CH last one

HIV/AIDS

-"HIV is a virus spread through certain body fluids that attacks the body's immune system, specifically the CD4 cells, often called T cells. Over time, HIV can destroy so many of these cells that the body can't fight off infections and disease. These special cells help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body. This damage to the immune system makes it harder and harder for the body to fight off infections and some other diseases. Opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS" -HIGH RISK : Homosexual men, incarcerated, multiple sex partners, IV drug risk, homelessness. -•Choose less risky sexual behaviors. HIV is mainly spread by having anal or vaginal sex without a condom or without taking medicines to prevent or treat HIV. -Sexual activities that don't involve contact with body fluids (semen, vaginal fluid, or blood) carry no risk of HIV transmission but may pose a risk for other STDs.

Scabies

-"The mite that burrows" -fingers, wrists, bend of arm, axillary, groin area, toes -itchy at night especially Treatment: -cream on EVERY surface of body from between the toes and all the way up avoiding the eyes, mouth, nose. Leave on for 8-12 hours (sleep in it) and wash off in shower -Permethrin cream and if it doesn't work can use ivermectin tablets but can cause liver damage -wash all linens on hot water and dry on high heat, if things cannot be laundered put in bag and tied up for 1-2 weeks. Hot sun for used couch, etc...

Rubella

-(German Measles, 3-day Measles) •Virus but a different virus than the measles. •Real bad if a pregnant woman gets this! can result in still born, or severe birth defects S/S: -In children, rubella is usually mild, with few noticeable symptoms. For children who do have symptoms, a red rash is typically the first sign. The rash generally first appears on the face and then spreads to the rest of the body, and lasts about three days. Other symptoms that may occur 1 to 5 days before the rash appears include: •a low-grade fever •headache •mild pink eye (redness or swelling of the white of the eye) •general discomfort •swollen and enlarged lymph nodes •cough •runny nose •It is characterized by a mild, maculopapular rash along with lymphadenopathy, and a slight fever. •The rash usually starts on the face, becomes generalized within 24 hours, and lasts a median of 3 days; it occurs in 50% to 80% of infected people. •Lymphadenopathy, which may precede rash, often involves posterior auricular or suboccipital lymph nodes, can be generalized, and lasts between 5 and 8 days. Transmission: A person with rubella may spread the disease to others up to one week before the rash appears, and remain contagious up to 7 days after. -However, 25% to 50% of people infected with rubella do not develop a rash or have any symptoms. Diagnosis: •Throat swab (best), nasal swab, or urine specimens for viral detection. •Blood also can be collected for serologic testing. •These lab tests take a few days to result - better safe than sorry. Consider rubella in unvaccinated patients with febrile rash illness and other rubella symptoms, esp. if they recently traveled outside of the US -VIRUS so treat the symptoms

Food intoxication

-(Toxins produced through bacterial growth, chemical containation, or dz-producing substances) Staphylococcus aureus Clostridium botulinum

Waterborne

-(fecal contamination of water) Cholera Typhoid fever Bacillary dysentery Giardia lamblia

Chlamydia (Non-gonococcal urethritis)

-A bacterial infection caused by Chlamydia trachomatis and is the most commonly reported STI in American women IF LEFT UNTREATED CAN: -Spread to sex partners -Lead to ectopic (tubal) pregnancy -Lead to pelvic inflammatory disease -Lead to infertility in men and women -Make it easier to transmit or acquire HIV during sex -Men and women who have been treated for chlamydia should be retested approximately 3 months after treatment, regardless of whether they believe that their sex partners were treated -If retesting at 3 months is not possible, clinicians should retest whenever persons next present for medical care in the 12-month period following initial treatment. -SEXUAL PARTNERS NEED TESTING AND TREATMENT IF THEY HAD SEXUAL CONTACT WITH THE PARTER DURING THE 60 DAYS PRECEDING THE CLIENT'S ONSET OF SYMPTOMS OR DIAGNOSIS. -To minimize disease transmission to sex partners, persons treated for chlamydia should be instructed to abstain from sexual intercourse for 7 days after single-dose therapy or until completion of a 7-day regimen and resolution of symptoms if present. Rectal s/s: Rectal pain, discharge, bleeding Treatment: -Doxycycline 100 mg orally 2 times/day for 7 days -Alternative Regimens: Azithromycin 1 g orally in a single dose OR Levofloxacin 500 mg orally once daily for 7 days -PREGNANT WOMEN: Recommended Regimen for Chlamydial Infection During Pregnancy -Azithromycin 1 g orally in a single dose -Alternative Regimen Amoxicillin 500 mg orally 3 times/day for 7 days

Steroids

-Anabolic steroids are synthetic variants of male sex hormone testosterone --Build muscle and said to be androgenic --Most commonly used in athletes and other individuals willing to risk potential and irreversible health consequences to build muscle -Potentially fatal risks --Blood clots, liver damage, premature cardiovascular changes, increased cholesterol --Increased potential for suicide and aggressive and risky behaviors. --Increased risk of depression with withdrawals.

Inhalants

-Contain volatile components with psychoactive properties --Many products found in home or workplace (e.g., spray paints, markers, glues, and cleaning fluids) -Produce a rapid high that may resemble alcohol intoxications; may progress to loss of sensation and even unconsciousness -Irreversible effects: --Hearing loss, limb spasms, CNS or brain damage, or bone marrow damage; may result in death from heart failure or suffocation Effects of intoxication •Dizziness •Uncoordinated movements •Hyporeflexia •Muscle weakness •Stupor or coma •Respiratory depression •Possible death No withdrawal manifestations

Gonorrhea symptoms in women, etc.

