Chapter 15 exam 1 (d) Flashcards
1
Q
T/F HIV is a bacteria infection
A
false it is viral
2
Q
HIV is a ___ virus that causes immunosuppression
A
retrovirus
3
Q
The viral infection of HIV causes the person to be susceptible to infections that would normally be controlled through___
A
body’s natural immune responses.
4
Q
Retrovirus causes ___ making people susceptible to other infections
A
immunosuppresion
5
Q
T/F most pts with HIV die from Aids
A
False most die to other infections
6
Q
In north america, the prevalence of HIV has been highest amongest which populations?
A
- Men having sex with men
- people of color
- people who live in poverty
- adolescents
7
Q
HIV remains a disease of marginalized individuals for example those that are disenfranchised by virtue of: (6)
A
- gender
- race
- sexual orientation
- poverty
- drug use
- lack of health care
8
Q
What 3 areas have the US made strides in to produce longer life spans and lower death rates
A
- prevention
- testing
- treatment
9
Q
HIV can only be transmitted under specific conditions that allow contact with ___
A
infected body fluids
10
Q
name the body fluids that have been confirmed transmitted body fluids
A
- blood
- semen
- vaginal secretions
- breast milk
11
Q
what is the most common mode of HIV transmission
A
sexual contact with an infected partner
12
Q
what does sexual activity involve?
A
contact with semen, vaginal secretions, and or blood
13
Q
How does contact with an infected sex partner give you HIV
A
it contains lymphocytes that cross from them to you in the infected fluid
14
Q
During sex who is most likely to get the infection?
A
the receiver
15
Q
Why is the receiver during sex most likely to contract HIV?
A
because they have prolonged contact with infected fluids
16
Q
who is more likely to get HIV: the hetrosexual woman with herpes (active) or the Hetrosexual male that performs anal
A
the woman. the likely hood of contracting the disease goes up if the presence of other STIs are present.
17
Q
What is the most common work related HIV transmission
A
puncture wounds
18
Q
Perinatal transmission can occur during (3)
A
- pregnancy
- delivery
- breastfeeding
19
Q
List 5 modes of transmission that HIV is NOT spread by
A
- hugging
- dry kissing
- shaking hands
- sharing eating utensils
- toilet seats
20
Q
transmission of HIV is subject to the same requirements as other microbes those are
A
- large enough amount of the virus must enter the body of a host
21
Q
What are some variables that influence whether infection will be established after an exposure``
A
- duration and frequency of contact with the organism
- volume, virulence, and concentration of the organism
- host immune status
22
Q
What type of virus is HIV
A
Ribonucleic acid virus
23
Q
why is HIV called a retrovirus
A
because it replicates in a ĥbackward manner
24
Q
How does the HIV virus enter the cell
A
binds to the specific CD4 and chemokine receptors
25
what cell does the HIV virus enter
CD4+T cell
26
HIV is a ribonucleic acid virus which replicates using its RNA template to produce _ which is then integrated into the cell
DNA
27
damage and destruction is caused by immune dysfunction in HIV by damaging and destroying ____ and _____
T helper cells and CD4+T lymhocytes
28
Viral RNA enters the cell, produces viral __in the presence of reverse transcriptase, and incorporates itself into the ___ ___ in the prescence of integrase, causing permanent ___ ___ and the production of new ___
dna
human genome
cellular infection
virons
29
The production of new virons causes two actions:
1. because all genetic material is replicated during cell division, all daughter cells will be infected
2. viral DNA in the genome will direct the cell to make new hiv
30
new viral RNA develops in long strands that are cut in the presence of ___
protease
31
the cut viral RNA leaves the cell through what process
the budding process
32
define viremia
large viral levels in the blood
33
5 cells that can be infected with the HIV virus
1. cd4+t cells
2. lymphocytes
3. monocytes/macrophages
4. astrocytes
5. oligodendrocytes
34
how long does the initial infiection with HIV that results in viremia last
few weeks
35
normal lab value for CD4+T cell count
800 to 1200 cells/ul
36
immune problems start to happen when CD4+T cell count drop to __
<500 cells /ul
37
Severe problems develop when CD4+t cells reach _
2oo cells /ul
38
if you have an insufficient immune response what happens
opportunistic disease will take over
