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Final 155 Flashcards

This deck was created by combining two or more decks

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
HIV pregnant women should not continue HIV drug therapy T/F
False they should continue or start HIVtherapy
25
What does the typicalHIV/AIDS pt die from
opportunistically infections or cancer
26
what is a viral load?
amount of virus present in blood and other body fluid. The higher the blood level of HIVviremia the greater risk for sexual transmission
27
What are the precautions for HCW
gloves especially with nonintact skin | or weaping dermatitis or open lesions
28
What is the age group thatis most likely to contract AIDS?
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
29
What is a result of HIVinfection immune system abnormalities?
lymphocytopenia increased production of incomplete nonfunctional antibodies Abnormally functioning macrophages
30
AIDS dementia complexis rareT-F?
false about 70percent of AIDS patients from barely noticible to severe dementia
31
a patientwith AIDS doesn't have to worry about TB?
TB occurs in2-10percent of all AIDS
32
toxoplasmosis is contracted by? | .
through contact with cat feces or ingesting infected undercooked meat. changes in mental status speech gait, headaches,fever
33
Entry Inhibitors do not prevent the HIV proteins from binding T/F.
False It prevents the cp41from binding to the CCR5 receptor and entering the CD4 T cells
34
when is a Western Blot used?
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
35
whatis required to receive a diagnosis of AIDS?
CD4tcells count lower than 200 or an opportunistic infection Once diagnosed as AiDS always an aids patient
36
Once inside a host it is the CD4 t- helper cells that are hijacked
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
37
Lymphadenopathy is?
Pt has persistently large lymph nodes
38
name four cancers that occur more readily in AIDS pts
Karposi.sarcoma purplish brown raised lesions Hodgkins lymphoma non-Hodgkins lymphoma Burkitts invasive cervical cancer
39
opertunistic infections are caused by?
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
40
what body fluidics HIV found.
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
First manifestations of HIV?
fever,night sweat, chills, headache, muscle aches, Acute HIVhave rash and sore throats which is confused with mononucleosis and viral meningitis
42
pregnant women with HIV have more likely chance for?
premature delivery, low birth weight, and transmitting the disease to infant
43
what are theABCs ofHiV
Abstinence Be faithful Condoms
44
PRN medications
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
Teaching nanda with deficient knowledge as etiology
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
Discussion
Exchange points of view, correct information, requires more time.
47
What must a goal statement include?
A time frame, be realistic, mutually developed, observable or measurable.
48
What's a risk diagnosis ?
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
Wholly compensatory
Nurse agency totally compensates for client self-care deficits.
50
Supportive educative
Nurse agency provides support counseling and teaching.
51
Activities of diagnosing
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
Internet
Information may be incomplete, misleading, or inaccurate.
53
Government responses to disaster
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
Analgesics in elderly
``` 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
Impact stage
Disaster has happened, assess damage, death , loss of propert, injury
56
Group teaching
Support groups
57
Demonstration/return demonstration
Perform motor skill for client then have them perform it back to you. Needs practice.
58
Opioid analgesics
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
Non-disaster stage
Preplan when vulnerable to disaster. Threat of disasters and there is time to prepare.
60
Purpose of nursing diagnosis is
To identify client strengths and health problems that can be prevented or resolved by collaborative and independent nursing interventions.
61
Reconstruction stage
Restore, rebuild mitigation (minimizes the effects or prevents future disasters and makes them right)
62
Audiovisual material
Use of visual and auditory stimulation, films.
63
Teaching nandas
Deficient knowledge ex-(low-cal diet) Readiness for enhanced knowledge ex-(exercise and activity) Noncompliance ex-(with medication plan)
64
Emergency stage
Help arrives, recovery begins
65
What's an actual diagnosis
A client problem that is present at the time of the nursing assessment. Ex) inefffective airway clearance and anxiety.
66
Affective domain of learning
Feelings related to values, attitudes, and opinions. Ex) asking them to change what they may value more.
67
Antagonist/antidote for opioids
Narcan (Nalaxone)
68
Nursing preparation to disaster
``` Know facilities plan Know your role Be supportive to patients Carry out plan as best you can Be available if off duty ```
69
Analogs
Verbal instruction with familiar images.
70
Printed material
Must fit reading level, use information in language used by client. 12th grade reading level is national average.
71
Psychomotor domain of learning
Integration of mental and motors abilities. Ex) ability to use motor skills for activity, giving injection.
72
Lecture-discussion
Allows for questions, better way to learn.
73
PCA
Patient controlled analgesia. Can improve pain relief and increase patient satisfaction. Reduces anxiety which helps relieve pain.
74
Teaching strategy: lecture
Short, but never short enough to really learn.
75
Partially compensatory
Nurse agency supplements clients limited self-care ability.
76
What to watch for with opioid use
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
SE titration
- You want to give the minimal dose that will give the maximum affect w/minimal side effects. (Start low & go slow)
78
Cognitive domain of learning
Intellectual behavior understanding. Ex) alert and orientated and able to listen and interact
79
Purpose of assessment is
To establish a database about the clients response to health concerns or illness and the ability to manage health care needs.
80
Natural disasters
Tornadoes, hurricanes, earthquake, flood, storm, epidemic
81
What are some activities done during assessment ?
``` Obtain a nursing health history Conduct a physical assessment Review client records Review nursing literature Consult supper persons Consult health care professionals ```
82
hyperkalemia
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
metabolic acidosis
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
hyperthyroidism
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
respiratory alkalosis
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
hypokalemia
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
thyroidectomy
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
hypothyroidism
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
hypoalbuminemia
low protein, caused by dehydration, malnutrition, dehydration, starving, dieting, burns liver disease, chronic infection
90
loop diuretics
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
addisons disease
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
calcium
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
hypernaturemia
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
normal ABG levels
pH- 7.35-7.45 HCO3- 21-28 pCo2- 35-45 02- 80-100
95
hyponaturemia
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
respiratory acidosis
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
cushings syndrome
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
Normal electrolyte levels
``` 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
metabolic alkalosis
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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