All of TEST 4 Material Combined _ yet incomplete; it is what it is

Eustress:

Positive stress, beneficial energy that motivates and results in hope, joy, and purposeful movement. Stressors are any uplifting, fun, or fulfilling event such as the birth of a child, a much-needed vacation, favorite physical activities, etc.

*NTK Piaget: 2-6 years

Preoperational; symbolic thinking, language used; egocentric thinking; imagination/experience grow, child decenters

Which intervention is the nurse's priority when caring for a child with HIV?

Protecting the child from infection

Benzodiazepines -

RELAX with Pam or Lam

What is the most important intervention during the panic phase of anxiety?

Removing the stimulus

Protease inhibitors

Reyataz

Which finding for a pregnant patient indicates a need for future intervention?

Rubella titer less than 1:8 (nonimmune)

*NTK viral exanthems (eruptive skin rash that is often related to a viral infection) are related to which diseases?

Rubeola (Measles) Rubella (German Measles) Roseola Varicella

_____ is crucial during acute episodes of phobia. Clients with phobias usually need _____.

Safety; professional help to resolve the condition

Which orders would the nurse expect to receive from the primary health care provider for the client at 10 weeks' gestation who has been diagnosed with syphilis? (Select all that apply) A wait-and-see approach Recommendation for elective abortion Screening and testing of sexual partners None, bc the syphilis will most likely not affect the fetus in utero Intramuscular benzathine penicillin G, 2.4 million units, 1 dose

Screening and testing of sexual partners Intramuscular benzathine penicillin G, 2.4 million units, 1 dose

Antianxiety/nonbarbiturate - Buspirone

"bus" trip to <anxiety & panic; no grapefruit juice

Dysfunctional Family dynamics refers to

'family functioning which fails to support the well-being of its

Adult vaccination schedule

*Tetanus - on initial dose; then booster every 10 years *Pneumococcal pneumonia - age 65 or older get 2 dose series (PCV15 followed by PPSV23 ) OR 1 dose of PCV20 *Varicella - 2 doses 50 and older (live vaccine & contraindicated for immunosuppressed -or- ppl w/Autoimmune Disease)

Test concentration per Sanderson:

- Drugs will hit a replication cycle & you'll need to worry about liver problems - Understand there's a need for Adherence to therapy - Nutrition, prevention of diarrhea, and prevention of STIs are very important

Down Syndrome Incidence and Risk Factors

1 of 691 births More common in boys Higher in non-Hispanic white population Maternal age Genetic predisposition

Which info would the nurse obtain in a health history for a sexually active 16 yr old to determine the client's risk for STIs? (Select all that apply) Sexual practices Barrier protection use Gender of sexual partners Number of sexual partners Use of illicit drugs before sex

Sexual practices Barrier protection use Gender of sexual partners Number of sexual partners Use of illicit drugs before sex

At which age would a child receive immunization for measles, mumps, and rubella (MMR)?

12 months

No child under the age of _____ should ever get aspirin bc of _____.

13; Reyes Syndrome

Which actions transmit HIV? (Select all that apply) Multiple mosquito bites Sharing syringe needles Breast-feeding a newborn Dry kissing an infected individual Anal intercourse Sharing drinking glasses

Sharing syringe needles Breast-feeding a newborn Anal intercourse

Phobia interventions

Stay with client during acute episode Remove stimulus Use anxiety reduction interventions Refer client to qualified provider & support resources

Which info regarding risks that may result from an untreated chlamydia infection would the nurse include when providing education for a female client? (Select all that apply) Sterility Ectopic pregnancy Blocked Fallopian tubes Pelvic inflammatory disease Increased likelihood of HIV infection

Sterility Ectopic pregnancy Blocked Fallopian tubes Pelvic inflammatory disease Increased likelihood of HIV infection

_____ of all cervical cancer is caused by _____.

90%; HPV

ART therapy is recommended when a patient's CD4 count is

<350 mm^3

Azithromycin 600mg, 2 tabs weekly for CD4 _____ to prevent _____ which is bacteria related to TB.

<50/mm^3; Mycobacterium Avarium Complex (MAC)

Which client has a higher risk for contracting HIV infection?

A client who shares equipment to snort or smoke drugs

allatosis

A fundamental concept underlying this reaction is that the body will attempt to return to a state of balance

HPV schedule

A two-dose series (0, 6-12 months) for most persons who initiate vaccination at ages 9 through 14 years. A three-dose series (0, 1-2, 6 months) for persons who initiate vaccination at ages 15 through 45 years, and for immunocompromised persons.

