HIV/AIDS (Exam 3) Flashcards
HIV Patho
must first enter hosts bloodstream and then hijack certain cells, especially CD4+ T cells
can create more virus particles; new particles can infect more cells
Acute HIV Infection
2-4 weeks after infection
similar to those with flu and can include a rash or sore throat; HA, nausea, sore throat
Chronic HIV Infection
10 years+ after
asymptomatic (CD4 >500) or symptomatic (CD4 200-500)
Late Chronic HIV Infection
AIDS; requires adult be HIV positive and have a CD4 count of less than 200 or less than 14% or one of 27 opportunistic infections/conditions
death occurs within 5 yrs w/o treatment
Wasting Syndrome
diarrhea
malabsorption
anorexia
oral/esophageal lesions that contribute to persistent weight loss and an emaciated appearance
HIV Infections
kaposis sarcoma
wasting syndrome
persistent candida
hairy oral leukoplakia
shingles
herpes lesions
cytomegalovirus (CMV)
pneumocystis jirovecii pneumonia
TB
HIV Risk Factors/Transmission
parenteral blood transmission-needle sticks increase viral load means higher risk; IVDU, exposure to blood via open wounds or mucous membranes carries a lower risk than needlestick; risk with transfusion decreases with screening; remains with donated blood in first few months of infection and screening blood test doesn’t ID donor as being positive
sexual-most common; higher for receiving partner
perinatal-exposure during pregnancy, during delivery or during postpartum in breast milk
racial/ethnic minority groups
elderly in florida
sex workers
low SES
MSM
sexual promiscuity
HIV Labs and Diagnostics
antibody antigen tests (positive test means pt has been infected with virus but not severity; antibodies can’t be detected 21+ days after exposure)
ELISA antibody tests measure pt response to virus aka antigen (positive test doesn’t mean they have HIV/AIDS, only that they’ve been infected)
New CDC algorithm uses a 4th gen HIV assay; if positive, HIV-1 NAT to differentiate between HIV-1 or HIV-2 RNA; indicates acute infection (IgM and IgG antibodies)
rapid tests for non clinical settings (finger prick, oral swab)
lymphocyte count (WBC <3500 and <1500 lymphocytes)
CD4 T cell and CD8 T cell (ratio is low, less than 2:1 in AIDS pts with more disease symptoms)
viral load testing directly measure the actual amount of HIV RNA particles in 1mL of blood; 40-80000 particles, higher number higher risk of transmission
HIV Meds
goal is to increase CD4, WBC, lymphocytes and decrease viral load
combination antiretroviral therapy (cART): NRTIs, NNRTIs, PIs, integrase inhibitors, fusion inhibitors, entry inhibitors
ensure cART drugs aren’t missed, delayed or administered in lower than prescribed doses; even a few missed doses can promote drug resistance
HIV Prevention
safe sex practices (condom, water based lube)
PrEP*
PEP*
AVOID STIGMA!!!
PrEP (Pre-Exposure Prophylaxis)
emitricitabine/tenofovir given for high risk exposures
reduces risk of HIV when taken daily (safe sex still)
not protected until after 4 days of use; monitor renal function q3 months
PEP (Post-Exposure Prophylaxis)
practiced after exposure to blood, tissue or body fluids
for sharps injuries, bleed wound, wash for at least a full minute and contact health center for testing and treatment
three drug cART within 2 hrs of exposure for best results
body fluids not considered infectious unless obviously bloody
HIV/AIDS Nursing Care
pain management
enhance nutrition (avoid protein and calorie deficiencies, treat cause if affecting eating, avoid high fat foods and monitor weight, I+O and cal count)
minimize diarrhea (diphenoxylate hydrochloride, loperamide)
skin care (KS most common skin lesion, monitor for progression and keeping lesions clean and dressed)
maintain safe environment if confusion occurs
psychological distress (depression, anxiety)
HIV/AIDS Education
transmission and preventive behaviors
safe sex
not sharing contaminated items
signs of common opportunistic infections
psychosocial integrity (encourage disclosure to sex partners, respect pt desire to inform family, ensure confidentiality, nonjudgmental approach, encourage expression of feelings)
Florida Omnibus AIDS Act of 1988
informed, voluntary, confidential testing (consent doesn’t have to be in writing)
positive results are reportable to state and consent must be documented
exceptions are prostitute conviction, inmate released from prison, pregnant women, healthcare workers with significant exposure to pt blood
Other Florida Laws
breach of confidentiality of STI info is a 3rd degree felony
minors don’t need parental consent for HIV/STD testing; forbids informing parents of minors HIV test result or treatment
prohibits discrimination against those who’re HIV positive in employment, housing, etc.
HIV/AIDS are notifiable diseases in FL
