Exam 2 aids/hgd/communication/stress/fluids&electrolyte Flashcards
HIV
Human Immunodifficiency Virus
what specific immune cells does HIV attack? What does it use it for?
CD4+ T-cells
high-jacks the host cell to produce more of itself
HIV binds to CD4+ cells in the host, also known as helper T cells. These cells are responsible for regulating the normal immune response. When the HIV DNA inserts itself into the CD4+ cell, it will cause cell death. This causes the number of CD4+ cells to decrease, therefore weakening the immune system.
AIDS
Acquired Immuno Deficiency Syndrome
When is AIDS diagnosed?
When CD4+ T-cells are less than or equal to 200 cells per uL or when opportunistic infection is diagnosed
AHI
Acute HIV Infection refers to the initial period after infection
at this moment EIA will be negative
After about how many weeks will symptoms appear after infection? And what symptoms appears?
1-4 weeks after infection
Symptoms include fatigue, fever, malaise, headache, muscle aches, rash, sore throat, swollen lymph glands
Whats the normal count for CD4+?
500-1500
How long may take for HIV to appear in tests?
3 - 6 mo
Name the steps for HIV life cycle
- HIV binds the T-cells
- Viral RNA is released into the host cell
- The viral RNA is converted into the viral DNA through a process called reverse transcriptase. During reverse transcriptase, an enzyme reads the sequence of viral DNA nucleic acids that have entered the host cell and transcribes the sequence into a complementary DNA sequence.
- Viral DNA enter the T-call’s nucleus and inserts itself into the T-cell’s DNA
- The T cell starts to make copies of HIV components
- Protease an enzyme helps create new virus particles.
- The new virion ( virus particle) is released from the T cell.
Opportunistic Infections examples
Tuberculosis Recurrent pneumonia Pneumocystis jirovecii pneumonia (aka PCP) Wasting syndrome Candidiasis of trachea, bronchi or lungs
Most common modes of transmission for HIV
Sexual Contact Male-to-male (MSM) Heterosexual Blood Exposure Injecting drug use (IDU) Occupational exposure Organ transplant Blood/blood products transfusion Perinatal Before or during birth Breastfeeding
What are the testings for HIV?
Screening tests
Orasure: detects HIV antibodies in oral fluid
Rapid test: detects HIV antibodies in blood from finger prick
Confirmatory tests
IFA: highly accurate detection of HIV antibodies from venous blood
Western blot: very specific detection of HIV antibodies from venous blood
What is HAART?
Highly Active Anti-Retroviral Treatment (HAART) includes at least 3 drugs. This is to reduce the likelihood of development of drug resistance.
There can be many, tough side effects to the drugs.
Drugs aim to keep the viral load at a minimum.
Stopping treatment often results in a quick jump in viral load.
A preschooler is admitted with a diagnosis of acute glomerulonephritis. The child’s history reveals a 5-lb weight gain in 1 week and periorbital edema. How can the nurse obtain the most accurate information on the status of the child’s edema?
- Weighing daily
- Observing body changes
- Measuring intake and output
- Monitoring electrolyte values
Correct 1. Weight monitoring is the most useful means of assessing fluid balance and changes in the edematous state; 1 L of fluid weighs about 2.2 lb.
2. Visual inspection is subjective and generally inaccurate. 3. Measuring intake and output is not as accurate as daily weights; fluid may be trapped in the third compartment. 4. Monitoring of electrolyte values is unreliable; they may or may not be altered with fluid shifts.
In an interview with a pregnant patient, the nurse discussed the three risk factors that have been cited as having a possible effect on prenatal development. They are:
- Nutrition, stress, and mother’s age.
- Prematurity, stress, and mother’s age.
- Nutrition, mother’s age, and fetal infections.
- Fetal infections, prematurity, and placenta previa.
Answer: 1.
