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©SKUBALA 1. 2 The Dust Mite Quietly lurking under our beds, inside sofas and carpet are creatures too small to see without a microscope or strong magnifying.

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Presentation on theme: "©SKUBALA 1. 2 The Dust Mite Quietly lurking under our beds, inside sofas and carpet are creatures too small to see without a microscope or strong magnifying."— Presentation transcript:


2 2 The Dust Mite Quietly lurking under our beds, inside sofas and carpet are creatures too small to see without a microscope or strong magnifying glass. OH, see how they itch!

3 ©SKUBALA 3 Antigen The dust mite deposits antigens on our skin surface and are immune system system reacts

4 ©SKUBALA 4 Inflammatory Response Antigens stick to the mast cell IgE antibodies, causing granules in the mast cell to fire their contents into the surrounding tissue.

5 ©SKUBALA 5 Response to Injury ADAPTIVE Hypertrophy – increased size Hyperplasia – increased number Atrophy – decreased size Metaplasia – change in type of cell; reversible MALADAPTIVE Dysplasia – reversible if stimulus is removed Anaplasia – often characteristic of malignant tumors


7 7 Inflammation vs. Infection Inflammation can be caused by non-living agents Inflammation is always present with infection A superimposed infection can occur with inflammation Infection is caused by the invasion of cells by microorganisms Infection is not always present with inflammation

8 ©SKUBALA 8 Iatrogenic vs Nosocomial Iatrogenic: Caused by the treatment of a physician, resulting in an adverse condition Nosocomial: Caused by exposure to an organism in the hospital setting

9 ©SKUBALA 9 Clinical Manifestations Localized Redness Heat Pain Swelling Loss of Function

10 ©SKUBALA 10 Clinical Manifestations Systemic Leukocytosis Malaise Nausea Anorexia Increased pulse Increased respiratory rate Fever

11 ©SKUBALA 11 Primary Defense Mechanisms Skin and mucous membranes Mononuclear phagocyte system Inflammatory response Immune system

12 ©SKUBALA 12 Mononuclear Phagocyte System MPS is made up of monocytes, macrophages and their precursor cells. Located in various tissues and organs Originate in bone marrow Function: Phagocytosis and participation in the immune response

13 ©SKUBALA 13 Inflammatory Response Vascular Vasoconstriction Release of histamine/chemicals Vasodilation Increased capillary permeability Fluid exudate

14 ©SKUBALA 14 Inflammatory Response Cellular Margination and diapedesis Chemotaxis to attract leukocytes Neutrophils Pus formation WBCs (bands) Monocytes Lymphocytes Eosinophils and basophils

15 ©SKUBALA 15 Mediators in Inflammatory Response Histamine Serotonin Kinins Complement components Fibrinopeptides Prostaglandins and leukotrienes Lympokines

16 ©SKUBALA 16 Stages of Febrile Response Prodromal Chill Flush Defervescence

17 ©SKUBALA 17 The Healing Process Regeneration – replacement of lost cells and tissue with cells of the same type Repair – healing as a result of lost cells being replaced by connective tissue Primary intention Secondary intention Tertiary intention

18 ©SKUBALA 18 Primary Intention Wound margins well approximated Surgical incisions Paper cuts Phases: Initial Granulation Scar contraction and maturation-

19 ©SKUBALA 19 Secondary Intention Wide, irregular wound margins Trauma Ulceration Infection Wound classification Red Yellow Black

20 ©SKUBALA 20 Tertiary Intention Delayed primary intention Delayed suturing Infection Larger deeper scar

21 ©SKUBALA 21

22 ©SKUBALA 22 Complications of Healing Keloid formation Contracture Dehiscence Adhesions

23 ©SKUBALA 23 Factors that Delay Wound Healing Nutritional deficiencies Inadequate blood supply Corticosteroid drugs Infection Mechanical friction on wound Advanced age Diabetes Mellitus Anemia

24 ©SKUBALA 24 Health Promotion Prevention Adequate nutrition Early recognition

25 ©SKUBALA 25 Interventions Observation of symptoms Fever Assess wound and document Consistency Color Odor Drainage

26 ©SKUBALA 26 Rest and immobilization Elevation Oxygenation Heat/Cold Wound management Prevent infection

27 ©SKUBALA 27 Wound Classifications Red wound Yellow wound Black Wound

28 ©SKUBALA 28 Red Wound Treatment PURPOSE: Protection and gentle atraumatic cleansing Dressing: Transparent film dressing Gauze dressing with antimicrobial ointment or solution Telfa dressing with antibiotic ointment

29 ©SKUBALA 29 Yellow Wound PURPOSE: Wound cleansing to remove nonviable tissue and absorb excess drainage Wound irrigation Wet to dry dressings With or without antimicrobial agent Hydrocolloidal dressing (Duoderm)

30 ©SKUBALA 30 Black Wound PURPOSE: Debridement of eschar and nonviable tissue Topical enzyme debridement Surgical debridement Hydrotherapy Chemical debridement Moist gauze dressing Hydrogel covered with gauze

31 ©SKUBALA 31

32 ©SKUBALA 32 Antibiotic Resistant Organisms Methicillin-resistant Staphylococcus aureus (MRSA) Vancomycin-resistant enterococci (VRE) Penicillin-resistant Streptococcus pneumoniae (PRSP)

33 ©SKUBALA 33 The Immune Response Immunity is a state in which the body is capable of responding to microorganisms such as bacteria, viruses, and tumor proteins.

