MNT II Test 1 Flashcards

Question

Transmission of HIV (how it is NOT transmitted too)

Answer 1

``` Virus also resides in semen, vaginal secretions, lymph system, and CNS Transmitted via blood, semen, preseminal fluid, vaginal fluid, breast milk, other body fluids ``` NOT transmitted via saliva, tears, and urine or through casual contact ``` Transmission also via sharing contaminated needles, by injecting contaminated blood products, from mother to baby before or during birth, or via breast milk ``` Universal precautions

Answer 2

```  Persons with male-to-male sexual contact  Heterosexuals with more than one sex partner  Intravenous drug users  Now low risk for hemophiliacs and other blood transfusion recipients  Mother-to-child infection declining  Homeless and mentally ill ```

Answer 3

 Acute HIV infection • 2 to 4 weeks after infection, flu-like symptoms, lasts a few days to 4 weeks, seroconversion  Asymptomatic chronic HIV infection • Lasts a few months to 10 years, few symptoms, subclinical changes  Symptomatic HIV infection • Fever, sweats, skin problems, fatigue, decline in nutrient status or body composition  AIDS or advanced HIV • Dx when a person has a T-cell < 200 cells/mm3 or develop an opportunistic infection or a tumor

Answer 4

 The goals of medical management of HIV are to: • Reduce HIV-related morbidity and mortality • Improve the quality of life • Restore and preserve immunologic function • Maximize suppression of viral replication • Optimize and extend the usefulness of currently available therapies • Minimize drug toxicity and manage side effects

Answer 5

Combination of at least two fully active antiretroviral agents known to kill virus or suppress replication • Drug therapy decisions based on: – Viral load levels (HIV-RNA) – Current and lowest CD4 cell counts – Current and past clinical conditions and symptoms – Life stage • Need at least 95% adherence to medication schedules for efficacy

Answer 6

OIs with bacteria, fungi, protozoa, or viruses cause diarrhea, malabsorption, fever, and weight loss • Cancers: Kaposi’s sarcoma, non-Hodgkin lymphomas, and cervical cancer • Neuromuscular diseases • HIV-liver disease • Tuberculosis and lung diseases • HIV-associated nephropathy • Gastrointestinal and pancreatic issues

Answer 7

Cancer develops on cells that line lymph or blood vessels • Affects the skin, mucous membranes and lymph nodes • KS in the esophagus causes pain, difficulty swallowing and chewing. In the GI tract can cause diarrhea and obstruction. Trush Common in persons with AIDS

Answer 8

 Abnormalities in fat metabolism  Body shape change  Glucose dysregulation and dyslipidemia  Bone disorders  Mitochondrial toxicity and lactatemia  Morphological changes: lipoatrophy; loss of subcutaneous adipose tissue; thinning of arms, legs, buttocks, and face

Answer 9

Maintain and expand nutrition knowledge and sense of empowerment • Maintain or restore healthy body weight and normal morphology • Preserve or restore optimal somatic and visceral protein status • Prevent nutrient deficiencies or excesses known to compromise immune function Nutrition Interventions – calculating energy and protein needs, fat recommendations, fluid & electrolyte needs, Vitamin & mineral supplementation

Answer 10

Energy and protein • Energy requirements increase 13% and protein increases 10% for every degree C of fever • Use Mifflin-St. Jeor equation plus 500 calories to replenish when HIV wasting is present or 40-50 kcal/kg • Protein 1.0 to 1.4 k/kg for maintenance; 1.5 to 2.0 g/kg for repletion  Fat • Individual tolerance; MCT • Omega-3 fatty acids may improve immune function Fluids and electrolytes – 30 to 35 ml/kg – Extra fluid and electrolytes for diarrhea, vomiting, night sweats, and prolonged fever • Vitamins and minerals supplement providing 100% RDA • Special concerns in pediatric patients

Answer 11

``` Low heights and weights • <50th percentile • Do not catch up Monitor growth and development, immune function, quality of life, CD4 percentage (not number) Assess every 1 to 6 months Multidisciplinary team find that out ```

Answer 12

``` High calorie/high protein diet Nutrient dense snacks Small frequent feedings When diarrhea present; avoid high fat foods and high fiber diet. Check if person is lactose intolerant Drug-nutrient interactions ```

Answer 13

Diarrhea and malabsorption • CD4 count <200 to 250 cells/mm3  Disorders of the oral cavity and esophagus • Neoplastic, bacterial, viral, or fungal; dysgeusia  Neurologic disorders  Alterations in metabolism and body shape • Wasting, lipodystrophy, obesity; stigma

Answer 14

St. John’s wort decreases plasma levels of indinavir; may cause drug resistance and treatment failure  Garlic supplements reduce blood levels of saquinavir  Milk thistle (silymarin) could lessen metabolism of medications and increase toxicity  High use of CAM; may not reported

Answer 15

Diarrhea and malabsorption • CD4 count <200 to 250 cells/mm3  Disorders of the oral cavity and esophagus • Neoplastic, bacterial, viral, or fungal; dysgeusia  Neurologic disorders  Alterations in metabolism and body shape • Wasting, lipodystrophy, obesity; stigm

Answer 16

``` AIDS AIDS enteropathy Candidiasis HIV encephalopathy HIV wasting syndrome Kaposis’s sarcoma Opportunistic infection ART & HAART Retrovirus Constitutional Disease ```

Answer 17

```  Dysgeusia  Ageusia  Hypogeusia  Candidiasis  Metastasis  Cheilosis  Cytokines  Cachexia  thrombocytopenia  Stomatitis  Neutropenia  Mucositis  Glossitis  Emesis  Palliative care  Xerostomia  Myelosuppresion  Oncology ```