Age

People at the extremes of life span are more likely to develop problems Age-related changes in immunologic function

Nutrition
Assessment of caloric intake as well as the type of calories that the patient is consuming

Nutrition
Vitamins help in regulation of cell proliferation and maturation of immune cells Inadequate intake of vitamins that are essential for DNA and protein synthesis may lead to protein-calorie deficiency and subsequently impaired immune function

Nutrition
Excess of deficiency of trace elements (copper, iron, manganese, selenium or zinc) in the diet generally suppresses immune function

Nutrition
Fatty acids are building blocks that make up the structural components of cell membranes Lipids are precursors of vitamins A, D, D and K as well as cholesterol Both excess and deficiency have been found to suppress immune function

Nutrition
Depletion of protein reserves results in atrophy of lymphoid tissues, depression of antibody response, reduction in the number of circulating T cells and impaired phagocytic function. As a result, susceptibility to infection is greatly increased

Infection and Immunization& &

Assess immunization and usual childhood diseases Assess past or present exposure to tuberculosis Assess exposure to any sexually transmitted diseases and blood borne pathogens such Hepatitis A, B, C, D, E infections and HIV infections

Allergy
Ask about history of any allergies including types of allergens, the symptoms experienced and seasonal variations in occurrence or severity in the symptoms

 Ask about any autoimmune disorders such as lupus erythematosus, rheumatoid arthritis or psoriasis

Disorders and Diseases

 Assess for history of cancer: type, date diagnosed, date and result of screening test Assess for family history of cancer

Disorders and Diseases

 Assess for DM, renal disease or COPD: onset and severity of illness as well as treatment

Disorders and Diseases

 Conditions such as burns and other forms of injury and infection may contribute to altered immune system function

Disorders and Diseases

Medications and Blood Transfusion

Ask for list of past and present medications Selected medications and effects on the immune system Ask for history of BT Ask for use of herbal agents and OTC drugs

Lifestyle and other factors

Assess history of smoking, alcohol consumption, dietary intake and nutritional status, amount of perceived stress, injection drug use, sexual practices, sexually transmitted diseases and occupational or residential exposure radiation or pollutants

Psychoneuroimmunologic factors

Physical Examination

Diagnostic Evaluation

Nursing Management