RNSG 1471 - Trinity Valley Community College



RNSG 2572Health Care Concepts 2Concept – IMMUNITYConcept Definition A physiologic process that provides an individual with protection or defense from disease.ExemplarsVaccinesOtitis MediaUrinary Tract InfectionCellulitisPneumoniaAppendicitisTrauma-SprainObjectives Part 1 – Alterations in Immunity ExemplarsExplain the correlation between otitis media, urinary tract infection, cellulitis, pneumonia, appendicitis, and trauma-sprain and the concept of Immunity (including compromised antecedents, deficit measurement in attributes, a list of negative consequences, and the interrelated concepts which may be involved).Identify conditions that place an individual at risk for imbalance leading to compromised Immunity resulting in otitis media, urinary tract infection, cellulitis, pneumonia, appendicitis, and trauma-sprain.Apply the nursing process with collaborative interventions for individuals experiencing otitis media, urinary tract infection, cellulitis, pneumonia, appendicitis, and trauma-sprain. Part 2 – Immunizations (Vaccines)Correlate the administration of Immunizations (Vaccines) to the concept of Immunity to include:A description of the antecedents of active and passive immunityThe promotion of attributes of immunity by immunizations, The positive outcome of protection from microorganisms with immunizations The relationship of the subconcepts of Immune response and Infectious response with immunizations.Identify conditions that place an individual at risk for a compromise in immunity that can be resolved with immunizations.Apply the nursing process with collaborative interventions for individuals receiving immunizations.Concept Analysis DiagramNote: Diagram on separate pageExplanation of Immunity Diagram:??????????? The Immunity Concept Analysis Diagram begins with the definition of the concept, as based on the attributes and antecedents. The attributes - normal WBC and differential counts, negative bacterial and viral cultures, soft, non-tender lymph nodes, recognition of self and recognition of foreign proteins - are the defining characteristics of immunity or what constitutes immunity. The antecedents are events or incidents that must be in play in order for immunity?to?exist. The antecedents for immunity consist of intact non-specific defenses or barriers, a functional lymphatic system, an optimal innate immune response, a functional inflammatory response, and appropriate adaptive (acquired) immune response—active and passive.? With these attributes and antecedents, immunity is a physiologic process that provides an individual with protection or defense from disease.??????????? There are interrelated concepts that impact immunity throughout the lifespan. These interrelated concepts include tissue integrity, cellular regulation, thermoregulation, comfort, coping, nutrition, mobility and functional ability. There are also sub-concepts that are major components of the immunity concept – inflammatory response, infectious response, and immune response. The sub-concepts are manifested when immunity is challenged.??????????? Consequences, positive or negative, are reliant upon the performance of the immune system. If any of the antecedents fail, for example, the result would be a negative outcome, such as infection-localized or systemic, cancer, immune suppression, immune deficiency, and chronic inflammatory response or exaggerated immune response that may lead to an allergic, cytotoxic or autoimmune reaction. If the immune system is healthy, positive outcomes will result;?in that, damaged tissue and cells are replaced with repaired or functional tissue (i.e., healing), recognition and removal of cell mutations that have demonstrated abnormal cell growth and development is effected, and protection of the body from invasion of microorganisms and other antigens occurs.??????????? Last, but not least, nursing care may or may not be required, as indicated by the dotted directional lines on the diagram. Nursing care may/may not be needed to keep immunity intact, or assist with negative consequences.Assignments Prior to class:1. Review definitions of inter-rated concepts on concept analysis diagram.2. Review concept analysis diagram.3. Review the following content from previous coursesImmunity Concept Analysis DiagramOxygenation Concept Analysis DiagramGas Exchange Concept Analysis DiagramTissue Integrity Concept Analysis DiagramThermoregulationAssigned reading:Giddens, J.F. (2013). Concepts for nursing practice. St. Louis. MO: Mosby Elsevier.Chapter 20: ImmunityChapter 22: InfectionLewis, S.L., Heitkemper, M.M., Dirksen, S.R., O’Brien, P.G., & Bucher, L. (2011). Medical surgical nursing (8th ed). St. Louis: Mosby Elsevier.Chapter 24: Integumentary Problems; Cellulitis; pg. 454Chapter 22: Visual and Auditory Problems; Otitis Media; pg. 425-426Chapter 28: Lower Respiratory Problems; Pneumonia; pg. 546-553.Chapter 43: Lower Gastrointestinal Problems; Appendicitis; pg. 1020-1022Chapter 46: Renal and Urologic Problems; Urinary Tract Infection; pg. 1122-1127Chapter 63: Musculoskeletal Trauma and Orthopedic Surgery; Sprain; pg. 1584-1586McKinney, E, James, S., Murray, S., Nelson, K., & Ashwill, J. (2013). Maternal-child nursing (4th ed). St. Louis: Elsevier Saunders.Chapter 41: The Child with an Infectious Disease; pg. 1007-1028Chapter 45: The Child with a Respiratory Alteration; Otitis Media; pg. 1151-1156Internet Resources:Otitis Media Urinary Tract Infection Pneumonia Appendicitis ImmunizationsCDC: 2013 Combined Immunization Schedule Birth through 18 Years Immunization Schedule 2013 of VAERS (Vaccine Adverse Effects Reporting System) Review the following Nursing Diagnoses: Otitis MediaPain HyperthermiaFatigueDeficient knowledgeUrinary Tract InfectionPainImpaired urinary eliminationDeficient knowledgeIneffective health maintenance Trauma—sprainAcute PainImpaired physical mobilityDeficient knowledgePneumoniaIneffective breathing pattern Ineffective airway clearance Impaired gas exchange Activity intolerance Anxiety Sleep disturbance Acute painCellulitisIneffective Health Acute Pain Ineffective peripheral tissue Perfusion Impaired Tissue integrity Risk for vascular Trauma: Risk factor: infusion of antibioticsImbalanced nutrition: Less than body requirementsAppendicitisDysfunctional gastrointestinal Acute Pain Risk for infection Disturbed Body image Ineffective Breathing pattern Deficient Fluid volume Imbalanced Nutrition: less than body ImmunityRisk for infection Effective therapeutic regimen managementConcept content outline:Concept:ImmunitySub Concepts: Inflammatory ResponseInfectious ResponseImmune ResponseRisk Factors:Applies to each exemplarGenetic predispositionAge Socioeconomic status Lack of knowledge about infection prevention Presence of other illness Drugs and medical treatment Environmental factors Assessment:Comprehensive historyPhysical assessmentCultural, behavioral, social assessmentPhysical and psychological clinical manifestationsDiagnostic testsPositive Outcomes: Replaces damaged tissue with repaired or functional tissueRecognizes and removes cell mutations Negative Outcomes: PhysiologicalPsychologicalClinical Management:Nursing interventionsCollaborative interventionsPharmacological therapyNon Pharmacological therapyProcedural therapyDiagnostic studiesExemplars: VaccinesOtitis MediaUrinary Tract InfectionCellulitisPneumoniaAppendicitisTrauma-Sprain ................
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