Human Immunodeficiency Virus (HIV) Flashcards
How is HIV transmitted to?
Blood
Semen
Vaginal secretions
Breast milk
(Not through casual contact)
Person who is receiving semen both oral or even anal and normal
Are most at risk for getting HIV
If there is trauma
It increases chances of HIV
Which gender is more at risk for getting HIV?
Women
Greater tissue exposure through vaginal sex
And oral sex men
HIV
Retrovirus that causes immunosuppression making person more susceptible to infections
Contact with blood transmissions
Sharing drug using paraphernalia
Puncture wounds
Splash exposure if you have broken skin
Trauma through nose and blood on straw of cocaine
Person with herpes
Higher risk of having HIV because of open skin
Example of puncture wounds
During surgery someone hands you scalpal the wrong technique and get stuck by accident if not looking
Treatment of HIV while pregnant
Decreases transmission to baby by 2%
What cells do HIV target
CD4T cells
Type of lymphocyte
HIV binds to the cell and it will replicate
Acute symptoms
3-9 weeks
Then during clinal latency symptoms go down
Clinical latency
Vague symptoms
The Lower your T cell count
The more symptomatic
On average HIV kills how many T cells a day?
1 billion
Normal range of CD4 T cell count
800-1200
When tcell decreases less than 500
Pt will exhibit symptoms, not severe
Severe problems develop when
<200 T cells
10 years of untreated HIV
Will start to develop AIDS
8-10 years of HIV
Symptomatic infection
Acute infection symptoms
Flu like symptoms
Fever, swollen , lymph nodes, sore throat, headache, malaise, nausea,muscle, and joint pain , diarrhea, or a diffuse rash
How long does acute infection last
2to 4 weeks after exposure
Highly infectious around this time
T cells are able to fight it off (win at this stage)
Asymptomatic infection
T cells >500 cells & low viral load
S/s-vague or absent
High risk behaviors may continue
Untreated -develop aids occurs 10 years
Symptomatic infections cells
T cells 200-500
Increased viral load
Symptoms become worse
HIV advances to a more active stage
Symptomatic infections s/s
Severe fatigue , fever, night sweats , chronic diarrhea , frequent headaches
Symptomatic infections/infections they can start to pick up
Shingles, persistent vaginal candidal infections
Herpes(oral or genital) and bacterial infections
Candidal infections
Thrush
SWish and swallow medicines to kill yeast
Yeast-that is growing in mouth down esophagus
Kaposi sarcoma
Looks like a bruise dark violet /black
Invades skin on torso and surface of organs
Not painful
Hairy leukoplakia
Caused by Epstein bar virus
Not painful
Vertical striking of tongue
Will occur during active phase
AIDS
Someone with a tcell count less than 200 or AIDS defining condition
Will develop one or more of opportunistic infections
What to look for in aids
Infections
Malignancies
Wasting syndrome
HIV related dementia
Pneumocystis Jerovecii pneumonia PJP(opportunistic)
Type of Funchal pneumonia not common with people with a healthy immune system
Can be seen in AIDS pts or pt who are really immunosuppressed (after organ transplant)
Window period
Have HIV in the body but immune system is strong enough to keep the count low.it is not strong enough to be detected on a test just yet.
When is it recommended for pt to go back and get re tested for HIV
About 6 weeks
What are two things we monitor for HIV progression
We monitor T cells and viral load
We want T cells to be high and viral to be low
Abnormal blood test
Decrease wbc
Low platelet count
Anemia associated with ART(antiretroviral therapy)
Altered living function
(Hepatitis b & c at high risk especially drug users
Resistance test
Can help determine if a pt is resistant to ART
Genotype assay
Tells us about the infection , gives us info about virus ,
Phenotype assay
Tells us which drugs might be the most effective for this particular case
What do we want to know as nurses
Disease progression and immune function, managing symptoms
When to indicate and monitor art
Prevent and or treat opportunistic infections
Prevent or decrease complications or Therapies
What is a complication of ART?
Anemia
Initial pt visit
Gather baseline data
Begin to establish report and use pt input to develop plan of care
Initiate teaching about spectrum of HIV , treatment , preventing t
What should we be prepared to do during pt visit
To teach things more than once
Drug therapy goals
Decrease viral load
Increase t counts
Prevent HIV related symptoms and opportunistic diseases
Delay disease progression
Prevent HIV transmission
Drug interactions
St. John’s wort
Antacids, proton pump inhibitors , supplements
Encourage pt to take meds as prescribed so avoid drug resistace
What happens when pt isn’t ready to stick to drug regimen
Probably hold off on the medication until they are ready
Prevention is what during prevention against opportunistic diseases
KEEEY
Encourage not to take what kind of vaccines for HIV pt
Live vaccines
What can significantly increase life expectancy in an HIV pt
Effective pt management
Pre-exposure prophylaxis (PrEP)
For high risk adult
Teach safe sex practices and condoms
Can no longer transmit disease
At risk pt
Received blood transfusion b4 1985
Shared needles
Sexual experience with another person
Had an STI
Assessment for HIV
Past health history
Medications(what do they take)
Functional health patterns(overall)
Presence of symptoms using a system review(cause concern , long flu)
Goals for care
Compliance drug regimens
Adopting healthy lifestyle
Beneficial relationships
Spiritual well being
Coping with Disease and its treatment
HIV prevention
Avoid risky behaviors
Modify risky behaviors
Candid culturally sensitive language appropiate age specific info behavior change counseling
Abstinence
Safe sex
Use of barriers
Perinatal transmission prevention
Ask if they plan on having kids because it can effect which drug they use ART
Appropriately medicate HIV-infected pregnant women
Work exposure HIV
Adhere to precautions and safety measures to avoid exposure
Report all exposures for timely treatment and counseling
Post exposure prophylaxis with combo ART can significantly decrease infection
Reaction to positive HIV test
Panic, anxiety fear guilt depression denial anger hopelessness
ART
Complex (make sure they follow as prescribed)
Has side effects
Does not work for everyone
Expensive
What can we do to avoid burn out and non adherence
Treatment recommended when immune suppression is great
Why adherence to ART is critical
To prevent disease progression
Opurtubistic disease
Viral drug resistance
How to delay desease progression
Adequate nutrition(chronic diarrhea, wasting syndrome need protein and proper diet)
Current vaccination
Health habits
Avoid risky behaviors
Supportive relationships
On death certificate of HIV pt it will probably say
They died of pneumonia but in the secondary slot it will say HIV
Metabolic disorders
LIPODYSTROPHY
Hyperlipidemia
Insulin resistance
Hyperglycemia
Bone disease
Lactic acidosis
Renal disease
Cardiovascular disease
Gerontological
Death rate from opportunistic infections increase
People 60 or older increasingly infected
Comorbidities
Polypharmacy
