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PHSC - Nursing - Adult I > Unit 2 - Management of Patients with Immune Deficiency Disorders (Ch. 32) > Flashcards

Unit 2 - Management of Patients with Immune Deficiency Disorders (Ch. 32) Flashcards

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1
Q

Candidiasis

A

Fungal infection, usually of the skin or mucous membranes, caused by Candida species

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2
Q

Enzyme immunoassay (EIA)

A

A blood test that can determine the presence of antibodies to HIV in the blood or saliva; a variant of this test is called enzyme-linked immunosorbent assay (ELISA)

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3
Q

HIV-1

A

Retrovirus isolated and recognized as the etiologic agent of HIV disease

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4
Q

HIV encephalopathy

A

Clinical syndrome characterized by a progressive decline in cognitive, behavioral and motor functions

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5
Q

Immune reconstitution inflammatory syndrome (IRIS)

A

a syndrome that results from rapid restoration of pathogen-specific immune responses to opportunistic infections

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6
Q

Kaposi sarcoma

A

Malignancy that involved the epithelial layer of blood and lymphatic vessels

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7
Q

Latent reservoir

A

The integrated HIV provirus within the CD4+T cell during the resting memory state; does not express viral proteins and is invisible to the immune system and medications

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8
Q

Mycobacterium avium complex (MAC)

A

opportunistic infection caused by mycobacterial organisms that commonly causes a respiratory illness but can also infect other body systems

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9
Q

Opportunistic infection

A

Illness caused by various organisms, some of which typically do not cause disease in people with normal immune systems

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10
Q

Peripheral neuropathy

A

Disorder characterized by sensory loss, pain, muscle weakness, and wasting of muscles in the hands or legs and feet

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11
Q

Pneumocystis pneumonia (PCP)

A

Common opportunistic lung infection; pathogen implicated is pneumocystis jirovecii

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12
Q

Polymerase chain reaction (PCR)

A

A sensitive laboratory technique that can detect and quantify HIV in a person’s blood or lymph nodes

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13
Q

Post-exposure prophylaxis (PEP)

A

Taking antiretroviral medicines as soon as possible, but no more than 72 hours (3 days) after possible HIV exposure; two to three drugs are usually prescribed which must be taken for 28 days

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14
Q

Pre-exposure prophylaxis (PrEP)

A

Prevention method for HIV-negative people who are at high risk of HIV infection; involves taking a specific combination of HIV medicines daily; use condoms and other prevention tools

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15
Q

Primary immune deficiency diseases (PIDDs)

A

Rare, genetic disorders that impair the immune system

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16
Q

Retrovirus

A

A virus that carries genetic material in ribonucleic acid (RNA) instead of DNA and contains reverse transcriptase

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17
Q

Viral load test

A

Measures the quantity of HIV RNA or DNA in the blood

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18
Q

Viral set point

A

Amount of virus in the blood after the initial burst of viremia and the immune response that follows

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19
Q

Wasting syndrome

A

Involuntary weight loss consisting of both lean and fat body mass

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20
Q

What are primary immune deficiency disorders (PIDDs)

A
  • Rare inherited disorders that impair the immune system
  • These rare inherited disorders not only lead to frequent infections, but also to increased risk of autoimmune disorders
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21
Q

When are the majority of primary immune deficiency disorders (PIDDs) diagnosed?

A

Majority diagnosed in infancy

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22
Q

List some clinical manifestations of primary immune deficiency disorders (PIDDs)

A
  • Multiple infection despite treatment
  • Infection with unusual or opportunistic organisms
  • Failure to thrive or poor growth
  • Positive family history
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23
Q

Name some things a nurse could do to help manage a patient with a PIDD

A
  • Be meticulous in the type of care they are giving
  • Appropriate hand hygiene and infection precautions
  • Continual monitoring of a patient’s condition, looking for early signs of infection
  • Teach patients, family, caregivers how to administer medications and therapy at home
  • Provide ongoing support and education and support for the patient and the a family
24
Q

True or False: Immune deficiency can be acquired?

A

FALSE; Immune deficiency can be acquired due to medical treatment such as chemotherapy OR infection from pathogens such as human immune deficiency virus (HIV)

25
Q

PLWHA?

A

Persons living with HIV/AIDS

26
Q

Important aspects of care for PLWHA?

A
  • Prevention
  • Early detection
  • Ongoing treatment
27
Q

HIV-1 is transmitted in ______ ______ that contain ______ ______?

A

body fluids; infected cells

28
Q

Name some modes of transmission for HIV-1

A
  • Blood and blood products
  • Seminal fluids
  • Vaginal secretions
  • Mother to child: Amniotic fluid, breast milk
  • HIV-1 is not transmitted through casual contact
29
Q

Risks associated with HIV infection (chart 32-2)?

A
  • Sharing infected injection drug use equipment
  • Having sexual relations with infected persons (both genders)
  • Infants born to mothers with HIV infection or who are breast-fed by HIV-infected mothers
  • People who receive organ transplants, HIV-infected blood, or blood products (especially between 1978 and1985)
30
Q

Prevention of HIV infection in achieved via?

A
  • Behavioral interventions
  • HIV testing
  • Linkage to treatment and care
31
Q

How do behavioral interventions promote HIV infection prevention?

A

By ensuring that people have the information, motivation, and skill necessary to reduce their risks

32
Q

How does HIV testing promote HIV infection prevention?

A

Most people change behaviors to protect their partners if they know they are infected with HIV

33
Q

How does linkage to treatment and care promote HIV infection prevention?

