24 The Immune and Lymphatic Systems and Cancer

24 The Immune and Lymphatic Systems and Cancer 1. Define important words in this chapter acquired immune deficiency syndrome (AIDS) the final stage of HIV infection, in which infections, tumors, and central nervous system symptoms appear due to a weakened immune system that is unable to fight infection. autoimmune disease a disease in which the body is unable to recognize its own tissue and begins to attack these tissues. benign non-cancerous. biopsy a removal of a sample of tissue for examination and diagnosis.

24 The Immune and Lymphatic Systems and Cancer 1. Define important words in this chapter breakthrough pain a type of severe pain that happens unexpectedly in people who have cancer a general term used to describe a disease in which abnormal cells grow in an uncontrolled way. homophobia a fear of homosexuality. human immunodeficiency virus (HIV) a virus that attacks the body’s immune system and gradually disables it; eventually can cause AIDS.

24 The Immune and Lymphatic Systems and Cancer 1. Define important words in this chapter lymph a clear yellowish fluid that carries disease-fighting cells called lymphocytes. malignant cancerous. metastasize to spread from one part of the body to another. opportunistic infection an illness caused by microorganisms that do not affect people with healthy immune systems but cause disease in people with weakened immune systems.

24 The Immune and Lymphatic Systems and Cancer 1. Define important words in this chapter remission the disappearance of signs and symptoms of cancer or other diseases; can be temporary or permanent. tumor a group of abnormally-growing cells.

24 The Immune and Lymphatic Systems and Cancer 2. Explain the structure and function of the immune and lymphatic systems Remember these points about the immune system: • Protects the body from harmful substances • Non-specific immunity is present at birth and protects the body from disease in general. • Specific immunity is acquired by the body and manufactures antibodies as a response to an antigen in the body. • With active immunity, vaccines cause the body to produce antibodies to protect against a particular disease. • With passive immunity, a person is given the antibodies needed to defend against the antigen.

24 The Immune and Lymphatic Systems and Cancer Transparency 24 -1: The Lymphatic System

24 The Immune and Lymphatic Systems and Cancer 2. Explain the structure and function of the immune and lymphatic systems Define the following term: lymph a clear yellowish fluid that carries disease-fighting cells called lymphocytes.

24 The Immune and Lymphatic Systems and Cancer 2. Explain the structure and function of the immune and lymphatic systems Remember these points about the lymphatic system: • Removes excess fluids and waste products from the tissues • Helps the immune system fight infection • Thymus gland makes T-cells, which attack and destroy specific types of pathogens.

24 The Immune and Lymphatic Systems and Cancer 2. Explain the structure and function of the immune and lymphatic systems Review the functions of the immune and lymphatic systems: • Protect against the invasion of foreign substances and pathogens • Return extra fluid to the circulatory system

24 The Immune and Lymphatic Systems and Cancer 3. Discuss changes in the immune and lymphatic systems due to aging Normal changes of aging in the immune and lymphatic systems: • Immune system weakens, causing increased risk of all types of infections. • Antibody response slows. • T-cells decrease in number. • Response to vaccine decreases.

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Define the following terms: acquired immune deficiency syndrome (AIDS) the final stage of HIV infection, in which infections, tumors, and central nervous system symptoms appear due to a weakened immune system that is unable to fight infection. human immunodeficiency virus (HIV) a virus that attacks the body’s immune system and gradually disables it; eventually can cause AIDS.

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Remember these points about HIV and AIDS: • HIV attacks the body’s immune system and damages or destroys cells. • Cause: HIV virus acquired through blood or body fluids from an infected person • AIDS is the final stage of HIV infection.

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Know the most common methods of transmission of HIV: • Unprotected or poorly-protected anal sex with an infected person • Unprotected or poorly-protected vaginal sex with an infected person • Sexual contact with many partners • Sharing drug needles or syringes

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system REMEMBER: In a healthcare setting, infections can be spread through accidental contact with contaminated body fluids, needles or other sharp objects, or contaminated supplies or equipment.

24 The Immune and Lymphatic Systems and Cancer Handout 24 -1: Myths About HIV and AIDS Myth: If a person is HIV positive, that means he or she has AIDS. Fact: Being HIV positive means that a person’s body was exposed to the virus. Since the person was exposed, there is a good chance that he or she is infected with the virus. But it does not mean that the person has AIDS develops over time. Myth: HIV is the same as AIDS. Fact: HIV is the virus that can cause AIDS is a group of symptoms that develop during the last stage of HIV infection. Myth: HIV can be spread by shaking hands, hugging, or kissing an infected person. Fact: HIV is not spread through casual contact. There is a slight possibility that a person could become HIV infected through kissing if both the infected and uninfected person had open, bleeding sores in their mouths, and the infected person’s blood got into the uninfected person’s bloodstream. If this is a concern, partners can check for such sores before kissing.

