CH 17 EAQ's: HIV

The nurse suspects which diagnosis in a pt with AIDS who has small purplish brown, raised lesions on the skin?

Kaposi sarcoma

Which is a common means of HIV transmission?

Sexual, perinatal, and parenteral. perinatal= from placenta, maternal blood/ body fluids. Parenteral= sharing needles or contaminated equipment. It is not transmitted by casual contact or sharing household utensils

Which is true regarding the risk for HIV transmission from patients receiving combination antiretroviral therapy (cART)?

The patients viral load may drop to undetectable levels, but there is still a risk for transmission Pt still remains positive

Which defines the concept known as treatment as prevention (TAP) of HIV?

The use of combination antiretroviral therapy (cART) reduces the viral load to undetectable levels, thereby reducing the risk for HIV transmission.

Which protozoal-like infection may occur as an opportunistic infection in pts with AIDS?

Giardiasis and toxoplasmosis

According to CDC, in the US and Canada, which population has the highest rates of new HIV infections?

African - American and hispanic adults

Why does anal intercourse has the highest risk for HIV transmission?

Anal intercourse allows seminal fluid to make contact w rectal mucous membranes and also tears the mucous membranes making infection more likely.

Which sexual act carries the highest risk for the transmission of HIV?

Anal sex

Which type of lab test measures a pts response to the virus in pts with HIV?

Antibody testing Viral load testing directly measures the actual amount of HIV viral RNA particles present in the blood.

Based on lab reports, the nurse concludes that a patients immunity is compromised and provides which instruction to the patient?

Avoid digging in the garden wash your genitals twice a day with antimicrobial soap if total bathing is not possible

Which nursing occurrence is a cause for post exposure prophylaxis (PEP) with combination antiretroviral therapy (cART)?

Being stuck by a contaminated sharp needle, being a victim of sexual assault. PEP and cART is used for adults who have had an occupational exposure, those who have had a nonoccupational exposure, and those who have suffered a sexual assault

To prevent possible HIV transmission which is the nurse's priority action after getting stuck by a hollow bore needle through a latex glove?

Bleed the wound and wash it for at least 1 full minute the nurse should begin three-drug cART before all test results are known but not before bleeding and washing the wound

Which phase of HIV life cycle involves separating from the infected cells membrane to search for another CD4+ T-cell to infect?

Budding

In HIV infections, more virus particles are created when the virus enters which type of host cell?

CD4+ T-cell

Which lab changes are most likely in a pt whose immune system is being overwhelmed by HIV?

CD4+ T-cell counts fall, viral numbers rise

Which fungal infection may occur as an opportunistic infection in patients with AIDS?

Candidiasis and Histoplasmosis Giardiasis and toxoplasmosis is a protozoal like infection. Norcardiosis and TB are bacterial infections

According to CDC lab classifications, which class of HIV is marked by CD4+ t-cell count greater than 500 cells/mm3 or a percentage of 29% or greater?

Class 1 Class 0: Normal Class 2: 200-499 Class 3: less than 200

The nurse suspects which opportunistic infection in a patient with AIDS who experiences impaired vision, fever, malaise, and swollen lymph nodes?

Cytomegalovirus (CMV) CMV may specifically affect the eye.

As the HIV progresses, which immunity abnormality occurs with poor CD4+ T-cell function?

Decreased numbers of lymphocytes, abnormal functioning macrophages, and increased production of incomplete and nonfunctional antibodies - viral load is likely to increase while mature T helper cells (CD4+) decrease as HIV progresses

Which s/s is a CNS indication of AIDS?

Dementia and confusion

How often should the patient taking tenofovir/emtricitabine for pre-exposure prophylaxis (PrEP) for HIV be tested for HIV?

Every 3 months Pt should be tested once before beginning PrEP, but continue to be screened.

Which clinical manifestation presents with adrenal insufficiency associated with AIDS?

Fatigue, nausea, electrolyte disturbances. also: weight loss and low blood pressure

The nurse expects which symptom in an adult with an acute infection that has occurred within 4 weeks of first being infected w HIV?

Fever, night sweats, and muscle aches. memory loss: AIDS Purplish lesions are a sign of Kaposi sarcoma that may occur w AIDS

The nurse educates a pt who is immunocompromised about preventing infection and identifies that which occurrence warrants immediate notification to the HCP?

