HIV Flashcards
What is HIV
- Retrovirus- stores genetic information as RNA not DNA
- Changes your DNA
- Host cell is no longer normal when it starts to divide, spreading it to the whole body
- Infection by HIV-1 (eastern hemisphere)
or HIV-2 (western hemisphere) - Progressively destroys lymphocytes
- ***Specifically CD4 cells (T cells)
- Typically with HIV 40-60% of cells are destroyed within the first few months and might slowly start to build back up. Destruction starts to slow down after 6 months
- Body now open for infection (Opportunistic infections or cancers)- r/t the destruction of CD4 cells (T cells)
- Can’t get rid of it
- ***Can be controlled – not cured
- Acquired immunodeficiency syndrome (AIDS) is most sever form:
Diagnosis:
- Measure progress by CD4 and viral load
- Healthy CD4 800-1300 cells/mcL Unhealthy: <200, super sick with HIV
Medical Management of HIV
- Antiretroviral therapy (ART)
- Introduced in the mid 1990s
- ***Taken daily (must take the treatment daily for it to work)
- Can dramatically prolong life
- Can lower the chance of infecting others
- Treatment (ART) can slow or prevent progresses through the stages
Stages:
Stage 1 – Acute HIV Infection
Within 2-4 weeks flu-like illness which may last a few weeks.
May have large viral load – very contagious
Stage 2 – Clinical Latency
Reproducing at low levels
No S/S - may last decades
Can still transmit the disease
At the end the load is larger and the T Cells are down
Stage 3 – AIDS
Damaged immune system susceptible to infection
T Cells drop below 200 cells/mm
Survival – 3 years
AIDS - Common Symptoms
◦Chills/fever ◦Swollen lymph nodes ◦Weakness◦Weight loss ◦Fatigue ◦Muscle aches ◦Sore throat/mouth ulcers
Important lifestyle changes with HIV/AIDS diagnosis
Stay healthy
Begin treatment as soon as diagnosed
ART - Slows progression, protects the immune system, reduces the chance of transmission
Regular check ups
Disclosure - VERY important. In some states it’s a crime not to tell
Get support - This is a life changing event. The patient may be emotional with feelings of sadness, hopelessness, and anger. Support groups are available.
Reducing risk to others
Transmission is through bodily fluids: Blood, semen and pre-seminal fluid, rectal and vaginal fluids, breast milk.
If patient has other STD’s the have 3X the chance for transmission
Prevention of transmission
Disclosure
Get tested and treated
Meds
Condoms
Diagnosing HIV
- Most useful screening tests detect HIV-specific antibodies
- ELISA and Western Blot
- May take 2 months (window period) to detect antibodies
- Other tests P24 tests for viral load. This is also used to keep track of the CD4 T Cells and viral loads
- Abnormal blood tests common; Neutropenia, thrombocytopenia, and anemia
Common potential complications
Common opportunistic diseases ◦Pneumocystis jiroveci pneumonia ◦Cryptococcal meningitis ◦Cytomegalovirus retinitis ◦Mycobacterium avium complex ◦Kaposi sarcoma ◦Influenza virus
Collaborative Care Focus
Monitoring HIV disease progression and immune function
Initiating and monitoring antiretroviral therapy (ART)
Preventing and detecting opportunistic infections
Preventing and treating complications of therapies
Ongoing health assessment
Nursing Management
Risk Factors Physical Assessment Continued Assessment Main goals◦Keep viral load low - Maintain immune function - Improve quality of life - Prevent opportunistic disease and new infections - Reduce disability
Nursing Interventions
Teach:
- Adhere to drug regimens
- Promote healthy lifestyle
- Prevent transmission to others
- Have supportive relationships
- Maintain productive activity
- Explore spirituality
- Come to terms with living with disease, disability, and death
- Cope with symptoms and treatments
Health Promotion
Prevention of HIV
Sexual encounters
Drug use
Perinatal transmission
Occupational exposure
HIV Testing
Early intervention
Promote a healthy immune system
MAJOR GOAL
PREVENTION
Routine testing - Use rapid testing
Modify risky behaviors
Offer tests universally to pregnant women
