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Module 4 (MedSurg 2) > HIV > Flashcards

HIV Flashcards

1
Q

HIV is a

A

Retrovirus causes immunosuppression making persons more susceptible to infections
errors during replication making different strains of HIV

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2
Q

HIV stands for

A

Human Immunodeficiency Virus

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3
Q

AIDS stands for

A

acquired immunodeficiency syndrome
1 (US) and 2 (Africa)

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4
Q

HIV targets what cells

A

CD4 (helps immune cells communicate esp. when foreign cells )
dendritic
T helper
monocytes
Macrophages

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5
Q

HIV Transmission

A

through contact with blood, semen, vaginal secretions, and breast milk
not from casual contact

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6
Q

The most common transmission of HIV?

A

sexual transmission
- tissue trauma receiver (anal sex)

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7
Q

Can you transfer HIV through breast milk?

A

yes, vaginal or breast milk

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8
Q

Sexual Transmission of HIV

A

Unprotected sex with an HIV-infected partner
-RECEIVER has the most risk
prolonged contact with infected fluids
women high risk
trauma (tearing) increases likelihood

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9
Q

Contact with Blood HIV +

A

Sharing drug-using paraphernalia
Puncture wounds (deep)
Accidental needle sticks
Splash exposures
- screening needs to be done for blood donors

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10
Q

Perinatal Transmission of HIV

A

Can occur during pregnancy, delivery, or breastfeeding will contract HIV
25% of infants born to women with untreated HIV tested HIV+
Treatment can  rate of transmission to < 2%
-DRUGS can be taken during pregnancy

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11
Q

Pathophysiology of HIV

A

RNA virus
-replicate backward manner going from RNA - DNA
once integrated inside of the cell’s DNA directs to make new HIV cells

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12
Q

What cell is targeted in HIV?

A

CD4+T
-lymphocyte
- binds through fusion and replicate

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13
Q

Lower the T cell count =

A

more symptomatic
destroy 1 billion T cells every day

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14
Q

Immune problems start when the CD4+T cell count raises greater than

A

500

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15
Q

CD4+T cell normal ranges

A

800-1200

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16
Q

Severe problems develop when CD4+T cells are lower than

A

200

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17
Q

What ultimately kills HIV patients?

A

Insufficient immune response allows for opportunistic diseases

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18
Q

How many years does it take HIV pts to develop AIDS?

A

8-10

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19
Q

What are the phases of HIV?

A

Acute infection (1-3 weeks)
HIV antibody test + (3 weeks to 3 months)
Asymptomatic (up to 8 years)
Symptomatic (8-10 years)
AIDs (10+)

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20
Q

Acute Infection s/s

A

flu-like symptoms
**fever, swollen lymph nodes, sore throat, HA, malaise, nausea, muscle and joint pain, diarrhea, diffuse rash
- 2-4 weeks after infection
highly infectious

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21
Q

What phase is the highest infectious?

A

acute infection

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22
Q

Asymptomatic infection s/s

A

generally absent
high-risk behaviors may continue
Untreated to AIDs

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23
Q

Asymptomatic infection lab

A

CD4+T greater than 500 with low viral load

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24
Q

Symptomatic infection lab values

A

CD4+T 200-500
High viral load

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25
Q

Symptomatic infection s/s

A

Persistent fevers
shingles
Night sweats
vaginal yeast infection and herpes
bacterial infections
Chronic diarrhea
Frequent HA
fatigue
HIV advances to a more active stage

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26
Q

Candida

A

oral thrush
persistent and down the esophagus
difficulty eating (swish and swallow meds)

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27
Q

Kaposi Sarcoma

A

LOOKS LIKE BRUISE INITIALLY DARK VIOLET/BLACK
invades skin on torsos and extremities and organ surfaces
-possible pain

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28
Q

Kaposi Sarcoma is caused by

A

herpes virus

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29
Q

Oral Hairy Leukoplakia

A

caused by Epstein-Barre virus
not painful
Vertical stripes on the side of the tongue
during active phase

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30
Q

AIDs defined by and lab value

A

CD4+ T-cell < 200cell/uL and or AIDS-defining condition
1+ opportunistic infections

