HIV/AIDS Flashcards
What is a retrovirus that’s transmitted by direct contact w/ infected blood and bodily fluids?
HIV/AIDS
What does HIV/AIDS do to the body?
Destroys ability to fight infection
Unprotected sex w/ multiple partners, needle sharing, blood transfusions, health care as an occupation, transmission during birth/breastmilk are what?
Risk factors
What is the goal of care in a pt who’s HIV/AIDS +?
Keeping CD4 count as high as possible, viral load as low as possible and staying underlying healthy w/ HAART meds
What diagnostic test is definitive for the diagnosis of HIV/AIDS?
Western Blot
What are typical manifestations of HIV/AIDS?
Fever, sore throat, arthralgia’s, myalgia’s, HA, rash, N/V, abd cramps and lymphadenopathy
What is arthralgia?
Pain in a joint
What is myalgia?
Pain in a muscle or group of muscles
What is lymphadenopathy?
Disease affecting the lymph nodes; enlargement of 2+ lymph nodes outside the inguinal chain
What is the most common cause of mental status changes for pts w/ HIV/AIDS and may be presented w/ memory loss, difficulty concentrating, lethargy and diminished motor speed?
AIDS dementia complex
Pneumocystitis Jiroveci Pneumonia, Tuberculosis, candidiasis, myobacterium avium complex, and cryptosporidiosis are all what?
Opportunistic infections
Name this opportunistic infection: bacterial disease affecting the lungs; present w/ cough productive of purulent sputum, fever, fatigue, wt. loss and lymphadenopathy?
Tuberculosis
Name this opportunistic infection: Most common one and common cause of death, fungal infection of lungs; present w/: fever, cough, dyspnea, tachy, sputum, mild chest pain; if severe: cyanosis and significant resp. distress?
Pneumocystitis Jiroveci Pneumonia
Name this opportunistic infection: common fungal infection on skin/mucous membranes and manifests as oral thrush/esophagitis; presents w/ white, friable plaques on buccal mucosa/tongue, difficulty swallowing, substernal pain/burning when swallowing, swollen tongue?
Candidiasis
Name this opportunistic infection: commonly found in food/water and soil; major cause of “wasting syndrome”, present w/ chills, fever, weakness, night sweats, abd pain, diarrhea, wt loss and nearly every organ can be infected?
Myobacterium Avium Complex (MAC)
Name this opportunistic infection: a protozoan infecting the GI tract and is an important cause of prolonged diarrhea?
Cryptosporidium
Kaposi sarcoma (lesions on skin/viscera), lymphomas (malignancy of lymphoid tissues) and cervical cancer are all what?
Secondary cancers to HIV/AIDS
What is one of the 1st symptoms of HIV/AIDS?
Fatigue
6wks-6mon after intial infection is what?
Window period of being + but not being able to test +
Newborns exposed to HIV/AIDS will appear how?
Premature, SGA, failure to thrive
At the time of pregnancy what do we want the CD4 count to be? And the viral load?
> 500; 0 or undetected
When do you start AZT to lessen the chances of transmission to baby? And when do you stop it?
@ the start of labor via IV; clamping of cord
What will baby need to be on after birth to lessen transmission?
PO AZT for 6-12wks
What is the choice of delivery for HIV/AIDS + moms to lessen transmission to baby?
C-section
When do you start testing babies for HIV/AIDS so you don’t get false results?
4-6mon
Risks to baby after birth are?
Side effects of AZT, complication from C-section, and opportunistic infections
What is important to teach in a pt w/ cryptosporidiosis?
Hydration, don’t wash dishes by hand, frequent hand washing and cleaning
What are the 3 major probs w/ oral candidiasis?
Dehydration, malnutrition and infections
What can you do to help a pt w/ oral candidiasis take in fluids/food/meds?
Numb mouth w/ lidocaine/ice chips; give cold foods/fluids and good oral care
Where can oral candidiasis spread to?
Vital organs
GI effects, blood discrasias, sore throat, and muscle wasting are side effects of what med?
AZT
What med enter target cells by binding to the protein envelope that surrounds the virus and effectiveness is measured by improved CD4 ct and reduced viral loads?
