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Final 155 Flashcards

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0
Q

Is

the vaginal area is more susceptible to HIV?

A

True the vaginal area has more mucus membrane then the penis thus HIV like otherSTDs are more easily transmitted
penis in rectalarea same idea for the rectal mucus a

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1
Q

WORKS should be cleaned with——-?

A

flush used needle And syringe with clean water

fill syringe with bleach shake 30-60seconds

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2
Q

HIV to AIDS takes years T/F?

A

false it could be months to years depending on the more times the HIV was encountered. more encounters the more likely the process will bested up to AIDS

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3
Q

fungal infections include?

A

food may taste funny because the Candidia stomactitis or esophagus is out of control. swallowing may be painful also
retrsternal pain-pain behind the ribs
woman withHIV may have persistent itching ,perineal irritation and a thick white discharge

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4
Q

Highly Active Antiretrviral Threapy HAART reduces the risk of transmission

A

False risk is always presenting HIV patients to transmit

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5
Q

newly made cells and compatible blood transfusions are not deemed safe by the immune system Tru or False

A

False it is the job of the immune system to recognize them and to monitor for foreign or non self substances

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6
Q

what are safer sex practices?

A

latex condom for genital anal sex
a condom or dental dam latex for or genital or oral/anal sex contact
latex gloves for finger or hand contact with vagina or rectum

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7
Q

HIV is transmitted by casual contact?T/F

A

False also not by mosquitoes or other insects

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8
Q

Intergrase is what?

A

Allows the viral ds viralDNA to be inserted into the host DNA
Intergrase inhibitors is a drug used to prevent viral DNA from integrating

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9
Q

what is the most common bacterial infection for -AIDS

A

MAC or my robacterium Adium complex it infects the respiratory and GI tract and is a systemic infection
culture from lymph nodes bone arrow, and blood to diagnose
look for weight loss mailse swollen lymph glands or organ disease

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10
Q

during assessment what should the nurse inquire about witha HIVpatient?

A 
when diagnoses
clinical symptoms
chronological infection hx
blood transfusion before1978-85
sexual practices
STD
Any TB or HEP
hemophilia or clotting issues
their overall knowledge of disease
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11
Q

AIDS is the most common secondary immune defiecny disease in the world and is caused by a virus

A

True

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12
Q

ElISA test may accurately test for HIV antibodies before 3weeks?

A

no the antibody is usually made anywhere from 3 weeks to 3 months and may not be detected up to 36 months after initial infection

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13
Q

Health are workers are not at risk of contacting HIV T/F

A

False. needle sticks and sharps are main means of occupational related HIVExposure

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14
Q

What is the first sign a woman may have for a HIV infection?

A

vaginal candidiasis

along with herpes,PID, cervical dysphasia, or cancer

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15
Q

NANDAS for aAIDS
risk for infection related to I mine deficiency
impAired gas exchange related to anemia, respiratory infection PCP,Karposi sarcoma, CMV,anemia, fatigue, pain
Acute pain or chronic pain r/t neuropathy,myelopathy, cancer or infection
Imbalanced nutrition less than body requirements r/t high metabolic need, nausea, and vomiting
Diarrhea r/t infection,food intolerance, or drugs
Impaired skin integrity r/t KS , infection, altered nutritional state, incontininance, immobility, hyperthermia, or cancer
Disturbed thought process r/t to AIDS dementia complex, enteral nervous system infection, or cancer
Chronic low self esteem r/t,, infection,changes in body, decreased self esteem or helplessness
Social isolation r/t stigma,virus transmittability infection control practices,or fear

A

additional. NDiagnosis
Activity intolerance r/t fatigue discomfort, cons defect, weakness, or anemia
Risk for injury r/t cons defect, mental status change, depression, or thrombocytopenia
Disturbed sensory preception(visual) r/t to CMV
retinitis or blindness
Sleep deprevation r/t pain discomfort, anxiety, or depression
Ineffective coping r/t the diagnosis of AIDS
Disabled family coping r/t the diagnosis of AIDS
Greiving r/t anticipated loss of role and function or impending death

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16
Q

HIV belongs to the group of viruses called———-.

