Unit 9 Chapter 17 HIV and AIDS Flashcards
What is HIV
Virus binds to CD4 Receptor sites on cells
* HIV genetic material enters cells and then
replicates when with cell replicates
does HIV decrease immunity?
A. No
B. Yes
B. Yes
What is the normal range for CD4 count?
A. 100-200
B. 600-700
C. 50-100
D.800-1000
D.800-1000
Is it important for patients who
How is HIV contracted or transmitted?
Sexual
* Semen, vaginal secretions
* Caused by genital, anal sex leads to microtears which can increase transmission of HIV , or oral sexual contact
Parenteral
* Sharing of needles or equipment contaminated with infected blood
Perinatal
* Placenta, contact with maternal blood and body fluids during birth, breast milk
What is the number one form of transmission for HIV?
Sexual
* Semen, vaginal secretions
* Caused by genital, anal, or oral sexual contact
Patient teaching for pregnant mothers with HIV
- Placenta, contact with maternal blood and body fluids during birth, breast milk
*Encourage C-section
*Do not breast feed
After a HIV+ mom gives birth to a baby boy. What is the interdisciplinary teams next action for both the mom and baby?
A. Administer vitamin K vaccine to babay
B. Ask mother if she wants her baby boy to have a circumcisopn>
C. Obtain an order for antiretroviral drug therapy
D. Administer pre exposure prophylaxis for babay.
C. Obtain an order for antiretroviral drug therapy
What is the typical precaution for clients who are HIV+ for health care workers?
A. Contact
B. Airborne
C. Standard
D. Droplet
C. Standard
includes hand washing and gloves
Use of standard precautions with Health Care Personnel
To prevent HIV transmission to patients, health care workers must wear gloves when in contact with patients’ mucous membranes or nonintact skin.
Are all persons susceptible to HIV infection
Teach all adults, age, gender, ethnicity, or sexual orientation they are susceptible to HIV infection
What are some preventions for HIV
- Condoms
- Cleaning/sterilizing drug paraphernalia
- Needle exchange programs
- Blood products screened for the HIV antibody
- Drug therapy for pregnant mothers
- Risk for transmission about 25% not using HIV drug therapy
- Risk for transmission about 8% with HIV drug therapy
- Use of standard precautions with Health Care Personnel
If a clients Viral load is high is sexual activity contraindicated?
A. No
B. Yes
B. Yes
When viral load is increased incidents transmission is higher
any blood contact or bodily fluid contact will transfer HIV to that person
Diagnostic patients
What are the s/s of HIV
Fever
* Night sweats
* Chills
* Headache
* Muscle aches
* Rash
*Diahrhea
* Sore throat
*flu like symptoms
*Low WBC
Thrush (infection on tongue
*Lymphedema(enlarged lymp nodes)
*weight loss
*Low CD4 count below 800 specifically below 500
*Lipodystropy(people to lose or gain fat in certain body areas
When is it confirmed that a client has contracted AIDS?
A. when the CD4 count has dropped below 200
B. When the patient contracts fungal pneumonia
C. The client reports having night sweats and chills
D. The client has not taken their antiretroviral medications in 2 days.
A. when the CD4 count has dropped below 200
What are the stages or classification of HIV
- Stage 1
- Confirmed HIV & CD4 count >500 or 29% or >
- Stage 2
- Confirmed HIV & CD4 count 200-499 or 14%-28
- Stage 3
- Confirmed HIV , CD4 count <200 or <14%, & has a documented AIDS defining illness
- Stage 4
- Confirmed HIV, no information about CD4 count and has an AIDS defining
illness
What is the Treatment for HIV and AIDS
** MULTIPLE Antiretroviral meds – reducing viral load significantly reduces the risk
of transmission**
What is a common side effect of Antiretroviral medications
- appetite loss can induce muscle wasting
Lipodystrophy is a condition that causes people to lose or gain fat in certain
body areas.
* Diarrhea from medications
* Fatigue
* Elevated cholesterol and Triglycerides
* Mood changes, depression
* Nausea and vomiting
* Insomnia
nursing intervention
-dietary consult
-high calorie
-high protein
Dietary considerations for clients with HIV
What might help:
* Eat several small meals per day instead of three large ones.
nursing intervention
-dietary consult
-high calorie
-high protein
- Drink smoothies or take nutritional supplements to make sure the body is
getting enough vitamins and minerals.
Goals for clients with HIV
-Take daily medication
-remain healthy as possible
-avoid secondary infections that can affect them
-improve nutritional status
Why is psychosocial support important for clients with HIV
- HIV is a long life disease process that may cause friction in relationships and how the public views a client with HIV. Depression is common for these individuals and we want to support them with counseling and make sure they are in the right state of mind.
Name 3 Opportunistic Infections for HIV
*Pneumocystis Jiroveci Pneumonia
*Toxoplasmosis encephalitis
*Cryptosporidiosis
*Candida Albicans
*Tuberculosis
* Bacterial infections
*Herpes Simplex, Varicella-zoster
*Cytomegalovirus respiratory, retinal, GI tract – can cause encephalitis, pneumonia, adrenalitis, hepatitis
*Cryptococcosis – debilitating meningitis * Histoplasmosis – respiratory infection
Which of the following drugs are used to treat this opportunistic infection: Cytomegalovirus Herpes Simplex, Varicella-zoster?
A. Penicillin
B. Metformin
C. Acyclovir
D. Bumetadine
C. Acyclovir
Your client with HIV has been admitted due to lesions filled with fluid around his perineal area. He reports pain on a 5/10 scale. What medication would you anticipate the provider to prescribe?