24 The Immune and Lymphatic Systems and Cancer Handout 24 -1 : Myths About HIV and AIDS (cont’d) Myth: HIV can be spread by touching telephones or cell phones that an infected person has used. Fact: The HIV virus cannot live outside of the body. It is not possible to become infected through saliva. Myth: HIV can be spread by touching doorknobs, tables, chairs, or push buttons. Fact: The HIV virus cannot live outside of the body. Myth: HIV can be spread by eating food that was prepared by an infected person. Fact: Once again, HIV dies very quickly outside the body. Even if the food prep person cut his finger and then arranged food on a plate, nobody could become infected from eating this food. Once any body fluid is dry, the virus is dead. Just about the only way infection could be spread in this way is if the food prep person cuts a finger and is bleeding into the food while an uninfected person with open sores in his mouth is eating it. This scenario is rather unlikely.

24 The Immune and Lymphatic Systems and Cancer Handout 24 -1 : Myths About HIV and AIDS (cont’d) Myth: HIV can be transmitted from toilets. Fact: Toilets have been blamed for just about everything, from getting people pregnant to giving people sexually-transmitted infections. The only way a person might possibly become HIV infected from a toilet seat is by having unprotected sex while sitting on it. Myth: HIV can be transmitted by mosquitoes. Fact: Although it sounds possible, mosquitoes, fleas, ticks, and lice do not spread HIV. For this to happen, the HIV would have to survive in the insect saliva and salivary glands. HIV is a human virus and cannot survive outside of the human body. As a result, HIV will not and does not survive in mosquitoes, fleas, ticks, or lice. If this were a route of transmission, many more people would have been infected a very long time ago.

24 The Immune and Lymphatic Systems and Cancer Handout 24 -1 : Myths About HIV and AIDS (cont’d) Myth: HIV can be spread by breathing the same air as an infected person. Fact: HIV does not spread through the air. Being in the same room with someone who is infected with the virus does not pose any risk of transmission. More information about HIV and AIDS is available at these websites: aids. gov, aidsinfo. nih. gov, and cdc. gov/hiv.

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Remember that HIV is not spread in any of these ways: • Through air or water or food • By pets or insects, including mosquitoes • In saliva, tears, or sweat • Through casual contact, such as hugging, shaking hands, sharing dishes, or touching doorknobs or toilet seats • Through closed-mouth or casual kissing, such as kissing someone’s cheek

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system The following are ways to protect against the spread of HIV/AIDS: • Practicing Standard Precautions. • Handling and disposing of sharps properly • Covering cuts, sores, tears, breaks, or rashes before caring for residents • Never sharing needles or syringes • Not having unprotected sex • Staying in a monogamous relationship • Practicing abstinence • Getting tested for HIV and re-tested if necessary

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Know the signs and symptoms of HIV infections and AIDS: • Flu-like symptoms • Headaches • Blurred vision • Loss of appetite • Nausea and vomiting • Weight loss • Night sweats • Shaking, chills • Dry cough

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Signs and symptoms of HIV infections and AIDS (cont'd): • Shortness of breath • Swollen lymph nodes • Sore throat • Cold sores or fever blisters on the lips • Mouth sores • White patches in the mouth or on the tongue • Cauliflower-like warts on the skin and in the mouth

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Signs and symptoms of HIV infections and AIDS (cont'd): • Bleeding, inflamed gums • Yeast infections • Skin rashes or sores • Bruising that does not go away • Dry skin • Memory loss

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Define the following term: opportunistic infection an illness caused by microorganisms due to a person’s inability to fight infection.

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system REMEMBER: People with weakened immune systems due to HIV/AIDS may get opportunistic infections, or diseases that a healthy person would be able to fight off. Lack of treatment for HIV/AIDS increases the risk of serious complications and death from the disease.

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Define the following term: autoimmune disease a disease in which the body is unable to recognize its own tissue and begins to attack these tissues.

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system Know these points about autoimmune diseases: • The body is unable to recognize its own tissue and attacks it. • Examples: systemic lupus erythematosis and rheumatoid arthritis • Cause: unknown, but may be genetic links, microorganisms or medications that act as triggers • Signs and symptoms: fever, fatigue, dizziness • Treatment: hormone supplements, medications, blood transfusions, insulin

24 The Immune and Lymphatic Systems and Cancer 4. Describe a common disorder of the immune system REMEMBER: Obesity increases the risk for certain immune system diseases or disorders, including kidney, prostrate, breast, endometrial, and ovarian cancers.

24 The Immune and Lymphatic Systems and Cancer 5. Discuss infection prevention guidelines for a resident with HIV/AIDS REMEMBER: It is very important that nursing assistants follow Standard Precautions with every single resident in their care. If an NA does this, there should be no difference in the care given to a resident with HIV/AIDS and care given to any other resident.

