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Adult Health > Chapter 15 exam 1 (d) > Flashcards

Chapter 15 exam 1 (d) Flashcards

1
Q

T/F HIV is a bacteria infection

A

false it is viral

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2
Q

HIV is a ___ virus that causes immunosuppression

A

retrovirus

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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.

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4
Q

Retrovirus causes ___ making people susceptible to other infections

A

immunosuppresion

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5
Q

T/F most pts with HIV die from Aids

A

False most die to other infections

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6
Q

In north america, the prevalence of HIV has been highest amongest which populations?

A
  1. Men having sex with men
  2. people of color
  3. people who live in poverty
  4. adolescents
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7
Q

HIV remains a disease of marginalized individuals for example those that are disenfranchised by virtue of: (6)

A
  1. gender
  2. race
  3. sexual orientation
  4. poverty
  5. drug use
  6. lack of health care
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8
Q

What 3 areas have the US made strides in to produce longer life spans and lower death rates

A
  1. prevention
  2. testing
  3. treatment
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9
Q

HIV can only be transmitted under specific conditions that allow contact with ___

A

infected body fluids

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10
Q

name the body fluids that have been confirmed transmitted body fluids

A
  1. blood
  2. semen
  3. vaginal secretions
  4. breast milk
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11
Q

what is the most common mode of HIV transmission

A

sexual contact with an infected partner

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12
Q

what does sexual activity involve?

A

contact with semen, vaginal secretions, and or blood

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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

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14
Q

During sex who is most likely to get the infection?

A

the receiver

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15
Q

Why is the receiver during sex most likely to contract HIV?

A

because they have prolonged contact with infected fluids

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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.

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17
Q

What is the most common work related HIV transmission

A

puncture wounds

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18
Q

Perinatal transmission can occur during (3)

A
  1. pregnancy
  2. delivery
  3. breastfeeding
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19
Q

List 5 modes of transmission that HIV is NOT spread by

A
  1. hugging
  2. dry kissing
  3. shaking hands
  4. sharing eating utensils
  5. toilet seats
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20
Q

transmission of HIV is subject to the same requirements as other microbes those are

A
  1. large enough amount of the virus must enter the body of a host
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21
Q

What are some variables that influence whether infection will be established after an exposure``

A
  1. duration and frequency of contact with the organism
  2. volume, virulence, and concentration of the organism
  3. host immune status
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22
Q

What type of virus is HIV

A

Ribonucleic acid virus

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23
Q

why is HIV called a retrovirus

A

because it replicates in a ĥbackward manner

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24
Q

How does the HIV virus enter the cell

A

binds to the specific CD4 and chemokine receptors

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25
Q

what cell does the HIV virus enter

A

CD4+T cell

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26
Q

HIV is a ribonucleic acid virus which replicates using its RNA template to produce _ which is then integrated into the cell

A

DNA

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27
Q

damage and destruction is caused by immune dysfunction in HIV by damaging and destroying ____ and _____

A

T helper cells and CD4+T lymhocytes

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28
Q

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 ___

A

dna
human genome
cellular infection
virons

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29
Q

The production of new virons causes two actions:

A
  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
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30
Q

new viral RNA develops in long strands that are cut in the presence of ___

A

protease

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31
Q

the cut viral RNA leaves the cell through what process

A

the budding process

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32
Q

define viremia

A

large viral levels in the blood

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33
Q

5 cells that can be infected with the HIV virus

A
  1. cd4+t cells
  2. lymphocytes
  3. monocytes/macrophages
  4. astrocytes
  5. oligodendrocytes
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34
Q

how long does the initial infiection with HIV that results in viremia last

A

few weeks

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35
Q

normal lab value for CD4+T cell count

A

800 to 1200 cells/ul

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36
Q

immune problems start to happen when CD4+T cell count drop to __

A

<500 cells /ul

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37
Q

Severe problems develop when CD4+t cells reach _

A

2oo cells /ul

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38
Q

if you have an insufficient immune response what happens

A

opportunistic disease will take over

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39
Q

4 stages of HIV infection

A
  1. acute
  2. asymptomatic
  3. symptomatic
  4. aids
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40
Q

when HIV specific antibodies develop .. is what stage

A

acute

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41
Q

During acute stage ____ like syndrome that may be mistaken for teh flue

A

mononucleosis

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42
Q

when does he symptoms of actue generally occur

A

2 to 4 weeks after the intial infetion

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43
Q

in acute stage how long does the symptoms generally last

A

1 to 2weeks although some symptoms may last months

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44
Q

during the acute phase some people develop neurologic complications such as (4)