The woman’s diet before and during pregnancy has a significant effect on fetal development; the mother’s age may contribute to a risk for chromosomal defects (older mothers) or the lack of prenatal care (adolescent mothers); pregnancy is often accompanied by stress because of all of the developmental changes, and it is important to know whether or not the mother has an effective support system.
A parent has brought her 6-month-old infant in for a wellchild check. Which of her statements indicates a need for further teaching?
1. “I can start giving her whole milk at about 12 months.”
2. “I can continue to breastfeed for another 6 months.”
3. “I’ve started giving her plenty of fruit juice as a way to
increase her vitamin intake.”
4. “I can start giving her solid food now.”
Answer: 3.
Breast milk or formula is recommended at this time; fruit juice is not considered a nutritive addition.
The type of injury a child is most vulnerable to at a specific age is most closely related to which of the following?
- Provision of adult supervision.
- Educational level of the parent
- Physical health of the child
- Developmental level of the child
Answer: 4.
The child’s cognitive and physical development need to be considered initially when assessing the potential risk for injury.
Which approach would be best for the nurse to use with a hospitalized toddler?
- Always give several choices.
- Set few limits to allow for open expression.
- Use noninvasive methods when possible.
- Gain cooperation before attempting treatment
Answer: 4.
Toddlers are learning to become independent and frequently display negative behavior if an effort to gain their trust is not provided initially. Providing too many choices does not support their efforts to gain control.
The nurse is providing information on prevention of sudden infant death syndrome (SIDS) to the mother of a young infant. Which of the following statements indicates that the mother has a good understanding? (Select all that apply.)
- “I won’t use a pacifier to help my baby sleep.”
- “I’ll be sure my baby does not spend any time on her
abdomen. ” - “I’ll place my baby on her back for sleep.”
- “I’ll be sure to keep my baby’s room cold.”
Answer: 3, 4.
The American Academy of Pediatrics has clearly recommended that infants be placed on their backs for sleep to help prevent SIDS. Keeping the room cool is also important.
In evaluating the gross-motor development of a 5-month-old infant, which of the following would the nurse expect the infant to do?
- Roll from abdomen to back
- Move from prone to sitting unassisted
- Sit upright without support
- Turn completely over
Answer: 1.
The 5-month-old infant should be able to turn from abdomen to back.
Parents are concerned about their toddler’s negativism and ask the nurse for guidance. Which is the most appropriate recommendation?
- Provide more attention.
- Reduce opportunities for a “no” answer.
- Be consistent with punishment.
- Provide opportunities for the toddler to make decisions.
Answer: 2. Giving toddlers realistic choices reduces the opportunity for a negative response and helps support their need for control.
When nurses are communicating with adolescents, they
should:
1. Be alert to clues to their emotional state.
2. Ask closed-ended questions to get straight answers.
3. Avoid looking for meaning behind adolescents’ words or actions.
4. Avoid discussing sensitive issues such sex and drugs.
Answer: 1.
Adolescents are searching for their identity and trying to become emotionally independent from parents while maintaining family ties. Depression, substance abuse, and violence are all real concerns during this period; thus the nurse must be aware of the adolescent’s emotional state.
Which of the following statements is most descriptive of the psychosocial development of school-age children?
- Boys and girls play equally with each other.
- Peer influence is not yet an important factor to the child.
- They like to play games with rigid rules.
- Children frequently have “best friends.”
Answer: 4.
Peer relationships become very important to school-age children, and they usually develop close friendships.
You are caring for a 4-year-old child who is hospitalized for an infection. He tells you that he is sick because he was “bad.” Which is the most correct interpretation of his comment?
- Indicative of extreme stress
- Representative of his cognitive development
- Suggestive of excessive discipline at home
- Indicative of his developing sense of inferiority
Answer: 2.
Preschoolers exhibit “egocentric” thought, meaning that they truly believe that their thinking is shared by others and that they can control their environment by their thoughts.
