Infection and HIV infection Flashcards
HIV transmission
through contact with body fluids such as
- blood
- semen
- vaginal secretions
- breast milk
pathophysiology of HIV
- RNA virus
- unable to replicate unless inside living cell
- binds to specific CD4 receptor sites and CCR5, CXCR4 co-receptors on a cell
components of HIV
virus is surrounded by an envelope made up on proteins and contains a core of viral RNA and proteins
HIV proteins bind to cell
- HIV glycoprotein 120 attaches to CD4 on the surface of T-cells
- RNA enters cells and produced viral DNA causing permanent cellular infection and production of new virions
HIV patho
- reverse transcriptase assists to make viral DNA
- all daughter cells from affected cells will be infected
viral load in the blood
initial infection
- viremia (large viral load) for 2-3 weeks
- transmission more likely
prolonged period of low viral load
- limited CM but replication still occurs
- rapid replications causes mutations that contribute to tx difficulties
cells with CD4 receptor sites
- T helper cells
- lymphocytes
- monocytes
- astrocytes
- oligodendrocytes
acute HIV infection
- fever, swollen lymph glands, sore throat, headache, malaise
- called acute retroviral syndrome and occur about 1-3 weeks after infection
- lasts 1-2 weeks
early chronic HIV infection
- generally asymptomatic
- most pts are not aware they are infected
- fatigue, low-grade fever, night sweats, lymphadenopathy
intermediate chronic HIV infection
- CD4 T cells drop
- viral load increases
- more active state
- worsening symptoms
- infections
- nervous system CM
- thrush, shingles, herpes, bacterial infections, kaposi’s sarcoma (KS)
CM of late chronic or AIDS
- severely compromised immune system
- risk for opportunistic disease
- malignancies, wasting, dementia
HIV dx
- rapid HIV- antibody tests
- may take 2 months to detect antibodies
- monitor progression through CD4 T-cell counts
- neutropenia
- thrombocytopenia
- anemia
- altered liver function tests
interprofessional care for HIV
- monitor disease progression and immune function
- initiating and monitoring antiretroviral therapy (ART)
- preventing, detecting, and treating opportunistic infections
- managing symptoms
- prevent further transmission
HIV medication therapy goals
- decrease viral load
- maintain/raise CD4 counts
- delay symptoms and opportunistic infections
- prevent transmission
antiretroviral therapy (ART)
- not a cure
- decrease viral replication and delay progression
- reduce viral loads by 90-99%
- multi-medication
- given regardless of CD4 count
HIV medication therapy
- nucleoside, non-nucleoside and nucleotide reverse transcriptase inhibitors: inhibit ability of HIV to make DNA copy
- fusion inhibitors: interfere with HIV CD4 receptor site binding
- protease inhibitors: interfere with activity of enzyme protease
- combination antiretroviral therapy: 3+ medications at full strength
nursing assessment questions for HIV
- received blood transfusion or clotting factors before 1985?
- shared needles, syringes, or other injection equipment?
- sexually active?
- history of STIs?
nursing dx of HIV
depends on
- stage
- presence of specific etiological problems
- social factors
nursing planning of HIV
- keep low viral load
- maintain immune function
- improve QOL
- reduce transmission
- prevent infections
- reduce disability
- adherence to medications
nursing implementation for HIV management
- primary prevention
- health promotion
HIV health promotion
- prevention and early detection
- safer, healthier, less risky behaviour (sexual intercourse, substance abuse, workplace risks)
HIV acute intervention
early intervention promotes health and limits or delays disability
Promoting a healthy immune system for HIV
- nutritional support
- Moderation or elimination of alcohol
- Adequate rest and activity
- Stress reduction
- Avoidance of exposure to new infections
- Mental health counselling
- Support groups and community activities
oral thrush and HIV
- opportunistic infection
- fungi involving hard and soft palate
kaposi’s sarcoma
- malignant vascular lesions on skin surface and internal organs
- cancer caused by HIV
