Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Nursing 3 Test 3
HIV/AIDS
| Question | Answer |
|---|---|
| HIV | Human Immunodeficiency Virus |
| HIV is spread through... | direct contact with blood(sex) and bodily fluids |
| AIDS | Acquired Immunodeficiency Syndrome |
| AIDS... | last stage of HIV disease, from infection to symptoms to occur it takes 8-10yrs, fatal disease:poor prognosis & no cure |
| HIV transmission | sexual, parenteral, perinatal |
| HIV is not transmitted through... | Tears, Saliva(has to be bodily fluid exchange) |
| Infectious period of HIV... | as soon as you are infected, especially in the begining b/c your viral load is so high |
| HIV transmission in healthcare workers | 0.3% risk following needle stick, lower risk:splashing eyes, mouth etc |
| HIV pathophysiology | retrovirus:single stranded RNA, Virus infects CD4 cells(Helper T-cells), Virus splices itself into genome, when cell replicates, new cell has HIV virus |
| seroconversion of HIV | antibodies produced to HIV virus, detectable at 6wks-6months post infection, person now HIV positive |
| replication of HIV virus results in... | increase in viral load(# of viruses) and decrease in CD4 cells |
| normal CD4 cell count | 800-1200 cells/ul |
| Acute HIV infection | contraction of virus and seroconversion |
| sypmtoms of HIV infection | flu like symptoms(fever,chills,sore throat,muscle aches), rash, lympadenopathy, high viral load, low CD4 count(soon returns to baseline) |
| how long do symptoms last with acute HIV infection | 1-3 wks to few months |
| Early Chronic HIV infection | CD4 counts>500cells/ul, asymptomatic or low grade fever, night sweats, fatigue, persistent generalized lympadenopathy |
| Intermediate chronic HIV infection | CD4 counts 250-500 cells/ul, syptoms worsen |
| Late chronic or AIDS | CD4 counts <200 cells/ul, opportunistic infections & cancers |
| Diagnosis of HIV | enzyme-linked immunoassay(EIA or ELISA) and Western Blot Analysis |
| EIA or ELISA | Enzyme-linked Immunoassay |
| ELISA | screening test, 99.9% accurate after 12 wks, positive tests must be repeated, must be confirmed with western blot test |
| Western Blot Analysis | more sophisticated test for HIV antibodies, used to confirm positive EIA/ELISA, if results are positive, pt considered HIV positive |
| AIDS Diagnosis | HIV positive and at least one of these: CD4 <200 cells/ul, opportunistic infections, opportunistic cancers, wasting sydrome, AIDS dementia |
| opportunistic infections | candidiasis, pneumocystitis pneumonia(PCP), Mycobacterium Avium Complex(MAC), TB, Herpes simplex virus(HSV), Varicella Zoster(VSV,shingles), Pelvic Inflammatory Disease(PID) |
| Candidiasis | oral thrush or esophagitis |
| candidiasis symptoms | mouth pain, dysphagia, retrosternal burning, white plaques in oropharynx |
| vaginal candidiasis symptoms | vaginal itching, thick white discharge |
| Pneumocystis Pneumonia(PCP) | caused by p.jiroveci, most common infection(75-80%) |
| s/s of pneumonia | fever, SOB, dyspnea, lung sounds at first rhonchi/rails then diminished once consolidation or atelectasis occurs |
| Mycobacterium Avium Complex(MAC) | systemic infection, CD4 <50 cells/ul |
| s/s of MAC | fever, debility, cachexia(wasting), diarrhea, abdominal pain |
| Secondary Cancers | Kaposi's Sarcoma, Malignant Lymphomas, Cervical Cancer in Women |
| Kaposi's Sarcoma | presenting symptom of AIDS, small purplish raised lesions on body, usually painless, may be painful later, may develop internally(serious), lungs, GI tract |
| Mean Survival after Kaposi's Sarcoma appear | 18 months after diagnosis |
| AIDS Dementia Complex | Effects of CNS, cognitive, motor, & behavioral impairments, memory loss, lethargy, ataxia, tremors |
| Wasting Syndrome | extreme weight loss, multiple factors r/t altered metabolism, poor appetite, malignancy, infection, side effects of drugs |
| Diagnostic CD4 cell count | monitors progress of disease, response to treatment |
| start treatment when CD4 cell count is... | <350 cells/ul |
| How often should you do a CD4 cell count | repeat 3-6 months |
| Diagnostic Viral load | measures presence of HIV RNA, monitors progress of diesease, evaluates response to treatment |
| start treatment when viral load levels are... | >100,000 copies/ml |
| goal of Viral load | undetectable, there is no zero |
| What other tests should be ordered? | WBC w/lymphocytes, CBC, CMP, other tests based on s/s |
| ART/ARV | Anti-retroviral Therapy |
| Anti-Retroviral Therapy(ART/ARV) | decrease viral load and increase CD4, delay infections, "cocktail" 3-4 drugs decreases chances of resistance, expensive, many s/e, cumbersome food & timing requirements, adherence is important,DO NOT COMBINE W/HERBALS |
| NRTI/NtRTI | Nucleoside/Nucleotide Reverse transcriptase Inhibitors |
| NRTI/NtRTI | inhibit action of Reverse Transcriptase |
| NRTI | zidovudine(AZT) emtricitabine(Emtriva) |
| NtRTI | tenofovir |
| side effects of Nucleoside reverse transcriptase inhibitors | n/v, diarrhea(common to all), skin discoloration, pancreatitis(AZT), rash(emtricitabine) |
| side effects of Nucleotide reverse transcriptase inhibitors | n/v, diarrhea(common to all) skin discoloration |
| ase= | enzyme |
| vir= | antiviral |
| NNRTI | Non-nucleoside RT Inhibitors |
| NNRTI | blocks action of reverse transcriptase, always used in combination, EX:efavirenz(Sustiva), severely teratogenic |
| side effects of NNRTI's | dizziness, confusion, diarrhea, highly teratogenic |
| Protease Inhibitors | Inhibits protease(enzyme necessary for viral maturation), combined w/other drugs inhibits virus at different stages |
| examples of protease inhibitors | ritonavir(Norvir), darunavir(Prezista) |
| side effects of protease inhibitors | nausea, diarrhea, taste perversion |
| 2011 ART Guidelines | adolescents, adults, pregnant women: CD4 < or = to 350 cells/ul or AIDS defining illness |
| 2011 ART Guidelines | One NNRTI and two NRTI's, all HIV+ pregnant women should be tx'ed prophylactically, HIV exposed: Infant recieves AZT for 6wks, CD4 and viral load testing 3-6 months |
| Other medications | chemotherapy, antibiotics, analgesics, antiemetics, antidiarrheal, oral progesterone(Megace) |
| oral progesterone(Megace) | stimulates appetite, tx of wt loss, tx of altered taste perception |
| Nursing Interventions | O2 PRN, IV fluids, medications as ordered, perineal care, especially for persistent diarrhea, encourage ambulation, rest, counseling, guidance to client and family, ventilation of feelings, high protein and hig caloric diet |
| Nursing Interventions:Education | Med therapy:s/e, protocol, need to take on time, proper oral care, nutrition, rest, prevent infections, s/s secondary & opportunistic infections, prevention of transmission |
| Health Promotion | assess risk factors, early detection, prevention of transmission |
| prevention of transmission | safe sex techniques, no sex,safe sex,condoms,monogamy, avoid sharing contaminated needles, clean spills etc with bleach solution, avoid donating blood, organs or sperm, perinatal precautions |
Created by:
jbittner
Popular Nursing sets