A 23 year old female witnessed the death of her 1 month old daughter 1 month ago. The patient has slowly started to decline in health by presenting with paralysis from an unknown source, double vision, and inability to speak. All diagnostic tests rule out any known cause of the symptoms. The patient may be presenting with? A. Conversion: expression of emotional conflicts through physical symptoms B. Denial: disowning consciously intolerable thoughts and impulses C. Projection: transferring one's internal feelings, thoughts, and unacceptable ideas and traits to someone else D. Repression: an unconscious process in which a patient blocks undesirable and unacceptable thoughts from conscious expression

A. Conversion: expression of emotional conflicts through physical symptoms

What is the goal of HARRT therapy?

Suppress infection Improve or maintain the immune system Provide prophylaxis of opportunistic infections Stimulate hematopoietic (blood cell) response Prevent or treat opportunistic infections and malignancies *Note: Pt. needs to understand ART does not eliminate the HIV infection.

Which consideration is most important when counseling the family of a child with HIV?

Susceptibility to infection

Nonnucleoside reverse transcriptase inhibitors:

Sustiva

Which explanation would the nurse provide to the students in a sex education course regarding the etiology for an increase in gonorrhea prevalence? (Select all that apply) Symptoms of the disease are vague Screening blood tests are expensive The incubation period is relatively short Causative organisms have become resistant to treatment Diagnostic tests for the causative organism are not yet available.

Symptoms of the disease are vague The incubation period is relatively short Causative organisms have become resistant to treatment

Nucleoside Reverse Transcriptase Inhibitors:

AZT, Retrovir; drugs that prevent the growth of the viral DNA chain, preventing it from inserting into the host DNA, so viral replication cannot occur

Which preexisting condition necessitates a cesarean birth?

Active genital herpes

What is administered for neonatal herpes infection?

Acyclovir

Which population would the nurse include in a community education session on STIs? (Select all that apply) Adolescents Homosexual men Transgender clients Multiple sex partners IV drug users

Adolescents Homosexual men Transgender clients Multiple sex partners IV drug users

Which factor that influences the spread of STIs would the nurse include in a teaching session? (Select all that apply) Age Drug abuse Lack of education Multiple sex partners Absent or subtle symptoms Limited access to health care

Age Drug abuse Lack of education Multiple sex partners Absent or subtle symptoms Limited access to health care

**NTK 3 Stage Reaction to stress (General Adaptation Syndrome)

Alarm/acute stress reaction - immediate threat Resistance/adaptation stage - chronic state of stress Exhaustion stage - all resources depleted

The nurse is assessing a female client with suspected primary syphilis. Which sign of primary syphilis would the nurse expect the client to exhibit?

An indurated painless nodule on the vulva that is draining

Drug of choice for prophylaxis and tx for Pneumocystis carinii pneumonia?

Bactrim DS (trimethoprim sulfamethoxazole

A breast-feeding teenage mother is diagnosed with syphilis. Which would be the medication of choice for this client?

Benzathine penicillin

scapegoating

Blaming an innocent person or a group for one's own troubles; a form of displacement in which a family member (usually the least powerful) is blamed for another family member's distress. The purpose is to keep the focus off the painful issue and problems of the blamers. In a family, the blamers are often the parents, and the scapegoat is the child.

A client who is pos for HIV is admitted to a surgical unit after an orthopedic procedure. The nurse realizes that HIV is transmissible through which means? (Select all that apply) Feces Blood Semen Urine Sweat Tears

Blood Semen (and bodily fluids)

How is HIV transmitted?

Bodily fluids -Blood -Semen -Vaginal fluid -Breast milk Oral sex, contaminated needles, contact with maternal blood during the birthing process

A pt. who is bipolar is ordered by the doctor to start taking Lithium 900 mg by mouth daily. What will you include in your diet teaching with this patient? A. Limiting salt intake B. A low-tyramine diet C. Importance of consuming sufficient amounts of sodium D. Limiting consumption of aged cheeses

C. Importance of consuming sufficient amounts of sodium

After throwing his lunch tray on the floor, a client complains to the nurse that the food was cold and the quality is poor. Which defense mechanism is this client using? A. denial B. displacement C. rationalization D. reaction formation

C. rationalization

In addition to being highly infectious, which additional fact would the nurse teach the client with gonorrhea?

