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kol- Med Surg 320 Spring > HIV > Flashcards

HIV Flashcards

1
Q

All the ways HIV is transmitted

A 
Blood **
Semen **
Urine 
Feces
Saliva
Tears
Cerebral spinal fluid
Brain tissue
Breast Milk **
Vaginal Secretions **
Amniotic Fluid

would have to have A LOT of exposure to contract HIV from non * ones

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2
Q

Primary ways HIV is spread

A
  • sexual contact: genital, anal, oral
  • Parenteral: IV drug use, blood transfusion (1978-1985)
  • perinatal: placenta/maternal blood/breastmilk/fluids
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3
Q

3 ways to reduce risk of transmitting HIV to baby from mom

A
  • -> risk reduced if mother being treated w/ antivirals
  • -> C Section
  • -> don’t breastfeed baby
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4
Q

The higher the viral load, the higher….

A

the risk of transmission

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5
Q

penis + vagina = sex - which one is more likely to infect the other if positive?

A

penis more likely give the vagina HIV then vagina giving the penis HIV

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6
Q

highest risk sexual behavior for HIV transmission?

A

Anal intercourse

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7
Q

what are the ABCD’s of safe sex

A

Abstinence
Being faithful
Condom use
Drugs (PREP)

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8
Q

risk of getting HIV from blood products today?

A

< 0.2% = low risK!

1978-1985 - higher risk

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9
Q

Babies born to mothers with HIV should be treated with HIV medications for _________ after delivery

A

4-6 weeks

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10
Q

As a nurse what do you do if you have a dirty needle stick?

A

If stuck: wash area, squeeze the area, report it, get labs

-24 hours to make decision about starting post exposure treatment after stick

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11
Q

What is 4th generation testing for HIV?

A

Detects HIV antibodies (HIV IgM and IgG) within 21 days
Detects p24 antigen (HIV capsid protein) within 14 days

(looking at ANTIBODIES and ANTIGENS)

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12
Q

If test positive need to determine if you have ____ or ____.

A

HIV 1 or HIV2

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13
Q

What is nucleic acid test for HIV?

A

tell if a person has HIV or tell how much virus is present in the blood (known as an HIV viral load test).
-detect HIV sooner than other types of tests, this test is very expensive and not routinely used for screening individuals unless they recently had a high-risk exposure or a possible exposure and have early symptoms of HIV infection.

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14
Q

what is a transmucosal exudate test for HIV?

A

(results in 20 minutes) only looking for antibodies

-If test is positive, results should be verified with further testing

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15
Q

what does viral load measure? why do i care?

A

amount of HIV viral RNA particles in the blood

-Test for HIV infectivity and therapy effectiveness

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16
Q

normal vs AIDS cd4 count

A 
normal = 500-1500
aids = <200
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17
Q

other labs to look at with HIV

A
  • Lymphocyte counts- low with AIDS
  • CD4 count normal 500-1500, indicator of HIV –> AIDS = <200
  • Viral Load testing/ Quantitative RNA assays
  • CBC- infection
  • CMP- infection
  • Toxoplasmosis antibody titer
  • LFT
  • Hepatitis A, B, C
  • Lipid profile
  • Syphilis - test yearly for HIV
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18
Q

4 stages of HIV infection

A
  1. acute
  2. chronic
  3. aids
  4. Unknown
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19
Q

Acute HIV infection stage - when do sxs start? CD4 count? contagious?

A
  • Flu like sxs 2-4 weeks after initial contact
  • VERY contagious –> high viral load
  • CD4 T-cell count > 500 cells/mm3 (no AIDS defining illness)
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20
Q

chronic HIV infection- cd4 t cell count? how long stay here? contagious?

A
  • HIV active and reproducing slowly
  • Lasts about 10 years untreated –> stay here indefinitely if treated with retrovirals
  • can transmit HIV to others
  • T-cell count between 200 and 499 cells/mm3 (no AIDS defining illness)
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21
Q

AIDs- cd4 count? how long stay here?

A
  • Immune system severely damaged and impaired
  • CD4+ count is below 200 cells/mm OR develop opportunistic infection
  • W/O treatment = death w/in 3 years
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22
Q

stage unknown HIV

A

Confirmed HIV with no further information regarding CD4 status/ illnesses

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23
Q

HIV –> AIDS = ?

A

-CD4 T-cell count < 200 cells/mm3 is indicative of AIDS
OR
-HIV positive and presence of Opportunistic Infections

(remember: CD4 T cell count Normal is 500-1500 cells/mm3)`

24
Q

who is getting screened for HIV

A

All adults between the ages of 13 and 65 (at least one test)
Annual screening for those at higher risk for HIV
Prenatal screening
Frequent testing for people with repeated high-risk exposure :sex workers, IV drug user

25
Q

assessment for HIV

A
  • History
  • Infections *
  • Malignancies
  • Endocrine problems
  • Neurological problems
  • Protein wasting
  • Skin problems
  • Kidney problems
  • Support
  • Current level of function
26
Q

priority assessment for HIV?

A

infections!

  • Should be monitored on a routine basis for immune function and presence of infections/ disease progression
  • At risk for opportunistic and pathogenic infections
27
Q

pathogenic vs opportunistic infections

A

Pathogenic Infection = Virulent organisms all people are susceptible to regardless of immune response

Opportunistic Infections =Organisms that take advantage of a weakened immune system
-Do not typically cause infections in people with healthy immune systems

28
Q

what accounts for many of the clinical signs of HIV?

