body. For example, receiving rabies immunoglobulin after an animal bite.
Passive artificial immunity
This reaction causes swelling in the deeper layers of skin and blood vessels, often affecting the lips, face, and throat. For example, a patient on an ACE inhibitor develops sudden facial and airway swelling.
What is angioedema
Definition: Main way the body fights stress by releasing cortisol.
Example: During prolonged illness, cortisol levels stay elevated to mobilize energy
what is Hypothalamus-Pituitary-Adrenal (HPA) Axis
This part of SBAR is a brief statement of the current problem. For example: “I’m calling about Mr. Jones in room 302; he is experiencing shortness of breath and his oxygen saturation is 84% on 2 liters.”
What is situation
This part of SBAR provides relevant history and context. For example: “Mr. Jones was admitted yesterday with pneumonia. He has a history of COPD and hypertension.”
What is background
This autoimmune disease is marked by a butterfly rash, arthritis, fatigue, and anemia.
CKD and cardiac changes are complications of this autoimmune disorder(HSIII)
what is Systemic Lupus Erythematosus (SLE)
This factor influences immune system strength through both physiological and psychological pathways:
Acute : may temporarily boost immune surveillance
Chronic stress: ↑ cortisol → suppresses T & B cell function
Decreased lymphocyte production weakens defense against infection
↑ Inflammatory cytokines → prolonged inflammation
Linked to delayed wound healing and higher infection risk
Poor practices → maladaptive behaviors (substance use, poor sleep, malnutrition)
Effective strategies (exercise, relaxation, social support) → help restore balance and strengthen immunity
What is Stress and Coping
These B cells are the activated form of naïve B cells. With help from T cells, they differentiate into plasma cells that secrete thousands of antibodies per second. The antibodies coat pathogens, neutralize toxins, and tag invaders for destruction by other immune cells. For example, during strep throat, they secrete antibodies that bind to Streptococcus bacteria.
What is Plasma cells
These proteins are released by virus-infected cells and signal nearby cells to heighten their antiviral defenses. For example, _____-alpha helps protect neighboring cells during a hepatitis C infection.
What is interferons
This occurs when the immune system mistakenly attacks the body’s own healthy tissues, leading to chronic inflammation and organ damage. Examples include lupus, rheumatoid arthritis, and type 1 diabetes.
What is auto immunity
This severe allergic reaction is systemic, involving airway constriction, low blood pressure, and shock. For example, a person with a peanut allergy develops wheezing, hives, and hypotension after exposure.
What is anaphylaxis
Definition: Behaviors that worsen stress effects.
Example: Smoking after exams, binge drinking after work stress, or overeating after an argument.
What is negative coping strategy
This part of SBAR includes the nurse’s ____ of the problem. For example: “His respiratory rate is 28, lungs have crackles, and he appears anxious and restless.”
What is assessment
This part of SBAR states what the nurse thinks is needed. For example: “I recommend increasing oxygen, ordering a chest X-ray, and having you evaluate the patient as soon as possible
What is Recommendation
A positive ANA test is used to help diagnose this autoimmune condition(HSIII)
what is Lupus