Can produce sterility

Which medication would the nurse administer to prevent maternal transmission of infection to the newborn of a client with gonorrhea? (Select all that apply) Penicillin Acyclovir Ceftriaxone Doxycycline Levofloxacin

Ceftriaxone

*NTK What drugs are we treating STDs with?

Ceftriaxone & Azithromycin

Which would the nurse identify as increasing the risk of HIV transmission? (Select all that apply) Childbirth Monogamy Breast-feeding Needle sharing Shared plates and cups

Childbirth Breast-feeding Needle sharing

Most frequent STI

Chlamydia

Which STI is most commonly reported?

Chlamydia

The nurse practitioner prescribes azithromycin for a sexually active woman with a history of mucopurulent discharge and bleeding associated with cervical dysplasia, dysuria, and dyspareunia. With which sexually transmitted infection are these clinical findings and medication therapy commonly associated?

Chlamydial infection

Which information will the nurse consider when planning care for a client with HIV who has been diagnosed with class 3 tuberculosis? (Select all that apply) Class 3 TB is a clinically active disease, which is contagious. TB is the leading cause of mortality in clients infected with HIV HIV-pos clients are more likely to have multidrug resistant TB Individuals with HIV usually have higher fevers with active TB infection Persons with active TB are usually treated on an outpatient basis

Class 3 TB is a clinically active disease, which is contagious. TB is the leading cause of mortality in clients infected with HIV Persons with active TB are usually treated on an outpatient basis

Which client would the nurse need to notify the health care provider about? A. Chlamydia - medication: Azithromycin B. Genital herpes - medication: Benzathine penicillin G C. Genital warts - medication: Imiquimod D. Gonorrhea - medication: Doxycycline

Client B Rationale: Genital herpes is an acute, recurring, incurable viral infection caused by herpes simplex virus. Antiviral drugs such as acyclovir and famciclovir are used for treatment - not antibiotics.

_____ is the best method for treating all cognitive disorders.

Cognitive therapy

Cognition

Comprehensive term used to refer to all processes involving thought "mental action or process of acquiring knowledge and understanding through thought, experience and the senses".

*NTK Piaget: 7-11

Concrete operational; logic applied, has objective/rational interpretations; conservation, numbers, ideas, classifications

Which topics will the school nurse include in adolescent education on STIs? (Select all that apply) Condom use Sexual identity Types of contraception Number of sexual partners Alcohol and drug consumption

Condom use Types of contraception Number of sexual partners

The nurse suspects that a newborn's mother contracted rubella during the first trimester of pregnancy. Which newborn problems support the assumption? (Select all that apply) Fever Seizures Deafness Conjunctivitis Cardiac anomalies

Deafness Cardiac anomolies

When a client asks to be screened for HIV infection, which info will the nurse include in client teaching about the test?

Detects antibodies to HIV and may not detect acute infection

Which events indicate a need to suggest testing of a client for HIV? Diagnosed with TB in 1985 Traveled to Italy and Greece in the late 1990s Received blood transfusions in 1980 during total hip replacement surgery Engaged in sexual relations with someone of the same sex for several years Spent several nights in jail for a DUI

Diagnosed with TB in 1985 Received blood transfusions in 1980 during total hip replacement surgery Engaged in sexual relations with someone of the same sex for several years

The nurse understands which preparations use toxoids but not live viruses? (Select all that apply) Rotavirus vaccine Varicella virus vaccine Measles, mumps, and rubella virus vaccine Diphtheria, hepatitis B, pertussis (acellular), polio, and tetanus vaccine Diphtheria and tetanus toxoids and acellular pertussis vaccine

Diphtheria, hepatitis B, pertussis (acellular), polio, and tetanus vaccine Diphtheria and tetanus toxoids and acellular pertussis vaccine

Most common of chromosome disorders; Most frequent cause of moderate to severe intellectual disability; Most parents raise at home until early adulthood> group homes are an option; Supported employment is encouraged - Vocational training starts in elementary school

Down Syndrom (Trisomy 21)

What is used to treat chlamydia?

Doxycycline

Which dietary changes would the nurse suggest to the client with diarrhea associated with HIV? (Select all that apply) Eat more fatty food Eat much less roughage Drink two cups of coffee daily Eat more spicy and sweet food Drink plenty of fluids between meals

Eat much less roughage Drink plenty of fluids between meals Rationale: Clients w HIV often suffer from diarrhea. Roughage should be limited in the diet of a client who has diarrhea associated w HIV bc it isn't easily digestible. Drinking plenty of fluids helps compensate for fluid loss. Fatty foods are avoided bc they alter the process of digestion; coffee and spicy and sweet food are avoided bc it stimulates the GI tract and leads to diarrhea

When teaching a group of older adults about differences between the common cold and influenza, the nurse would educate the clients that it is most important to communicate with the health care provider about which symptom?

