Ignatavicius: Medical-Surgical Nursing, 7th Edition

Chapter 19: Inflammation and the Immune Response

Key Points - Print
OVERVIEW
Inflammation and immunity are critical to maintaining health and preventing disease as the
two major defenses that protect a person against diseases and other problems.
These defenses also help the body recover after injury or tissue damage.
The body has some defenses to prevent organisms from gaining access to the internal
environment, such as intact skin and mucous membranes, skin surface normal flora, and
natural chemicals that inhibit bacterial growth.
Invasion of the bodys internal environment occurs much more often than does an actual
disease or illness because of proper immune function.
The purpose of inflammation and immunity is to meet the human need for protection by
neutralizing, eliminating, or destroying organisms that invade the internal environment.
Immune system cells distinguish between the bodys own healthy self cells and other, non-self
proteins and cells.
This ability to recognize self versus non-self, which is necessary to prevent healthy body cells
from being destroyed along with the invaders, is called self-tolerance.
When all the functions of inflammation and immunity are working well, the individual is
immunocompetent.
Immune function is variable during life, related to nutritional status, environmental
conditions, drugs, disease, and age.
Immune function is most efficient when people are in their 20s and 30s and slowly declines
with increasing age.
Immune function declines with age, making the older adult at increased risk for infection and
cancer development.
INFLAMMATION
Inflammation and immunity are provided through the actions and products of white blood
cells, also called leukocytes.
Different types of WBCs provide different types of immune or inflammatory protection.
The differential of the WBC count can be used to determine the patients risk for infection, the
presence or absence of infection, the presence or absence of an allergic reaction, and whether
an infection is bacterial or viral.
WBCs are the only body cells able to recognize non-self cells and to attack them.
Self-tolerance is the special ability of WBCs to recognize healthy self cells and not attempt to
attack or destroy them.
Human leukocyte antigens (HLAs) are a persons tissue type and are inherited from parents.
Immunocompetence requires that all three parts of inflammation and immunity have optimal
functioning.
Inflammation is a general, nonspecific protective response.
Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

Key Points - Print

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The five cardinal manifestations of inflammation are redness, warmth, swelling, pain, and loss
of function.
Remember, inflammation and infection are not the same.
Infection is frequently accompanied by inflammation but inflammation often occurs without
infection.
The tissue responses to inflammation are helpful if confined to the area of invasion or
infection and do not extend beyond the acute phase.
Chronic inflammation can damage tissues and reduce function.
The cells and actions of cell-mediated immunity control and coordinate the entire
inflammatory and immune responses.
Inflammation cannot be transferred from one person to another.
IMMUNITY

Immunity is an adaptive internal protection that results in long-term

resistance to the effects of invading microorganisms. This means that the
responses are not automatic.
Immune function declines with age, making the older adult at increased risk for infection and
cancer development.
Antibody-mediated immunity (also known as humoral immunity) can be transferred from one
person or animal to another.
Antibodies transferred from one person into another person have a short-term effect.
Natural, active immunity is the most beneficial and long-lasting type of immunity.
Innate-native immunity is any natural protective feature of a person. It can be a barrier to
prevent organisms from entering the body or can be an attacking force that eliminates
organisms that have already entered the body.
Vaccinations cause artificial active immunity and require boosters for best long-term effects.
A persons normal membrane proteins would be antigens in another person.
Solid organs transplanted into recipients seldom are a perfectly identical match of human
leukocyte antigens, unless the organ is obtained from an identical sibling.
The transplant recipients immune system cells recognize a newly transplanted organs cells as
non-self.
Transplant rejection is a normal response of the immune system that can damage or destroy
the transplanted organ.
Without intervention, the hosts immune system starts inflammatory and immunologic actions
to destroy or eliminate these non-self cells causing rejection of the transplant graft.
Patients who receive transplanted organs (unless from an identical sibling) need to take
immunosuppressive drugs daily to prevent transplant rejection.
Patients who take immunosuppressive drugs have an increased risk for infection and cancer
development.

Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.