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Caring For Adult Clients 1 > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

What are three processes needed for immunity?

A
  1. Inflammation
  2. Cell mediated immunity- T cells
  3. Humoral immunity- Antibodies
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2
Q

Which immune process is lost in HIV?

A

Cell mediated immunity

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3
Q

Why is HIV a retrovirus?

A

-It replicates in a “backward” manner going from RNA to DNA.

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4
Q

What is the target cell for HIV?

A

-CD-4 T cell

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5
Q

What turns HIV RNA into HIV DNA?

A

-Reverse transcriptase

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6
Q

What enzyme matures the virus?

A

-Protease

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7
Q

What ways is HIV transmitted?

A

-Male to male sexual contact
-Heterosexual contact
-Injection drug use
-Perinatal

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8
Q

Contact with what bodily fluids can transmit HIV?

A

-Blood
-Semen
-Vaginal secretions
-Breastmilk
-Pregnancy
-US Blood supply
-Drug paraphernalia

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9
Q

What is PrEP?

A

-Pre exposure prophylaxis
-Strategy to reduce risk of sexually-acquired infection in high risk adults.

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10
Q

What drug is administered as PrEP?

A

-Truvada

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11
Q

What are 2 ways an RN can be exposed to HIV?

A

-Needlesticks
-Mucous membranes or no-intact skin
-Use standard precautions with all patients.

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12
Q

When should Post-Exposure Prophylaxis (PEP) be administered?

A

-As soon possible.
-Ideally within 2-36 hrs after exposure.
-Adhere to the full 28 day course.

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13
Q

What drugs are administered as PEP?

A

-Tenofovir combined with lamivudine or emtricitabine.

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14
Q

What are the different types of HIV tests?

A

-At- home test
-ELISA (enzyme-linked immunosorbent assay)
-Western blot
-Antigen/antibody test- Current gold standard
-Nucleic acid test (NATs)- tests for genetic material. Expensive

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15
Q

HIV progression is also monitored by?

A

-Viral load
-The lower the viral load the less active the disease

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16
Q

What is U=U?

A

-Undetectable=Untransmittable
-Undetectable for 6 months
-Teach to still use barriers

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17
Q

What is a normal CD4 T+?

A

-800-1200 cells/uL
-Stage 1

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18
Q

What is the CD4 count when immune problems arise?

A

-<500 cells/uL.
-Stage 2

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19
Q

What is the CD4 when symptoms worsen, viral load increases, and the is symptomatic infection?

A

-<200 cells/uL
-When a diagnosis of AIDS is made.

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20
Q

What does an Acute HIV infection (Stage 1) look like?

A

-Non specific- like mono
-Fever
-Nausea
-Malaise
-Swollen lymph nodes
-Headache
-Sore throat
-Muscle and joint pain
-Diarrhea
-Diffuse rash

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21
Q

When do these symptoms occur?

A

-2-3 weeks after infection
-Highly infectious

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22
Q

What is cART?

A

-Combination anti-retrovirus therapy

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23
Q

What is the example of cART discussed?

A

-BIKTARVY

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24
Q

What are the three drugs that make up BIKTARVY?

A

-Bectegravir
-Tenofovir Alafenamide
-Emtricitabine
-Taken at the same time everyday. 1 tablet a day regimen.