Elevated temperature

Beta blockers

Fall risk, low BP

genital herpes symptoms

Fluid-filled vesicles in the genital area; painful, crusted sores on the genitals, anus, thighs, or buttocks. Can spread to the lips through oral contact.

Genital Ulcers

Genital Herpes Syphilis HPV

Which sexually transmitted infection receives antiviral medications as the treatment choice?

Genital herpes

The nurse in the clinic is assessing a teenager with a tentative diagnosis of primary syphilis. Which is an early sign of this infection?

Genital lesion

Shortly after girth the nurse instills erythromycin ophthalmic ointment in the newborn's eyes. The father asks why an antibiotic is needed. The nurse explains it is routinely administered to prevent which type of infection?

Gonorrhea

Which disease would the nurse suspect in a 16-year-old client with a history of multiple sexual partners who is complaining of increased vaginal discharge, intermittent vaginal bleeding, excessive bleeding during menstruation, and pain in the lower abdomen?

Gonorrhea

*Antianxiety/non-barbiturate

Grapefruit juice >> effects!

Which diagnostic criterion should the nurse use to explain AIDS to a client with HIV?

Has a CD4+ T cell lymphocyte level of less than 200 cells/ mm^3 (60%)

*NTK Four discrete personal attributes (coping styles) people can develop to help manage stress:

Health-sustaining habits (e.g., medical compliance, proper diet, relaxation, pacing one's energy) Life satisfactions (e.g., work, family, hobbies, humor, spiritual solace, arts, nature) Social supports Effective and healthy responses to stress

Communicable from Mother to Fetus

Hep A & B (viral) TB (bacterial; high fetus mortality) HPV

Which immunizations are crucial to HIV/AIDS patients?

Hep A & B; pneumovax; flu; Td (NO LIVE VIRUSES)

Upon assessment of a client with HIV, the nurse discovers red to purple lesions on the client's neck, arms, and chest. Which virus presents skin lesions?

Herpesvirus 8 (HHV-8)

What is ART or HAART therapy?

Highly Effective Antiretroviral Therapy

A rubella vaccination is prescribed for a client. Which statement made by the client is cause for concern?

I have been trying to conceive a baby for a few months because it could affect the fetus.

Which statement by an adolescent during an annual physical examination indicates the need for HIV testing?

I have shared needles when using drugs

The nurse is obtaining a health history form a client with HIV with a low viral load who has been asymptomatic for years. Which statement by the client indicates the need for additional education on the disease process?

I occasionally have oral sex without the use of protection.

Which nursing intervention indicates misinformation when providing care for clients with HIV?

I will ask the client to avoid involvement in community activities.

Which client statement confirms that the client who is being treated for an STI has understood the nurse's instructions regarding future sexual contacts?

I won't have unprotected sex again, and I'll tell my partners to be tested for STIs.

Which statement by the nursing student indicates understanding of the precautions need in the provision of care to a child who is HIV positive?

I'll put on gloves if I'm going to be in contact with bodily fluids.

*NTK General STI treatment includes:

IM dose of Ceftriaxone and large PO dose (1 gm) of Azithromycin (+/- antibiotic tx at home)

A mother diagnosed w AIDS states she has been caring for her baby even though she has not been feeling well. Which important information would the nurse determine regarding the care provided by the mother?

If the mother is breast-feeding her baby

Hoarding disorder

Indecisiveness is associated with hoarding. Stressful life events seem to precede the onset of symptoms. The disorder is strongly heritable.

Which guidance would the nurse provide to a sexually active 16 yr old client when she inquires as to how she can protect herself from contracting HIV?

Insist that her partner use a condom when having sex.

Which education is appropriate to give a client at 16 weeks' gestation whose partner has just informed her that he has genital herpes?

Latex or polyurethane condoms must be used when the couple is having intercourse.

What is used for sexually acquired epididymitis?

Levofloxacin

Which clinic manifestations would the nurse expect to find in a client who has acute HIV infection? (Select all that apply) Malaise Confusion Constipation Swollen lymph glands Oropharyngeal candidiasis

Malaise Swollen lymph glands

A child is admitted with a fever, headache, cough, and has had a sore throat for the past week. Three days later, a rash appears at the hairline and spreads rapidly over the body. Which disease process would the nurse anticipate providing teaching for?