-Develop 7-21 days after exposure, or not at all -Dysuria (painful urination) -Vaginal bleeding between periods and dysmenorrhea Physical Assessment Findings: -Yellowish-green vaginal discharge -"Friable" cervix Diagnostic Tests: -Urine culture -Penile swab/culture -Endocervical culture Rectal S/S: -Discharge -Anal itching -Soreness -Bleeding -Painful bowel movements

Pediculosis Capitis (Head Lice)

-Flick nits don't come off, flick dandruff it comes off -itch behind ears and back of neck -Rid & Nix shampoo make sure has permethrin in it. Then section off hair and comb it and wipe gunk on tissue and put tissue in bag and seal and throw in dumpster -do NOT share bows, headbands, hairbrushes -stuffed animals put in bag for 2 weeks, vacuum good, boil hairbrush in hot water, wash all things that are washable in hot water and dry on high heat -contact precautions

Foodborne

-Food infection (bacterial, viral, parasitic infection of food Norovirus Salmonellosis Hep A Trichinosis E. coli

acquired immunity

-Immunity that is present only after exposure and is highly specific. -active= immunization -passive= passed on by breastfeeding or from someone person to person

VACCINATION PREVENTABLE DISEASES

-It is important that children complete their vaccines and receive them the right amount of time to make sure that they prevent themselves from getting and spreading these diseases. Anthrax Diphtheria (D) Hepatitis A and B (HAV and HBV) Haemophilus Influenza type B (HiB) Human Papilloma virus (HPV) Influenza (Flu) Measles (M) Meningococcal Mumps (M) Pertussis (P; whooping cough) Pneumococcal Polio Rabies Rotavirus Rubella (R) Shingles (Herpes Zoster) Tetanus (T) Tuberculosis (TB) Varicella (Chickenpox)

Methamphetamine (MA)

-Pleasurable effects are caused by the release of high levels of dopamine in the brain, leading to increased energy, a sense of euphoria, and increased productivity. --Short-term effects: increased heart rate, insomnia, excessive talking, excitation, and aggressive behavior --Prolonged use results in tolerance and physiological dependence -Negative consequences range from anxiety, convulsions, and paranoia, to brain damage. -The impact of MA abuse on communities, families, and social networks is considerable. --Young children of users are at risk for abuse and neglect. --Prenatal use puts children at risk for developmental problems, aggression, and attention disorders. --Exposure to combustible second-hand fumes. --Associated with increased incidence of violence (e.g., domestic abuse, homicide, and suicide)

Gonorrhea "The Clap"

-Primarily spread by genital-to-genital contact BUT can be spread by anal-to-genital or oral-to-genital contact. -More than 1 MILLION infections occur each year. Only half have symptoms = soooooo you can see how it spreads so easily. -Can also be transmitted to a newborn during delivery -untreated can lead to PID (Pelvic Inflammatory Disease) which could cause infertility in women, ectopic pregnancy, scar tissue that blocks fallopian tubes, long-term pelvice/abdominal pain. You Need to Screen: -All sexually active females younger than 25 should be screened (per CDC). -Older omen who have high risk factors should be screened (per CDC). -All pregnant woman at risk should be screened at the first prenatal visit and rescreened in the third trimester if at continued high risk. Treatment: -500 mg of IM ceftriaxone in a single dose. ALL THAT STANDS BETWEEN US AND UNTREATABLE GONORRHEA per the CDC (2021). -Medication will stop the infection, but will not repair any permanent damage done by the disease. -As of 2020, the CDC no longer recommends Azithromycin due to growing resistance. -GONORRHEA IS BECOMING HARDER & HARDER TO TREAT!!!!

herd immunity

-Refers to the immunity of a group or community. It is the resistance of a group of people to invasion and spread of an infectious agent. -is based on the resistance of a high proportion of individual members of a group to infection. It is the basis for increasing immunization coverage for vaccine preventable diseases.

5th disease

-Symptoms are mild and may include fever, runny nose, HA, and rash. -More common in children than adults. -You may also have painful or swollen joints. Transmission: •Respiratory secretions •Can also spread through blood and blood products •This on Parvovirus B19 ONLY INFECTS HUMANS. (Dogs can get different Parvovirus') Usually diagnosed in physical exam but blood test can be performed. Wash those hands! -Spread through secretions. -Most contagious before rash occurs. -Once you get a rash - go to school, work, etc,

Lyme Disease

-Tick-borne disease caused by the spirochete Borrelia burgdorferi. -most commonly REPORTED tickborne infection in the US Early S/S (3-30 days after bite): •Fever, chills, swollen lymph nodes, fatigue, muscle aches, joint aches •BULLS EYE RASH called Erythema migrans rash begins at the site of tick bite (average is 7 days after bite) Late S/S: •Severe HAs. Severe neck stiffness. •Arthritis with severe joint pain and swelling. Particularly knees and large joints. •Facial palsy •Heart palpitations •Nerve pain •Problems with short-term memory •Numbness or tingling in hands and feet Diagnosis: •Signs and Symptoms •History of recent (within the last 30 days) tickbite •Laboratory tests = Enzyme Immunoassay (EIA) or Immunofluorescence Assay (IFA)

Vertical and horizontal transmission

-Vertical= occurs when the inspection is passed from parent to offspring be a sperm, placenta, milk, or contact in the vaginal canal at Birth -Horizontal= is the person to person spread of infection through one or more of the following four routes: direct or indirect contact, common vehicle, airborne, or vectorborne

Parvovirus B19

-Virus associated with aplastic anemia in patients with sickle cell anemia. -related to 5th disease

Bacterial Vaginosis (BV)

-a condition in women in which there is an abnormal overgrowth of certain bacteria in the vagina -NOT A STI -like trich, treat w/ Metronidazole and remember to avoid alcohol of all types even germx 48 hrs before and after treatment

-Leading cause of communicable dz deaths include

-acute respiratory infections (including PNE and FLU), HIV/AIDS, diarrheal dz, TB, malaria, and measles. -Other dz that pose significant threat to community health include: viral hepatitis and STI's. -CH Nurses must maintain knowledge of dz rates, modes of transmission, incubation early manifestations, periods of communicability, and how to intervene at all levels of prevention R/T communicable dz. -CDC recommend routine immunizations according to age. -Populations at risk- Young, older adult, immunosuppressed clients, high-risk lifestyles, international travelers, HCWs.

isolation precautions

-airborne, droplet, contact, and protective environment -contact: gown, gloves. be sure to wash hands!