A

Retrovirouses single stranded RNA and converts double stranded DNA

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17
Q

HIV protease is?

A

Chemical scissors that cut one long protein strand into functional pieces. These pieces bud off to infect other CD4cells
protease inhibitors work here to inhibit HIV protease

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18
Q

cryptocococsis widely spread with AIDS what are its symptoms

A

fever headache, blurred vision, nausea, vomiting, nuchal rigidity-neck pain, mild concussion, and other mental status changes

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19
Q

The drug that prevents single stranded HIV RNA to converting to double stranded DNAis

A

Nucleoside analog reverse transcriptase inhibitors NARTIS

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20
Q

only one infection. an be present at a time T/F

A

False the infection may be protozoan, fungal, bacterial, or viral and must be treAted immediately due to they may progress and cause death

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21
Q

cryptospordiosis may result in what fatal syndrome

A

severe wasting syndrome, with electrolyte imbalances

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22
Q

what is a protozoan infection common to HIV

A

PCP pneumocystis jroveci pneumonia is the most common

asses for dyspepsia on exertion, tachycardia, a persistent dry cough, and fever
may have weight loss and fatigue listen for crackles

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23
Q

Normal healthy adult has how manyCD4 cells?

A

800-1000 cells/mm3

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24
Q

HIV pregnant women should not continue HIV drug therapy T/F

A

False they should continue or start HIVtherapy

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25
Q

What does the typicalHIV/AIDS pt die from

A

opportunistically infections or cancer

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26
Q

what is a viral load?

A

amount of virus present in blood and other body fluid. The higher the blood level of HIVviremia

the greater risk for sexual transmission

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27
Q

What are the precautions for HCW

A

gloves especially with nonintact skin

or weaping dermatitis or open lesions

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28
Q

What is the age group thatis most likely to contract AIDS?

A

21-44
men on men sex highest risk46
either sex using intervenors drugs 20
Hispanics african Americans are increasing
women are fastest growing group due to sexual exposure and drug use 16

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29
Q

What is a result of HIVinfection immune system abnormalities?

A

lymphocytopenia
increased production of incomplete nonfunctional antibodies
Abnormally functioning macrophages

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30
Q

AIDS dementia complexis rareT-F?

A

false about 70percent of AIDS patients from barely noticible to severe dementia

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31
Q

a patientwith AIDS doesn’t have to worry about TB?

A

TB occurs in2-10percent of all AIDS

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32
Q

toxoplasmosis is contracted by?

.

A

through contact with cat feces or ingesting infected undercooked meat.
changes in mental status speech gait, headaches,fever

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33
Q

Entry Inhibitors do not prevent the HIV proteins from binding T/F.

A

False It prevents the cp41from binding to the CCR5 receptor and entering the CD4 T cells

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34
Q

when is a Western Blot used?

A

when an ELISA comes back positive. if 2 antibodies are found of the major HIV antigens then the person has tested positive for HIV not AIDS

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35
Q

whatis required to receive a diagnosis of AIDS?

A

CD4tcells count lower than 200
or an opportunistic infection
Once diagnosed as AiDS always an aids patient

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36
Q

Once inside a host it is the CD4 t- helper cells that are hijacked

A

True known as CD4 cells, helper inducer cells,T Cells, or T4 cell directs immune system defenses and regulates the activity of the immune system

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37
Q

Lymphadenopathy is?

A

Pt has persistently large lymph nodes

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38
Q

name four cancers that occur more readily in AIDS pts

A

Karposi.sarcoma purplish brown raised lesions
Hodgkins lymphoma
non-Hodgkins lymphoma Burkitts
invasive cervical cancer

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39
Q

opertunistic infections are caused by?

A

organisms that are in the normal environment and are kept in check by the normal immune system and maybe responsible forthe clinical manifestations of the progressingHIV patient

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40
Q

what body fluidics HIV found.

A

blood, semen, vaginal secretions, breast milk, amniotic fluid, feces, urine, saliva, tears,cerebrospinal fluid, lymph odes, cervical cells,corneal tissues, brain tissue
Blood andSemen havethehighest concentration

,

41
Q

First manifestations of HIV?