Measles

Distress:

Negative stress, draining energy resulting in anxiety, depression, fatigue; stressors include losses, demands, worries, etc.

To ensure antibody-mediated immunity, which actions would the nurse instruct an older client to implement? (Select all that apply) Obtain a shingles vaccination Receive a tetanus booster injection Obtain the pneumococcal vaccination Receive annual testing for TB Receive an annual influenza vaccination Avoid obtaining the pertussis vaccination

Obtain a shingles vaccination Receive a tetanus booster injection Obtain the pneumococcal vaccination Receive an annual influenza vaccination

The nurse in the clinic is obtaining the health history of a 16 yr old boy with a complaint of a thick urethral discharge. Which is the most appropriate nursing action to help confirm a tentative diagnosis of gonorrhea?

Obtaining a urethral specimen for a culture

Trichotillomania

One of the oldest recorded psychiatric problems. The phrase "I was so annoyed that I wanted to pull my hair out" attests to the anxiety-related component of the disorder. Typically, it is the hair of the head, but it may come from anywhere on the body including eyebrows, eyelashes, pubic areas, axilla, and limbs. The amount of hair removed ranges from small patches to complete baldness.

What is used to treat syphilis?

Penicillin

Forchheimer's sign

Petechiae (small red or purple spots) on soft palate; sign of Rubella (German Measles)

What would you do to prepare to take care of a child w a disability?

Play therapy; offer headphones; be aware of social component; most children w intellectual disabilities are on a strict routine; private room for these pts. to make communication easier.

Which is included in the care of a newborn infant whose mother has untreated syphilis since the second trimester of pregnancy?

Testing for congenital syphilis

Which medication used to treat syphilis is contraindicated in pregnancy?

Tetracycline Rationale: Can be administered to clients who are allergic to penicillin G; can cause birth defects or staining/discoloration to the fetus' developing teeth. Amoxicillin is safe to treat syphilis in pregnancy. Clotrimazole is used to treat candidiasis and Metronidazole is used to treat bacterial vaginosis.

Pneumococcal vaccine

The CDC recommends vaccination for all immunosuppressed adults naive to pneumococcal vaccinations. The CDC recommends vaccination with PCV13 (pneumococcal conjugate vaccine) followed by PPSV23 (pneumococcal polysaccharide vaccine) in eight weeks to one year later.

MAOIs

The Tyramine Tyrant,"PIT" must stay away from SPAM [smoked, pickled, aged, and marinated) PIT = phenelzine, iscarboxaizid, Tranylcypromin

Which lab test would the nurse anticipate being used to diagnose a patient's cognition deficits?

There is no lab test for that; would need an MRI which can identify abnormalities in the brain; Formal neuropsychometric testing which is needed to identify mild cognitive impairments; genetic testing

Benzos

Tolerance/dependence risks, dizzy, drowsy, <BP

An adolescent reports irritation in the vagina and yellowish green, malodorous discharge. Which infection is the adolescent likely to have?

Trichomoniasis

Down Syndrome =

Trisomy 21

Which medication reduces the risk of HIV infection in unaffected individuals?

Truvada Rationale: first medication approved to reduce the risk for HIV infection

To reduce the incidence of HIV transmission, which basic strategies would the nurse teach a health class? (Select all that apply) Using condoms Using separate toilets Practicing sexual abstinence Preventing direct casual contacts Sterilizing the household utensils

Using condoms Practicing sexual abstinence

Gonorrhea has become _____; it is treated _____; if culture comes bk & pt. needs different tx, they _____.

VERY resistant; at the clinic (not a take home med); come bk to the clinic for tx.

Vaginal/Penile Discharge

Vaginitis and Urethritis Candida Trichomonas Bacterial vaginosis

Why do we have a high IV substance abuse problem in the state of GA? What increases IV substance abuse in Ga?

We are a highly transient state; depression

An older adult has undergone chemo. Which agent could be administered to decrease the risk of a potentially contagious common viral infection?

Zoster vaccine

*Serotonin syndrome

[ANA's GI] -Agitation, neuromuscular incoordination, Autonomic instability (>HR, Labile BP, Hyperthermia), Super Serotonin Saving, GI-n/v/d

Severe anxiety is associated with

a focus on a specific detail such as the sharpness of the needle and would include shaking hands or other physical symptoms that prevent a smooth injection.