24 The Immune and Lymphatic Systems and Cancer 5. Discuss infection prevention guidelines for a resident with HIV/AIDS Know these infection prevention guidelines for HIV/AIDS: • Follow Standard Precautions. • Cover all broken skin with appropriate bandages before giving care. • Wear appropriate PPE. • Wash hands and other areas of body immediately after contact with blood or body fluids.

24 The Immune and Lymphatic Systems and Cancer 5. Discuss infection prevention guidelines for a resident with HIV/AIDS Infection prevention guidelines for HIV/AIDS (cont'd): • Handle and dispose of sharps carefully. • Remind residents and visitors to wash their hands often. • Do not share residents’ personal items. • Properly disinfect surfaces.

24 The Immune and Lymphatic Systems and Cancer 6. Discuss care guidelines for a resident with HIV/AIDS Define the following term: homophobia a fear of homosexuality.

24 The Immune and Lymphatic Systems and Cancer 6. Discuss care guidelines for a resident with HIV/AIDS Remember these care guidelines for HIV/AIDS: • Wash hands often and help residents wash hands. • Disinfect surfaces often. • Protect resident from people having known contagious diseases. • Change linen whenever it is soiled. • Observe for skin breakdown. • Change positions every two hours or as directed • Give back rubs for comfort. • Monitor vital signs often.

24 The Immune and Lymphatic Systems and Cancer 6. Discuss care guidelines for a resident with HIV/AIDS Care guidelines for HIV/AIDS (cont'd): • Allow rest and recognize limitations. • Encourage independence. • Ambulate carefully. • Allow time for ADLs. • Perform ROM exercises as ordered. • Give quality mouth care frequently. • Use soft toothbrushes or swabs for oral care. • Carefully measure weight and intake and output.

24 The Immune and Lymphatic Systems and Cancer 6. Discuss care guidelines for a resident with HIV/AIDS Care guidelines for HIV/AIDS (cont'd): • Report if resident is not eating or not enjoying food. • Encourage resident to follow his special diet. • Encourage fluids. • Give small meals throughout day or BRAT diet (bananas, rice, applesauce, and toast) for nausea and diarrhea. • Offer a trip to the bathroom or bedpan as often as needed. • Give emotional support. Some people avoid a person with AIDS due to homophobia. • Be aware of other support systems.

24 The Immune and Lymphatic Systems and Cancer 6. Discuss care guidelines for a resident with HIV/AIDS Report any of these symptoms of HIV/AIDS to the nurse: • Changes in vital signs, especially fever • Loss of appetite, nausea, vomiting, or diarrhea • Reduced intake of fluids • Weight loss • Dysphagia (difficulty swallowing) • Mouth sores or discomfort • Bruising of the skin

24 The Immune and Lymphatic Systems and Cancer 6. Discuss care guidelines for a resident with HIV/AIDS Report any of these symptoms of HIV/AIDS (cont'd): • Cracks, breaks, rashes, lumps, or sores anywhere on the skin • Pressure ulcers • Bleeding from anywhere on the body • Blood in the stool • Nervousness, withdrawal, severe mood swings, or depression • Behavior that puts resident or others at risk, suicidal thoughts or comments

24 The Immune and Lymphatic Systems and Cancer 7. Describe cancer Define the following terms: cancer a general term used to describe a disease in which abnormal cells grow in an uncontrolled way. tumor a group of abnormally-growing cells. benign non-cancerous. malignant cancerous. metastasize to spread from one part of the body to another.

24 The Immune and Lymphatic Systems and Cancer 7. Describe cancer Remember these facts about cancer: • Usually occurs in the form of a tumor that grows on or within the human body. • Tumors are either benign (non-cancerous) or malignant (cancerous). • Can act in different ways. It can metastasize, or spread, to other areas of the body.

24 The Immune and Lymphatic Systems and Cancer 7. Describe cancer Know the risk factors for cancer: • Genetic factors • Certain lifestyle choices, such as tobacco use • Alcohol use • Poor diet/obesity • Lack of physical activity • Certain infections • Environmental exposure, such as radiation • Sun exposure

24 The Immune and Lymphatic Systems and Cancer 7. Describe cancer Understand the signs of cancer, as described by the American Cancer Society: • Unexplained weight loss • Fever • Fatigue • Pain • Skin changes • Change in bowel/bladder function

24 The Immune and Lymphatic Systems and Cancer 7. Describe cancer Understand the signs of cancer, as described by the American Cancer Society (cont’d): • Sore that does not heal • White patches inside the mouth or on the tongue • Unusual bleeding/discharge • Any thickening in breast, testicle, or other areas • Indigestion, difficulty swallowing • New mole or change in appearance of existing mole or wart • Nagging cough or hoarseness

24 The Immune and Lymphatic Systems and Cancer 7. Describe cancer Define the following terms: biopsy a removal of a sample of tissue for examination and diagnosis. remission the disappearance of signs and symptoms of cancer or other diseases; can be temporary or permanent.