At a well-child examination, the mother comments that her toddler eats little at mealtime, will only sit briefly at the table, and wants snacks all the time. Which of the following should the nurse recommend?
- Provide nutritious snacks.
- Offer rewards for eating at mealtimes.
- Avoid snacks so she is hungry at mealtime.
- Explain to her firmly why eating at mealtime is important
Answer: 1.
Toddlers are not growing as quickly as they did during infancy and thus eat smaller meals; nutritious snacks can help to ensure that they gain the nutrients they need.
An 8-year-old child is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which of the following will most help her adjust to the hospital?
1. Explain hospital routines such as meal times to her.
2. Use terms such as “honey” and “dear” to show a caring
attitude.
3. Explain when her parents can visit and why siblings cannot
come to see her.
4. Since she is young, orient her parents to her room and
hospital facility.
Answer: 1.
School-age children are able to think logically and can classify objects or routines; having an understanding of what to expect can help them cope with a new experience.
The school nurse is counseling an obese 10-year-old child. What factor would be important to consider when planning an intervention to support the child’s health?
1. Concentrate on the child only rather than the family since
it is the child’s responsibility.
2. Consider the use of medications to suppress the appetite.
3. First plan for weight loss through dieting and then add
activity as tolerated.
4. Plan food intake to allow for growth
Answer: 4.
Although growth slows down during the school-age years, it is still important that appropriate nutrients be provided to promote growth. Children need adequate caloric intake along with activity for gross-motor development. Dieting might not provide the intake necessary.
You are working in an adolescent health center when a 15-yearold patient shares with you that she thinks she is pregnant and is worried that she may now have a sexually transmitted infection (STI). Her pregnancy test is negative. What is your next priority of care?
1. Contact her parents to alert them of her need for birth
control.
2. Refer her to a primary health care provider to obtain a
prescription for birth control.
3. Counsel her on safe sex practices.
4. Ask her to have her partner come to the clinic for STI
testing.
Answer: 3.
Adolescent pregnancy and STIs are concerns that should be addressed by the nurse to support health care.
While working in the high-school clinic, one of the students tells you that she is worried about her friend who has started to refuse to participate in group activities, no longer cares about how she looks at school, and is not going to all of her classes. Your assessment of these symptoms may indicate that:
1. She has just broken up with her boyfriend and time will
heal all.
2. You will need to observe her over time to see if symptoms
persist.
3. School may be too difficult for her right now.
4. She may be at increased risk for suicide.
Answer: 4.
Depression is a major health concern for adolescents and can be triggered by many factors; the symptoms that are listed indicate increased risk.
Ms. X is diagnosed with acquired immunodeficiency syndrome (AIDS). The nurse caring for this patient is aware that for a patient to be diagnosed with HIV she should have which condition?
a. Infection of HIV, have a CD4+ T-cell count of 500 cells/microliter, history of acute HIV infection
b. Infection with Tuberculosis, HIV and cytomegalovirus
c. Infection of HIV, have a CD4+ T-cell count of >200 cells/microliter, history of acute HIV infection
d. Infection with HIV, history of HIV infection and T-cell count below 200 cells/microliter
Answer C. The three criteria for a client to be diagnosed with AIDS are the following:
• HIV positive
• CD4+ T-cell count below 200 cells/microliter
• Have one or more specific conditions that include acute infection of HIV
The nurse observes precaution in caring for Mr. X as HIV is most easily transmitted in:
a. Vaginal secretions and urine
b. Breast milk and tears
c. Feces and saliva
d. Blood and semen
Answer D. Keyword: MOST EASILY. Rationale: HIV is MOST EASILY transmitted in blood, semen and vaginal secretions. However, it has been noted to be found in fecal materials, urine, saliva, tears and breast milk.