A. Metformin
B. Metoprolol
C. Acyclovir
D. Gabapentin
D. Gabapentin
PATIENTS WITH HERPES ZOSTER HAVE NERVE PAIN ADMINISTER NEURONTIN
Your client has a past medical history of HIV. Has been admitted to the emergency department due to a fever and he is experiencing night sweats. What is the nurse’s priority action?
A. Place the patient in airborne precaution
B.Administer Rifampin
C. Obtain a sputum culture
D. Obtain a PPD test
A. Place the patient in airborne precaution
Maintain Airborne Precautions along with Standard Precautions for a patient with HIV-III (AIDS) who also has TB symptoms until parameters other than a skin test come back negative for TB.
What are the s/s of Tuberculosis
Ask about cough,
dyspnea,
chest pain,
fever,
chills,
night sweats,
weight loss, and
anorexia
s/s of Histoplasmosis
– respiratory infection
-dyspnea,
-fever,
-cough, and
-weight loss.
-enlargement of lymph nodes,
- the spleen, or
-the liver.
Nursing care for Histoplasmosis
- administer O2 therapy
-maintain patent airway
s/s of Pneumocystis Jiroveci Pneumonia
*Dyspnea on exertion,
*tachypnea,
dry persistent cough,
persistent low grade fever,
*fatigue,
weight loss,
breath sounds for crackles
Nursing intervention for PJP
-Assess lung sounds
-high protein and high-calorie diet
-assess lung sounds
s/s *Toxoplasmosis encephalitis
caused cat feces or undercooked meat, raw food
-*change of loc confused
*increased ICP
*headache seizures
changes in mental status, neurologic deficits,
*headaches,
*fever.
*changes with speech, gait, and vision; seizures; lethargy; and confusion.
Perform a comprehensive mental status examination and monitor the patient to detect subtle changes.
Nursing Care for client with Toxoplasmosis encephalitis
*decrease environmental stimuli due to seizure risk
Administer mannitol
*instruct client not to change cat litter
*instruct client not to eat raw fruits or raw meats
Adverse effect of mannitol
- hypertension
pulmonary edema
s/s *Candida Albicans
-fungal infection that affects the entire oral airway
*Food taste funny,
*mouth pain,
*difficulty swallowing,
*pain behind sternum
*Cottage cheese-like, yellowish white plaques, and inflammation
Women – vaginal candidiasis, severe pruritis, perineal irritation, thick white discharge
Nursing Care for Candida Albicans
-the patient may not want to eat due to pain and food tasting weird,
-find out patients’ preferred foods
-dietary consult
SMOOTHIES
or tpn
s/s for Cryptosporidiosis
GI INFECTION
-diarrhea
-weightloss
-monitor for fluid and electrolyte imbalances
nursing intervention:
-high calorie
-high protein
-monitor weight
s/s of Cryptococcosis
– debilitating meningitis
-fever,
-headache,
-blurred vision,
-nausea and vomiting,
-neck stiffness,
-confusion,
-mental status changes.
-seizures
-mild malaise
Nursing care for Cryptococcosis
*decrease environmental stimuli due to seizure risk
Administer mannitol
seizure precaution
What is a skin malignancies that is associated with AIDS?
Kaposi’s sarcoma
Malignanacies occur due to a weakened immune system
most common AIDS related malignancy. Related to co-
infection with herpes virus-8
* Small, purplish brown, raised lesions on the skin and mucous membranes
Other Malignancies associated with AIDS
Malignant lymphoma’s
* Hodgins’ lymphoma, non-Hodgkin’s B-Cell lymphomas
* Human Papilloma Virus (HPV) – results in multiple types of malignancies (patient may faint 15 minutes after administration- patient is assessed after administration)
Nursing Priorities for HIV AND AIDS
- Risk for Infection r/t immune deficiency
- Inadequate Oxygenation r/t anemia, respiratory infections, Kaposi’s
sarcoma - Pain r/t neuropathy (HIV medication), cancer or infection
- Inadequate nutrition
*Reduced skin integrity - Confusion r/t AIDS dementia – caused by the virus - later stage of HIV
*Reduced self esteem - Potential loss of social contact
MEDICATION COMPLIANCE
Patient teaching for Preventing Infection and HIV and AIDS
- During the times when your white blood cell counts are low:
- Avoid crowds and other large gatherings of people.
- Do not share personal articles such as toothbrushes, toothpaste,
washcloths, or deodorant sticks. - If possible, bathe daily, using an antimicrobial soap. If total bathing is not possible, wash the armpits, groin, genitals, and anal area twice a day with an antimicrobial soap.
- Clean your toothbrush at least weekly by either running it through the dishwasher or rinsing it in liquid laundry bleach (and
then rinsing out the bleach with hot running water). - Wash your hands thoroughly with an antimicrobial soap before
you eat or drink, after touching a pet, after shaking hands with anyone, as soon as you come home from any outing, and after using the toilet. - Avoid eating undercooked meat, fish, and eggs.
- Wash dishes between use with hot, sudsy water or use a dishwasher.
- Do not change pet li er boxes. If unavoidable, use gloves and
wash hands immediately. - Avoid turtles and reptiles as pets.
- Do not feed pets raw or undercooked meat.
- Take your temperature at least once a day and whenever you do
not feel well.
Report any of these indications of infection to your primary health care provider immediately:
- Temperature greater than 100° F (37.8° C)
- Persistent cough (with or without sputum)
- Pus or foul-smelling drainage from any open skin area or normal body opening
- Presence of a boil or abscess
- Urine that is cloudy or foul-smelling or that burns on urination
- Take all prescribed drugs.
- Do not dig in the garden or work with houseplants.
- Avoid travel to areas with poor sanitation or primitive health care facilities.
patient teaching precaution
-do not share needles
-get tested
-reduce sexual partners