Moderate level anxiety is associated with

a focus on immediate concerns, a narrowing the perceptual field with selective inattention, and ability to perform some tasks despite concerns about performance.

relaxation technique: biofeedback

a mind-body technique that uses instruments to teach self-regulation and self-control over physiological responses instruments measure, process, and provide information about neuromuscular and autonomic nervous system activity. Immediate feedback is provided in physical, physiological, auditory, and/or visual signals

The projection ego defense mechanism is observed when

a person attributes his/her own unacceptable feelings/thoughts onto another person in an effort to reduce anxiety. Other defenses do not transfer an inner feeling/failure outward onto another.

Anxiety

a reaction to a future threat that may or may not happen; the threat is only in the mind of the person experiencing anxiety.

Anxiety is

a subjective distressful experience activated by the perception of threat, which has mind and body cause and expression

Rubella

a viral infection characterized by a low-grade fever, swollen glands, inflamed eyes, and a fine, pink rash; also called German measles - pregnancy exposure in the 1st trimester may result in fetal death or abnormalities

How are the mumps tranmitted?

airborne, saliva, possibly urine

*NTK Sexual transmission includes

all organs and orifices

mental illness refers to

all psychiatric disorders that have definable diagnoses. These disorders are manifested in significant dysfunctions that may be related to developmental, biological, or psychological disturbances in mental functioning

*NTK _____ methods are used instead of conventional methods; _____ methods are used along with conventional methods.

alternative; complementary

Famciclovir

an antiviral medication that helps in reducing the symptoms of infection.

Stress

an internal or external event that is experienced and perceived as a threat and the individual determines whether resources and abilities for management are available, exceeded, or exhausted.

What causes tetanus?

anaerobic gram pos spore forming rod shaped "Clostridium tetani" bacteria; the spores release bacteria that spread in the body and release "tetanospasmin" - a neurotoxin

Methdilazine medication

anithistamine; treats the skin and provides relief from itching

Complications of the mumps include:

aseptic meningitis; Orchitis (swollen testes, rare, but can cause sterility); sensorineural deafness

Dysfunctional Group dynamics is similar to family dynamics and includes

assessment of structure, roles, and complexity; these factors can be adaptive (healthy) or maladaptive (unhealthy)

Syphilis, gonorrhea, and chlamydia are all infections caused by _____.

bacteria

Tetanus

bacterial disease that affects the nervous system, leading to painful muscle contraction, particularly jaw and neck; "lock jaw"

*NTK Cerebellum -

balance and complex motor function; walking and standing, and other complex motor functions.

*NTK What should you do if a client comes in taking herbal meds?

be sure pt. knows that herbal meds can have negative interactions w meds especially psych meds

compulsion =

behavior

According to HIV disease classification, a client is in the second stage of HIV disease if the CD4+ T cell count is

between 200 and 499 cells/mm^3

What happens as a result of chronic stress?

burnout

when stress is used for growth and development, resilience can buffer

burnout

Tetanus in soil can infect the host

but cannot be transmitted to another human. It is an infectious disease (preventable) but is not a communicable disease.

Obsessions and compulsions

can occur separately, but often are experienced together. Cognitive therapy is the best method for treating all anxiety disorders including OCD.

Infectious Disease:

caused by pathogens invading the host, colonizing, and stimulating the inflammatory response to produce host symptoms.

*NTK: syphilis

causes fetus infection (passes the placental barrier); tx: benzylpenicillin (also may have a discharge)

Candidiasis

causes vaginal itching, painful urination, and thick, white, lumpy, and cottage cheese-like discharge

Major areas of the brain

cerebrum (voluntary activity); cerebellum (balance and complex motor function); diencephalon (interprets sensory impulses); brain stem (regulates cardiac and resp. function - cranial nerves); limbic system (emotion, behavior, LT memory, olfaction); hippocampus (consolidates from ST memory to LT memory)

Mutations-

changes in a specific stretch of DNA occur through deletion, addition, or recopying; some cause no changes while others are responsible for the underlying cause of Intellectual D and Developmental D.

Bacterial vaginosis

characteristic "fishy" odor along with white, gray, or milky and thin discharge

Post-Traumatic Stress Disorder (PTSD)

characterized by flashbacks, nightmares, intrusive thoughts, impaired social functioning (can include fear of leaving the home) and fear of dying. Physical manifestations could include palpitations, shortness of breath, nausea, and dizziness.