Nurse Jaja is giving an injection to Ms. X. After giving an injection, the nurse accidentally stuck her finger with the needle when the client became very agitated. To determine if the nurse became infected with HIV when is the best time to test her for HIV antibodies?
a. Immediately and repeat the test after 12 weeks
b. Immediately and repeat the test after 4 weeks
c. After a week and repeat the test in 4 months
d. After a weeks and repeat the test in 6 months
Answer A. Keyword: BEST TIME. Rationale: To determine if a preexisting infection is present a test should be done immediately and is repeated again in 3 months time (12 weeks) to detect seroconversion as a result of the needle stick.
The blood test first used to identify a response to HIV infection is:
a. Western blot
b. ELISA test
c. CD4+ T-cell count
d. CBC
Answer B. Keyword: FIRST. Rationale: The ELISA test is the first screening test for HIV. A Western blot test confirms a positive ELISA test. Other blood tests that support the diagnosis of HIV include CD4+ and CD8 + counts, CBC, immunoglobulin levels, p24 antigen assay, and quantitative ribonucleic acid assays.
What is the main reason why it is difficult to develop a vaccine against HIV?
a. HIV is still unknown to human
b. HIV mutates easily
c. HIV spreads rapidly throughout the body
d. HIV matures easily
Answer B. Keyword: MAIN REASON. Rationale: HIV was identified in 1983, thus, A is incorrect. By 1988 two strains of HIV existed, HIV-1 and HIV-2. Viruses spread rapidly and mature easily but these factors don’t affect the potential for development against HIV. Mutating too easily makes it hard to create a vaccine against it.
Human Immunodeficiency virus belongs to which classifications?
a. Rhabdovirus
b. Rhinovirus
c. Retrovirus
d. Rotavirus
Answer C. Rationale: HIV is a retrovirus that has a ribonucleic acid dependent reverse transcriptase.
B-cells are involved in which of the following types of immunity?
a. Humoral immunity
b. Cell-mediated immunity
c. Antigen-mediated immunity
d. All of these
Answer A. Keyword: B-CELLS. Rationale: B-Cells are responsible for humoral or immunoglobulin mediated immunity. T-cells are responsible for cell-mediated immunity. There is such thing as antigen-mediated immunity.
The average length of time from HIV infection to the development of AIDS is?
a. Less than 3 years
b. 5-7 years
c. 10 years
d. More than 10 years
Answer C. Keyword: AVERAGE LENGTH OF TIME. Rationale: epidemiologic studies show the average time from initial contact with HIV to the development of AIDS is 10 years.
A client with acquired immunodeficiency syndrome (AIDS) has a nursing diagnosis of Imbalanced nutrition: less than body requirements. The nurse plans which of the following goals with this client?
a) consume foods and beverages that are high in glucose
b) plan large menus and cook meals in advance
c) eat low-calorie snacks between meals
d) eat small, frequent meals throughout the day
D
- The client should eat small, frequent meals throughout the day. The client also should take in nutrient-dense and high-calorie meals and snacks rather than those that are high in glucose only. The client is encouraged to eat favorite foods to keep intake up and plan meals that are easy to prepare. The client can also avoid taking fluids with meals to increase food intake before satiety sets in.
A client with acquired immunodeficiency syndrome (AIDS) is experiencing shortness of breath related to Pneumocystis jiroveci pneumonia. Which measure should the nurse include in the plan of care to assist the client in performing activities of daily living?
a) provide supportive care with hygiene needs
b) provide meals and snacks with high-protein, high calorie, and high-nutritional value
c) provide small, frequent meals
d) offer low microbial foods
A
- Providing supportive care with hygiene needs as needed reduces the client’s physical and emotional energy demands and conserves energy resources for other functions such as breathing. Options B, C, and D are important interventions for the client with AIDS but do not address the subject of activities of daily living. Option B will assist the client in maintaining appropriate weight and proper nutrition. Option C will assist the client in tolerating meals better. Option D will decrease the client’s risk of infection.
