HIV & AIDS

Question 1

Diagnostic tests used for HIV

Answer 1

ELISA
Western Blot
HIV VIral Load
CBC
CD4 count

Question 2

ELISA is ___% effective when performed at least _______ weeks after exposure to virus

Answer 2

99&

13

Question 3

This tx measures the amount of actively replicating HIV

Answer 3

HIV viral load

Question 4

a viral load >5,000-10,000 = need to _______

Answer 4

treatment

Question 5

the GOAL of antiretroviral therapy is_____________

Answer 5

<50 (undetectable)

Question 6

most widely used test to monitor for progress of the disease and to guide therapy

Answer 6

CD4 count

Question 7

Requirements determined by the CDC for AIDS

Answer 7

1) presence of Opportunistic infections

2) CD4 count below 200/mm

Question 8

GOAL of pharmacologic therapy

Answer 8

• suppress HIV infection

- Prophylaxis/treatment for opportunistic infections

Question 9

How to measure effectiveness of pharmacologic therapy

Answer 9

• viral load

- CD4 cell counts

Question 10

HAART

Answer 10

Highly Active Antiretroviral Therapy

–combines three or four drugs

Question 11

_________ may be given to prevent infection once a patients’ CD4 count declines

Answer 11

antibiotics

Question 12

With effective pharmacologic therapy you would expect to see an (increase/decrease) in the CD4 count….and a (increase/decrease) in the viral load.

Answer 12

• increase

- decrease

Question 13

Reasons for non-compliance with HAART Therapy

Answer 13

1) complicated, expensive
2) specific schedule
3) major adverse reactions
4) less than perfect adherence —->resistance

Question 14

what class of drug is the antiretroviral treatment, Zidovudine? 
(ie, AZT, Azidothymidine)

Answer 14

Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Question 15

Zidovudine often is given to clients with a CD4 cell count less than ________________

Answer 15

500/mm

Question 16

_____________ may be used prophylactically following a documented Parenteral exposure to HIV

Answer 16

Zidovudine

Question 17

Nursing considerations for Zidovudine

Answer 17

1) swallow capsule whole-DO NOT CRUSH
2) Assess for adverse effects-Nausea & headache
3) assess CBC with differential and creatinine phosphokinase

Question 18

Patient education r/t Zidovudine

Answer 18

1) DOES NOT CURE HIV-
slows the progression
2) Take 30 minutes before meals (or) 60 minutes after meals.
3) continue lab studies to monitor for toxicity
4) IF pt develops severe anemia/neutropenia

Question 19

How does the class of drugs “Protease Inhibitors” work…???

Answer 19

They make the virus non-infectious

Question 20

Downside for “Protease Inhibitors”

Answer 20

Disadvantage is viral resistance occurs quickly

Question 21

S/E of Protease Inhibitors

Answer 21

• Metabolic derangements
  a) elevated cholesterol
  b) elevated triglycerides
  c) Insulin Resistance
  d) Diabetes Mellitus
  e) Changes in body fat composition

Question 22

_______ is given in combination with HAART for Kaposi Sarcoma

Answer 22

Interferons

Question 23

All clients affected with HIV should be given the following vaccines:

Answer 23

1) Pneumococcal
2) Influenza
3) Hepatitis B
4) Haemophilus Influenza

Question 24

HIV patients with a positive PPD and a negative CXR are given __________

Answer 24

isoniazid

Question 25

HIV patients affected by Pneumonia (PCP) are usually given__________

Answer 25

Bactrim (trimethoprim-sulfamethoxazole)

Question 26

Patient may be asymptomatic for ______ years after being infected

Answer 26

8-10years

Question 27

Clinical Manifestations of AIDS

Answer 27

• Fever
• Fatigue
• Night Sweats
• Weight loss (Cachexia-wasting)
• Diarrhea
• Rash/dry skin
• Candidiasis/oral ulcers
• AIDS dementia complex
• CD4 count <200/mm

Question 28

(4) Opportunistic Infections

Answer 28

1) PCP Pneumonia _(MOST COMMON)
2) Toxoplasmosis
3) Tuberculosis
4) Candidiasis-oral thrush

Question 29

S/S of Kaposi Sarcoma

Answer 29

purple lesions on skin or in GI tract, lungs and lymphatic system

Question 30

(True / False)

Peripheral neuropathy is a clinical manifestation of HIV

Answer 30

True

Question 31

NURSING INTERVENTIONS FOR PT AT RISK FOR INFECTION

Answer 31

1) hand washing
2) Avoid people with infections
3) Annual skin test for TB
4) Check WBC, culture wounds, urine, blood, sputum
5) Monitor for fever, cough, oral lesions, UTI symptoms

Question 32

NURSING INTERVENTIONS FOR PT AT RISK FOR NUTRITIONAL PROBLEMS

Answer 32

1) Monitor electrolytes
2) Assess oral ulcers and pain
3) Meds for candidiasis/diarrhea
4) Weight -I/O
5) increase protein/calories
6) soft foods in small portions
7) Assist with eating
8) Supplements

Question 33

NURSING INTERVENTIONS FOR PATIENT WITH DIARRHEA

Answer 33

1) ANTIDIARRHEAL MED
2) SMALL MEALS
3) MAINTAIN FLUID INTAKE OF AT LEAST 3L/DAY

Question 34

NURSING INTERVENTIONS FOR PATIENT WITH AIRWAY CLEARANCE PROBLEMS

Answer 34

1) Assess resp rate, rhythm, pattern, cough, sputum
2) cough and deep breath Q2 hours
3) Semi-fowlers position
4) Supplemental O2