34 ©SKUBALA 34 Immunity Functions of immune response Defense Homeostasis Surveillance Properties of the immune response Specificity Memory Self-recognition Self-limitation Specialization

35 ©SKUBALA 35 Specificity Antigen – introduced into body Cellular reaction Antibody formed Sensitized lymphocytes Antigen/antibody complex

36 ©SKUBALA 36 Types of Immunity Natural Immunity Not produced by an immune response Innate Acquired Immunity Active acquired Passive acquired

37 ©SKUBALA 37 Components - Immune System Thymus Bone marrow Tonsils Gut – Genital – Bronchial Lymph nodes Spleen

38 ©SKUBALA 38 Humoral Immunity Antibody-mediated immunity Antigen-antibody interactions Immunoglobulins IgG IgA IgM IgD IgE

39 ©SKUBALA 39

40 ©SKUBALA 40 Cell Mediated Immunity Immunity from pathogens that survive inside of cells such as viruses/bacteria Immunity from fungal infections Rejection of transplanted tissues Contact hypersensitivity reaction Tumor immunity

41 ©SKUBALA 41 Cell Mediated Immunity Cell Types T- lymphocytes (CD3) T-cytotoxic T-helper (CD4) T-suppressor (CD8) Natural killer cells Cytokines Macrophages

42 ©SKUBALA 42 Altered Immune Response Hypersensitivity reactions Allergic disorders Immunodeficiency Autoimmune Disorders

43 ©SKUBALA 43

44 ©SKUBALA 44 Hypersensitivity Reactions Immediate – humoral immunity Types I, II, III Delayed – cell mediated immunity Type IV Immunoglobulins

45 ©SKUBALA 45 Type I: Anaphylactoid Reactions Sensitized IgE Localized Wheal and flare Systemic Anaphylactic shock Clinical significance

46 ©SKUBALA 46 Anaphylactic Shock Bronchial constriction Airway constriction Airway obstruction Vascular collapse Target organs affected (Fig 12-7)

47 ©SKUBALA 47 Initial Symptoms Edema Uticaria

48 ©SKUBALA 48 Symptoms of Shock Rapid, weak pulse Hypotension Dilated pupils Dyspnea Possible cyanosis Bronchial edema Angioedema

49 ©SKUBALA 49 Type II: Cytotoxic and Cytolytic Reactions IgG or IgM Complement system Cytolisis/Enhanced phagocytosis Clinical significance – transfusion reactions

50 ©SKUBALA 50 Type III: Immune- Complex Reactions Antigen IgG and IgM Complement system Chemotactic factors Clinical significance

51 ©SKUBALA 51 Type IV: Delayed Hypersensitivity Reaction Intracellular or extracellular antigens No immunoglobulins involved T-lymphocytes Clinical significance

52 ©SKUBALA 52 Allergic Disorders Health history Family history Past and present allergies Physical exam

53 ©SKUBALA 53 Allergic Disorders Diagnostics Lymphocyte count < 1200/µl Eosinophil count RAST (radioallergosorbent test) Sputum/nasal/bronchial secretions PFTs Skin Tests

54 ©SKUBALA 54 Skin Tests Types Cutaneous scratch Intracutaneous injection Results: A + reaction - implies sensitivity

55 ©SKUBALA 55 Nursing Care/Therapy Therapy: Reduce exposure Treat symptoms Desensitization Be prepared: –Anaphylactic reactions –List allergies –Shell fish

56 ©SKUBALA 56 Anaphylaxis Sudden onset antibiotics blood products insect bites Therapeutic Management Recognize signs/symptoms Maintain patent airway Prevent spread Administer drugs: Epinephrine Benadryl O2 Establish IV: IVFs/Dopamine

57 ©SKUBALA 57 Chronic Allergies Allergen recognition and control Stress management Environmental controls Bee-sting kits Medic alert bracelets

58 ©SKUBALA 58 Drug Therapy Antihistamines Epinephrine Corticosteroids Antipruritics Mast-cell stabilizers

59 ©SKUBALA 59 Immunotherapy Anaphylactic reactions to insect venom Unavoidable exposure Drug therapy ineffective

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