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31
Q

HIV wasting syndrome

A

loss of weight by at least 10% along with diarrhea, chronic weakness, and documented fevers lasting up to a month which can only be accounted for by HIV. - more in the face
- decrease in fat and lean body

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32
Q

Pneumocysitis jirovecii pneumonia

A

caused by yeast fungus PJ
in lungs of healthy but opportunistic with weak immune system

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33
Q

S/S of PJP

A

fever
dry cough or wheezing
SOB
fatigue
chest pain or tightness

34
Q

Tx of PJP

A

trimethoprim/sulfamethoxazole (TMP/SMX), the brand names are (Bactrim or Septra). Given PO or IV for 3 weeks.

35
Q

Dx of HIV

A

HIV-specific antibodies and/or antigens
May take several weeks to detect antibodies (window period)
Performed using blood or saliva
Combination (4th generation) tests can detect HIV earlier
Negative results – retest in 6 wks

36
Q

What is the window period?

A

several weeks after initial infection to detect antibodies
-false

37
Q

If you get a negative HIV test during the window period, then you should come back when?

A

in 6 weeks

38
Q

In HIV pts we want the T cell count to be ________ and the viral load to be _______

A

T = high
Load = low (less active immune system)

39
Q

HIV progression is monitored by

A

CD4T
Viral Load

40
Q

Dx abnormal blood tests are common due to

A

HIV, opportunistic infections and complications of therapy
low WBC, platelets, anemia (ART), and alter LFT

41
Q

Resistance tests can help determine if a pt is resisant to

A

ART

42
Q

What helps HCPs know which med is effective?

A

Assay (geno and pheno)

43
Q

Genotype Assay

A

about the infection itself

44
Q

Phenotype Assay

A

which drugs might be the most effective for the pt

45
Q

Hep B and C is possible for the pt to be at risk if they are a

A

drug user

46
Q

Interprofessional Care of the HIV pt

A

Monitor disease progression, immune function & manage symptoms
Initiate and monitor ART
Prevent, detect and/or treat opportunistic infections
Prevent or decrease complications of therapies
Prevent further transmission of HIV

47
Q

Initial pt visit of an HIV pt

A

baseline data
rapport and input for the care plan
teaching of HIV, Tx, Prevention of transmission, improve health, and family planning

48
Q

Main Goals of Drug Therapies

A

lower viral load
increase T cells
prevent HIV symptoms and opportunistic diseases
delay progression
prevent transmission

49
Q

OTC drug interactions for HIV pt

A

Antacids
Proton pump inhibitors
supplements

50
Q

DRUG INTERACTION TO ARTs

A

St. John’s wort and OTC
avoid or not at the same time

51
Q

The main thing about drug therapies before the start on an HIV pt is

A

are they going to take the medicine regimen as prescribed
if not drug resistance might develop and go to a different medicine

52
Q

For opportunistic disease on an HIV pt what is the best mgmt?

A

prevention
onset delayed with adequate measures
increased life expectancy if preventative

53
Q

Pre-exposure prophylaxis of HIV

A

reduce risk of sex-acquired infection in adults at high risk
with prevention interventions

54
Q

Should an autoimmune pt take a live virus vaccine?

A

no

55
Q

When asking questions for at high risk of HIV, the nurse should be

A

blunt and candid
use their language

56
Q

What questions should you ask at-risk patients?

A

Received a blood transfusion or clotting factors before 1985?
Shared needles with another person?
Had a sexual experience with your penis, vagina, rectum, or mouth in contact with these areas of another person?
Had a sexually transmitted infection?

57
Q

What needs to be assessed in dx pts thoroughly?

A

pst health hx
med
functional health patterns
s/s

58
Q

Goals for HIV pts

A

Compliance with drug regimens
Adopting a healthy lifestyle
Beneficial relationships
Spiritual well-being regarding life and death
Coping with the disease and its treatment

59
Q

Health Promotion of HIV

A

infection is preventable
avoid risky behaviors
modify risk behaviors
culture sensitive, age specific

60
Q

What are some ways to prevent HIV through sexual intercourse?