39
4 stages of HIV infection
1. acute
2. asymptomatic
3. symptomatic
4. aids
40
when HIV specific antibodies develop .. is what stage
acute
41
During acute stage ____ like syndrome that may be mistaken for teh flue
mononucleosis
42
when does he symptoms of actue generally occur
2 to 4 weeks after the intial infetion
43
in acute stage how long does the symptoms generally last
1 to 2weeks although some symptoms may last months
44
during the acute phase some people develop neurologic complications such as (4)
1. aseptic meningitis
2. peripheral neuropathy
3. facial palsy
4. guillain-barre syndrome
45
what is high viral load
the amount of HIV circulating in the blood
46
what is the most common mistake made by health care providers about acute HIV symptoms
they think it is a bad case of the flu
47
what is asymptomatic infection in regards to HIV
the interval between untreated HIV infection and a diagnosis of aids
48
what is the CD4 cell counts doing during the asymptomatic infection
remain above 500 cells/ul
49
during the asymptomatic infection phase of HIV is the infected person aware of their status
normally no
50
what is the median interval between infection and diagnosis of AIDS
11 years
51
Some of the symptoms of asymptomatic infection
```
fatigue
headache
low-grade fever
night sweats
PGL
```
52
symptomatic infection occurs as the CD4+T cell count does what
drops to 200 t0 500 cells / ul
53
what does the viral load do during symptomatic infection
increases
54
what are some s/s of symptomatic infection
sx seen earlier become worse, persistent fever, drenching night sweats, chronic diarrhea, recurrent headaches
55
what are some system wide complications of symptomatic infection
infections, lymphadenopathy, and nervous system complications
56
List some infections that typically occur during symptomatic infection
1. shingles
2. persistent vaginal candidal infections
3. outbreaks of oral or genital herpes
4. bacterial infections
57
a diagnosis of AIDS can not be made until the HIV-infected patient meets criteria established by _
cdc
58
Aids is characterized by (5)
1. severe immune system suppression and cd4+t cll counts <200 cells /ul
2. an opportunistic infection
3. an opportunistic cancer
4. wasting syndrome
5. AIDS dementia complex
59
what is wasting syndrom
loss of 10% or more of ideal body mass
60
Kaposi's sarcoma is
purple/brownish lesions on an HIV infected person
61
what are the common opportunistic diseases associated with HIV (5)
1. cryptococcal meningitis
2. cytomegalovirus retinitis
3. mycobacterium avium complex
4. kaposi sarcoma
5. influenza virus
62
in recent years what has decreased the occurrences of opportunistic diseases?
advances in HIV treatment
63
how is HIV infection diagnosed
testing for HIV antibodies and / or antigen in the blood
64
what is a window period
the time(4 weeks) delay after infection before antibodies can be detected in the blood
65
__ ___ ___ tests provide results in 20 minutes and are recommended by the CDC
rapid hiv-antibody test
66
positive antibody tests should be what
confirmed by another test usually the western blot
67
what does a test report that reads undetectable mean
that the viral load is lower than the test is able to report
68
what is the teaching requirement needed for undetectable viral load mean
that the person has not eliminated the virus and that they can still pass HIV on to others
69
what can cause abnormal blood test results in HIV infection
opportunistic diseases or complications of therapy
70
what is lymphopenia
below normal numbers of lymphocytes
71
what is neutropenia
below normal numbers of neutrophils
72
what is thrombocytopenia
low platelet counts
73
what are common abnormal findings on diagnostic studies
lymphopenia, neutropenia, thrombocytopenia and anemia
74
____ ___ ____, caused by HIV infection, drug therapy, or co-infection with a hepatitis virus is common
altered liver function
75
resistance tests can help determine new drug combinations for patients not responding to ART they are (2)
genotype assay
| phenotype assay
76
collaborative care of HIV-infected patient focuses on (7)
(1) monitoring HIV disease progression and immune function
(2) initiating and monitoring antiretroviral therapy (ART)
(3) preventing the development of opportunistic diseases
(4) detecting and treating opportunistic diseases
(5) managing symptoms
(6) preventing or decreasing complications of treatment
(7) preventing further transmission of HIV.