Syphilis

-an STD that attacks many parts of the body and is caused by a small bacterium called a spirochete -MUST ABSTAIN FROM SEX UNTIL THE SYPHILIS SORES ARE COMPLETELY HEALED! -treatment: Penicillin

MRSA (methicillin-resistant Staphylococcus aureus)

-an infection caused by specific bacteria that has become resistant to many antibiotics•a cause of staph infection that is difficult to treat because of resistance to some antibiotics -CONTACT PRECAUTIONS •The risk increases with activities or places that involve crowding, skin-to-skin contact, and shared equipment or supplies. •In places such as a hospital or nursing home, MRSA can cause severe problems such as •bloodstream infections, •pneumonia, or •surgical site infections. Spread: •People who have MRSA germs on their skin or who are infected with MRSA may be able to spread the germ to other people. In addition to being passed to patients directly from unclean hands of healthcare workers or visitors, MRSA can be spread when patients contact contaminated bed linens, bed rails, and medical equipment. Treatment: -meds Mupirocin. bactrium -warm compress pulls out all the gross stuff -clean 2-3 times a day

Vaccine failure

-can occur as result of: the host, improper administration, and improper storage -Primary: not enough antibodies produced when first vaccinated -Secondary: enough antibodies are produced after vaccination, but levels decrease over time

Trichomoniasis

-easily confused with BV KNOW THE DIFFERENCE -green, watery discharge -treat w/ Metronidazole and remember to avoid alcohol of all types even germx 48 hrs before and after treatment

Reportable diseases to the CDC include:

-gonnorhea (AKA "The Clap") -Chlamydia - most commonly reported STI in American women -syphilis -HIV/AIDS -Hepatitis C

Impetigo

-inflammatory skin disease with pustules that rupture and become crusted -Most often caused by *Staphylococcus Aureus or Group A Streptococcus* (know if bugs are gram +, gram - or anaerobes) -Lesions begin as erythematous papules that evolve into a vesicle or pustule. -Pustules rupture leaving a *honey-colored crust*

Signs of Syphilis

-painless syphilis sores, non itchy body rash on palms of hands and soles of feet, all over body, or just a few places, can also affect the eye -stage 1: sores 3-90 days after exposure -stage 2: body rash 4-10 wks after exposure -stage 3: affects internal organs 3-15 yrs after exposure

Energy drinks

-put you at risk for sugar diabetes •Increase blood pressure •Increase your risk for irregular heart rhythms •Impact your sleep •Cause weight gain •Cause tooth decay •Contribute to mental health problems •Increase diabetes risk •Cause kidney damage •Contribute to substance abuse problems

C. diff

-spore-forming, Gram-positive anaerobic bacillus that produces two exotoxins: toxin A and toxin B. It is a common cause of antibiotic-associated diarrhea (AAD) and accounts for 15 to 25% of all episodes of AAD. -CONTACT PRECAUTIONS HIGHLY CONTAGIOUS FECAL ORAL ROUTE -S/S: watery diarrhea fever loss of appetite nausea abdominal pain/tenderness Increased risk pt: -antibiotic exposure (e.g., fluoroquinolones, third/fourth generation cephalosporins, clindamycin, carbapenems) -gastrointestinal surgery/manipulation -long length of stay in healthcare settings -a serious underlying illness -immunocompromising conditions -advanced age -Diagnosis: -stool culture, toxin testing, antigen detection, molecular tests Treatment: should usually be treated with an appropriate course (about 10 days) of treatment, including oral vancomycin or fidaxomicin. After treatment, repeat C. diff testing is not recommended if the patient's symptoms have resolved, as patients often remain colonized.

Direct contact:

-transmission of infectious agent from infected host to susceptible host ia direct contact STIs, HIV/AIDS, chlamydia, gonorrhea, syphilis, human papilloma virus , genital herpes, hepatitis B, C, D Infectious mononucleosis Enterobiasis (pinworms) Impetigo Lice, scabies

Vector-borne:

-via a carrier such as a mosquito or tick West Nile Virus Lyme dz Rocky Mountain spotted fever Malaria

Immunization vs Vaccine

-you get a vaccination for the flu and it is not until 2 weeks later when your body develops antibodies that you are considered immunized

cane use

1. Used for balance and support 2. Hold in opposite hand of the affected extremity 3. Advance cane at the same time the affected leg moves forward 4. Rubber tip on the point will help prevent slippage CANE, BAD LEG, GOOD LEG C-Cane O- opposite A- affected L- leg -make sure it is level with greater trochanter

removing PPE order " Doffing"

1. gloves 2. goggles 3. gown 4. mask -if gown dirty take it off before gloves/with them

Putting on PPE order

1. gown 2. mask 3. goggles 4. gloves

Walker use

1. stand adjacent to the client on the affected side 2. instruct client to put all 4 points walker flat on the ground before putting weight on hand pieces 3. Instruct client to move the walker forward, followed by the affected or weaker foot, and then the unaffected foot pick them up, set them down, walk to them no scooting! No tennis balls or rollators Tie things on side, not front. Will tip.

children in smoking houses

According to the Centers for Disease Control and PreventionTrusted Source, children living in homes with secondhand smoke are more likely to have: •sudden infant death syndrome •asthma •respiratory infections •ear infections •other illnesses

Other lesions disregard size

Cyst - raised, encapsulated, fluid-filled lesion Wheal - circumscribed area of skin edema Example: Hives Purpura - Flat, red-purple discoloration caused by RBCs lodged in the skin (if less than 1 cm term is petechiae) Example: thrombocytopenia

Hepatitis C

It is an infection of the liver and is spread through contact with blood from an infected person S/S- Anorexia, nausea, vomiting, jaundice, dark urine, clay colored stool, abdominal pain Transmission: It is usually spread through needles that people use for drugs. PPE: standard precaution- gloves Vaccine?- No there is no vaccine but there is a cure. Treatment: It lasts 8-12 weeks There are different types of genotypes which they will run tests in taking a specific treatment for it If you get a needle stick- Wash with soap and water

less than 1 cm lesions

Macule = Flat, nonpalpable discoloration less than 1 cm (example: freckle) Papule = solid elevation less than 1 cm (example: raised nevus) Pustule - vesicle-like lesion with purulent content less than 1 cm (example: impetigo) Vesicular - small fluid-filled sack like might be seen with poison ivy

How soon after exposure to HIV can an HIV test detect if a person is infected?

