Unit 14 Flashcards
What is HIV Progression?
Stage 1: onset of flu like symptoms, they go away; HIV positive, sexual transmission possible
Stage 2: can last for years, drug management started to maintain immunity; progresses to AIDS; Watch for thresh
Stage 3: AIDS; poor protection against infection (low WBC, low lymphocytes, incomplete antibodies, and abnormal fining macrophages)
What is HIV health promotion and maintenance?
Teach how it is transmitted and how to reduce exposure
Sharing household items will not transmit HIV
It is not spread by insects (including mosquitos)
What is cART, TAP, and Pre-exposure prophylaxis?
cART - start within 28 days, HIV testing done at 1, 3, 6 months; Reduce the viral load, slow progression, increase T-cells; Dont miss or delay taking medication
TAP - treatment as prevention
Pre-Exposure - Use of HIV drugs (Truvada and discover) before exposure; must take for 7 days; kidney fxn is tested every 3 months.
What are transmission types for HIV?
Needles - #1 for healthcare
Blood —> into the mucous membranes
Prenatal (placental, vaginal, breast milk) - Dont prechew food
What are risk factors for HIV?
Gay sexually active men
Drug users
Other STDs
Stress
Repeated exposure, poor immune system, poor nutrition
What are interventions for HIV?
Nutrition - drugs, I/Os, mouth care
Prevent opportunistic infections - TB is the most prevelant
Drug therapy - doesn’t kill
Enhance Gas Exchange
Manage pain
Get rid of inflammation to improve patient outcome
What are common drug types used in HIV?
Fusion - prevents interaction for entry of HIV into other cells
Nucleoside - prevent HIV genetic turning into human genetics
Integrase - prevent viral DNA from integrating into the nuclei of host
Protease - inhibits HIV protease (clips DNA strand into smaller active pieces)
What is pancreatitis?
Premature activation of excessive pancreatic enzymes that destroy duct Al tissue and pancreatic cells, resulting in auto digestion and fibrosis of the pancreas.
What is common diagnostics, labs, and medical management for pancreatitis?
Management - pain meds don’t do much; small frequent, moderate-to-high carbs and protein, low fat meals (4000-6000cal/day)
May need to replace calcium and magnesium !!!
Medication: ranitidine, omeprazole - decrease gastric acid
NPO with NG, suction, and TPN
May need antibiotics or pancreatic-enzyme replacement therapy
What are complications from pancreatitis?
Self-limiting
Organ failure
Sepsis
Death
What are common liver function tests?
AST
ALT
Ammonia
Hep B, C
What are the managements for liver failure?
Promote rest
Improve nutritional status
Provide skin care
Reduce risk of injury (bleeding)
Dont take any alcohol or illicit drugs, check OTC medications with provider
Collaborate!!
Cirrhosis may cause feeling of guilt, be aware
What should I understand about liver transplants?
Med adherence
Not alcoholic
MELD (model for endstage liver disease) determines need
CI: metastatic tumors, sever cardiac disease
What is ulcerative colitis?
Inflammation of rectum and colon, distribution can remain consistent
Peaks in 15-25 years and 55-65 years
Bloody stools
Complications: hemorrhage, nutritional deficiency, cancer
Infrequent need for surgery
What is Crohn’s disease?
Often in the ileum and small intestines, progresses slow and unpredictable
Peak: 15-40 years
Fatty stools (they float)
Surgery need is common
What are types of drugs used for ulcerative colitis?
Aminosalicylates
Glucocorticoids
Antidiarrheal
Immunomodulators
What are the basics of hepatitis?
Hep A and E are related to oral and feces
Hep B, C, and D are related
Hep B and C can cause long-term liver problems
What are some precautions for low immune system?
Avoid crowds
Dont share personal items
Wash toothbrush weekly
Dont touch plants/soil
Avoid undercooked food
T/F The immune system is complex, but AIDS causes a suppression of the immune system which leads to cancer
True
Do the T-cells fall slowly or fast in HIV?
Slowly
What are HIV transmission in relation to healthcare workers?
Needles are #1 cause
Standard precautions are best
Start post-exposure prophylaxis (cART within 2hrs, HIV drugs within 24-36 hours)
What are manifestations of liver failure?
Jaundice - untreated bilirubin lvls can lead to brain stem damage
Portal hypertension
Ascites (fluid in the abdomen, watch for hernia) (TX: nutrition, diuretics, bed rest, paracentesis - pulling fluid off, transjugular intrahepatic portosystemic shunt (TIPS) - 2nd line of therapy)
Esophageal Varices - may use balloon tampon add to expand
Hepatic encephalopathy (coma) - confusion leading to agitation leading to coma; cannot copy picture or writing, ammonia needs to go down and personality may return to normal
What is portal hypertension?
Obstruction of the portal vein causing a block in the blood flow
S/S: Ascites , esophageal varices, splenomegaly, varicella hemorrhage, gastropathy (if it is slow bleeding there is no death), biliary obstruction
What is ostomy info/care?
Watch for air in bag
Keep skin dry
Placement changes consistency of stool
Can be reversed