A

fever,night sweat, chills, headache, muscle aches, Acute HIVhave rash and sore throats which is confused with mononucleosis and viral meningitis

42
Q

pregnant women with HIV have more likely chance for?

A

premature delivery, low birth weight, and transmitting the disease to infant

43
Q

what are theABCs ofHiV

A

Abstinence
Be faithful
Condoms

44
Q

PRN medications

A

Pain medication that is given on an as needed basis after doing a pain assessment on the patient. Can only be given every few hours depending on the drug.

45
Q

Teaching nanda with deficient knowledge as etiology

A

Risk for impaired parenting related to deficient knowledge(skills in infant care and feeding)
Risk for injection related to deficient knowledge (stds and their prevention)
Anxiety related to deficient knowledge (bone marrow aspiration)
Others that can be used: risk for injury, ineffective breast feeding, coping, or health maintenance

46
Q

Discussion

A

Exchange points of view, correct information, requires more time.

47
Q

What must a goal statement include?

A

A time frame, be realistic, mutually developed, observable or measurable.

48
Q

What’s a risk diagnosis ?

A

A clinical judgement that a problem does not exis, but the presence of risk factors indicates that a problem is likely to develop unless nurses intervene.
Ex) risk for injection risk for falls.

49
Q

Wholly compensatory

A

Nurse agency totally compensates for client self-care deficits.

50
Q

Supportive educative

A

Nurse agency provides support counseling and teaching.

51
Q

Activities of diagnosing

A

Interpret and analyze data
-compare data against standards
-cluster or group data
-identify gaps and inconsistencies
Determine strengths, rushed and problems
Formulate nursing diagnosis and collaborative problem statements

52
Q

Internet

A

Information may be incomplete, misleading, or inaccurate.

53
Q

Government responses to disaster

A

FEMA-federal emergency management agency
SEMA-state emergency management agency
CERT-community emergency response team
NDRM-National disaster medical systems(homeland security)
Red cross-volunteers

54
Q

Analgesics in elderly

A 
Metabolize drugs slower
Start low and go slow
NSAIDS – High incidence of GI bleed
Nephrotoxicity
Avoid using Demerol/Codeine (causes constipation)
Increased cognitive impairment
Slow GFR (glomerular filtration rate)
Decreased GI motility and absorption
55
Q

Impact stage

A

Disaster has happened, assess damage, death , loss of propert, injury

56
Q

Group teaching

A

Support groups

57
Q

Demonstration/return demonstration

A

Perform motor skill for client then have them perform it back to you. Needs practice.

58
Q

Opioid analgesics

A

Mainstay in the management of all types of pain. Block the release of neurotransmitters in the spinal cord.
Ex) morphine, fentanyl, hydrocodone, meperidine, methadone, codeine

59
Q

Non-disaster stage

A

Preplan when vulnerable to disaster. Threat of disasters and there is time to prepare.

60
Q

Purpose of nursing diagnosis is

A

To identify client strengths and health problems that can be prevented or resolved by collaborative and independent nursing interventions.

61
Q

Reconstruction stage

A

Restore, rebuild mitigation (minimizes the effects or prevents future disasters and makes them right)

62
Q

Audiovisual material

A

Use of visual and auditory stimulation, films.

63
Q

Teaching nandas

A

Deficient knowledge ex-(low-cal diet)
Readiness for enhanced knowledge ex-(exercise and activity)
Noncompliance ex-(with medication plan)

64
Q

Emergency stage

A

Help arrives, recovery begins

65
Q

What’s an actual diagnosis

A

A client problem that is present at the time of the nursing assessment.
Ex) inefffective airway clearance and anxiety.

66
Q

Affective domain of learning

A

Feelings related to values, attitudes, and opinions. Ex) asking them to change what they may value more.

67
Q

Antagonist/antidote for opioids

A

Narcan (Nalaxone)

68
Q

Nursing preparation to disaster

A 
Know facilities plan
Know your role
Be supportive to patients
Carry out plan as best you can
Be available if off duty
69
Q

Analogs

A

Verbal instruction with familiar images.

70
Q

Printed material

A

Must fit reading level, use information in language used by client. 12th grade reading level is national average.