No HIV test can detect HIV immediately after infection. If you think you've been exposed to HIV in the last 72 hours, talk to your health care provider about post-exposure prophylaxis (PEP), right away. The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have HIV is called the window period. The window period varies from person to person and depends on the type of test used to detect HIV. •A nucleic acid test (NAT) can usually tell you if you are infected with HIV 10 to 33 days after an exposure. •An antigen/antibody test performed by a laboratory on blood from a vein can usually detect HIV infection 18 to 45 days after an exposure. Antigen/ antibody tests done with blood from a finger prick can take longer to detect HIV (18 to 90 days after an exposure). When the goal is to tell for sure that a person does not have HIV, an antigen/antibody test performed by a laboratory on blood from a vein is preferred. •Antibody tests can usually take 23 to 90 days to reliably detect HIV infection. Most rapid tests and home tests are antibody tests. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid.

greater than 1cm lesions

Patch - Flat, nonpalpable area of skin discoloration, larger than a macule (greater than 1 cm) Example: vitiligo Plaque - raised lesion, same or different color from surrounding skin, can result from a collection of papules Example: psoriasis vulgaris Bulla - Fluid filled Example: 2nd degree burn

Prevention Strategies for Substance Abuse

Primary prevention: -Needs assessment to identify high-risk situations and potential problems -Decriminalization and legalization of drugsCommunity-based programs -Training of health professionals -Faith-based initiatives -Volunteer consumer groups -Organized sports programs -Employer programs Secondary prevention: -Screening and finding resources •CAGE: an alcoholism screening test •Clinical Institute Withdrawal Assessment (CIWA) •Use evidence-based programs -Efforts should be specific to aggregates, rather than directed at the "general public" -Incorporate culturally sensitive and appropriate interventions and strategies -Work toward improving individuals' general competencies, communication skills, and self-esteem Tertiary Prevention: •Assist the patient to develop a plan to avoid high-risk situations to enhance coping and lifestyle changes. •Provide emotional support to recovering substance users and their families, including positive reinforcement.

Portals of Entry

Respiratory passages GI Skin Mucous membranes Genitourinary tract Eyes Blood vessels

Portals of Exit

Respiratory secretions Feces Blood Semen Vaginal secretions Saliva and emesis Skin lesion exudate

pelvic inflammatory disease (PID)

Risk factors: -Have an STI and do not get treated or not treated properly. -Have more than one sex partner. -Have a sex partner who has sex partners other than you. -Have had PID before -Are sexually active and 25 years of age or younger. -Douche S/S: -PAIN IN LOWER ABDOMEN -FEVER -UNUSUAL DISCHARGE WITH A BAD ODOR FROM VAGINA -PAIN AND/OR BLEEDING DURING SEX -BURNING WHEN URINATING -BLEEDING BETWEEN PERIODS

Hepatitis B

S/S :fatigue, poor appetite, stomach pain, nausea, and jaundice abdominal pain, dark urine, clay-colored stool, joint pain. Mainly gloves are needed in someone with hep B same as when caring for any other patient on contact precautions Yes there is a hepatitis B vaccination- is series of 3 IM injections second and third does administered at 1 and 6 months, after first dose Treatment -no medication available to treat acute hepatitis b. but symptoms HCP usually recommend rest adequate nutrition and fluids. -Chronic Hep B several medications are approved to treat chronic hep b but not everyone with it needs medication. However, people who start treatment may need to take medication indefinitely. -They need to take care of their livers get vaccinated against hep a and tested for hep c, avoid drinking alcohol follow healthy diet stay physically active, check with PCP before taking any prescription pills supplements or OTC medication. Also caution on taking acetaminophen Hepatitis B is spread through blood semen or other body fluids from a person infected with virus enters the body of someone who is not infected. With sexual contact, needle sharing, syringes, or other drug-injection equipment's or mother to baby at birth.

Hepatitis A

Signs & Symptoms: - Fatigue, N/V, abdominal pain/discomfort (upper right side beneath your ribs), clay-colored BMs, loss of appetite, low-grade fever, dark urine, joint pain, jaundice, intense itching How is it transferred/spread & what PPE is needed? - Fecal-oral: contaminated food/water or direct contact from an infected individual. - Gloves when handling a possible affected individual; gloves, masks, & gowns when cleaning up vomit or feces from a possible affected individual. Is there a vaccine? - Yes, there are two types: one is two different shots, 6 months apart, and the other is a combination shot that protects from hepatitis A & B. What is the treatment? Nursing interventions? - Hep A usually requires no treatment; there is no long-lasting illness. - If treatment is needed, doctors suggest rest, adequate nutrition, & fluids. - Nursing interventions: monitor dietary intake & calorie count, encourage upright position while eating, teach proper hygiene & safe sexual practices, monitor serum glucose.

Hepatitis E

Signs and Symptoms FEVER, FATIGUE, LOSS OF APPETITE, N/V, ABD PAIN, JAUNDICE, DARK URINE, CLAY COLORED STOOL, JOINT PAIN How is it transferred/spread? FECAL/ ORAL ROUTE: CONTAMINATED DRINKING WATER, UNDERCOOKED PORK OR DEER MEAT, CONSUMPTION OF UNCOOKED OR UNDERCOOKED MEAT FROM INFECTED ANIMALS What PPE/precaution is needed? CONTACT PRECAUTIONS (GOWN AND GLOVES) GOOD SANITATION, CLEAN DRINKING WATER, FULLY COOKED MEATS Is there a vaccine? If so, who needs the vaccine? NO FDA APPROVED VACCINE IN THE UNITED STATES. A RECOMBINANT VACCINE IS APPROVED FOR USE IN CHINA What are the treatments/nursing interventions for the treatment? IT RESOLVES ON ITS OWN WITHOUT TREATMENT, BUT SUPPORTIVE THERAPY SHOULD BE USED. PTS NEED REST, ADEQUATE FLUID AND NUTRITION, AVOID ALCOHOL, AND CHECK WITH THEIR PHYSICIAN BEFORE TAKING DRUGS THAT MAY AFFECT THE LIVER (ACETAMINOPHEN). HOSPITALIZATION MAY BE NECESSARY AND SHOULD BE CONSIDERED FOR PREGNANT WOMEN.

