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Module 4 (MedSurg 2) > HIV > Flashcards

HIV Flashcards

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1
Q

HIV is a

A

Retrovirus causes immunosuppression making persons more susceptible to infections
errors during replication making different strains of HIV

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2
Q

HIV stands for

A

Human Immunodeficiency Virus

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3
Q

AIDS stands for

A

acquired immunodeficiency syndrome
1 (US) and 2 (Africa)

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4
Q

HIV targets what cells

A

CD4 (helps immune cells communicate esp. when foreign cells )
dendritic
T helper
monocytes
Macrophages

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5
Q

HIV Transmission

A

through contact with blood, semen, vaginal secretions, and breast milk
not from casual contact

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6
Q

The most common transmission of HIV?

A

sexual transmission
- tissue trauma receiver (anal sex)

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7
Q

Can you transfer HIV through breast milk?

A

yes, vaginal or breast milk

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8
Q

Sexual Transmission of HIV

A

Unprotected sex with an HIV-infected partner
-RECEIVER has the most risk
prolonged contact with infected fluids
women high risk
trauma (tearing) increases likelihood

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9
Q

Contact with Blood HIV +

A

Sharing drug-using paraphernalia
Puncture wounds (deep)
Accidental needle sticks
Splash exposures
- screening needs to be done for blood donors

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10
Q

Perinatal Transmission of HIV

A

Can occur during pregnancy, delivery, or breastfeeding will contract HIV
25% of infants born to women with untreated HIV tested HIV+
Treatment can  rate of transmission to < 2%
-DRUGS can be taken during pregnancy

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11
Q

Pathophysiology of HIV

A

RNA virus
-replicate backward manner going from RNA - DNA
once integrated inside of the cell’s DNA directs to make new HIV cells

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12
Q

What cell is targeted in HIV?

A

CD4+T
-lymphocyte
- binds through fusion and replicate

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13
Q

Lower the T cell count =

A

more symptomatic
destroy 1 billion T cells every day

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14
Q

Immune problems start when the CD4+T cell count raises greater than

A

500

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15
Q

CD4+T cell normal ranges

A

800-1200

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16
Q

Severe problems develop when CD4+T cells are lower than

A

200

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17
Q

What ultimately kills HIV patients?

A

Insufficient immune response allows for opportunistic diseases

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18
Q

How many years does it take HIV pts to develop AIDS?

A

8-10

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19
Q

What are the phases of HIV?

A

Acute infection (1-3 weeks)
HIV antibody test + (3 weeks to 3 months)
Asymptomatic (up to 8 years)
Symptomatic (8-10 years)
AIDs (10+)

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20
Q

Acute Infection s/s

A

flu-like symptoms
**fever, swollen lymph nodes, sore throat, HA, malaise, nausea, muscle and joint pain, diarrhea, diffuse rash
- 2-4 weeks after infection
highly infectious

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21
Q

What phase is the highest infectious?

