Chapter 15: Med Surg & Childhood Diseases Flashcards Preview

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Flashcards in Chapter 15: Med Surg & Childhood Diseases Deck (54)
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1

how is HIV transmitted?

infected blood, semen, vaginal secretions, and breast milk

2

risk by needle stick

high viral load, deep puncture, needle with hollow bore and visible blood, device used for venous or arterial access, or pt who dies within 60 days after you've been exposed

3

what is HIV?

RNA virus (retrovirus) goes from RNA to DNA, during reverse transcriptase all daughter cells are effected since genetic material is duplicated and viral DNA in the genome will allow HIV to replicate

4

viremia

initial infection with large amounts of it in blood

5

normal CD4 count

800-1200, normal life is 100 days, but in HIV it's about 2 days

6

HIV CD4 cells

immune issues develop when levels are <200 (opportunistic diseases develop at this time)

7

Acute infection

seroconversion occurs (when HIV antibodies form) and is often accompanied by swollen lymph glands, sore throat, headache, malaise, nausea, joint pain, diarrhea, and rash, high viral load is noted (lasts for few weeks-months)

8

early chronic infection

about 11 years, seen as asymptomatic although fatigue, headache, low grade fever are noted, t cells are 500+ & viral load is low

9

intermediate chronic infection

t cells drop to 200-500 and viral load is high, persistent fever, night sweats, chronic diarrhea, fatigue, oropharyngeal candidiasis (thrush), shingles, vaginal candidiasis, herpes, oral hairy leukoplakia

10

late chronic infection

AIDS, T cells <200, opportunistic infection occurs, wasting syndrome, AIDS dementia complex, opportunistic cancer may be present

11

oral hairy leukoplakia

painless, white, raised lesions on the lateral aspect of tongue

12

how much of a delay before HIV antibodies can be detected?

2 months- window period refers to the time between infection and development of antibodies, can still transmit disease!

13

rapid HIV-antibody test

results available in 20 minutes, if positive, need to be confirmed by western blot

14

genotype assay

detects drug-resistant viral mutations that are present in reverse transcriptase and protease genes- very helpful in deciding new drug combinations for patients who do not respond to therapy

15

phenotype assay

measures the growth of HIV in various concentrations of antiretroviral drugs- very helpful in deciding new drug combinations for patients who do not respond to therapy

16

ART

should be used in combination and not alone, because resistance develops rapidly, decreases viral load up to 90%

17

if a patient is asymptomatic, but is positive for HIV, when should you treat?

when t cells are less than 350, recommend treatment if t cells are 350-500

18

health promotion

prevent HIV and detect HIV early, educate!

19

acute intervention

promote health and limit disability & manage problems caused by HIV

20

ambulatory and home care

maximize quality of life and resolve life and death issues

21

what if I am exposed to HIV at work?

postexposure prophylaxis (PEP) measures should be taken- ART therapy based on extent of exposure, volume of exposure, and the status of pt

22

negative effects of ART

prolonged use can cause fat deposits in tummy, upper back, breasts, and arms, legs, face due to lipodystrophy, hyperlipidemia, insulin resistance and hyperglycemia, bone disease, lactic acidosis, and cardiovascular disease

23

bacteria

enter the cell and grow inside human cells or secrete toxins that damage cells

24

viruses

do not have cellular structure, only reproduce in living organism

25

fungi

similar to plants, lack chlorophyll, usually localized, but can spread in immunocompromised pt

26

protozoa

single celled, animal like microorganisms that live in soil and bodies of water

27

prions

infectious particles that contain abnormally shaped proteins and typically affect the nervous system

28

highest risk for HAIs

surgery pt, immunocompromised, elderly

29

chickenpox clinical manifestations

slight fever, malaise, and anorexia for the first 24 hours, rash is very itchy, rapidly progresses from macule to papule to vesicle, sparse on distal limbs

30

chickenpox therapeutic management

Acyclovir (Zovirax), antihistamines to relieve itching, maintain standard, airborne, and contact precautions, don't use aspirin