71
Q

Psychomotor domain of learning

A

Integration of mental and motors abilities. Ex) ability to use motor skills for activity, giving injection.

72
Q

Lecture-discussion

A

Allows for questions, better way to learn.

73
Q

PCA

A

Patient controlled analgesia. Can improve pain relief and increase patient satisfaction. Reduces anxiety which helps relieve pain.

74
Q

Teaching strategy: lecture

A

Short, but never short enough to really learn.

75
Q

Partially compensatory

A

Nurse agency supplements clients limited self-care ability.

76
Q

What to watch for with opioid use

A

Watch patient for Respiratory Depression, hold med if respiratory rate is less than 10.

Constipation is a main side effect of Opioids along with urinary retention and puritis (itching).

77
Q

SE titration

A
  • You want to give the minimal dose that will give the maximum affect w/minimal side effects. (Start low & go
    slow)
78
Q

Cognitive domain of learning

A

Intellectual behavior understanding. Ex) alert and orientated and able to listen and interact

79
Q

Purpose of assessment is

A

To establish a database about the clients response to health concerns or illness and the ability to manage health care needs.

80
Q

Natural disasters

A

Tornadoes, hurricanes, earthquake, flood, storm, epidemic

81
Q

What are some activities done during assessment ?

A 
Obtain a nursing health history
Conduct a physical assessment
Review client records
Review nursing literature 
Consult supper persons
Consult health care professionals
82
Q

hyperkalemia

A

potassium above 5- caused by excessive intake, too much IV, k sparing diuretics(aldactalone,spiractalone) can cause muscle weakness, arrythmias, cardiac arrest, GI upset, give k-exelate, give a loop, give insulin d50

83
Q

metabolic acidosis

A

HCO3 below 21 pH below 7.35, caused by renal disease, uncontrolled diabetic, DKA, seizures, diarhhea(out your ass) k-sparings, your gonna see and increases RR, kussmauls respirations, give k-exelate to get rid of k, also give d50 w/ insulin

84
Q

hyperthyroidism

A

sustained release of thyroid hormone (over active) increased level of t3 and t4 and a decreased level of TSH, causes are autoimmune (graves) or goiters, everything speeds up so tachycardia, increased metabolism, increased systolic BP, frequent bowel movements, fast RR, warm moist skin, muscle weakness, restlessness, increased temperature give an anti thyroid med PTU, a b-blocker to manage their hypertension and tachycardia(propranolol, inderal) an iodine solution SSKI, Lugol) and tapazole

85
Q

respiratory alkalosis

A

co2 below 35, pH above 7.45, caused mostly by fear and anxiety, also aspirin toxicity, they are hyperventilating (give a mask or paper bag) give mucomyst for aspirin tox

86
Q

hypokalemia

A

potassium less than 3.5- caused by loops, steroids, ng tubes vomiting, diarhhea, metabolic alkalosis, these pts have arrhythmia, shallow respirations, low BP, altered LOC, hypoactive bowel sounds, distended abdomen, leg cramps give IV at 10 an hour ONLY on a pump never IV push, monitor site for phlebitis because k is a vesicant and is very irritating to skin, increase potassium intake, give supplements STOP digoxin because of possible dig toxicity

87
Q

thyroidectomy

A

removal of all ( total) or part of the thyroid gland (subtotal) women who are of child bearing age usually have a subtotal thyroidectomy and before either surgery is done the client must have a normal (euthroid) state with iodine if they have a total then they must take synthroid lifelong and if they have a partial they may still produce some thyroid hormone. teach them how to support their head and neck while turning before surgery also teach them how to cough and deep breathe before surgery, and after surgery have calcium gluconate at the bed side because the surgery will cause hypocalcemia and look for chvoteks and trousseaus and stridor can be the first sign of hypocalcemia. check the front and back of their dressings to make sure they are not bleeding have a crash cart, calcium and a trach kit at the bedside also, the parathyroid glands may accidently be removed so this is a risk of doing the surgery

