Week 8 - HIV/AIDS Flashcards
what is HIV
- human immunodeficiency virus
- RNA virus or retrovirus
where is HIV found (5)
- body fluids
- breast milk
- blood
- semen
- vaginal secretions
how can HIV be transmitted (4)
- sexual intercourse w an infected partner
- blood transfusion
- sharing of drug paraphernalia (Needles)
- perinatally at time of delivery or thru breastfeeding
how long does the ability to transmit HIV last
- lifelong
how is HIV NOT spread
not spread casually, so not through: - tears - saliva - urine - feces - sweat - sputum - sharing eating utensils - working w an HIV infected person etc.
what are risk factors for HIV (4)
- IV drug use
- mother to child
- unsafe sexual practices
- blood transfusions
how can HIV be prevented (4)
- education
- safe sexual activities (condoms, outercourse, etc.)
- do not share injecting equipment
- if a pregnant women has HIV, optimal ART
describe the typical course of HIV
- acute retroviral syndrome
- early chronic infection
- intermediate chronic infection
- late chronic infection = AIDS
what manifestations are seen during acute infection of HIV (acute retroviral syndrome) (10)
- fever
- swollen lymph glands
- sore throat
- headache
- malaise
- nausea
- muscle and joint pain
- diarrhea
- diffuse rash
- neuro complications (less common)
basically just like flu like symptoms, is often mistaken for a cold or flu
what neuro complications may occur during acute infection of HIV (3)
- aseptic meningitis
- peripheral neuropathy
- GBS
what symptoms are seen during early chronic infection (7)
- asymptomatic, vague, nonspecific; may experience:
- fatigue
- headache
- low grade fever
- night swears
- persistent generalized lymphadenopathy
- normal or slightly decreased CD4
what symptoms are seen during intermediate chronic infection of HIV (10)
worsened symptoms seen in earlier stages:
- persistent fever
- frequent drenching night swats
- severe fatigue
- chronic diarrhea
- recurrent headache
- lymphadenopathy
- localized infections
- nervous system manifestations
- low CD4
what is the most common infection associated w intermediate chronic infection of HIV
- oropharyngeal candidiasis –> thrush
what is the treatment for thrush
- nyastatin swish and swallow or swish & spit
what symptoms are seen during later chronic infection of HIV (AIDS) (2)
- severely compromised immune system
- opportunistic diseases that contribute to disability & death
what is included in diagnostic studies for HIV (6)
- HIV antibodies
- CD4+ T cell count
- low WBC
- low neutrophils
- low plts
- altered liver fnxn tests
as HIV progresses, what happen to CD4+T cells counts? what does this indicate
- decreases = indicates decreased immune function
what is the primary goal of treatment for HIV
- treat the symptoms
what are secondary goals for HIV treatment (6)
- monitor disease progression
- monitor immune function (CD4+T cell counts)
- initiate and monitor ART (anti-retro virals)
- prevent opportunistic infection
- treat complications
- follow ups
is there a cure for HIV
- no
why/when do most pts with HIV come to the hospital (2)
- w exacerbation
- or an opportunistic infection
what info should be gathered during the initial visit to the hospital (8)
- detailed health history history
- assess for risks of HIV ( blood transfusion before 1985, shared needles, sexual history, STIs)
- physical exam
- immunization history
- when were they diagnosed? is this a new diagnosis?
- previous hospitalizations or treatment?
- med regime
- supports
what is included in collab care for HIV (3)
- drug therapy for HIV infection
- prevention of opportunistic infections
- health promotion & promote healthy immune system
what is the drug therapy for HIV infection
- ARTs (anti retro virals)
what effect do ARTs have (5)
- decrease viral load
- maintain or raise CD4+ T cell counts
- delay development of HIV related symptoms
- delay opportunistic infection
- reduces transmission
describe the med regime for ARTs (3)
- may have to taken anywhere from 3-20 pills/day = adherence difficult
- should be taken at same time every day
- must maintain 95% adherence to avoid drug resistance
when should ARTs be started
- can be delayed until CD4 drops below 500
(used to be “hit it early, hit it hard” , but s/e and difficult w adherence made pts question their ability to sustain ART for long period of time)
what is care for HIV dependent on
- chief complaint
ex. opportunistic infection
what are some examples of opportunistic infections that can occur in a pt with HIV (5)
- shingles
- oropharyngeal candidiasis
- pneumonia
- herpes
- karposis sarcoma
how can opportunistic infections be prevented in a pt with HIV (3)
- ART
- vaccines
- disease-specific prevention measures
what is the rapid treatment for opportunistic infections in pts with HIV (4)
- antifungals
- antibiotics
- immunizations
- continue ART
why is health promotion and promoting a healthy immune system important
- delays HIV disease progression
what are some interventions to promote a healthy immune system in pts w HIV (8)
- nutritional support (approp lvls of vitamins, micronutrients)
- moderation or elimination of alcohol, smoking, and drug use
- adequate rest
- exercise
- stress reduction
- avoid exposure to new infectious agents
- mental heath counselling
- involvement in support groups & community activities
what are imp considerations regarding antibiotic use in pts with HIV (5)
- dependent on pt
- decrease risk for antibiotic resistance
- do not use antibiotics prophylactically (need to prevent resistance)
- consider pts ability to fight infection, status of their immune system, and overall health
- consider how the pt is after antibiotics are finished (did it clear it up or not? need longer or something different?)
what is done upon discharge of pts with HIV (2)
- assess need for education
- provide identified supports (social work, home care)
what should a pt with HIV be educated on upon discharge (8)
- about the disease, its risks, transmission, etc.
- harm reduction
- health promotion strategies (rest, nutrition, avoid alcohol & drugs, mental health supports, etc.)
- follow up
- how to prevent infection (hygeine, vaccines, etc.)
- when to seek care (signs of infection)
- med adherence, ARTs info