Cervicitis/penile discharge

chlamydia (#1 reported STI) - Tx: Doxycycline Gonorrhea (drug resistance) - Both are bacterial

maladaptive coping - avoidance

clients are extremely sensitive to rejection, feel inadequate, and are socially inhibited, avoid interpersonal contact due to fears of rejection or criticism; can lead to longer recovery times, less effective problem solving, increased emotional distress, and other maladaptive disorders

Adaptive coping includes

cognitive restructuring and behaviors that promote learning and problem solving.

Multiclass (3 drug combo) Atripla

combo NNRTI, NRTI; has bee discontinued and replaced with Truvada & Descovy w Tivicay

Therapeutic management of Varicella

common rash care Antipyretics NO aspirin (bc of risk of Reye's syndrome) May use antiviral acyclovir PO or IV Airborne & contact isolation if hospitalized with varicella or zoster

Pertussis

commonly seen in young children; characterized by a whooping cough

Declarative episodic-

consciously learn and recall information

*NTK Hippocampus -

consolidates from ST memory to LT memory

Rubeola:

contagious disease caused by RNA virus and characterized by fever, inflammation of the mucous membranes, and rose-colored spots on the skin; also called measles - if hospitalized, airborne isolation required.

oral thrush symptoms

creamy white or yellow raised lesions in mouth; lesions can bleed; and can spread in immunocompromised or to mothers of infected babies

Perceptual field could be assessed to

determine the degree of anxiety in a given client because the perceptual field narrows as anxiety increases. Nurses should promote verbalization of feelings by the client with Anxiety disorder.

breast milk helps prevent

diabetes and cardiovascular disease

entry inhibitors

dolutegravir ***Tivicay

Key with all intellectual disorders

early intervention

Necessary services for the Lifespan of a person with Downs (Trisomy 21) include:

education, transitional services, respite care, social services, financial supplements, psychotherapy, and preventive or correctional medical care.

*NTK Limbic system -

emotion, behavior, LT memory, olfaction;

The nurse is counseling an HIV pos woman on precautions to be followed. How often should the patient go for routine gynecological care including pelvic examination?

every 6 months

HIV Medications

f *Atripla (combo NNRTI, NRTI) is now discontinued

*NTK Piaget: 12 years - adulthood

formal operational; thinks abstractly, hypothetical ideas (broader issues); Ethics, politics, social/moral issues explored

Genome

full set of DNA that creates a human.

Dysuria, heavy greenish-yellow purulent discharge, and swollen Bartholin glands are signs of

gonorrhea

According to HIV disease classification, a client is in the first stage of HIV disease if the CD4+ T cell count is

greater than 500 cells/ mm^3

best prevention

hand washing

Live vaccines are contraindicated in a patient who:

has HIV

Obsessive-compulsive disorders (OCD)

have one or two components. Obsessions are thoughts, impulses, or images that persist and recur; they cannot be dismissed from the mind despite attempts to do so with willpower. The thoughts often seem senseless to the person and cause severe anxiety.

TIC is used to

help individuals who have experienced trauma, and their behavior may not be acceptable.

It is important to consider concurrent tx for ____ when taking ART medications.

hepatitis; TB; cancer; herpes

Painful blisters on the genitalia, fever, malaise, dysuria, and dyspareunia are signs of

herpes simplex 2 virus infection

HIV/AIDS pts should eat a diet:

high in vegetables, fruits, whole grains, and legumes; avoid raw eggs...cookie dough, raw meats and fish

Acute stress disorder (ASD)

high-anxiety condition usually occurs immediately after a highly traumatic event with symptoms that persist for at least 3 days; symptoms can last up to one month and usually resolve within one month but if not, a diagnosis of PTSD is considered.

Executive function-

higher thinking process that allows for flexibility, adaptability and goal directedness.

Voluntary counseling and HIV testing should be offered to all pregnant women as early in the pregnancy as possible to

identify HIV infected women so that tx can be initiated early

*NTK What type of pt. should never take a live vaccine?

immunocompromised

Post exposure prophylaxis (PEP) to Hep B virus requires _____ for the unvaccinated.

immunoglobins

Stress causes prolonged changes in the immune system, which can result in impaired immune function; and increases the person is more susceptible to changes in health, such as

increased risk for infection, high-blood pressure, diabetes, and cancers

stress response

individual and family

Exemplar: maladaptive coping

individual and family patterns

Diphtheria

infection of local tissue of upper respiratory tract with production of toxin which causes systemic effects on the heart and peripheral tissues; oropharynx, nose infection; airway inflammation; direct contact or droplet transmission

Communicable Disease:

infectious diseases that are transmitted by contact from a source to a susceptible host.

