Patient w/ HIV

Question 1

When caring for a Pt with HIV, the nurse should know…

Answer 1

• the disease process
• the labs/Dx tests
• How to teach/support the patient

Question 2

Is HIV-1 or HIV-2 more prevalent in the US?

Answer 2

HIV-1

Question 3

For which body fluids should a nurse use precautions to avoid HIV transmission?

Answer 3

Blood mainly
Less common but still documented infectious: CSF, Synovial Fluid, Pleural Fluid, Amniotic Fluid
- Note: HIV is also transmittable by breast milk, semen/pre-seminal fluid, rectal/vaginal fluid. However, nurses don’t usually contact these fluids on the job :)

Question 4

What incidences/situations can expose a healthcare worker to HIV?

Answer 4

• Contaminated Needle-stick or sharp object
• Mucous Membrane Contact (with infectious body fluids)
• Healthcare worker’s skin not intact

Question 5

What percent of HIV contaminated needle-sticks have been documented to infect healthcare workers?

Answer 5

.02%

Question 6

When is Post-Exposure Prophylaxis used?

Answer 6

After exposure to HIV, whether sexual or occupational

Question 7

When should Post-Exposure Prophylaxis be initiated?

Answer 7

As soon as possible following exposure (1-2 hours), preferably no later than 72 hours after

Question 8

What is PrEP, and how well does it reduce rate of HIV infection?

Answer 8

Pre-exposure Prophylaxis, reduces rate of sexual infection by 99%, and 74% by injection drug use

Question 9

Important teaching point about PrEP regarding other STIs?

Answer 9

Continue to use condoms, PrEP only effective against HIV

Question 10

What if a patient forgets to take their doses of PrEP?

Answer 10

Lessens effectiveness in prevention HIV infection

Question 11

Candidates for PrEP?

Answer 11

-Anal/Vaginal Sex (last 6 months) &: 
partner HIV+, 
inconsistent condom use, 
STI diagnosis (last 6 months)
-Injection drug user &: 
Injects with someone HIV+
Shares injection equipment

Question 12

Education for patient diagnosed with AIDS, regarding immunocompromised precautions?

Answer 12

• Avoid crowded places/traveling to countries with poor sanitation
• Avoid raw/undercooked foods (including fruits/veg.)
• Avoid cleaning litterboxes (toxoplasmosis risk)
• Keep home clean/avoid sick family
• Continue ART and CD4/Viral Load testing (monitor immune function)

Question 13

Why is it patient adherence to a HIV medication regimen important?

Answer 13

If medication taken incorrectly, viral load can increase further damaging the immune system
Virus can also mutate causing resistance to medications

Question 14

When are the patient and healthcare worker tested for HIV following Healthcare-related exposure?

Answer 14

Patient tested following exposure

Healthcare worker tested at exposure, 6 weeks, 12 weeks, and 6 months

Question 15

Important consideration for a pregnant patient with HIV?

Answer 15

Decrease the risk of perinatal transmission

Question 16

T/F A Healthcare worker should begin Post-Exposure Prophylaxis after being spat on by a HIV+ psych patient?

Answer 16

False, HIV cannot be transmitted through spit unless there is evidence of blood in it, as well as contact with a portal of entry on the healthcare worker