A client who was tested for human immunodeficiency virus (HIV) after a recent exposure had a negative result. During the post-test counseling session, the nurse tells the client which of the following?
a) the test should be repeated in 6 months
b) this ensures that the client is not infected with the HIV virus
c) the client no longer needs to protect himself from sexual partners
d) the client probably has immunity to the acquired immunodeficiency virus
A
- A negative test result indicates that no HIV antibodies were detected in the blood sample. A repeated test in 6 months is recommended because false-negative test results have occurred early in the infection. Options B, C, and D are incorrect.
A client is diagnosed with late stage human immunodeficiency virus (HIV), and the client and family are extremely upset about the diagnosis. The priority psychosocial nursing intervention for the client and family is to:
a) tell the client and family to stop smoking because it will predispose the client to respiratory infections
b) tell the client and family that raw or improperly washed foods can produce microbes
c) encourage the client and family to discuss their feelings about the disease
d) advise the client to avoid becoming pregnant because of the risk of transmission of the infection
C
- The priority psychosocial nursing intervention for the client and family is to encourage the client and family to discuss their feelings about the disease. Options A, B, and D identify physiological not psychosocial concerns.
A client is diagnosed with human immunodeficiency virus (HIV) infection. The nurse prepares a care plan for the client, knowing that HIV is primarily a condition in which:
a) immunosuppression occurs and is indicated by a T4 lymphocyte count of less than 200/mm3
b) bacterial infection occurs, causing weakness
c) fungal infection occurs, causing a rash and pruritus
d) protozoan infection occurs, causing a fever and nonproductive cough
A
- HIV infection causes immunosuppression and is indicated by a T4 lymphocyte count of less than 200/mm3. Although bacterial, fungal, and protozoal infection can occur, these occur as opportunistic infections as a result of the immunosuppression.
Which of the following nursing actions is essential before an EIA test is performed?
a) Performing a Western blot test
b) Obtaining a written consent from the patient
c) Performing a polymerase chain reaction test
d) Obtaining a general consent for medical care from the patient
D
Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing. The Western blot test is performed if the results of the EIA test are positive. A polymerase chain reaction test, which measures viral loads, is used if diagnosis is confirmed as positive.
A patient is administered foscarnet to treat a case of cytomegalovirus (CMV) retinitis. Which of the following adverse effects should the nurse closely monitor in the patient?
a) Hypotension
b) Peripheral neuropathy
c) Electrolyte imbalances
d) Anemia
C
Alterations in renal function, fever, nausea, electrolyte imbalances, and diarrhea are the most common adverse effects of foscarnet and should be closely monitored. The drug does not cause hypotension. On the other hand, peripheral neuropathy is an adverse effect of administering drugs such as didanosine and zalcitabine. Anemia is an adverse effect of administering zidovudine
What intervention is a priority when treating a patient with HIV /AIDS?
a) Monitoring skin integrity
b) Assessing neurologic status
c) Monitoring psychological status
d) Assessing fluid and electrolyte balance
D
Fluid and electrolyte deficits are a priority in monitoring patients with HIV/AIDS. Assessment of fluid loss and electrolyte imbalance is essential. Skin integrity should be monitored, but is a lower priority. Neurologic and psychological status should also be monitored, but this is not as high a priority as fluid and electrolyte imbalance.
Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS?
a) Pneumocystis carinii
b) Cytomegalovirus
c) Mycobacterium avium
d) Cryptococcus neoformans
B
Cytomegalovirus is a species-specific herpes virus. Cryptococcus neoformans is a fungus that causes an opportunistic infection in patients with HIV/AIDS. Mycobacterium avium is an acid-fast bacillus that commonly causes a respiratory illness. Pneumocystis carinii is an organism that is thought to be protozoan, but believed to be a fungus based on its structure.
