med 2052 Exam #2 - Immunity

Question 1

discuss the cells involved when the client has HIV

Answer 1

CD4 (helper) T Cells

T and B cells

Question 2

discuss symptoms/treatments for AIDS

Answer 2

SYMPTOMS: chills, asymptomatic for 10 years, rash, anorexia, N/V, weight loss, weakness, fatigue, headache, sore throat, nigh sweats

TREATMENT:

Question 3

discuss Karposi’s sarcoma

Answer 3

painless purplish or brown skin lesions.

cancer that develops from the cells the line lymph or blood vessels. It usually appears at tumors on the skin or on mucosal surfaces such as inside the mouth. Can be life threatening in the lungs, liver, or digestive tract.

Question 4

data collection for the client who is at risk for HIV

Answer 4

Those who have had unprotected sex (vaginal, anal, oral)

Multiple sex partners, occupational exposure, blood transfusion, IV drug use with contaminated needle

Question 5

define HIV

Answer 5

Human Immunodeficiency Virus is a retrovirus that is transmitted through blood and body fluids (semen, vaginal secretions). HIV integrates its RNA into host cell DNA

Question 6

discuss ways to prevent sexual transmission of HIV

Answer 6

Encourage the use of condoms

Encourage patient to avoid having multipole sex partners

Abstain from anal sex

Question 7

discuss HAART for HIV clients

Answer 7

AKA Highly active antiretroviral therapy: includes 5 classes of drugs NRTI’s, NNRTI’s, Protease inhibitors, Entry inhibitors, and integrase inhibitors. Since each classification attacks different parts in the virus developmental cycle, using different drugs simultaneously is considered more effective in containing the virus and lowering overall viral load.

Question 8

discuss cytomegalovirus (CMV)

Answer 8

One-celled parasitic infection of the gastrointestinal tract causing diarrhea, fever, and weight loss

Cytomegalovirus: Viral infection of the eyes, lungs, stomach; GI tract. Side effects: diarrhea, fever, and weight loss. Diagnostic tests: None Medications: antivirals slides (med) 3 Nursing considerations: hand hygiene, no crowds or sick people, no raw foods.

Question 9

describe manifestations of pneumocystis jirveci (carinii) pneumonia

Answer 9

Fungal infection of the lungs. Side effects: Night sweats, Cough, fever, chest pain, sputum production. Diagnostic tests: X-ray, CBC with differential, bronchoscopy, culture Nursing considerations:

Question 10

list the types of opportunistic infections observed in the AIDS client

Answer 10

An infection that occurs when the “host” has a weakened immune system; an infection that wouldn’t typically happen in a healthy person.

Question 11

manifestations of wasting syndrome

Answer 11

unwanted weight loss that is equal to more than 10% of a persons body weight. Weight loss can result in loss of both fat and muscle

S/S: weight loss, muscle loss, lack of appetite, fatigue, decreased strength.

tx: exercise, high protein diet, meds to improve and increase appetite such as dronabinol (Marionol)

Question 12

transmission precautions for the AIDS clients/ ways HIV trasmitted

Answer 12

transmitted through blood and body fluids (semen, vaginal secretions).

one must wear gloves and proper PPI

Question 13

important labs for the client taking ritonavir (Norvir)

Answer 13

.

Question 14

pregnancy and HIV/AIDS

Answer 14

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Question 15

describe the HIV retrovirus

Answer 15

Human Immunodeficiency Virus is a retrovirus that is transmitted through blood and body fluids (semen, vaginal secretions). HIV integrates its RNA into host cell DNA

Question 16

how do you know when the HIV client has AIDS

Answer 16

when CD4 count is less than 200 cells/mm3.

they get defining conditions

Question 17

nursing diagnosis for the AIDS client

Answer 17

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Question 18

diagnostic tests for the HIV/AIDS

Answer 18

Positive antibody assays: ELISA (most common) - 2 positives

Plasma HIV-1 RNA viral load: viral load coincide with active viral replication

Question 19

teaching fro the client treated with acyclovir (Zovirax) for genital herpes

Answer 19

may cause confusion, give meds with food, ensure client understand the drug isn’t to cure the viral infection, but it reduces symptoms and they do not prevent the spread of viruses from one person to another