A
  1. aseptic meningitis
  2. peripheral neuropathy
  3. facial palsy
  4. guillain-barre syndrome
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45
Q

what is high viral load

A

the amount of HIV circulating in the blood

46
Q

what is the most common mistake made by health care providers about acute HIV symptoms

A

they think it is a bad case of the flu

47
Q

what is asymptomatic infection in regards to HIV

A

the interval between untreated HIV infection and a diagnosis of aids

48
Q

what is the CD4 cell counts doing during the asymptomatic infection

A

remain above 500 cells/ul

49
Q

during the asymptomatic infection phase of HIV is the infected person aware of their status

A

normally no

50
Q

what is the median interval between infection and diagnosis of AIDS

A

11 years

51
Q

Some of the symptoms of asymptomatic infection

A 
fatigue
headache
low-grade fever
night sweats
PGL
52
Q

symptomatic infection occurs as the CD4+T cell count does what

A

drops to 200 t0 500 cells / ul

53
Q

what does the viral load do during symptomatic infection

A

increases

54
Q

what are some s/s of symptomatic infection

A

sx seen earlier become worse, persistent fever, drenching night sweats, chronic diarrhea, recurrent headaches

55
Q

what are some system wide complications of symptomatic infection

A

infections, lymphadenopathy, and nervous system complications

56
Q

List some infections that typically occur during symptomatic infection

A
  1. shingles
  2. persistent vaginal candidal infections
  3. outbreaks of oral or genital herpes
  4. bacterial infections
57
Q

a diagnosis of AIDS can not be made until the HIV-infected patient meets criteria established by _

A

cdc

58
Q

Aids is characterized by (5)

A
  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
Q

what is wasting syndrom

A

loss of 10% or more of ideal body mass

60
Q

Kaposi’s sarcoma is

A

purple/brownish lesions on an HIV infected person

61
Q

what are the common opportunistic diseases associated with HIV (5)

A
  1. cryptococcal meningitis
  2. cytomegalovirus retinitis
  3. mycobacterium avium complex
  4. kaposi sarcoma
  5. influenza virus
62
Q

in recent years what has decreased the occurrences of opportunistic diseases?

A

advances in HIV treatment

63
Q

how is HIV infection diagnosed

A

testing for HIV antibodies and / or antigen in the blood

64
Q

what is a window period

A

the time(4 weeks) delay after infection before antibodies can be detected in the blood

65
Q

__ ___ ___ tests provide results in 20 minutes and are recommended by the CDC

A

rapid hiv-antibody test

66
Q

positive antibody tests should be what

A

confirmed by another test usually the western blot

67
Q

what does a test report that reads undetectable mean

A

that the viral load is lower than the test is able to report

68
Q

what is the teaching requirement needed for undetectable viral load mean

A

that the person has not eliminated the virus and that they can still pass HIV on to others

69
Q

what can cause abnormal blood test results in HIV infection

A

opportunistic diseases or complications of therapy

70
Q

what is lymphopenia

A

below normal numbers of lymphocytes

71
Q

what is neutropenia

A

below normal numbers of neutrophils

72
Q

what is thrombocytopenia

A

low platelet counts

73
Q

what are common abnormal findings on diagnostic studies

A

lymphopenia, neutropenia, thrombocytopenia and anemia

74
Q

____ ___ ____, caused by HIV infection, drug therapy, or co-infection with a hepatitis virus is common

A

altered liver function

75
Q

resistance tests can help determine new drug combinations for patients not responding to ART they are (2)

A

genotype assay

phenotype assay

76
Q

collaborative care of HIV-infected patient focuses on (7)

A

(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
Q

what does the nurse do during the initial patient visit?