A

Enables individuals with HIV to live longer, healthier lives and reduce their risk of transmitting HIV

34
Q

Name some preventive educational considerations to protect against HIV infection

A
  • Consistent and correct use of condoms
  • Medical male circumcision
  • Female condoms
  • Dental dams
  • Harm reduction framework for people who inject drugs
  • Reproductive education
  • LGTB communities
35
Q

What is the idea behind harm reduction framework?

A
  • Uses practical strategies and ideas aimed at reducing negative consequences associated with drug use
  • Using harm reduction framework, the nurse works with people who inject drugs to assist them to increase their healthy behaviors
36
Q

Topics for the nurse to consider when using harm reduction framework?

A
  • Needle exchange programs
  • The use of bleach to clean used needles and syringes
  • Avoidance of sharing needles and syringes with others
37
Q

Topics for the nurse to consider when providing reproduction education?

A
  • The use of artificial insemination in some cases
  • The benefits of taking ART to reduce perinatal HIV transmission
  • Refrain from breastfeeding infants, because HIV is transmitted through breast milk
38
Q

Topics for the nurse to consider when providing preventive education to the LGTB community?

A
  • LGTB youth are at high risk for HIV infection
  • Take into consideration that many of these people have no/limited social support, are stigmatized, are isolated, have increased stressors, and may have been abused/harassed
  • Remain nonjudgmental in educating about HIV prevention
39
Q

True or False: Lambskin condoms are available as an alternative for people with a latex allergy and protect against HIV infection?

A

False; Lambskin condoms do not protect against HIV infection

40
Q

What type of precaution is used to prevent the risk of HIV transmission to health care providers?

A

Standard precaution

41
Q

What is post-exposure prophylaxis (PEP)?

A
  • PEP includes taking antiretroviral medicines as soon as possible, but no more than 72 hours (3 days) after possible HIV exposure
  • 2 to 3 drugs are prescribe for 28 days
42
Q

What type of virus is HIV?

A

HIV is in the subfamily of lentiviruses and is a RETROVIRUS because it carries its genetic material in the form of ribonucleic acid (RNA) rather than deoxyribonucleic acid (DNA)

43
Q

What type of cells does HIV target

A

HIV targets cells with CD4+ receptors, which are expressed on the surface of T lymphocytes, monocytes, dendritic cells, and brain microglia

44
Q

List the steps in the life cycle of HIV

A
  1. Attachment/Binding
  2. Fusion/Uncoating
  3. DNA synthesis (reverse transcription)
  4. Integration
  5. Transcription (DNA –> RNA)
  6. Translation (RNA –> proteins)
  7. Cleavage (protein modification)
  8. Assembly
  9. Budding
45
Q

Describe the binding/attachment phase of the HIV life cycle and list the class of drugs used to stop infection at this stage

A
  • HIV binds (attaches itself ) to the receptors on the surface of a CD4+ cell

Drugs: CCR5 antagonists, Post-attachment inhibitors

46
Q

Describe the Fusion phase of the HIV life cycle and list the class of drugs used to stop infection at this stage

A
  • The HIV envelope and the CD4+ cell membrane fuse (join together), which allows HIV to enter the cell

Drugs: fusion inhibitors

47
Q

Describe the DNA synthesis (reverse transcription) phase of the HIV life cycle and list the class of drugs used to stop infection at this stage

A
  • Inside the CD4+ cell, HIV releases and uses reverse transcriptase (an HIV enzyme) to convert its genetic material — HIV RNA — into HIV DNA. The conversion of HIV DNA allows HIV to enter the CD4+ cell nucleus an combine with the cell’s genetic material

Drugs: Non-nucleoside reverse transcriptase inhibitors (NNRTIs), Nucleoside reverse transcriptase inhibitors (NRTIs)

48
Q

Describe the integration phase of the HIV life cycle and list the class of drugs used to stop infection at this stage

A
  • Inside the CD4+ cell nucleus, HIV releases integrase (an HIV enzyme). HIV uses integrase to insert (integrate) its viral DNA into the DNA of the CD4+ cell

Drugs: Integrase inhibitors

49
Q

Describe the replication (transcription/translation) phase of the HIV life cycle and list the class of drugs used to stop infection at this stage

A
  • Once integrated into the CD4+ cell DNA, HIV begins to use the machinery of the CD4+ cell to make long chains of HIV proteins. The proteins chains are the building blocks for more HIV
50
Q

Describe the assembly phase of the HIV life cycle and list the class of drugs used to stop infection at this stage

A
  • New HIV proteins and HIV RNA move to the surface of the cell and assemble into immature (noninfectious) HIV
51
Q

Describe the budding phase of the HIV life cycle and list the class of drugs used to stop infection at this stage

A
  • Newly formed immature (noninfectious) HIV pushes itself out of the host CD4+ cell. The new HIV releases protease (an HIV enzyme). Protease breaks up the long protein chains in the immature virus, creating the mature (infectious) virus

Drugs: Protease inhibitors (PIs)

52
Q

Normal CD4+ T-cell count

A

500-1500 cells/mm^3 of blood

53
Q

HIV infection - Stage 0

A

Early HIV infection; inferred from laboratory testing

54
Q

HIV infection - Stage 1

A
  • Primary/acute
  • Period of infection with HIV to the development of HIV-specific antibodies
  • Dramatic drops in CD4+ T-cell counts (normally 500 to 1500 cells/mm^3 of blood)
55
Q

HIV infection - Stage 2

A

Occurs when the CD4+ T-cell counts are between 200 and 499 cells/mm^3

56
Q

HIV infection - Stage 3

A
  • CD4+ T-cell count drops below 200 cells/mm^3 of blood
  • Considered to have Aids for surveillance purposes
57
Q

HIV infection - Stage unknown

A

No information on CD4+ T-cell count or percentage

PHSC - Nursing - Adult I (7 decks)

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