Immunodeficiency & HIV

Question 1

What is the difference in primary & secondary immunodefiency disorders?

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Answer 1

Primary = genetic

Secondary = Acquired

Question 2

Is HIV a primary or secondary immunodeficiency disorder?

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Answer 2

Secondary; becaue it’s acquired

Question 3

How is HIV transmitted?

Answer 3

Through bodily fluids
* blood
* seminal fluid
* vaginal secretions
* amniotic fluid
* breast milk

Question 4

Which 3 groups of individuals are at highest risk for acquiring HIV?

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Answer 4

• Elderly
• Gay individuals
• People who had organ or blood transplants before 1985

Question 5

How can HIV be prevented?

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Answer 5

• Standard precautions
• Safe sex practices & safe behaviors
• Do not share drug injection equipment
• Blood screening & treatment of blood products

Question 6

Health Care Provider Treatment for HIV Post-Exposure Prophylaxis

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Answer 6

If HCP thinks they have HIV they will:

1.) Get a vaccine
2.) Inform the charge nurse
3.) Get tested in the ED
4.) Inform employee health
5.) Take pre-exposure prophylactic drug

Question 7

What are the stages of HIV Disease?

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Answer 7

1.) Primary Infection
* testing negative
* Slight / minimal signs & symptoms
* No antibodies

2.) HIV Asymptomatic
* Test positive
* Non-specific signs & symptoms
* Good Immune response
* CD4+ count = 500+

3.) HIV Symptomatic
* CD4+ Count = 200 - 499
* Specific signs & symptoms of HIV

4.) AIDS
* CD4+ < 200

Question 8

Describe Primary Infection (Stages of HIV)

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Answer 8

• Testing negative
• Slight - minimal signs & symtpoms
• No antibodies

Question 9

Describe HIV Asymptomatic (Stages of HIV)

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Answer 9

• Testing positive for HIV
• Non-specific signs & symptoms
• CD4+ Count = 500+ (Good immune response)

Question 10

Describe HIV Symptomatic (Stages of HIV)

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Answer 10

CD4+ Count = 200 - 499
* Specific signs & symptoms of HIV
* increased risk for infection due to lowering CD4+ Count

Question 11

Describe AIDS (Stages of HIV)

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Answer 11

• CD4+ Count < 200

• As level drop below 100 cell / mm3, the immune system is signfiicantly impaired

Question 12

What are gerontological considerations of HIV?

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Answer 12

1/4 of people living with HIV are 50+ years

Question 13

What is Pneumocystic carinii pneumonia or PCP? (AIDS/HIV complication)

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Answer 13

• most common, life-threatening infection
• Can cause respiratory failure & pulmonary impairment if left untreated
• Broad-spectrum antibiotics don’t work
• **S/S = cough, fever, chills, dyspnea, chest pain

Question 14

What respiratory infections are complications of AIDS/HIV?

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Answer 14

• PCP (Pneumocystic carinii pneumonia)
• MAC (Mycobacterium avium complex)
• Tb

Question 16

What is Wasting Syndrome?

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Answer 16

• 10% weight loss
• Chronic diarrhea, fever, & weakness without any other cause

• Protein energy malnutrition (due to decreased albumin)
• Anorexia, diarrhea, GI malabsorption, & lack of nutrition may contribute

Question 17

What are potential GI complications of HIV/AIDs?

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Answer 17

• Oral candidiasis
• Diarrhea related to HIV infection or enteric pathogens
• Wasting syndrome

Question 18

What are potential oncologic complications of HIV/AIDS?

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Answer 18

• Kaposi’s Sarcoma (cutaneous lesions but may involve multiple organ systems)
• B-Cell Lymphomas

Question 19

What are potential Neurologic complications of HIV/AIDS?

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Answer 19

HIV Encephalopathy
* Progressive cognitive, behavioral, & motor decline

• probably directly related to HIV infection

Question 20

What testing / diagnostics are used in HIV & AIDS?

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Answer 20

• CD4+ / CD8
• EIA

Question 21

The clinic nurse is caring for a patient admitted with AIDS. The nurse has assessed that the patient is experiencing a progressive decline in cognitive, behavioral, & motor functions. The nurse recognizes that these symptoms are most likely related to the onset of which complication?

a.) B-Cell Lymphoma
b.) Kaposi’s Sarcoma
c.) HIV Encephalopathy
d.) Wasting Sydnrome

Answer 21

c.) HIV Encephalopathy

Question 22

A nurse has experienced percutaneous exposure to an HIV-positive patient’s blood as a result of a needle stick injury. The nurse has informed the supervisor & identified the patient. What action should the nurse take next?

a.) Flush the wound with Chlorhexidine
b.) Report to the ED or employee health
c.) Apply a hydrocolloid dressing to the wound site
d.) Follow up with their PCP

Answer 22

b.) Report to the ED or employee helath

Question 23

A patient has been diagnosed with AIDS complicated by chronic diarrhea. What nursing intervention would be appropriate for this patient?

a.) Position the patient in a high Folwer’s position whenever possible
b.) Temporarily eliminate animal protein in the patient’s diet
c.) Make sure the patient eats at least two servings of raw fruit each day
d.) Obtain a stool culture to identify possible pathogens

Answer 23

d.) Obtain a stool culture to identify possible pathogens