Foul smelling or cloudy urine may indicate infection. Persistent cough with or w/o also indicates infection, but not an intermittent cough. Pt needs to contact HCP for temp greater than 100

Which class of drugs for HIV infection prevents viral binding?

Fusion inhibitors prevent the interaction needed for entry of HIV into CD4+ cell

Which criterion is a component of a diagnosis of AIDS?

HIV positive, CD4+ cell count percentage of less than 14%, an opportunistic infection, CD4+ of less than 200 cells.

The nurse suspects which opportunistic infection when caring for a patient with AIDS with painful genital lesions, fever, and malaise?

Herpes simplex virus

Which statement about HIV requires correction?

If the use of cART causes the viral load to drop below undetectable levels, there is no risk for HIV transmission.

Abnormal functioning of which body system is responsible for the s/s of HIV infection?

Immune

For which population may Pre-exposure prophylaxis (PrEP) for the HIV virus be appropriate?

Injection drug users, men who have sex with men, non monogamous heterosexually active men and women, Adults who are HIV negative and in a relationship w a partner who is HIV positive. (It is not appropriate for those who are pos)

Which class of drugs for HIV infection prevents the virus from inserting its DNA into the hosts DNA?

Integrase Inhibitors HIV uses its enzyme integrase to get its DNA into the nucleus of the hosts CD4+ t-cell and insert it into the hosts DNA. Viral binding to the CD4 receptor and to either of the coreceptors is needed for HIV to enter the cell.

Neutropenic precautions

Isolation procedures to protect an immunocompromisd patient from infections (Know: pt has weakened immune system because of HIV= low wbc and CD4+ cell counts)

Which disease and tx related endocrine problem may occur in pts w HIV?

Lipoatrophy, lipodystrophy, diabetes, adrenal insufficiency, and elevated triglycerides.

Which s/s is a GI indication of AIDS?

Nausea and Diarrhea

Which bacterial infection may occur as an opportunistic infection in patients w AIDS?

Nocardiosis and Tuberculosis

A higher incidence of which condition occurs among pregnant women with HIV?

Premature delivery, transmission of the disease to the infant, and low birth weight infants.

Which class of drugs for HIV infection reduces how well HIV genetic material can be converted into human genetic material?

Nucleoside reverse transcriptase inhibitors (NRTIs) NRTIs prevent viral replication by reducing how well reverse transcriptase can convert HIV genetic material into human genetic material.

When determining the financial resources of a pt w AIDS, the nurse recognizes that the info obtained will help with the assessment of which patient status?

Nutritional Status Their financial resources may give the nurse insight into food intake, weight loss/ gain or skin condition.

Which class of drugs for HIV prevents new virus particles from splitting into functional pieces?

Protease inhibitors

Which features of HIV convert its RNA into DNA and insert it into the hosts DNA?

Reverse transcriptase and integrase enzymes The HIV enzyme reverse transcriptase converts hiv's RNA into DNA which makes the viral genetic material the same as human DNA

How does gender affect HIV transmission?

The infection is more easily transmitted from infected men to uninfected women. HIV is most easily transmitted when infected body fluids come into contact w mucous membranes. The vagina has more mucous membrane (surface area) that does the urethra of the penis. women should use barrier methods of protection.

Which type of food item does the nurse instruct the pt w HIV to avoid?

Undercooked meat and rare fish

The nurse suspects which diagnosis in a pt w AIDS who presents w headaches, fluid- filled blisters, and low grade fever?

Varicella- zoster virus (shingles)

When a pts first positive HIV test takes place within 6 mo after a negative HIV test result, the nurse recognizes that the pts lab classification according to the CDC will change from class 0 to class 1 if which event occurs?

When the CD4+ Tcell count is greater than 500 cells or a percentage of 29% or greater.

Which medication education does the nurse provide for a patient who takes combination tenofovir/emtricitabine for pre-exposure prophylaxis (PrEP) for HIV?

You will be protected only after 7 days of consistent dosing Pt can miss 1 day after initial 7 days of consistent dosing and still be protected. two consecutively missed doses greatly reduce protection and you need to start over with another 7 day period. The once-daily dosing is currently the only approved dosing regimen.

Which features of HIV assist the viral particle in finding a host?

gp41 and gp120 docking proteins viral particle features include an outer envelope with these "docking proteins" that assist in finding a host.

Which s/s is an immunologic indication of AIDS?

lymphadenopathy and high blood immunoglobulin levels.