Hepatitis D

Signs and Symptoms : abdominal pain, N/V, fatigue, jaundice, dark urine, ascites Could also be asymptomatic Will go away on it's own, chronic HDV gradually develops over time How is it transferred/spread and what PPE is needed? Have to have Hep B before you get D. Hep B spread: vaginal and anal sex, sharing toothbrush, razors, nail clippers Hep D spread: Can be transmitted through body fluids such as blood, semen, vaginal fluid Standard precautions Is there a vaccine There is no current vaccine for Hep D. Prevent of Hel B with the Hep B vaccine will protect against a future Hep D infection What is the treatment? Nursing interventions. No treatment is used specifically for HDV however, Pegylated interferon alpha is the treatment generally recommended for Hep D but the response rate to this is low.

Treatment of HPV

To remove warts and relieve symptoms: Cryotherapy (during pregnancy) Imiquimod & Podophyllin (not with pregnancy) Podofilox (for external warts)

endemic, epidemic, pandemic

endemic- typically presents at low to moderate level in a population epidemic - occurrence at unusually high rate in a population pandemic- global epidemic: current concern- H5N1 avian influenza virus

Substance abuse

is the medical term used to describe a pattern of using a substance (drug) that causes significant problems or distress. This may be missing work or school, using the substance in dangerous situations, such as driving a car. It may lead to substance-related legal problems, or continued substance use that interferes with friendships, family relationships, or both. -a maladaptive pattern of substance use that is manifested by recurrent and significant adverse consequences related to repeated use of a substance. --Failure to fulfil major role obligations --Repeated use in physically hazardous situations --Multiple legal problems --Recurrent social and interpersonal problems

Tolerance

more of the drug is needed to achieve the same "high"

pertusis (whooping cough)

• Caused by Bordetella pertussis - aerobic Gr- coccobacili • Bacteria affect the ciliated escalator system (prevent the movement of mucus) - mucus accumulates in trachea • Infants can suffer from the brain damage caused by severe coughing • Transmitted by droplets • Treatment: Combination antibiotic therapy • Vaccine is available - DTP as routine childhood vaccines -Antivaccine movement has caused an increase in this. Vaccinate babies, and people that are going to be around babies

Aspartame

•"Diet" foods and drinks •Free methanol is created when aspartame is heated. Free methanol breaks down into formaldehyde, a known carcinogen and neurotoxin. •Can increase chance of type 2 DM.

Herpes Zoster (Shingles)

•1 out of 3 people in the US will develop shingles in their lifetime. •Anyone who has recovered from chickenpox may develop shingles; even kids can get shingles! •The risk of getting shingles increases as you age. •Those who have a higher chance of getting shingles are those with a weakened immune system and/or receive immunosuppressive drugs. •The same virus that causes chickenpox causes shingles. (Varicella) •The chickenpox virus stays dormant (inactive) in the body. RASH: •PAINFUL •Develops on one side of the face or body •People often have pain, itching, and/or tingling in the area where the rash will develop. This may occur 1-5 days before the rash. •Usually occurs in a single stripe either around the left or right side of the body. •Other symptoms: fever, headache, chills, upset stomach Transmission: •The virus that causes shingles can spread from a person with active shingles to cause chickenpox in someone who has never had chickenpox or has never received the chickenpox vaccine. •DIRECT CONTACT WITH FLUID FROM BLISTERS •ONLY CONTAGIOUS DURING BLISTER PHASE! •Shingles is less contagious than chickpox. COVER THE RASH!!!! -AVOID PREGNANT, PEOPLE W WEAKE IMMUNE SYSTEMS, and PREMATURE OR LOW BIRTH WEIGHT INFANTS

Alcohol

•A blood alcohol concentration of 0.08% (80g/dL) is considered legally intoxicated for adults operating automobiles in the U.S. •Death could occur from acute toxicity in levels greater than about 0.4% (400g/dL). •INTENDED EFFECTS: relaxation, decreased social anxiety, stress reduction EFFECTS OF EXCESS: Slurred speech, memory impairment, altered judgment, decreased motor skills, decreased level of consciousness, respiratory arrest, death (with large doses) CHRONIC USE EFFECTS: Heart damage, liver damage, erosive gastritis, GI bleeds, acute pancreatitis, sexual dysfunction

HPV (human papilloma virus)

•A group of more than 150 viruses. Each virus has its own number which is called its HPV type. can cause: •Mouth cancer, cervical cancer, genital warts •Throat cancer, vaginal cancer •Anus cancer, vulvar cancer •Rectum cancer, penile cancer S/S: -usually appear as a small bump or group of bumps in the general area and they can be small or large raised or flat or shaped like a cauliflower -words can appear within weeks or months after sexual contact with an infected partner even if the infected partner has no signs of these -if left untreated they might go away, remain unchanged, or increase in size or number

Opioid Withdrawal

•Can occur within hours to days of stopping the drug. •Heroin users may have withdrawal symptoms within 6-8 hours after use is stopped. •Meperidine users withdraw faster than heroin users. S an S: anxious mood, nausea, vomiting, muscle aches, excessive tearing and running nose, sweating and dilated pupils. Treatment: •Methadone = a long-acting opioid that can be substituted for the opioid of addiction. •Can be titrated down during rehab to ease withdrawal symptoms. •Users do NOT crave methadone. •The client must be monitored long-term.