A

gather baseline data
begin to establish rapport
develop a plan of care with the patient
initiate teaching

78
Q

8 nursing interventions that can help the patient

A
  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
Q

what is the main goal of drug therapy planning

A
  1. decrease viral load
  2. maintain/increase cd4+ counts
  3. prevent hiv-related symptoms and opportunistic diseases
  4. delay disease prgression
80
Q

what is ART

A

antiretroviral therapy

81
Q

can HIV be cured

A

nope

82
Q

when taken correctly what can reduce viral loads by 90 to 99%?

A

ART

83
Q

what is the major problem with ART

A

resistance develops rapidly when they are used alone or taken in inadequate doses.

84
Q

ART drugs have ___ and potentially ___ interactions with other commonly used drugs including OTC and herbal therapies

A

dangerous and lethal interactions

85
Q

The complexity of HIV disease is related to its ___ nature

A

chronic

86
Q

what is the most effective health care strategy regarding HIV

A

primary prevention and health promotion

87
Q

The major drug classifications for HIV include: (6)

A
  1. entry/fusion inhibitors, 2.non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3.nucleoside reverse transcriptase inhibitors (NRTIs) 4.nucleotide reverse transcriptase inhibitors (ntRTIs)
  2. Integrase inhibitors and 6.protease inhibitors (PI)
88
Q

the goal of HIV infection is:

A

to develop safer, healthier, and less risky behaviors

89
Q

two techniques to help achieve the goal of HIV prevention is

A

safe activities and

risk reducing activities

90
Q

safe activiies are

A

those that eliminate risk

91
Q

risk reducing activitivies are

A

those that decrease but do not eliminate risk

92
Q

what type of conversation should you have regarding HIV with your pt.

A

candid, culturally sensitive, language appropriate age-specific and behavior changing counseling

93
Q

what are some of the things you can educate your patient on regarding decreasing the risk of sexual intercourse infection

A
  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
Q

what are some pt education you can teach your pt regarding decreasing risks of drug use

A
  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
Q

3 pt education you can teach your pt regarding decreasing risks for perinatal transmission

A
  1. family planning
  2. prevent HIV in women
  3. appropriately medicate HIV infected pregnant women.
96
Q

what are some teaching education for your pt. regarding decreasing risk for work

A
  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
Q

what are some safe sexual activities

A

masturbation, mutual masturbation

98
Q

what does efficacy mean

A

protection provided under ideal circumstances

99
Q

what does effectiveness mean

A

protection provided in real life circumstances

100
Q

what is the age recommendation for HIV testing?

A

13 to 64

101
Q

all people react differently to having a postive test result what are some that your pt could express

A

panic, anxiety, fear, guilt, depression, denial, anger, hopelessness, powerlessness,

102
Q

what is the draw back to ART therapy

A
  1. is complex
  2. has side effects
  3. does not work for everyone
  4. is expensive
103
Q

what is the most critical thing to prevent disease progression, opportunistic diseases and viral drug resistance

A

drug adherence

104
Q

what is the best approach to ART

A

an individual approach

105
Q

9 interventions that help delay the disease progression of HIV are

A
  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
Q

chronic diseases are characterized by __ ___

A

acute exacerbations

107
Q

HIV ultimately ends in

A

death

108
Q

common physical problems with disease and drug side effects are:

A
  1. anxiety, fear, depression
  2. diarrhea
  3. peripheral neuropathy
  4. pain
  5. n/v
  6. fatigue
109
Q

metabolic disorders caused by the disease or drug side effects are

A
  1. hyperlipidemia
  2. insulin resistance
  3. bone disease
  4. lactic acidosis
  5. renal disease
  6. cardiovascular disease
110
Q

what are the 4 nursing interventions that we as nurses need to focus on regarding HIV?

A
  1. pt. comfort
  2. promoting acceptance of finite nature of life
  3. helping significant others deal with loss
  4. maintaining safe environment
111
Q

the population that is growing the fastest with HIV is

A

older adult

Adult Health (9 decks)

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