A

abstinence (not realistic)
noncontact safe sex
barriers

61
Q

What are some ways to prevent HIV through decreased drug use?

A

don’t
no sharing equipment
no sex under the influence of impairing substances
help with substance abuse

62
Q

What are some ways to prevent HIV through decreased perinatal trans.?

A

family planning (esp. younger)
prevent for women
appropriate medication for pregnant women (ART)

63
Q

What are some ways to prevent HIV through decreased work?

A

adhere to precautions and safety from exposure
report all exposures for tx and counseling
prophylaxis after exposure with ARTs and decrease risk of infection

64
Q

REactions to postive HIV tests

A

similar to life-threatening or chronic illness
panic
anxiety
fear, guilt
depression
denial
anger
hopeless

65
Q

ART means

A

Antiretroviral Therapy

66
Q

ART can significantly slow HIV progression, but

A

complex regimen
side effects
not for everyone
expensive

67
Q

When do you start ART?

A

pt readiness
recommended when immune suppression is excellent to avoid burnout and non-adherence

68
Q

What happens when ART is not taken as prescribed?

A

mutation of HIV
and can pass on to already-positive HIV

69
Q

Adherence to ART is critical to prevent

A

disease progression
opportunistic disease
drug resistance
mutations

70
Q

How can an HIV pt support a healthy immune system?

A

adequate nutrition (bc of diarrhea, electrolyte imbalance and wasting syndrome)
vaccinations
habits
avoid risks
supportive relationships

71
Q

Acute Exacerbations of HIV

A

NO CURE
CONTINUES FOR LIFE
physical disability
impairs social, emotional, economic,a nd spiritual wellbeing
ultimately leads to death

72
Q

What can lead to discrimination and result in social isolation, dependence, frustration, low self-image, loss of control, and economic pressures?

A

Stigma
and further involvement in risky behaviors

73
Q

Can your employer ask if you have AIDS?

A

no

74
Q

Common side effects of disease and drug for HIV

A

Anxiety, fear, depression
Diarrhea
Peripheral neuropathy
Pain
Nausea/vomiting
Fatigue
malaise

75
Q

Metabolic disorders

A

lipodystrophy
hyperlipidemia
DM: insulin resistance AND hyperglycemia
bone disease
lactic acidosis
renal disease
CV disease

76
Q

What PPE is used with HIV pts?

A

Gloves

77
Q

Gerontologic Considerations

A

increase risk of HIV of older
death from opportunistic
60+ more frisky and in denial
comorbidities
polypharmacy

78
Q

Transmission of HIV from an infected individual to another most commonly occurs as a result of which of the following?
Unprotected anal or vaginal sexual intercourse
Low levels of virus in the blood and high levels of CD4+T cells
Transmission from mother to infant during labor and delivery and breastfeeding
Sharing of drug-using equipment, including needles, syringes, pipes, and straws

A

Unprotected anal or vaginal sexual intercourse

79
Q

A diagnosis of AIDS can be made for a patient with HIV when which of the following are present?
CD4+ T-cell count <500/µL
WBC count <3000/µL (3 × 109/L)
Development of oral candidiasis (thrush)
Onset of Pneumocystis jiroveci pneumonia

A

Onset of Pneumocystis jiroveci pneumonia

80
Q

The nurse is teaching a newly diagnosed 34-year-old male about his HIV infection. Which statement by the patient indicates the need for additional education?
“I will need to take my HIV medication daily for the rest of my life.”
“Although I only take one pill, it has multiple medications combined into a single tablet.”
“I should notify my HIV provider if I get fevers that do not go away with Tylenol or aspirin.”
“Once my viral load is undetectable, I don’t have to worry about taking my medication every day.”

A

“Once my viral load is undetectable, I don’t have to worry about taking my medication every day.”

81
Q

The nurse is caring for a patient who is receiving antiretroviral therapy (ART) for the treatment of HIV. Which assessment best indicates that the patient’s condition is improving?
Decreased viral load
Increased drug resistance
Decreased CD4+ T-cell count
Increased aminotransferase levels

A

Decreased viral load

Module 4 (MedSurg 2) (36 decks)

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