77
what does the nurse do during the initial patient visit?
gather baseline data
begin to establish rapport
develop a plan of care with the patient
initiate teaching
78
8 nursing interventions that can help the patient
1. adhere to drug regimens
2. promote a healthy lifestyle that includes avoiding exposure to other sexually transmitted and blood-borne diseases
3. protect others from HIV
4. maintain or develop healthy and supportive relationships
5. maintain activities and productivity
6. explore spiritual issues
7. come to terms with issues related to disease, disability, and death
8. cope with symptoms caused by HIV and its treatments
79
what is the main goal of drug therapy planning
1. decrease viral load
2. maintain/increase cd4+ counts
3. prevent hiv-related symptoms and opportunistic diseases
4. delay disease prgression
80
what is ART
antiretroviral therapy
81
can HIV be cured
nope
82
when taken correctly what can reduce viral loads by 90 to 99%?
ART
83
what is the major problem with ART
resistance develops rapidly when they are used alone or taken in inadequate doses.
84
ART drugs have ___ and potentially ___ interactions with other commonly used drugs including OTC and herbal therapies
dangerous and lethal interactions
85
The complexity of HIV disease is related to its ___ nature
chronic
86
what is the most effective health care strategy regarding HIV
primary prevention and health promotion
87
The major drug classifications for HIV include: (6)
1. entry/fusion inhibitors, 2.non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3.nucleoside reverse transcriptase inhibitors (NRTIs) 4.nucleotide reverse transcriptase inhibitors (ntRTIs)
5. Integrase inhibitors and 6.protease inhibitors (PI)
88
the goal of HIV infection is:
to develop safer, healthier, and less risky behaviors
89
two techniques to help achieve the goal of HIV prevention is
safe activities and
| risk reducing activities
90
safe activiies are
those that eliminate risk
91
risk reducing activitivies are
those that decrease but do not eliminate risk
92
what type of conversation should you have regarding HIV with your pt.
candid, culturally sensitive, language appropriate age-specific and behavior changing counseling
93
what are some of the things you can educate your patient on regarding decreasing the risk of sexual intercourse infection
1. abstinence
2. non contact safe sex
3. use of barriers
4. male and female condoms have 100% efficacy and are more than 90% effective
94
what are some pt education you can teach your pt regarding decreasing risks of drug use
1. do not use drugs
2. do not share equipment
3. do not have sex under the influence of any impairing substance
(wow. . i like drunk sex :( )
95
3 pt education you can teach your pt regarding decreasing risks for perinatal transmission
1. family planning
2. prevent HIV in women
3. appropriately medicate HIV infected pregnant women.
96
what are some teaching education for your pt. regarding decreasing risk for work
1. adhere to precautions and safety measures to avoid exposure.
report all exposures for timely treatment and counseling
post-exposure prophylaxis with combination ART can significantly decrease risk of infection
97
what are some safe sexual activities
masturbation, mutual masturbation
98
what does efficacy mean
protection provided under ideal circumstances
99
what does effectiveness mean
protection provided in real life circumstances
100
what is the age recommendation for HIV testing?
13 to 64
101
all people react differently to having a postive test result what are some that your pt could express
panic, anxiety, fear, guilt, depression, denial, anger, hopelessness, powerlessness,
102
what is the draw back to ART therapy
1. is complex
2. has side effects
3. does not work for everyone
4. is expensive
103
what is the most critical thing to prevent disease progression, opportunistic diseases and viral drug resistance
drug adherence
104
what is the best approach to ART
an individual approach
105
9 interventions that help delay the disease progression of HIV are
1. nutritional support to maintain lean body mass
2. moderation or elimination of ETOH, tobacco and drug use
3. keeping up to date with vaccines
4. getting adequate rest and exercise
5. reducing stress
6. avoiding exposure to new infectious agents
7. accessing mental health counseling
8. getting involved in support groups and community activities
9. developing a consistent relation with health care providers
106
chronic diseases are characterized by __ ___
acute exacerbations
107
HIV ultimately ends in
death
108
common physical problems with disease and drug side effects are:
1. anxiety, fear, depression
2. diarrhea
3. peripheral neuropathy
4. pain
5. n/v
6. fatigue
109
metabolic disorders caused by the disease or drug side effects are
1. hyperlipidemia
2. insulin resistance
3. bone disease
4. lactic acidosis
5. renal disease
6. cardiovascular disease
110
what are the 4 nursing interventions that we as nurses need to focus on regarding HIV?
1. pt. comfort
2. promoting acceptance of finite nature of life
3. helping significant others deal with loss
4. maintaining safe environment
111
the population that is growing the fastest with HIV is
older adult
