Flashcards in Chapter 15: Med Surg & Childhood Diseases Deck (54)
how is HIV transmitted?
infected blood, semen, vaginal secretions, and breast milk
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
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
initial infection with large amounts of it in blood
normal CD4 count
800-1200, normal life is 100 days, but in HIV it's about 2 days
HIV CD4 cells
immune issues develop when levels are <200 (opportunistic diseases develop at this time)
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)
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
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
late chronic infection
AIDS, T cells <200, opportunistic infection occurs, wasting syndrome, AIDS dementia complex, opportunistic cancer may be present
oral hairy leukoplakia
painless, white, raised lesions on the lateral aspect of tongue
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!
rapid HIV-antibody test
results available in 20 minutes, if positive, need to be confirmed by western blot
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
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
should be used in combination and not alone, because resistance develops rapidly, decreases viral load up to 90%
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
prevent HIV and detect HIV early, educate!
promote health and limit disability & manage problems caused by HIV
ambulatory and home care
maximize quality of life and resolve life and death issues
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
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
enter the cell and grow inside human cells or secrete toxins that damage cells
do not have cellular structure, only reproduce in living organism
similar to plants, lack chlorophyll, usually localized, but can spread in immunocompromised pt
single celled, animal like microorganisms that live in soil and bodies of water
infectious particles that contain abnormally shaped proteins and typically affect the nervous system
highest risk for HAIs
surgery pt, immunocompromised, elderly
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