NUR 641 Topic 1 DQ 1

Sample Answer for NUR 641 Topic 1 DQ 1 Included After Question


Part 1

What are the differences between primary and secondary line of defense? What factors interfere with these mechanisms? How are these levels of immunity affected in a child, an elderly person, or a person with a chronic disease? Include active, passive, innate, and acquired immunity.

Part 2

Choose an inflammatory or infectious process and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.

A Sample Answer For the Assignment: NUR 641 Topic 1 DQ 1

Title: NUR 641 Topic 1 DQ 1

Part 1

The primary line of defense consists of initial barriers that protect us against pathogenic organisms that enters our body. It is also known as the innate immune response and is not specialized for specific pathogens. The primary defense systems are made up of the skin as well as the mucus membrane found in the body openings. The intact skin offers protection in the external boundaries while mucous membranes provides defense in the internal boundaries (McCance & Huether, 2010). However, both skin and mucous membranes secrete chemicals that restrict microbial growth on their surfaces. The secondary line of defense, on the other hand, refers to cellular and molecular responses of the immune systems to an infectious agent. Unlike the primary line of defense, the secondary defense is also known as adaptive immune system and offers protection when the innate responses are breached. The secondary defense system are made of T lymphocytes, B lymphocytes, antibodies, and cytokines mainly found in the blood and tissues.

Tissue injuries interfere with the first line of defense. The premise occurs when the integrity of the skin is broken due to fire, a bruise or a deep cut. These exposes the internal body tissues to pathogens, which will penetrate the openings and invade cells. Further, damaging effects of disease conditions like cystic fibrosis and smoking can affect the mucociliary escalator, resulting in the colonization of the lower respiratory tract as well as frequent infections (Cai, Tang, Zhu, & Zhou, 2018). On the other hand, infections of the blood or body tissues interferes with the classical pathways for the protection of the body through the secondary defenses.

These can include pathogens that use human blood for nutrition and excrete wastes in the same. Infections caused by pathogens weakens the immune systems. The levels of immunity are compromised by the pathogens that alters the lines of defenses in the body. In other words, extremely high levels of pathogens within the body may overwhelm the inhibitors associated with innate immunity.

However, even as the two levels of immunity play a crucial role in keeping out diseases, the manner in which they achieve this objectives differs depending on the age. Unsurprisingly, the immune system begins to lose its potency in warding off pathogens as the body ages. According to literature on the matter, the process through which the body loses its immune capacity is referred to as immunosenescence (Simon, Hollander, & McMichael, 2015). During this process, the body loses its capacity to defend itself against infections as well as the advancement of elongated immune memory to vaccines.

Old people are characterized by insufficient production of competent lymphocytes while the competency of memory cells also declines leading to a weak immune system. Further, the innate immune system also declines with advancing age. Age results in alterations in innate cell numbers with bias towards myeloid lineages observed during hematopoiesis. Also, the aging macrophages are characterized by decreased respiratory burst. For this reason, they display reduced HLA II expression and phagocytic function. Therefore, due to immunosenescence, the active, passive, innate and acquired immunity are compromised in old people.

Part 2

The process of inflammation, also known as the inflammatory response, happens when tissues within the body are injured by trauma, heat, bacteria, toxins or any other relevant cause. One of the most important inflammatory conditions is gout. According to PR Newswire (2018), gout occurs in response to the deposition of monosodium urate (MSU) crystals. The development of gout leads to the existence of several pathophysiological checkpoints within the body system. The first checkpoint entails the elevation of urate concentrations in the sense that its overproduction and under-secretion lead to total urate balance. The overproduction of urate exists because of alterations in the pathways responsible for the synthesis and degradation of the same.

On the other hand, renal undersecretion is a significant contributor to the presence of elevated serum urate concentrations, and occurs via alterations that accompany urate transporters inside the renal tubule. The undersecretion of extrarenal urate also leads to the advancement of hyperuricaemia. The next important checkpoint in the pathophysiology of gout involves the formation of MSU crystal. Certain individuals presenting with evidence of deposition of the MSU crystal manifest with gout symptomatology. The acute inflammatory response the aforesaid crystals characterizes an acute auto-inflammatory response that is self-limiting and sterile, and which is influenced by the mediation of the activated innate immune response (Desai, Steiger, & Anders, 2017).

Further during the process, the interleukin-1-beta plays an important role in terms of its contribution to the acute inflammatory response as it relates to the MSU crystals. However, in other patients, advanced gout may be accompanied with damage to the structural joint. This type of damage in gout may be mediated by both direct impact of MSU crystals upon the tissues of the joint or by the indirect impact of joint inflammation. Thus, MSU crystals play an important part in the pathophysiology of and pathogenesis of inflammatory gout.

In order to combat gout, patients will need to be educated on measures that they can undertake to reduce the inflammation associated with it. One of the most important patient educations undertaken by medical professionals entails adherence to medications. In most cases, educators will prescribed non-steroidal anti-inflammatory drugs, steroids, and colchicine to relieve pain and inflammation (Neogi & Dalbeth, 2018). However, most patients do not follow prescriptions and it becomes the duty of nurses in conjunction with pharmacists to educate them on the importance of appropriately taking their prescription. The purpose herein will be to reduce instances of confusion as regards the treatment modalities for both long-term chronic gout and acute gout. Moreover, educating patients on the dietary changes to make also helps in managing gout. Changing diet may help to reduce the frequency of flares associated with gout.

Since obesity also significantly contributes to instances of gout and other health diseases, losing weight becomes an important goal for people who are at risk of getting or have already contacted gout (Neogi & Dalbeth, 2018). Even then, education in diet changes should be accompanied by recommended urate-reducing drugs. These patients should be informed that changing their diets alone may not make them reduce their levels of blood urate by 15% inasmuch as they may make significant changes to their diet. Lastly, patients with gout should be encouraged to consume a little over 2 liters of water daily alongside potassium citrate (60 mEq/d) for purposes of alkalizing the urine when the crystals becomes recurrent.


Cai, Q., Tang, D., Zhu, H., & Zhou, J. (2018). Research on key technologies for immune monitoring of intelligent manufacturing system. International Journal of Advanced Manufacturing Technology, 94(5–8), 1607–1621.

Desai, J., Steiger, S., & Anders, H.-J. (2017). Molecular Pathophysiology of Gout. Trends in Molecular Medicine, 23(8), 756–768.

McCance, K. L., & Huether, S. E. (2010). Pathophysiology: The biologic basis for disease in adults and children. St. Louis, Mo: Mosby Elsevier.

Neogi, T., & Dalbeth, N. (2018). Patient education and engagement in treat-to-target gout care. Lancet, 392(10156), 1379–1381.

PR Newswire. (2018, October 25). New Clinical Consensus Statement Designed to Address Controversies in Pathophysiology and Treatment of Gout. PR Newswire US. Retrieved from

Simon, A. K., Hollander, G. A., & McMichael, A. (2015). Evolution of the immune system in humans from infancy to old age. Proceedings. Biological sciences, 282(1821), 20143085.