A

acute infection

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22
Q

Asymptomatic infection s/s

A

generally absent
high-risk behaviors may continue
Untreated to AIDs

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23
Q

Asymptomatic infection lab

A

CD4+T greater than 500 with low viral load

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24
Q

Symptomatic infection lab values

A

CD4+T 200-500
High viral load

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25
Symptomatic infection s/s
Persistent fevers **shingles** Night sweats **vaginal yeast infection and herpes** **bacterial infections** Chronic diarrhea Frequent HA fatigue HIV advances to a more active stage
26
Candida
oral thrush persistent and down the esophagus difficulty eating (swish and swallow meds)
27
Kaposi Sarcoma
**LOOKS LIKE BRUISE INITIALLY DARK VIOLET/BLACK** invades skin on torsos and extremities and organ surfaces -possible pain
28
Kaposi Sarcoma is caused by
herpes virus
29
Oral Hairy Leukoplakia
caused by **Epstein-Barre** virus not painful **Vertical stripes on the side of the tongue during active phase**
30
AIDs defined by and lab value
CD4+ T-cell < 200cell/uL and or AIDS-defining condition 1+ opportunistic infections
31
HIV wasting syndrome
loss of weight by at least 10% along with diarrhea, chronic weakness, and documented fevers lasting up to a month which can only be accounted for by HIV. - more in the face - decrease in fat and lean body
32
Pneumocysitis jirovecii pneumonia
caused by yeast fungus PJ in lungs of healthy but opportunistic with weak immune system
33
S/S of PJP
fever dry cough or wheezing SOB fatigue chest pain or tightness
34
Tx of PJP
trimethoprim/sulfamethoxazole (TMP/SMX), the brand names are (Bactrim or Septra). Given PO or IV for 3 weeks.
35
Dx of HIV
HIV-specific antibodies and/or antigens May take several weeks to detect antibodies (window period) Performed using blood or saliva Combination (4th generation) tests can detect HIV earlier Negative results – retest in 6 wks
36
What is the window period?
several weeks after initial infection to detect antibodies -false
37
If you get a negative HIV test during the window period, then you should come back when?
in 6 weeks
38
In HIV pts we want the T cell count to be ________ and the viral load to be _______
T = high Load = low (less active immune system)
39
HIV progression is monitored by
CD4T Viral Load
40
Dx abnormal blood tests are common due to
HIV, opportunistic infections and complications of therapy low WBC, platelets, anemia (ART), and alter LFT
41
Resistance tests can help determine if a pt is resisant to
ART
42
What helps HCPs know which med is effective?
Assay (geno and pheno)
43
Genotype Assay
about the infection itself
44
Phenotype Assay
which drugs might be the most effective for the pt
45
Hep B and C is possible for the pt to be at risk if they are a
drug user
46
Interprofessional Care of the HIV pt
Monitor disease progression, immune function & manage symptoms Initiate and monitor ART Prevent, detect and/or treat opportunistic infections Prevent or decrease complications of therapies Prevent further transmission of HIV
47
Initial pt visit of an HIV pt
**baseline data** **rapport** and input for the care plan teaching of HIV, Tx, Prevention of transmission, improve health, and family planning
48
Main Goals of Drug Therapies
lower viral load increase T cells prevent HIV symptoms and opportunistic diseases delay progression prevent transmission
49
OTC drug interactions for HIV pt
Antacids Proton pump inhibitors supplements
50
DRUG INTERACTION TO ARTs
St. John's wort and OTC avoid or not at the same time
51
The main thing about drug therapies before the start on an HIV pt is
are they going to take the medicine regimen as prescribed if not drug resistance might develop and go to a different medicine
52
For opportunistic disease on an HIV pt what is the best mgmt?
prevention onset delayed with adequate measures increased life expectancy if preventative
53
Pre-exposure prophylaxis of HIV
reduce risk of sex-acquired infection in adults at high risk with prevention interventions
54
Should an autoimmune pt take a live virus vaccine?
no
55
When asking questions for at high risk of HIV, the nurse should be
blunt and candid use their language
56
What questions should you ask at-risk patients?
Received a blood transfusion or clotting factors before 1985? Shared needles with another person? Had a sexual experience with your penis, vagina, rectum, or mouth in contact with these areas of another person? Had a sexually transmitted infection?
57
What needs to be assessed in dx pts thoroughly?
pst health hx med functional health patterns s/s
58
Goals for HIV pts
Compliance with drug regimens Adopting a healthy lifestyle Beneficial relationships Spiritual well-being regarding life and death Coping with the disease and its treatment
59
Health Promotion of HIV
infection is preventable avoid risky behaviors modify risk behaviors culture sensitive, age specific
60
What are some ways to prevent HIV through sexual intercourse?
abstinence (not realistic) noncontact safe sex barriers
61
What are some ways to prevent HIV through decreased drug use?
don't no sharing equipment no sex under the influence of impairing substances help with substance abuse
62
What are some ways to prevent HIV through decreased perinatal trans.?
family planning (esp. younger) prevent for women appropriate medication for pregnant women (ART)
63
What are some ways to prevent HIV through decreased work?
adhere to precautions and safety from exposure report all exposures for tx and counseling prophylaxis after exposure with ARTs and decrease risk of infection
64
REactions to postive HIV tests
similar to life-threatening or chronic illness panic anxiety fear, guilt depression denial anger hopeless
65
ART means
Antiretroviral Therapy
66
ART can significantly slow HIV progression, but
complex regimen side effects not for everyone expensive
67
When do you start ART?
pt readiness recommended when **immune suppression is excellent to avoid burnout and non-adherence**
68
What happens when ART is not taken as prescribed?
mutation of HIV and can pass on to already-positive HIV
69
Adherence to ART is critical to prevent
disease progression opportunistic disease drug resistance mutations
70
How can an HIV pt support a healthy immune system?
adequate nutrition (bc of diarrhea, electrolyte imbalance and wasting syndrome) vaccinations habits avoid risks supportive relationships
71
Acute Exacerbations of HIV
NO CURE CONTINUES FOR LIFE physical disability impairs social, emotional, economic,a nd spiritual wellbeing ultimately leads to death
72
What can lead to discrimination and result in social isolation, dependence, frustration, low self-image, loss of control, and economic pressures?
Stigma and further involvement in risky behaviors
73
Can your employer ask if you have AIDS?
no
74
Common side effects of disease and drug for HIV
Anxiety, fear, depression Diarrhea Peripheral neuropathy Pain Nausea/vomiting Fatigue **malaise**
75
Metabolic disorders
lipodystrophy hyperlipidemia DM: insulin resistance AND hyperglycemia bone disease lactic acidosis renal disease CV disease
76
What PPE is used with HIV pts?
Gloves
77
Gerontologic Considerations
increase risk of HIV of older death from opportunistic 60+ more frisky and in denial comorbidities polypharmacy
78
Transmission of HIV from an infected individual to another most commonly occurs as a result of which of the following? Unprotected anal or vaginal sexual intercourse Low levels of virus in the blood and high levels of CD4+T cells Transmission from mother to infant during labor and delivery and breastfeeding Sharing of drug-using equipment, including needles, syringes, pipes, and straws
Unprotected anal or vaginal sexual intercourse
79
A diagnosis of AIDS can be made for a patient with HIV when which of the following are present? CD4+ T-cell count <500/µL WBC count <3000/µL (3 × 109/L) Development of oral candidiasis (thrush) Onset of Pneumocystis jiroveci pneumonia
Onset of Pneumocystis jiroveci pneumonia
80
The nurse is teaching a newly diagnosed 34-year-old male about his HIV infection. Which statement by the patient indicates the need for additional education? “I will need to take my HIV medication daily for the rest of my life.” “Although I only take one pill, it has multiple medications combined into a single tablet.” “I should notify my HIV provider if I get fevers that do not go away with Tylenol or aspirin.” “Once my viral load is undetectable, I don’t have to worry about taking my medication every day.”
“Once my viral load is undetectable, I don’t have to worry about taking my medication every day.”
81
The nurse is caring for a patient who is receiving antiretroviral therapy (ART) for the treatment of HIV. Which assessment best indicates that the patient’s condition is improving? Decreased viral load Increased drug resistance Decreased CD4+ T-cell count Increased aminotransferase levels
Decreased viral load

Module 4 (MedSurg 2) (36 decks)

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