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25
What are the goals of drug therapy?
-Decrease viral load -Maintain/increase CD4 T counts -Prevent HIV related symptoms and opportunistic diseases -Delay disease progression -Prevent HIV transmission
26
What are benefits of drug therapy adherence?
-Reduce viral load -Prevent opportunistic disease -Decreases/helps prevent resistance
27
What are challenges of drug therapy adherence?
-Lifelong commitment -Schedule/ time/ memory -Side effects/ interactions -Decreased WBC count -Low platelet counts -Anemia
28
What are some examples of opportunistic infections?
-Cytomegalovirus retinitis -Herpes simplex virus -Varicella zoster virus- shingles -Epstein-Barr virus -Oral hairy leukoplakia -Oral thrush -Pneumocystis jiroveci pneumonia -Kaposi’s sarcoma- Reddish brown lesions -NHL B cell
29
What are clinical manifestations of wasting syndrome?
-Weight loss >10% -Fever -Chronic weakness -Diarrhea -Lasts longer than 30 days
30
What is some patient teaching related to infection prevention?
-Avoid crowds -Stay away from undercooked eggs, meats -Don’t handle litter boxes, turtles, snakes, or garden -Use antimicrobial soaps -Report if temp >100 F/ cough/ drainage/ cloudy urine
31
CANCER
32
What are some characteristics of benign tumors
-Slow growth -Encapsulated -Well differentiated -No metastasis -Lipoma
33
What are characteristics of malignant tumors
-Rapid, uncontrolled growth -Loosely adhered -Undifferentiated in structure, size, shape -Divide indiscriminately -Loss of contact inhibition- Disregard cell boundaries -Divides continuously -Metastasis (Invades tissue)
34
Proto-oncogenes
-Regulate normal cellular processes such as promoting growth. -Genetic locks that keep cells functioning normally -Mutations that alter their expression can activate to function as oncogenes -With cancer protocol-oncogenes get turned into oncogenes.
35
Tumor suppressor genes
-Suppress growth -Function to regulate cell growth -Prevent cells from going through cell cycle -Mutations make them inactive -Result in loss of suppression of tumor growth
36
What is the main contributing factor of cancer?
-Age
37
What are carcinogens?
-Cancer-causing agents capable of producing cell mutation. -Many are detoxified by protective enzymes and are excreted. -Failure of protective mechanisms allows them to enter the cell’s nucleus and alter its DNA
38
Chemical carcinogenes
-Benzene -Arsenic -Formaldehyde
39
Radiation carcinogens
-Damage to DNA
40
What is the main source of UV exposure?
-The sun
41
Ultraviolet radiation
-Associated with melanoma, squamous and basal cell carcinoma.
42
Promotion stage of mutation
-Reversible proliferation of altered cells
43
Activities of promotion that are reversible
-Smoking -Obesity -Alcohol use -Dietary fat
44
Patient teaching for promotion stage
-Teach about a healthy lifestyle
45
For disease to be clinically evident
-Tumor must reach a critical mass that can be detected -Detectable= 1cm
46
Progression stage of mutation
-Increased growth rate of tumor -Invasiveness -Metastasis -Spreads through blood and lymph
47
How does metastasis occur?
-Begins with rapid growth of primary tumor -Develops its own blood supply -Tumor cells can detach and invade surrounding tissue -Most mobile cells do not survive -Surviving tumor cells must create an environment conducive to growth and development.
48
Tumor angiogenesis
-Tumor develops its own blood supply
49
What are main sites of metastasis?
-Brain and cerebrospinal fluid -Lung -Liver -Adrenals -Bone- spine and femur
50
Cancer prevention: Primary (These people do not have cancer)
-Avoid or reduce exposure to know or suspected carcinogens -Eat a balanced diet -Limit alcohol intake -Exercise regularly -Maintain a healthy weight -Get adequate rest -Eliminate, reduce, or cope with stress -Have a regular health exam -Be familiar with family history
51
Cancer prevention: secondary (These people may have cancer. Trying to catch it early)
-Screening/Early detection -Identify high risk groups -Screening examinations -Self-monitoring -Diagnostics -“CAUTION”
52
7 Warning signs of cancer: “CAUTION”
-Change in bowel or bladder habits -A sore that does not heal -Unusual bleeding or discharge -Thickening or lump in the breast, testicle, or elsewhere -Indigestion or difficulty swallowing -Obvious change in the size, color, shape, or thickness of a wart, mole, or mouth sore. -Nagging cough or hoarseness -These changes last for weeks or months
53
Classification of cancer: Grading
-4 grades of abnormal cells
54
Cancer grading: Grade 1
-Cells differ slightly from normal cells and are well differentiated
55
Cancer grading: Grade II
-Cells are more abnormal and moderately different
56
Cancer grading: Grade III
-Cells are very abnormal and poorly differentiated
57
Cancer grading: Grade IV
-Cells are immature and primitive and undifferentiated.
58
Clinical staging of cancer: Stage I
-Tumor is limited to tissue of origin; localized tumor growth
59
Clinical staging of cancer: Stage II
-Limited to local spread
60
Clinical staging of cancer: Stage III
-Extensive local and regional spread
61
Clinical staging of cancer: Stage IV
-Metastasis
62
Clinical staging of cancer: Stage 0
-Cancer in situ
63
TNM staging of cancer
T=Tumor size N=Lymph node status M=Metastasis
64
TNM staging: Tumor
T1: 0-2 cm T2: 2-5 cm T3: >5 cm T4: tumor has broken through skin or attached to chest wall
65
TNM staging: Nodes
N0: Surgeon can’t feel any nodes N1: Surgeon can feel swollen nodes N2: Nodes feel swollen and lumpy N3: Swollen nodes located near collarbone
66
TNM staging: Metastasis
M0: Tested nodes are cancer free M1: Tested nodes show cancer cells or micro metastasis

Caring For Adult Clients 1 (2 decks)

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