7.1 HIV

Question 1

Primary Immune Deficiency Disorder (PIDD)

Answer 1

• Genetic
• Most present during first year of life
• More often in males
• Prevent body from developing normal immune responses

Question 2

PIDD Signs and Symptoms

Answer 2

• Multiple Infections

- Failure to thrive/poor growth of infant

Question 3

Nursing Care

Answer 3

• Must be meticulous
• Appropriate hand hygiene
• Infection prevention cautions
• Monitor signs of infection
• Educational support for family

Question 4

Acquired Immunodeficiency

Answer 4

• Related to medical treatment such as chemotherapy

- Infection agents such as HIV virus, human immune deficiency virus, AIDS.

Question 5

HIV

Answer 5

• Transmitted through blood, semen, vaginal secretions, breast milk, not through casual contact

Question 6

Prevention of HIV

Answer 6

• Education of risky behavior
• HIV testing, treatment, and care
• Proper condom use
• Needle exchange programs
• Pre-exposure prophylaxis

Question 7

HIV Reproduction Education

Answer 7

• Artificial insemination

- Antiretroviral Therapy (ART)

Question 8

HIV Medication

Answer 8

• Combination drugs
• Protease inhibitors
• NRTI (nucleotide reverse transcriptase inhibitor)
• Entry inhibitors
• Integrase inhibitors

Question 9

HIV Risk Factors

Answer 9

• LGBT youth are at high risk due to dealing with family rejection and lack of support

Question 10

Risk of HIV Transmission to Healthcare Workers

Answer 10

• Hand hygiene
• PPE
• Safe handling of needles and sharps
• Cleaning equipment, waste disposal, disinfecting surfaces
• PEP (Post Exposure Prophylaxis) such as Anti-Viral meds no more than 72 hours after exposure. (Get to employee health or ER as fast as possible)

Question 11

Risk of HIV Transmission to Healthcare Workers

Answer 11

• Very low risk (0.23%)

- Less than 1% after exposure

Question 12

HIV Pathophysiology

Answer 12

• Retrovirus (Carries genetic material in form of RNA)
• Targets CD4 receptors on T-Lymphocytes, monocytes, dendritic cells, and brain microglia.
• HIV is a complex life cycle

Question 13

Stages of HIV

Answer 13

0 - Acute infectious stage (can test negative but still highly contagious) Very dangerous for transmission
Stage 1 - Clinical Latency (primary acute period. Dramatic drop in CD4 T-cell count (normal is 500-1500 per mL of blood)
Stage 2 - Early stage of AIDS. T-cell 200-499
Stage 3 - T-lymphocytes drop below 200 Considered to have AIDS. Risk of opportunistic infections.
Unknown Stage - Opportunistic infections are often.

Question 14

Clinical Manifestation of HIV

Answer 14

• Asymptomatic at first
• Fatigue/Skin Rash
• Later stages may have respiratory issues from pneumocystis pneumonia.
• Anorexia/N/V/Oral Thrush (Candidiasis)

Question 15

Clinical Manifestations of HIV

Answer 15

• Kaposi’s Sarcoma (Cancer) and skin lesions
• HIV encephalopathy (AIDS dementia)
• Herpes Zoster and Herpes Simplex and Dermatitis
• ## Fungal infections in the mouth

Question 16

ART (Antiretroviral Therapy)

Answer 16

• Keeps CD4 counts high which reduces HIV morbidity

Question 17

Assessment of HIV

Answer 17

• Risk Factors
• Sexual Practices
• IV Drug Abuse
• Assess each system (physical status, skin lesions, weight)
• Depression
• Frequent Infections, Nutritional status, Dietary change
• Respiratory status (Cough, Shortness of Breath, Sputum)
• Level of consciousness/Mental Status Change

Question 18

Wasting Syndrome

Answer 18

• Involuntary loss of 10% body weight

Question 19

Promoting Bowel Patterns

Answer 19

• Assessing diarrhea
• Avoid foods that irritate bowel such as raw fruits, carbonated drinks, raw vegetables.
• Administer Meds to assist bowel patterns.

Question 20

Promoting Preventing Infection

Answer 20

• Monitor S/S (fever, chills, culturing wounds)
• Educate patient and family
• Monitor WBC and CD4 Count

Question 21

Improve Airway Clearance

Answer 21

• Assess respiratory status, rate of breath, breath sounds
• Elevate head of bed
• Provide oxygen if needed

Question 22

Improve Nutritional Status

Answer 22

• Giving easy to eat high calorie food
• Oral thrush could be painful so easy to swallow food
• Dietary consult for assistance
• Meds for nausea prior to meals

Question 23

Improvement of Knowledge

Answer 23

• Instruction on transmission
• Correct condom use
• IV Drug use risk
• Patient should demonstrate skills back with props or verbally tell you about the risk.

Question 24

Decreased sense of social isolation

Answer 24

• Provide support systems (family and friends)
• Re-assuring it is not passed through casual contact
• Provide information how to protect themselves

Question 25

Evaluation

Answer 25

• Do they need home health nursing for medication administration/wound care/respiratory care
• Patients with HIV/AIDS must remain in the community
  Terminal Stages
• Hospice Care to provide physical and emotional support