Entry inhibitors; Fuzeon (Enfuvirtide), Maraviroc
Nevirapine (Viramune), delavirdine (Rescriptor), efavirenz (Sustiva) and Intelence (Etravirine) are all what?
Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)
What is the 1 limitation to NNRTIs?
High incidence of cross resistance to NRTIs
What 2 NNRTIs significantly reduce serum levels of the PIs?
Nevirapine and Efavirenz
What NNRTI med has reported risk for liver toxicity and Steven’s Johnson syndrome?
Nevirapine
What 3-4 antiviral agents are used in combo for Highly Active Antiretroviral Therapy (HAART)?
Zidovudine (Retrovir, AZT), an NRTI plus a 2nd NRTI and a NNRTI
Fat deposition in the midsection, breast and neck; atrophy in the face, buttocks and extremities; matabolic abnormalities like increased low-density lipoprotein choles/triglycerides and insulin resistance are all what?
Body composition changes/metabolic abnormalities associated w/ HAART
What med is given to pts w/ a CD4 ct less than 350?
NRTIs like Zidovudine
Combivir-Epivir+Retrovir, Epivir (Iamivudine), Zerit (Stavudine), Hivid (Zalcitabine), Videx (Didanosine), Retrovir (AZT, zidovudine), Ziagen (Abacavir), Trizivir (Abacavir+Epivir+Retrovir), Emtriva (Emtricitabine), Epzicom (Iamivudine+abacavir) and Truvada (Tenofovir+Emtricitabine) are all what classification of meds?
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
These meds and nucleoside analogues are associated w/ metabolic derangements and include: elevated choles/triglycerides, insuling resistance, DM, and changes in body fat compostion to abd and skeletal wasting (lipodystrophy)?
Protease Inhibitors (PIs)
Saquinavir (Invirase), Ritonavir (Norvir), Indinavir (Crixivan), Nelfinavir (Viracept), Amprenavir (Agenerase), Lopinavir/ritonavir (Kaletra), Darunavir (Prezista), Atazanavir (Reyataz), Fosamprenavir (Lexiva) and Tipranavir (Aptivus) are all what classification of meds?
Protease Inhibitors (PIs)
What supplementation is contraindicated when using HIV meds?
Garlic
Ineffective coping, impaired skin integrity, imbalance nutrition: less than, risk for deficient fluid volume/infection, anxiety, deficient knowledge are all what?
Diagnosis
What are the 3 mainly used antiretroviral nucleoside analogues?
Zidovudine, Didanosine and Abacavir
Nursing considerations for Zidovudine?
PO, assess for adverse effects: Nausea and HA, assess CBC; allergic reaction and CD4 ct >350 (contraindication)
Pt. teaching for Zidovudine?
Take @ least 30min-1hr after meals; notify doc of infection/bleeding or an adverse response: sore throat, swollen lymph glands and fever, continue follow-ups and lab studies
Nursing considerations for Didanosine?
Assess for med interference of absorption or concurrent admin, notify doc if develop peripheral neuropathy, diarrhea, depression and stop drug and notify doc if develops manifestations of pancreatitis or hepatic failure: N/V, severe abd pain, elevated bilirubin or elevated serum enzymes
Pt teaching for Didanosine?
Take on empty stomach 1hr before meals or 2hrs after, don’t use w/ alcohol, stop/notify doc if N/V, diarrhea or abd pain develops, call doc if extremity pain, weakness, numbness or tingling occurs and notify if any s/s of infection/bleeding
Nursing considerations for Abacavir?
Assess for hypersensitivity, anemia and neutropenia, evaluate increased CD4 ct and lower blood levels, notify doc if develops evidence of pancreatitis, impaired hepatic function or painful peripheral neuropathy
Pt. teaching of Abacavir?
Take w/ or w/o food/water, report s/s of hypersensitivity/infections/changes in condition
What should pts be alert for when taking HAART?
Dizziness; caution while driving and w/ any activities that require alertness
What should be reported to the physician if they occur during HAART treatment?
Decrease urinary output, seizures, syncope, jaundice, wheezing, abnormal sensation in hands/feet, vomit, diarrhea, difficult breathing, drastic changes in BP, bleeding, new symptoms, worsening of infection, fever/chills