Measles (Rubeola)

•Caused by a Virus Most at Risk: •Infants and children aged <5 years •Adults aged >20 years •Pregnant women •People with compromised immune systems, such as from leukemia and HIV infection S/S the 3 C's: •Cough •Coryza (runny nose) •Conjunctivitis •Koplik spots (begins as red in mouth 2 days before rash then changes to white spots) followed by a maculopapular rash -•Flat red spots (macules) that appear on the face at the hairline and spread down towards neck, trunk, arms, legs, and feet. Small raised bumps (papules) may also appear on top of the flat red spots. -The rash usually appears about 14 days after a person is exposed. The rash spreads from the head to the trunk to the lower extremities. Patients are considered to be contagious from 4 days before to 4 days after the rash appears. Of note, sometimes immunocompromised patients do not develop the rash. Transmission: -Measles is one of the most contagious of all infectious diseases; approximately 9 out of 10 susceptible persons with close contact to a measles patient will develop measles. The virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. -Measles virus can remain infectious in the air for up to two hours after an infected person leaves an area. Diagnosis: -Healthcare providers should obtain both a serum sample and a throat swab (or nasopharyngeal swab) from patients suspected to have measles at first contact with them. -Detection of measles-specific IgM antibody and measles RNA by real-time polymerase chain reaction (RT-PCR) are the most common methods for confirming measles infection. •Airborne Precautions in Healthcare Settings (Yes, N95 Respirator should be used in health care settings) -ISOLATE FOR 4 DAYS AFTER DEVELOPING THE RASH -Healthcare providers should report suspected measles cases to the health department within 24 hours.

Roseola (6th Disease)

•Caused by virus' •More common in babies 6-24 months of age. •Contagious BEFORE rash appears. •The rash is NOT contagious! Roseola symptoms might include: -Fever. Roseola often starts with a high fever — often higher than 103 F (39.4 C). It starts suddenly and lasts 3 to 5 days. Some children also may have a sore throat, runny nose or cough along with or before the fever. -Your child may also develop swollen lymph nodes in the neck. -Rash. After the fever goes away, a rash often appears. A roseola rash is many small spots or patches. These spots tend to be flat.

MRSA Terms

•Furuncle = also known as a boil, is a painful infection that forms around a hair follicle and contains pus. A carbuncle is collection of boils that develop under the skin. When bacteria infect hair follicles, the follicles can swell and turn into boils and carbuncles. A furuncle starts as a red lump. It may be tender. •Carbuncle = a severe abscess or multiple boil in the skin, typically infected with staphylococcus bacteria. •Carbuncle = a "car load" of furuncles......lol!!

Who is at risk for MRSA

•In healthcare facilities such as hospitals and nursing homes, patients or residents most likely to get an MRSA infection are those with other health conditions making them sick. Also, hospital or nursing home patients who have been treated with antibiotics, have wounds or invasive medical devices such as catheters, or have certain procedures like surgery or dialysis are more likely to get an infection. •Being treated in the same room as or close to another patient with MRSA can also increase a patient's risk of getting MRSA, as the bacteria are easily spread on unclean hands or medical equipment.

MDMA (Ecstasy/Molly)

•It is chemically similar to both stimulants and hallucinogens, producing feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception. -effects last about 3 to 6 hours, although many users take a second dose as the effects of the first dose begin to fade. Over the course of the week following moderate use of the drug, a person may experience: •irritability •impulsiveness and aggression •depression •sleep problems •anxiety •memory and attention problems •decreased appetite •decreased interest in and pleasure from sex Withdrawal s/s: •fatigue •loss of appetite •depression •trouble concentrating

SAFETY nursing care w/ withdrawal and intoxicaiton pts

•Maintain a safe environment to prevent falls •Provide close observation •Orient the client to person, place, and time •Create a low-stimulation environment •Administer medications prescribed to treat the effects of intoxication or manage withdrawal. •Provide emotional support to client and family. Encourage attendance at self-help groups.

Adult S/S of rubella and complications

•Most adults who get rubella usually have a mild illness, with low-grade fever, sore throat, and a rash that starts on the face and spreads to the rest of the body. •Some adults may also have a headache, pink eye, and general discomfort before the rash appears. •About 25 to 50% of people infected with rubella will not experience any symptoms. Complications: The most serious complication from rubella infection is the harm it can cause a pregnant woman's developing baby. If an unvaccinated pregnant woman gets infected with rubella virus she can have a miscarriage, or her baby can die just after birth. Also, she can pass the virus to her developing baby who can develop serious birth defects such as— •heart problems, •loss of hearing and eyesight, •intellectual disability, and •liver or spleen damage.

Mumps complications

•Mumps can occasionally cause complications, especially in adults. Complications include: •inflammation of the testicles (orchitis) in males who have reached puberty; rarely does this lead to fertility problems •inflammation of the brain (encephalitis) •inflammation of the tissue covering the brain and spinal cord (meningitis) •inflammation of the ovaries (oophoritis) and/or breast tissue (mastitis) •deafness

Emergency Tx for Opioid Overdose

•Naloxone (Narcan) •Dramatically reverses the signs of overdose. May be given IM, SQ, IV, or intra-nasally. education for family and friends: s/s of overdose and how to administer narcan -•ALL clients given Naloxone at home or in the fields must go to the hospital.

Nicotine cessation meds

•Nicotine gum, lozenges, and patches --chew gum every 1-2 hrs. Bite into piece put up against cheek. bit into piece again and put against other cheek. continue this cycle for 30 minutes -- patches on hairless portion of upper body wear gloves when changing out on somebody •Bupropion (Wellbutrin) •Varenicline (Chantix) ---stop smoking and can cause you to be sick if smoke with it. --crazy people can't take will make them worse. Alternative/ natural remedies: •hypnosis •acupuncture •herbs •essential oils However, the safety and efficacy of each option is mostly unknown.