Which blood test confirms the presence of antibodies to HIV?
a) p24 antigen
b) Reverse transcriptase
c) Enzyme-linked immunosorbent assay (ELISA)
d) Erythrocyte sedimentation rate (ESR)
C
ELISA, as well as Western blot assay, identifies and confirms the presence of antibodies to HIV. The ESR is an indicator of the presence of inflammation in the body. The p24 antigen is a blood test that measures viral core protein. Reverse transcriptase is not a blood test. Rather, it is an enzyme that transforms single-stranded RNA into a double-stranded DNA.
When assisting the patient to interpret a negative HIV test result, what does the nurse tell the patient this result means?
a) Antibodies to the AIDS virus are in his blood.
b) He is immune to the AIDS virus.
c) His body has not produced antibodies to the AIDS virus.
d) He has not been infected with HIV.
C
A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that, if infected, the body has not produced antibodies (which takes from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged. The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet. When antibodies to the AIDS virus are detected in the blood, the test is interpreted as positive.
Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm?
a) Stage 2
b) Stage 1
c) Stage 3
d) Primary infection (acute HIV infection or acute HIV syndrome)
D
More than 500 CD4+ T lymphocytes/mm indicates CDC stage 1.
The term used to define the balance between the amount of HIV in the body and the immune response is which of the following?
a) Primary infection stage
b) Viral clearance rate
c) Window period
d) Viral set point
D
The viral set point is the balance between the amount of HIV in the body and the immune response. During the primary infection period, the window period occurs since a person is infected with HIV but negative on the HIV antibody blood test. The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage. The amount of virus in circulation and the number of infected cells equals the rate of viral clearance.
Which of the following statements reflects the treatment of HIV infection?
a) Treatment should be offered to individuals with plasma HIV RNA levels less than 55,000 copies/mL (RT-PCR assay).
b) Treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).
c) Treatment should be offered to only select patients once they reach CDC category B: HIV symptomatic.
d) Treatment should be offered to all patients once they reach CDC category B: HIV symptomatic.
B
Although specific therapies vary, treatment of HIV infection for an individual patient is based on three factors: the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).Treatment should be offered to all patients with the primary infection (acute HIV syndrome). In general, treatment should be offered to individuals with fewer than 350 CD4+ T cells/mm or plasma HIV RNA levels exceeding 55,000 copies/mL (RT-PCR assay).
When do most perinatal HIV infections occur?
a) Through casual contact
b) In utero
c) Through breastfeeding
d) After exposure during delivery
D
Mother-to-child transmission of HIV-1 may occur in utero or through breastfeeding, but most perinatal infections are thought to occur after exposure during delivery.
Other than abstinence, what is the only proven method of decreasing the risk for sexual transmission of HIV infection?
a) Spermicides
b) Consistent and correct use of condoms
c) Vaginal lubricants
d) Birth control pills
B
Other than abstinence, consistent and correct use of condoms is the only method proven to decrease the risk for sexual transmission of HIV infection. Vaginal lubricants, birth control pills, and spermicides do not decrease the risk for sexual transmission of HIV infection.
Which diagnostic test measures HIV RNA in the plasma?
a) ELISA
b) Viral load
c) Enzyme immunoassay
d) Western blot assay
B
A viral load test measures the quantity of HIV RNA in the blood. Enzyme immunoassay is a blood test that can determine the presence of antibodies to HIV in the blood or saliva that is also referred to as an ELISA. A Western blot assay is a blood test that identifies antibodies to HIV and is used to confirm the results of an EIA (ELISA) test.
The nurse teaches the patient that lowering his or her viral load will have what effect?
a) A longer survival time
b) A shorter survival time
c) A longer immunity
d) A shorter time to AIDS diagnosis
A
The lower the patient’s viral load, the longer the survival time.
Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy?
a) HIV RNA
b) CD4 counts
c) Western blot assay
d) ELISA
B
The most important consideration in decisions to initiate antiretroviral therapy is CD4 counts
Which assessment finding is not likely to cause noncompliance with antiretroviral treatment?
a) Past substance abuse
b) Active substance abuse
c) Lack of social support
d) Depression
A
Past substance abuse has not been implicated as a factor for noncompliance with antiretroviral treatment. Factors associated with nonadherence include active substance abuse, depression, and lack of social support.