24 The Immune and Lymphatic Systems and Cancer 7. Describe cancer REMEMBER: A diagnosis of cancer is made after various tests, such as a biopsy, have been performed. After the diagnosis of cancer is made, the treatment plan is developed. Treatment is based on whether or not the cancer has spread to other parts of the body, or metastasized.

24 The Immune and Lymphatic Systems and Cancer 7. Describe cancer There are various treatments for cancer, and they are often used in combination: • Surgery • Radiation therapy • Chemotherapy • Hormone therapy • Immunotherapy

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer It is important to follow these infection prevention guidelines when caring for residents with cancer: • Follow Standard Precautions. • Wear PPE as required.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Remember these skin care guidelines for residents with cancer: • Observe skin to prevent pressure ulcers. • Change position every two hours or as directed. • Follow special skin care orders exactly. • Use special mattresses or pads in beds and chairs to reduce risk of pressure ulcers.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Skin care guidelines for residents with cancer (cont'd): • Keep skin clean and dry. • Apply lotion to dry skin. • Do not use lotion on areas receiving radiation therapy. • Do not remove any markings used with radiation therapy. • Report signs of infection.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Use these oral care guidelines for residents with cancer: • Give oral care often. • Be gentle. • Use soft brushes or special swabs. • Use mild mouth rinses to reduce bad taste from medication or vomiting.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Remember these nutrition guidelines for residents with cancer: • Provide small, frequent meals to reduce nausea and prevent weight loss. • Serve favorite foods and nutritious snacks. • Provide food when hunger occurs. • Try cool or cold foods. • Cut foods into small pieces. • Use plastic utensils. • Weigh residents as ordered and report loss or gain. • Encourage fluids. • Monitor I&O and report changes.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Know these guidelines for bladder and bowel changes for residents with cancer: • Assist residents with toileting often. • Give catheter care as needed. • Carefully measure output. • Test stool for occult blood as ordered.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Know these guidelines for mobility for residents with cancer: • Allow plenty of time for rest. • Recognize limitations. • Assist with ambulation.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Define the following term: breakthrough pain a type of severe pain that happens unexpectedly in people who have cancer.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer REMEMBER: Cancer can cause severe pain. It can affect the ability to sleep, eat, and move. Medications and other measures are used to treat pain. Observe and report signs of pain in residents with cancer.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Know these care guidelines for pain in residents with cancer: • Be alert for signs of pain and report immediately. • Provide comfort measures, such as back rubs and repositioning. Play soft music, read, or talk quietly with residents. • Notify nurse of side effects of pain medication. • Report irritation around transdermal patches or resident having more than one patch on the body. • Observe for redness, swelling, or warmth around the insertion site of PCA pump. • Report signs of breakthrough pain.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Remember these vital signs guidelines for residents with cancer: • Monitor all vital signs, especially temperature. • Report changes in vital signs to nurse.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Remember these guidelines for supporting self-image in residents with cancer: • Help residents stay clean and well-groomed. • Offer wigs, scarves, or hats for hair loss. • Assist with application of makeup as requested.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Know these guidelines for understanding the mental status and meeting the emotional needs of residents with cancer: • Be sensitive to residents’ wishes. • Listen if residents want to express feelings. • Spend as much time with residents as possible. • Encourage activities. • Ask social worker about support groups.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Understanding the mental status and meeting the emotional needs of residents with cancer (cont'd): • Do not use clichés. • Provide support during painful episodes and difficult times. • Remind residents that there can be good days ahead. • Observe and report signs of depression or comments about suicide.

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Know the symptoms to observe and report: • Pain or increased pain • Changes in vital signs • Signs of new bumps or lumps or changes in skin • Rashes, cracks, sores, breaks, or reddened areas on the skin • Odors

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Symptoms to observe and report (cont'd): • Burns or skin irritation • Bruising of the skin • Difficulty with ambulation • Fainting • Increased fatigue or weakness

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Symptoms to observe and report (cont'd): • Chest pain or tightness • Shortness of breath • Appetite changes or weight loss • Difficulty chewing or swallowing • Dry, sore mouth and mouth or lip sores

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Symptoms to observe and report (cont'd): • Inflammation or irritation of the mucous membranes in the mouth • Bleeding from inside the mouth • Nausea or vomiting • Flatus, diarrhea, or constipation • Blood in the stool

24 The Immune and Lymphatic Systems and Cancer 8. Discuss care guidelines for a resident with cancer Symptoms to observe and report (cont'd): • Change in output • Any change in urine or blood in urine • Urinary tract infection • Change in mental status or confusion • Anxiety, fear, or angry feelings • Signs of depression