Vaping

•One JUUL pod = 20 cigarettes (1 pack) of nicotine •Nicotine is primary ingredient and is highly addictive •Nicotine raises BP, HR and increases the chance of having a MI •Data suggests a link between chronic lung disease and asthma with vaping •The FDA has not approved the use of vapes to help people quit smoking. •Could contain more nicotine than cigarettes because many JUULs have extra nicotine. •More adolescents and youth getting "hooked" on vaping. •One study from Johns Hopkins University stated that vapes contain thousands of chemical ingredients....most of which are not yet identified.

Environmental Factors

•Physical, biologic, social, and cultural factors that are external to the human host. Examples: •Using mosquito repellants, getting rid of standing water, washing utensils after contact with raw meat, etc.

Complications of Shingles

•Post-herpetic neuralgia (PHN) = people have pain even after the rash is gone. •May have pain for many years. •Pain can interfere with daily life. •Could lead to vision loss if shingles on the face or in the eye.

Vulnerable Aggregates to substance abuse

•Preadolescents and Adolescents* •Women* •Elderly* Ethnocultural Considerations

MMR vaccine

•Separate doses by 28 days! •PREGNANT WOMEN SHOULD NOT GET THIS VACCINE! It is a Live Virus. Has to be mixed. •Vaccine is stored in the refrigerator. •Given sub-cutaneous in upper arm. at age 1 and 4 LIVE VIRUS we don't give these under the age of a year

Tobacco

•Smoking is the foremost preventable cause of death in the United States. •Nicotine, the active ingredient in the tobacco plant, is a toxic drug. To protect itself, the body quickly develops tolerance to the nicotine. •If a person smokes regularly, tolerance to nicotine develops within hours. •Secondhand smoke contains higher concentrations of toxic and carcinogenic compounds than mainstream smoke. •Chewing tobacco and snuff are less addicting because nicotine enters the blood stream less directly. -Smokeless tobacco products increased risk for cancer of the lips, mouth, and throat

Alcohol Withdrawal

•Stage 1 ▫Starts within 4-12 hours of last drink. ▫Mild tremors, nausea, HAs, palpitations •Stage 2 ▫Increased tremors, confusion, hyperthermic, hyperactive, nightmares, Increased BP, increased respirations, and hallucinations •Stage 3 ▫Medical Emergency! ▫DTs are most comoon Clients feel things crawling on them Seizures are possible. Symptoms: abdominal cramping, vomiting, tremors, inability to sleep, restlessness, increased heart rate, increased blood pressure, increased respiratory rate, and increased temperature; tonic-clonic seizures Alcohol withdrawal delirium: Medical Emergency Can occur 2-3 days after cessation of alcohol. •Severe disorientation •Severe hypertension •Cardiac dysrhythmias •Could progress to death

Nicotine withdrawal symptoms

•Tingling in hands and feet •Sweating •Nausea and stomach pain •Constipation and gas •HAs •Sore throat •Insomnia •Difficulty concentrating •Irritability •Weight gain •Depression

MRSA patient education

•To prevent another MRSA infection and to prevent spreading MRSA to others: •Take antibiotics exactly as prescribed by your healthcare provider. Talk with your healthcare provider if you have any questions about your antibiotics, or if you develop any side effects, especially diarrhea, since that could be a difficile infection, which needs to be treated immediately. •Clean your hands often, especially before and after changing your wound dressing or bandage. •People who live with you should clean their hands often. •Keep any wounds clean and covered, and change bandages as instructed until healed. •If you have wounds or an intravascular device (such as a catheter or dialysis port) make sure that you know how to take care of them to reduce your risk of infection. •Ask each day if your temporary medical device (for example, a catheter) can be removed. •If you see the access area start to look infected (red, swollen, warm, draining), call your doctor right away, especially if you have a fever. •Do not share personal items such as towels or razors. •Wash and dry your clothes and bed linens in the warmest temperatures recommended on the labels. Tell your healthcare providers that you have MRSA. This includes home health nurses and aides, therapists, and personnel in doctors' offices. •Follow other instructions given by your healthcare provider.

Substance (drug) dependence

•Tolerance to or need for increased amounts of the drug to get an effect •Withdrawal symptoms that happen if you decrease or stop using the drug that you find difficult to cut down or quit •Spending a lot of time to get, use, and recover from the effects of using drugs •Withdrawal from social and recreational activities •Continued use of the drug even though you are aware of the physical, psychological, and family or social problems that are caused by your ongoing drug abuse

Influenza

•Types A and B are most common. •Type A is usually responsible for large epidemics. •Type B is usually more regionalized. S/S: -Fever, chills, cough, sore throat, runny nose, nasal congestion, body aches, HA, fatigue, and possible N, V, and D. Not everyone has fever. Treatment: •Flu Vaccine •Antiviral Drugs •Relenza, Oseltamivir, are some of the antivirals for flu. -Relenza (zanamivir) is an inhalation powder for oral inhalation approved for treatment of acute uncomplicated illness due to influenza A and B virus in adults and pediatric patients aged 7 years of age and older who have been symptomatic for no more than 2 days. -Relenza is indicated for preventive use (prophylaxis) in adults and pediatric patients aged 5 years of age and older.

Mumps

•Viral Illness •The average incubation period for mumps is 16 to 18 days, with a range of 12 to 25 days. S/S: Swollen cheeks and jaw - OH MY! •The most common symptoms include: •Fever •Headache •Muscle aches •Tiredness •Loss of appetite •Swollen and tender salivary glands under the ears on one or both sides (parotitis) Transmission: •Spread by a Virus •coughing, sneezing, or talking, •sharing items, such as cups or eating utensils, with others, and •touching objects or surfaces with unwashed hands that are then touched by others. Mumps likely spreads 2 days before the salivary glands begin to swell and up to five days after the swelling begins. DIRECT CONTACT AND DROPLET Diagnosis: Serology (serum samples) •The first (acute-phase) serum sample should be collected as soon as possible upon suspicion of mumps disease. Collect 7-10 ml of blood in a red-top or serum-separator tube (SST). Oral or buccal swab samples •Collect oral or buccal swab samples as soon as mumps disease is suspected. RT-PCR has the greatest diagnostic sensitivity when samples collected at first contact with a suspected case.

