Chapter 21 Immunity

1. Chapter 21Immunity

2. Immune Senescence • Definition • Age related decline in immune system function. • Increases body’s susceptibility to infection. • Diminishes strength of immune response.

3. The Immune System An antigen (invading bacteria) enters the body.  A macrophage attacks the antigen and retains some of the antigen’s protein on its surface.  The macrophage carries the protein markers to lymphoid tissue; T-lymphocytes interpret them as foreign.  Antibodies attack the antigens.

4. Major Components of the Immune System • Thymus gland • Bone marrow • Lymph nodes • Spleen • Other organs • Cells

5. Cells Involved in the Immune System • Macrophages • B-cells • T-cells • NK-cells

6. Factors Contributing to High Risk of Infection in Older Adults • High prevalence of chronic conditions • High rate of hospitalization and institutionalization • Age-related changes

7. Interventions to Strengthen the Immune System • Promote good general health. • Assure immunizations are current. • Encourage foods that have positive effect on immunity • Assist patient to maintain skin integrity. • Teach stress management techniques. • Encourage regular exercise.

8. Interventions to Strengthen the Immune System (cont.) • Counsel against overuse of antibiotics. • Teach infection control measures. • Adhere to strict infection prevention measures.

9. Effects of Aging on the Immune System • Thymus gland progressively declines in size. • Immature T-cells increase. • T-cell function declines. • Cell-mediated immunity is deficient. • Serum distribution of IgA and IgG increase.

10. Effects of Aging on the Immune System (cont.) • Serum distribution of IgM and IgD decrease. • Antibody response to vaccines is reduced. • Skin loses macrophages.

11. Effects of Fasting on the Immune System • Increased: • Macrophage activity • Immunoglobulin levels • Neutrophil antibacterial activity • Improvement of: • Cell-mediated immunity • Ability of monocytes to kill bacteria • Natural killer cell activity

12. Effects of Fasting on the Immune System (cont.) • Reductions in: • Free radicals • Antioxidant damage

13. Factors Affecting the Immune System • Diet • Exercise • Immunization • Stress • Mind-body connection • Antibiotic use

14. Immunizations Recommended for Elders • Pneumococcal polysaccharide vaccine • Once in a lifetime • Influenza vaccine • Annually • Tetanus and diphtheria toxoids • Every 10 years

15. “If At Risk” Vaccinations • Varicella • Once • Measles; mumps; rubella • Once

16. Organs Involved in Stress Response • Thymus • Spleen • Lymph nodes • Stress can affect the function of the immune system.

17. Stress Reduction Measures • Progressive relaxation • Meditation • Prayer • Yoga • Imagery • Exercise • Diversional activity

18. Traits Consistent with a Strong Immune System • Assertiveness • Faith in God or a higher power • Ability to trust and offer unconditional love • Willingness to be open and confide in others • Purposeful activity • Control over one’s life

19. Traits Consistent with a Strong Immune System (cont.) • Acceptance of stress as a challenge rather than a threat • Altruism • Development and exercise of multiple facets of personality

20. Promoting Safe Antibiotic Use • Assist patients in health promotion efforts. • Adhere to strict infection control practices. • Use alternatives to antibiotics whenever possible. • Educate about the realities and risks of antibiotics. • Advise patients not to save and use antibiotics for future illnesses.

21. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).