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Nurs 230 Exam 3 > HIV > Flashcards

HIV Flashcards

1
Q

undetectable means what ***

A

untransmittable

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2
Q

transmits thru contact with body fluids ***

A

blood
semen
vaginal secretions
breast milk

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3
Q

most common work related HIV transmission ***

A

needle stick/puncture wound

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4
Q

perinatal transmission ***

A

25% of babys will get unless treatment is used

with treatment it reduces to 2%

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5
Q

pathophysiology of HIV

A

a retrovirus (replicates backwards, RNA to DNA)

needs a host to make copies of itself

T cells : HIV uses this specific receptor attached to CD4 cells to latch and enter the cell to begin replicating

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6
Q

how HIV works

A

gets into CD4 cell and replicates then kills cell and moves on

can kill 1 billion CD4 cells a day

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7
Q

normal CD4 count

A

800-1200 pr uL

HIV destroys billions of CD4 cells daily

body is able to replace for many years

eventually it cant keep up

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8
Q

when do immune problems start? ***

A

below 500 CD4 cells

severe problems: under 200 CD4 cells
-high risk of opportunistic diseases

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9
Q

phases of infection ***

A
  1. acute infection 1-3 weeks
  2. asymptomatic infection 3 weeks - 3 months
    *(HIV antibody test become positive)
  3. symptomatic infection
  4. AIDS
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10
Q

acute infection

A

2-4 weeks after infected

flu like symptoms (lasting 1-2 weeks)
*fever, HA, rash, swollen lymph nodes, sore throat, malaise

high viral load but low CD4 count

important to ask social history

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11
Q

asymptomatic disease

A

CD4 remain above 500

viral load is low

symptoms:
*low-grade fever, night sweats, persistant generalized lymphadenopathy

this is where they maty spread it without knowing

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12
Q

symptomatic disease state

A

CD4 drop to 200-500

viral load increases

early symptoms (worsen)
*main one = night sweats (drenching)
*lymphadenopathy
*persistant fever
*HA
*fatigue

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13
Q

common infections ***

A

candidiasis: yeast
*oral (thrush) or vaginal infections

shingles (varicella-zoster virus)

herpes outbreak (oral or genital)

bacterial infections

kaposi sarcoma
*large dark purple leasions (malignant lesions from HIV)

oral hairy leukoplakia

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14
Q

oral thrush vs oral hairy leukoplakia ***

A

oral thrush:
*white cottage cheese (bad pain)

oral hairy leukoplakia:
*white flaky only on sides of tongue (no pain)

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15
Q

late chronic or AIDS

A

CD4 under 200

opportunistic infection

wasting syndrome (10% loss of ideal BM)

AIDS dementia complex (ADC)

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16
Q

diagnotic studies

A

blood or saliva antibodies or antigen screens are best

“window period”
*time between infection and antibodies (delay up to 2 months)

rapid HIV antibody test (approved self test)
*results in 20 min
*blood sooner than saliva
*if positive itll be followed by other test

17
Q

more diagnotic tests

nucleic acid test (NAT)

4th Gen HIV test: antigen/antibody combo

A

these are the test if you home test is positive

NAT: 10-33 days after exposure
*if viral load is present or not

4th gen HIV test: 18-45 days after exposure
*used as definitive diagnosis

18
Q

monitoring HIV progression ***

A

lbs every 6 months after stalized

CD4 count

Viral load (VL)

we want high CD4 and low VL

19
Q

CDC guidlines for 13-64 year olds ***

A

should be screened at least once and annually for those at high risk

20
Q

collaborative care
Drug therapy goals***

A

drug therapy (goals)

  1. decrease VL
  2. maintain or raise CD4 cells
  3. delay onset of HIV symptoms and opportunistic diseases
21
Q

ART: anti-retroviral therapy
What it does
How many we take***

A

inhibit replication of virus does not kill virus

drug resistance with monotherpay or inadequate dose

so we use combination therapy (3 or more)

22
Q

combination therapy meds we use ***

A

nuceloside reverse transcriptase inhibitors (NRTIs)
*blocks HIV replication

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
*bind to and disable reverse transcriptase (cant replicate)

protease inhibitors (PIs)
*blocks an enzyme the virus needs to replicate

integrase inhibitors
*blocks an enzyme the virus needs to replicate

entry/fusion inhibitors
*blocks virus from entering CD4 cells

23
Q

side effects of ART meds ***

A

GI: N/V/D

hematology: anemia, neutropenia

liver: hepatitis, elevated liver enzymes

metabolic: decrease blood glucose

genral: fatigue, HA

24
Q

ART
Complainant rate needed***

A

95 compliance rate needed to be effective

may react with OTC

expensive

25
Q

prevent infection ***

A

prophylaxis if CD4 under 200

*trimathoprim & sulfamethoxazole (bactrim or septra)
antibotics that prevent pneumonia

*pentamadine (IV,PO, or aerosol)

26
Q

biktarvy ***

A

bictegravir - integrase inhibitor

emtricitabine - NRTI

tenofovir - NtRTI

27
Q

Truvada ***

A

Emtricitabine- NRTI

tenofovir disoproxil fumarate- NtRTI

28
Q

TB ***

A

9 months prophylaxis w/:

isoniozid (INH)

29
Q

aids dementia

A

HIV infects brain (mental and physical decline)

stage 1-5

1=minimal changes

3=unable to work, may do minimal self car

5=vegetative

30
Q

health maintenance

A

nutrition
exercise
safer sex practices
avoid ETOH, drug use, tobacco
pet caution
regular check ups

31
Q

PrEP ***

A

take once daily

Truvada (most common)

Descovy

32
Q

what does PrEP do? ***

A

reduce the risk of HIV

reduces getting HIV thru IVDA by 74%

33
Q

PrEP education ***

A

high risk people should know about it:

*HIV positive partner
*MSM
*multiple partners
*dont always use barrier protecton
*IVDA

34
Q

PrEP workup ***

A

prescription for 3 months at a time

must follow up every 3 months with provider

Nurs 230 Exam 3 (6 decks)

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