Question 20

nursing considerations for client taking tetracycline

Answer 20

monitor client for N/V and diarrhea. monitor I&O. take on empty stomach, take with a full glass of water, avoid administering to children under age 8, avoid high IV doses, avoid prolonged exposure to sunlight use alternative birth control

Question 21

superinfection and antibiotic therapy

Answer 21

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Question 22

most common use of sulfonamides

Answer 22

to treat UTI, acute otitis media, ulcerative colitis

Question 23

adverse effects of sulfonamides

Answer 23

CRYSTALLURIA, PHOTOSENSITIVITY. n/v, anorexia, diarrhea, abdominal pain, stomatitis, chills, fever

Question 24

discuss culture and sensitivity tests

Answer 24

culture is to determine was the germ is and sensitivity is to determine which medication is needed

Question 25

discuss standard precautions

Answer 25

Standard precautions is washing hands before and after patient contact. No other special equipment or room is needed.

Question 26

discuss care after an accidental needle stick

Answer 26

wash area with warm water and soap for 5-10 minutes. report to charge nurse and fill out any paperwork. get blood tests done.

Question 27

discuss HIV encephalopathy

Answer 27

AIDS dementia complex (ADC). neurological disorder directly caused by HIV.

S/S: memory and concentration problems, diminished emotional and or intellectual response, marked behavioral changes, diminished strength, loss of motor skills, loss of fine motor skills, loss of mobility, dementia

Question 28

psychosocial interventions fro the client diagnosed with AIDS

Answer 28

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Question 29

discuss peak and trough levels. give an example of a drug that requires this

Answer 29

Vancomyic and ahminoglycosides. samples for peak levels should be collected 30 minutes after administration of drug IM or IV. trough levels for the client should be collected prior to the next dose or one hour before IV infusion

Question 30

adverse effects of aminoglycosides

Answer 30

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Question 31

nursing considerations when administering ceftraxone (rocephin)

Answer 31

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Question 32

teaching for the client prescribed penicillin V potassium (Pen-VK)

Answer 32

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Question 33

teaching for the client taking amaxicilling and clavulanate (Augmentin)

Answer 33

take with full glass of water on empty stomach. keep oral suspensions refrigerated, reduce risk of superinfection by eating yogurt or buttermilk, may interfere with birth control, notify PCP of allergic reactions, complete full course of antibiotics

Question 34

discuss the actions of oral NRTIs (abacavir, Iamivudine, and zidovudine (Trizivir)

Answer 34

NNRTIs attach themselves to reverse transcriptase and prevent the enzyme from converting RNA to DNA. As a consequence, HIV’s genetic material cannot be incorporated into the normal genetic material of the invaded cell. The cell is prevented from producing new virus.

Question 35

describe the screening tests for HIV

Answer 35

cbc, viral load, ELISA, western blot

Question 36

nursing considerations when administering metronidazole (flagyl)

Answer 36

Do not drink while on this drug. Will get massively sick.

Question 37

risk factors associated with HIV

Answer 37

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Question 38

medication for the pregnant HIV client

Answer 38

antivirals

Question 39

care for the AIDS patient exposed to communicable disease

Answer 39

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Question 40

nursing considerations for the client taking zidovudine (retrovir)/ labs to monitor

Answer 40

Classes: Antiretrovirals; Nucleoside-Nucleotide Reverse Transcriptase Inhibitor (NRTI’s). Action: inhibits reverse transcriptase, needed to convert RNA into DNA in HIV. Side effects: severe bone marrow suppression, agranulocytosis, thrombocytopenia, pancreatitis, lactic acidosis, seizures, anemia. Nursing considerations: Monitor CBC, instruct patient to take drug with food to reduce stomach upset, and to avoid esophageal irritation take drug while sitting upright and with plenty of fluids, advise patient blood transfusions may be necessary due to drug-related anemia, monitor for hyperventilation, nausea, and abdominal pain- all indications of lactic acidosis.