88
Q

hypothyroidism

A

under active thyroid gland due to thyroidectomy, atrophy of the gland, autoimmune disorders, there is an increased TSH and a decreased t3 and t4, people have slow metabolism, happens to women more than men, they also have cardiomegaly, activity intolerance, high cholesterol, slurred slow speech, altered LOC, and are overweight, treat with synthroid and if they had a thyroidectomy make sure they take this med all their life. put them on a low calorie diet

89
Q

hypoalbuminemia

A

low protein, caused by dehydration, malnutrition, dehydration, starving, dieting, burns liver disease, chronic infection

90
Q

loop diuretics

A

examples (lasix,bumex) they lose k+, calcium and sodium, given for SIADH and FVE, know BP, k level, creatinine, BUN before you give also STOP them when a pt has FVD or is dehydrated or metabolic alkalosis K low)

91
Q

addisons disease

A

hypo function of the adrenal cortex, due to surgery, autoimmune disease, trauma, tumors, atrophy of the gland, they are going to have a bronzy appearance due to an increases MSH and have increased potassium and low sodium, give them d50 w/ insulin, and a loop diuretic, they are going to have hypoglycemia, weight loss, nausea, anorexia, diarrhea, the goal is to replace glucocorticoids and mineralcorticoids by giving a synthetic aldosterone (cortisone, Florinef) make sure they take this med with meals to prevent to GI upset or bleed. pt may have addisonian crisis (hypovolemic shock due to lack of aldosterone

92
Q

calcium

A

when calcium is up, phosphate is down, when calcium is low, the pt can have trousseaus and chvoteks, nerve impulses, skeletal, muscle contractions, if pt had thyroid or neck surgery they can also have low calcium,

93
Q

hypernaturemia

A

sodium over 145- caused by steroids, sweating, cushings pt, over infusing IV, infection, fever pt will have a decreased LOC, muscle twitching, full bounding pulse, pad the side rails because they can seize, give a loop, hypotonic IV, eat low sodium less than 2 gram, stop smoking, exercise, fresh fruits and veggies

94
Q

normal ABG levels

A

pH- 7.35-7.45
HCO3- 21-28
pCo2- 35-45
02- 80-100

95
Q

hyponaturemia

A

less than 136 low sodium caused by diuertics, ace inhibitors, addisons patient, diarrhea and vomitting, drowning, renal failure, diabetic, may have altered LOC, cerebral edema, anxious, hyper, muscle weakness, twitching, orthostatic hypotension, tachycardia treat the cause, increase intake, give normal saline or lactated ringers (isotonic) or a hypertonic IV solution, restrict fluids to people with water intoxication (dilutional hyponaturemia) (low na but over hydrated)

96
Q

respiratory acidosis

A

co2 above 45, pH below 7.35, they are hypo ventilating, also caused by narcotics, COPD, head/neck trauma, obesity, cushings, asthma, smoking. give them pain meds, tell them to cough and deep breathe, mechanically ventilate, steroids, low flow o2, give narcan for opioid overdose, make sure their LOC is WNL (earliest sign of hypoxia)

97
Q

cushings syndrome

A

excessive secretion of cortisol from the adrenal glands, excess glucocorticoids, excess secretion of ACTH and aldosterone, pt’s will have weight gain, pinpoint pupils, low potassium and high sodium, high blood glucose, delayed wound healing and poor nutrition, do strict i&O’s and a low sodium diet, and restrict fluid, highest risk is a patient on long term steroids, if they have an adrenalectomy it’s to remove the adrenal glands due to hyperfunction, if they can’t operate on pt due to cancer of adrenal cortex, MITOTANE is given

98
Q

Normal electrolyte levels

A 
k- 3.5-5.0 (potassium)
na- 136-145 (sodium)
ca- 9.0-10.5 ( calcium) 
mg- 1.3-2.1 (magnesium)
phosphorous- 3.0-4.5
cl- 98-106 (chloride)
albumin- 3.4-5
hemoglobin 12-16 female 14-18 male
hematocrit 36-47 female 42-52 male
99
Q

metabolic alkalosis

A

HCO3 above 28 pH above 7.45, k is low, caused by antacid use (tums) TPN therapy, they are going to complain of muscle weakness, vomiting, you want to give antiemetics

Nursing 155/150 (7 decks)

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