Wernicke-Korsakoff Syndrome

•Wernicke-Korsakoff syndrome is a condition that is similar to dementia and is caused by drinking too much alcohol. •In Wernicke-Korsakoff syndrome the damage to the brain is caused in a very specific way. Alcohol prevents the body from getting enough thiamine (vitamin B1), which is vital for brain cells to work properly. •Korsakoff's syndrome is a long-term condition that develops when Wernicke's encephalopathy is left untreated, or is not treated soon enough. Over time, the damage to the brain becomes more difficult to recover from. •Symptoms include amnesia, tremor, coma, disorientation, and vision problems, The disorder's main features are problems in acquiring new information or establishing new memories, and in retrieving previous memories. •Wernicke's encephalopathy represents the "acute" phase of the disorder and Korsakoff's amnesic syndrome represents the disorder progressing to a "chronic" or long-lasting stage.

GENITAL HERPES (Herpes Simplex Virus)

•What is genital herpes? •Genital herpes is an STD caused by two types of viruses. The viruses are called herpes simplex type 1 and herpes simplex type 2. -WOMAN W ACTIVE BREAKOUT WILL NOT DELIVERY VAGINALLY -IF YOU HAVE THIS MORE LIKELY TO GET HIV -THERE IS NO CURE FOR GENITAL HERPES!!!! -can give Acyclovir and valacyclorir to lessen s/s but not a cure •Signs and Symptoms •Most people may never develop symptoms or the symptoms are too mild to notice. •Develop within 2-30 days, or longer, or not at all. •Small, painful fluid-filled blisters on genitals, mouth or anus. •Blisters progress to open sores that crust over and heal within 1-2 weeks. •Blisters may be "hidden" in the vagina. •First episode most severe, subsequent episodes milder. •Itching or burning on skin in area where blisters are about to appear. •Initial infection often accompanied by fever, headache and swollen lymph nodes. •Blisters go away, but infection is still in the body. •Blisters can return periodically, but usually with shorter duration and less severity. Transmission: •If you do not have herpes, you can get infected if you come into contact with the herpes virus in: •A herpes sore; •Saliva (if your partner has an oral herpes infection) or genital secretions (if your partner has a genital herpes infection); •Skin in the oral area if your partner has an oral herpes infection, or skin in the genital area if your partner has a genital herpes infection. •You can get herpes from a sex partner who does not have a visible sore or who may not know he or she is infected. It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes. •You will not get herpes from toilet seats, bedding, or swimming pools, or from touching objects around you such as silverware, soap, or towels.

Vaccines to prevent shingles in the U.S.

•Zostavax •Shingrix •CDC recommends a shingles vaccine (see above) and pneumonia vaccine at the same visit. •Given as a single dose in the deltoid. NOT IM. The vaccine has to be repeated if given IM. •Live virus so has to be reconstituted and has to be given immediately after reconstitution to minimize potency loss. •Unused vaccine should be discarded within 30 minutes.

addiction

•a devastating brain disease where, without proper treatment, people have trouble stopping using drugs even when they really want to and even after it causes terrible consequences to their health and other parts of their lives. Because of changes to how the brain functions after repeated drug use, people that are addicted crave the drug just to feel "normal"

Short-Term Effects of Heroin

•dry mouth •warm flushing skin •heavy feeling arms and legs •feeling sick to the stomach and throwing up •severe itching •clouded thinking •a temporary feeling of intense happiness •going "on the nod," switching back and forth between being conscious and semi-conscious •increased risk of HIV and hepatitis (a liver disease) through shared needles When mixed with alcohol, short-term effects can include: coma—a deep state of unconsciousness dangerously slowed (or even stopped) breathing that can lead to overdose death

PEP (post-exposure prophylaxis)

•means taking antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected. •PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. If you think you've recently been exposed to HIV during sex or through sharing needles and works to prepare drugs or if you've been sexually assaulted, talk to your health care provider or an emergency room doctor about PEP right away.

Heroin

•mixed with water and injected with a needle. It can also be sniffed, smoked, or snorted. •It is an opioid. •Heroin overdose deaths have dramatically increased over the last decade. •23% of people who use heroin become dependent on it. •It is synthesized from morphine. •CNS stimulant = euphoria and sedation Heroin is considered an opiate. •Opiate intoxication: •Pupils = PINPOINT •Respiratory depression •Coma

Heroin Withdrawal Symptoms

•muscle and bone pain •cold flashes with chills •throwing up •diarrhea •trouble sleeping •restlessness •strong craving for the drug

Long-Term Effects of Heroin

•problems sleeping •damage to the tissues inside the nose for people who sniff or snort it •painful area of tissue filled with puss (an abscess) •infection of the heart •constipation and stomach cramping •liver and kidney disease •lung problems •mental health problems, such as depression •sexual problems for men •changes in menstrual cycles for women

dependence

•the need to continue use of the drug to avoid withdrawal symptoms -Pattern of repeated, self-administered use -Tolerance, withdrawal, and compulsive drug-taking behaviors -A craving or strong desire for the substance -Preoccupation with supply, money to purchase, and getting through time between periods of use -Denial is a primary indication of dependence and can include

Pre-exposure prophylaxis (or PrEP)

•when people at very high risk for HIV take HIV medicines daily to lower their chances of getting infected. PrEP can stop HIV from taking hold and spreading throughout your body. It is highly effective for preventing HIV if used as prescribed, but it is much less effective when not taken consistently. •Daily PrEP reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. Your risk of getting HIV from sex can be even lower if you combine PrEP with condoms and other prevention methods. What population would benefit from PrEP? those at high risk and those w positive partners -DO NOT STOP USING CONDOMS JUST BC YOU TAKE THIS -When taken every day, PrEP is safe and highly effective in preventing HIV infection. PrEP reaches maximum protection from HIV for receptive anal sex at about 7 days of daily use. For receptive vaginal sex and injection drug use, PrEP reaches maximum protection at about 20 days of daily use. No data are yet available about how long it takes to reach maximum protection for insertive anal or insertive vaginal sex.