A

opportunistic Protozoan, viral, bacterial or fungal infections

29
Q

nurse role in managing opportunistic infections?

A
  • assess for s/s
  • monitor patient response to treatment
  • report appropriately
30
Q

Most common opportunistic infection in patients with HIV?

what kind of infection is it? what we gonna do about it?

A

Pneumocystis Pneumonia: PCP, (Pneumocystis jiroveci)

  • -Fungal infection
  • Give support and Bactrim –> @ risk for hospital acquired infections from vent/central line
31
Q

Pneumocystis Pneumonia/ PCP presents with

A
  • Persistent cough
  • Low grade fever
  • Tachypnea
  • Dyspnea
  • Crackles in lungs
  • Wheezing
  • Fatigue
32
Q

how do we diagnose Pneumocystis Pneumonia: PCP?

A

Presentation
Sputum Culture
Bronchial Lavage
Transbronchial or open lung biopsy

33
Q

treatment forPneumocystis Pneumonia: PCP

A
  • Trimethoprim Sulfamethoxazole (Bactrim)

- Support (O2, Positive pressure)

34
Q

which OI is present in cat feces and undercooked meat?

A

Toxoplasmosis encephalitis

35
Q

how does Toxoplasmosis encephalitis manifest?

A
  • Neurological changes
  • Fever
  • Lethargy
  • Headaches
36
Q

how do we treat Toxoplasmosis encephalitis?

A

-Treated with pyrimethamine and sulfadiazine

37
Q

what is Disseminated MAC?

A

-Mycobacterium avium complex

38
Q

when do you get Disseminated MAC

A
  • **-CD4 T lymphocyte < 50 cells/mm3

* -Occurs in patients who are not on Antiretroviral treatment (ART) - never seen w/ someone on retrovirals!

39
Q

s/s of Disseminated multi-organ infection (MAC)

A

Anemia, fever, night sweats, fatigue, diarrhea, abdominal pain, weight loss

40
Q

treatment for Disseminated MAC

A
  • Support

- Clarithromycin, ethambutol and rifabutin

41
Q

s/s of TB in HIV patient

A

Cough, dyspnea, chest pain, night sweats, weight loss, anorexia, dyspnea, fever, chills

42
Q

considerations for testing HIV+ patient for TB?

A
  • If CD4+ T-cell count is below 200 cells/mm3, TB skin test may not be positive
  • Diagnosed by Nucleic acid amplification test (NAAT), chest xray, sputum smear or culture
43
Q

OI’s in HIV pateints

A

TB
Disseminated MAC
PCP Pneumonia
Toxoplasmosis encephalitis

+

Cryptosporidiosis (Intestinal Infection)
Candida stomatitis or esophagitis
Cryptococcosis
Histoplasmosis
Cytomegalovirus
Herpes simplex
Shingles
44
Q

Malignancies with HIV+

A 
Kaposi’s Sarcoma: but them on ART
Lymphomas
Cervical Cancer
Lung cancer
Anal Cancer
GI Cancer
45
Q

Malignant Lymphomas - types and s/s

A

S/s: Swollen lymph nodes, fever, night sweats, fatigue

46
Q

disease that causes anal cancer? how we test?

A

HPV- anal PAP test

47
Q

how often should HIV + get cervical pap?

A

every 6 months

48
Q

Other Assessment findings related to retroviral therapy

A
  • Gonadal dysfunction
  • Body shape changes
  • Lipid abnormalities
  • Lipodystrophy (buffalo neck)
  • Lipoatrophy
  • Type I DM
  • AIDS Dementia Complex
  • AIDS Wasting Syndrome
49
Q

key to managing OI’s?

A

early assessment/detection and management!

50
Q

interventions to prevent infections in HIV+

A 
Education
Monitor VS’s and temperature 
No fresh plants of flowers
No visitors who are sick
Hand washing
Inspect patient’s mouth, skin and genitals for breakdown
Avoid catheters
51
Q

what kind of precautions for we put on HIV patients?

A

reverse = caution taking things in the room

52
Q

How often should HIV patients bathe?

A

daily with antibacterial soap

53
Q

what things should HIV + patients avoid

A
  • sharing personal items
  • contact w/ sick people
  • changing cat litter
54
Q

-Highly Active Antiretroviral Therapy (HAART)

A

Drugs should be taken correctly 90% of the time

55
Q

nutrition interventions for HIV+

A
  • Determine the cause of deficits, then make adjustments
  • Monitor weight, I’s & O’s,
  • High calorie, high protein/ Low fat
  • Small frequent meals
  • Mouth care (sodium bicarbonate, soft toothbrush)
  • Avoid foods that can cause infections
  • cannot leave water out for a few hours, avoid tap water
56
Q

diarrhea interventions for HIV+

A
  • Symptom Management
  • Drug therapy
  • Food choices
  • Avoid alcohol and caffeine
  • Avoid dairy products
  • Small, frequent meals
  • Fluid intake
  • Skin assessment
57
Q

Skin integrity interventions for HIV+

A
  • **Kaposi’s sarcoma often responds to Anti Retroviral Therapy
  • Analgesics
  • Prevent infections
  • Herpes simplex- clean with NS
  • Assess, assess, assess

kol- Med Surg 320 Spring (43 decks)

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