HIV/AIDS

Question 1

Risk transmission of HIV

Answer 1

Sharing infected injection drug use equipment

Having sexual relations with infected individuals (both male and female)

Infants born to mothers with HIV infection and/or who are breast-fed by HIV-infected mothers

People who receive organ transplants, HIV-infected blood, or blood products (especially between 1978-1985)

Question 2

How is HIV transmitted?

Answer 2

by body fluids containing HIV or infected CD4 lymphocytes

Question 3

dental dam

Answer 3

used for oral sex with females and prevents contract with vaginal secretions which ultimately prevents the spread of HIV

Question 4

prevention of HIV transmission

Answer 4

Standard precautions

Safer sex practices

Abstain from sharing sexual fluids

Reduce the number of sexual partners to one

Always use latex condoms

Do not share drug injection equipment

Blood screening and treatment of blood products

Question 5

Patients who are HIV seropositive should be advised to:

Answer 5

Inform previous, present, and prospective sexual and drug-using partners of their HIV-positive status.

Avoid having unprotected sex with another HIV-seropositive person.

Avoid donating blood, plasma, body organs, or sperm

Question 6

Prevention for health care providers

Answer 6

hand hygiene
personal protective equipment (PPE)
soiled patient care equipment handling
environmental control
textiles and laundry
needles and other sharps
patient resuscitation 
prioritize single patient room
respiratory hygiene/cough etiquette

Question 7

guidelines for postexposure prophylaxis

Answer 7

Start within 2 hours after exposure. Make sure that you are being monitored for symptoms of toxicity. Practice safer sex until follow-up testing is complete.

Continue the HIV medications for the full 4 weeks after exposure.

The majority of HIV exposures will warrant a combination of antiretroviral agents.

Follow up with postexposure testing at 1 month, 3 months, and 6 months, and perhaps 1 year.

Question 8

What is HIV?

Answer 8

belongs to a group of viruses known as retroviruses, which carry their genetic material in the form of ribonucleic acid (RNA) rather than deoxyribonucleic acid (DNA).

Question 9

HIV targets cells with ____ receptors

Answer 9

CD4

Question 10

steps of the HIV life cycle

Answer 10

attachment
uncoating
DNA synthesis
integration
transcription
translation
cleavage
budding

Question 11

a mutation of _____ is highly protective against HIV

Answer 11

CCR5

Question 12

stage 1 of HIV

Answer 12

Those who are HIV positive test negative on the HIV antibody blood test, although they are infected and highly infectious, because their viral loads are very high.

By the time neutralizing antibodies can be detected, HIV-1 is firmly established in the host.

Question 13

Primary infection is characterized by

Answer 13

high levels of viral replication, widespread dissemination of HIV throughout the body, and destruction of CD4+ T cells, which leads to dramatic drops in CD4+ T-cell counts

Question 14

normal count for CD4+ T-cell

Answer 14

500 to 1,500 cells/mm3 of blood

Question 15

HIV asymptomatic

Answer 15

More than 500 CD4+ T lymphocytes/mm3

Upon reaching the viral set point, chronic asymptomatic state begins

Body has sufficient immune response to defend against pathogens

Question 16

The higher the viral set point…

Answer 16

the poorer the prognosis.

Question 17

HIV symptomatic (stage 2)

Answer 17

200–499 CD4+ lymphocytes/mm3

CD4 T cells gradually fall

When CD4 T-lymphocyte cells are between 200 and 499 and when the count drops below 200 cells/mm3 of blood; at this point, the person is considered to have AIDS.

Question 18

AIDS

Answer 18

stage 3 classification

CD4 T-lymphocyte cells are below 200 cells/mm3

Question 19

EIA

Answer 19

test where antibodies are detected, resulting in positive results and marking the end of the window period

Question 20

western blot

Answer 20

also detects antibodies to HIV; used to confirm seropositivity when the EIA result is positive.

Question 21

viral load

Answer 21

Measures plasma HIV RNA levels. Currently, these tests are used to track viral load and response to treatment of HIV infection.

Viral load is a better predictor of the risk of HIV disease progression than the CD4+ count. The lower the viral load, the longer the time to AIDS diagnosis and the longer the survival time.

Question 22

CD4/CD8

Answer 22

these are markers found on lymphocytes. HIV kills CD4+ cells, which results in a significantly impaired immune system

Question 23

OraQuick

Answer 23

Quickly (approximately 20 minutes) and reliably detects antibodies to HIV-1

Question 24

Samples are tested using _____ __________ _________ __________ to determine the presence of antibodies to HIV

Answer 24

two different laboratory techniques

Question 25

Factors associated with nonadherence include

Answer 25

active substance abuse, depression, and lack of social support

Question 26

An adequate CD4 response for most patients on ART is an increase in CD4 count in the range of ____ to _____ per year, generally with an accelerated response in the first _____ months

Answer 26

50 and 150

3

Question 27

_____ _______ is the most important indicator of response to ART.

Answer 27

viral load

Question 28

adverse effects of HIV treatment

Answer 28

hepatotoxicity, nephrotoxicity, and osteopenia, risk of cardiovascular disease and myocardial infarction

Question 29

NNRTIs

Answer 29

Prevents virus from taking over the cell and reproducing

Question 30

NRTIS

Answer 30

Competes with nucleosides virus needs to develop

Question 31

protease inhibitors

Answer 31

block protease activity within HIV virus, preventing maturation of virus

Question 32

fusion inhibitors

Answer 32

Prevents cell entry

Question 33

CCR5 coreceptor antagonists

Answer 33

Blocks receptor sites

Question 34

integrase inhibitor

Answer 34

Prevents provirus formation

Question 35

Pneumocystic jiroveci pneumonia (PCP)

Answer 35

nonproductive cough, fever chills, dyspnea, and chest pain

if untreated, progresses to pulmonary impairment and respiratory failure

Question 36

MAC

Answer 36

MAC comprises a group of acid-fast bacilli (mycobacteria)

Most patients with AIDS who have T-cell counts lower than 100 cells/mm3 have widespread disease at diagnosis and are debilitated.

Question 37

Oral candidiasis

Answer 37

fungus/thrush; creamy-white patches in the oral cavity

Question 38

Wasting syndrome

Answer 38

AIDS wasting syndrome includes involuntary weight loss consisting of both lean and fat mass

Protein energy malnutrition

Question 39

Kaposi’s sarcoma

Answer 39

The most common HIV-related malignancy

they can appear anywhere on the body and are usually brownish pink to deep purple. They may be flat or raised and surrounded by ecchymoses (hemorrhagic patches) and edema

Question 40

B-cell lymphomas

Answer 40

tend to develop outside the lymph nodes, most commonly in the brain, bone marrow, and gastrointestinal tract

Question 41

HIV encephalopathy

Answer 41

Signs and symptoms may be subtle and difficult to distinguish from fatigue, depression, or the adverse effects of treatment for infections and malignancies.

Early manifestations include memory deficits, headache, difficulty concentrating, progressive confusion, psychomotor slowing, apathy, and ataxia.

Question 42

Foods that act as bowel irritants

Answer 42

raw fruits and vegetables, carbonated beverages, spicy foods, and foods of extreme temperatures

Question 43

nursing assessment for HIV

Answer 43

Assess physical and psychosocial status
Identify potential risk factors
Immune system function
Nutritional status
Skin integrity
Respiratory status and neurologic status
Fluid and electrolyte balance
Knowledge level