Nursing study guide
Immunodeficiency
Recognize impaired host defense, prevent avoidable exposure, and respond early when infection may present subtly.
Primary
Inherited immune-system disorders can affect antibodies, lymphocytes, phagocytes, complement, or more than one pathway.
Secondary
Illness, malnutrition, cancer, HIV, loss of splenic function, and immunosuppressive treatment can weaken host defense.
Nursing lens
Know the patient's baseline, individual emergency plan, treatment timing, exposure risks, and signs that require escalation.
Foundations
The missing immune function shapes the infection pattern
Immunodeficiency is not one disease and does not create one universal presentation.
| Defense problem | Pattern to recognize | Nursing connection |
|---|---|---|
| Antibody | Repeated sinopulmonary or gastrointestinal infections | Trend frequency, organisms, treatment response, respiratory status, hydration, and immunoglobulin plan. |
| Cellular | Severe viral, fungal, or opportunistic infection | Use the patient-specific exposure, prophylaxis, testing, and escalation plan. |
| Phagocyte | Deep skin or organ infection and impaired inflammatory response | Inspect skin, mouth, lines, wounds, and subtle functional or vital-sign change. |
| Complement / asplenia | Invasive infection from particular encapsulated organisms | Confirm vaccination and prophylaxis plans and treat fever or rapid decline as time sensitive. |
Recognition
Repeated, severe, unusual, or persistent infection deserves attention
The absence of dramatic inflammation does not prove that infection is minor.
History
Frequency, severity, organism, site, exposure, family history, growth or weight change, procedures, devices, medicines, and prior response.
Subtle change
Fatigue, reduced intake, new confusion, functional decline, cough, dyspnea, diarrhea, oral lesions, drainage, or pain may precede fever.
Treatment response
Poor response, incomplete recovery, recurrence, or infection with an unusual organism can be clinically important.
Assessment + tests
Connect the specimen, immune pathway, and clinical picture
No isolated laboratory value replaces assessment or specialist interpretation.
Immediate assessment
Airway, breathing, circulation, mentation, perfusion, hydration, skin, mouth, lines, wounds, and the suspected infection site.
Common studies
CBC with differential, cultures, organ-function tests, imaging, immunoglobulins, lymphocyte studies, complement, or disease-specific testing may be ordered.
Trend
Compare with the patient's own baseline, treatment cycle, recent exposure, prophylaxis, and prior organisms—not only a population reference range.
Prevention
Layer ordinary infection prevention with the individual plan
Protect the patient without unnecessary isolation or stigma.
Every encounter
Hand hygiene, respiratory etiquette, aseptic device care, safe food and water practices when prescribed, and prompt attention to skin or oral problems.
Exposure
Screen visitors and care-team exposures according to the current plan; use transmission-based precautions for suspected or confirmed infection.
Vaccines
Vaccine timing and use of live vaccines depend on the immune defect and therapy. Verify with the treating team rather than assuming.
Environment
Avoid unneeded invasive devices and follow exact central-line, wound, and infusion-care procedures.
Treatment safety
Support replacement, prevention, and rapid treatment
Therapy varies with the underlying immune problem.
Immunoglobulin
Verify product, dose, route, rate, premedication, baseline assessment, reaction plan, and ordered monitoring.
Antimicrobials
Collect ordered specimens when safe, give time-critical therapy promptly, and monitor allergies, interactions, organ function, and response.
Disease-directed care
Growth factors, immune-modifying treatment, stem-cell transplant, HIV therapy, or changes to immunosuppression require specialist plans.
Teaching
Use a written plan for medicines, prophylaxis, missed doses, exposure, fever, travel, vaccines, and emergency contact.
Escalation
Treat rapid decline and suspected serious infection as time sensitive
Immunocompromised patients can deteriorate before classic findings appear.
Escalate now
New breathing difficulty, altered mental status, poor perfusion, severe weakness, uncontrolled bleeding, stiff neck, rapidly spreading skin change, or other acute deterioration.
Follow the plan
Use the patient's prescribed fever or neutropenia pathway and facility sepsis process; do not wait for every sign.
Communicate
State the immune condition or therapy, current cycle, prophylaxis, devices, recent exposures, onset, vital trends, and actions already taken.
Sources
Reference notes
Specialist guidance and the individual emergency plan determine bedside decisions.