A patient taking amprenavir (APV, Agenerase) complains of “getting fat.” What is the nurse’s best action?
a) Assess the patient’s diet.
b) Arrange for a psychological counseling.
c) Teach the patient about medication side effects.
d) Have the patient increase exercise.
C
The patient needs to be aware of the potential for fat redistribution. Exercise, diet, and counseling will not change the outcome of this side effect.
A client receiving atazanavir (ATV, Reyataz) requires what priority intervention?
a) Cardiac assessment
b) Renal function tests
c) Increased fluids
d) Diet modification
A
This medication may cause prolongation of the PR interval and first degree AV block. Patients with underlying conduction deficits may develop problems. A cardiac assessment will assist in determining if the patient has underlying problems that could be exacerbated by this drug therapy. The other interventions are not necessary.
What test will the nurse assess to determine the patient’s response to antiretroviral therapy?
a) Western blot
b) CBC
c) EIA enzyme immunoassay
d) Viral load
D
Viral load is used to assess response to treatment of HIV infection. The other tests are not used in this way.
The nurse is teaching the patient with HIV about therapy. What is essential for the nurse to include in the teaching plan? Select all that apply.
a) Medication therapy is rarely effective.
b) Patients rarely respond to medication therapy.
c) The goal of antiretroviral therapy is to prevent opportunistic infections.
d) The CD4 count is the major indicator of immune function and guides therapy.
e) Antiretroviral therapy targets different stages of the HIV life cycle.
D, E
The CD4 count is the major indicator of immune function. Antiretroviral therapy in HIV targets different stages of the HIV life cycle. Therapy does not prevent opportunistic infections. Medication therapy is effective and most patients respond well to therapy.
A patient being treated for HIV/AIDS has a decreased appetite, almost to the point of anorexia. What is the nurse’s best action?
a) Talk to the patient about his unwillingness to eat.
b) Ask his family to bring in food that he enjoys.
c) Ask the dietician to prepare his favorite meals.
d) Administer megestrol acetate (Megace).
D
Appetite stimulants are successfully used in patients with AIDS-related anorexia. The anorexia is compounded by medications that cause nausea and vomiting. The anorexia has a physiologic cause, and this must be addressed. Bringing in favorite foods or making favorite foods may have little or no effect on the patient’s appetite; it is physiologically rather than psychologically based
For stress what is the contributor/ aggravator of medical conditions
Cardiovascular disease Immune disorders Asthma Diabetes Digestive disorders Skin disorders Psychological disorders
Stress
Condition in which the human system responds to changes in its normal balanced state
Tensions that threaten equilibrium
Stressor
Anything that a person perceives as challenging, threatening, or demanding.
(positive or negative)
Types of External Stressors
Environment (temp, noise, space…)
Social interaction (rudeness, bossiness…)
Major life events (birth, death, divorce…)
Daily hassles (commuting, misplaced keys…)
Type of Internal Stressors
Life choices: (overloaded schedule, caffeine…)
Negative self talk: (self-criticism, pessimistic…)
Mind trap:(unrealistic expectation, taking things personally)
Personality traits: (perfectionist, workaholics)
What is LAS? And give an Example
Local Adaptation Syndrome
A. Response of body tissue, an organ, or a part of the body to the stress of trauma, illness, or other physiological change
B. Examples
- reflex pain response=localized response of CNS to stimulus of pain ( remove hand from hot surface)
- inflammatory response
How does LAS take affect on the vascular system?
What examples for each affect on how the patient is affected?
Brief constriction -> pallor and numb
Increase blood flow -> redness & heat
Inc Histamine -> Swelling
Cell permeability -> Loss of function