How is Rubeola (Measles) transmitted?

infectious droplets; less frequently - airborne; very contagious

CAM or ICAM *on test both ways

integrative, complementary, and alternative medicine that is important soln for "fight or flight" response which needs to reversed regularly

CAM Integrative health care involves

interprofessional grp practices in which a pt. seeks care simultaneously from more than one type of practitioner

Perception-

is the interpretation of the environment and is dependent on the acuity of sensory input.

Stress negatively affects the body's ability to produce protective factors meaning that

it can make people sick - more infections, colds, flu, etc.

Antidepressants - SSRIs & SNRIs

keep serotonin and/or norepinephrine in the synapses = soothing effect

*NTK Retrovirus drugs have high risk for _____.

kidney failure

According to HIV disease classification, a client with HIV is in the third stage of the disease if the CD4+ T cell count is

less than 200 cells/mm^3

The following should be included in health history assessment

level of consciousness, speech pattern, memory; in infants and children: ask about anything that might have occurred during the pregnancy or delivery; is child meeting milestones for age

Panic states _____ so focus should be shifted to breathing.

limit ability to comprehend environment

*NTK Major side effect for all ART meds:

liver dysfunction

A persistent allopathic load can cause

long-term physiological problems such as chronic hypertension, depression, sleep deprivation, chronic fatigue syndrome, and autoimmune disorders

Varicella prodromal phase

low grade fever, malaise, anorexia; rash

Kaposi sarcoma symptoms

malignant vascular, red to purple lesions on the skin

Cromolyn medication

manages allergic rhinitis and asthma

What blood cancer is more likely to develop in ppl w down syndrome?

megakaryoblastic acute myeiogenous leukemia; they are also at risk for epilepsy, dementia, sensory problems like hearing loss, and decreased fertility

Declarative sematic-

memory of knowledge, words and facts

Rubella

mild viral disease characterized by fever, sore throat, and swelling in the lymph nodes behind the ear and back of the neck; a rash may appear and spread to the torso and arms

Mild anxiety causes

motivating behavior and alertness but would not block out other environmental stimuli.

Need to be old enough to take paper pencil test and read for_____ which tests ability to think, understand, remember, assesses motor skills, problem solving skills

neuropsychometric testing

*NTK: What are the stipulations of communicable STIs?

no sex without condoms for 6 months until repeat testing; Further STI testing needs to be done to ck for all STIs especially HIV; and you must report all STIs to the PHD and all sexual partners.

Use the 0-10 SUDS method to determine if symptoms of stress are subsiding. What symptoms can be evaluated with the SUDS 0-10?

not sleeping, ability to concentrate, vital signs, etc.

*NTK Diencephalon - i

nterprets sensory impulses; heat, cold, pain, pressure, etc.

Down Syndrome Etiology

o 95% is created when the chromosome 21 fails to separate in the gamete (egg cell) o Known as nondisjunction o Affects physical and neurologic development of the baby. o Translocation- occurs when an adult who appears normal carries a chromosome that is partially fused ( Trisomy 21 or 14) § Not associated with age o Mosaic DS a condition in which some cells of the body are normal, but some have trisomy 21 § These children may have fewer symptoms

Impaired cognition

observable or measurable disturbance in one or more of the cognitive processes related to abnormalities in the brain.

A client with AIDS reports painless, white, raised lesions on the lateral aspect of the tongue. Which disease would the nurse suspect?

oral hairy leukoplakia

A client visits a pcp and reports chills, severe abdominal pain, and increased vaginal discharge. Which infection would the nurse suspect?

pelvic inflammatory disease

Risk factors for cognitive development issues

populations; individual risk factors (personal behaviors, environmental factors, congential or genetic conditions such as chromosomal abnormalities, Health condiditons (may lead to temp. or long-term cognition chges); hypoxia (infection) at birth

*NTK integrative therapies

practices used by licensed healthcare providers who use conventional and complementary therapies

Gabapentin

prescribed to clients suffering from neuralgia caused by shingles

prophylaxis

prevention of disease

codependency

primary factor is family stress response that blurs the personal boundaries and puts others needs ahead of their own. One person is controlled or manipulated by another who has an illness or addiction.

Fear

reality based: a reaction to an immediate, real threat

-adrenergic

receptor antagonists - BLOCKER

Panic disorder: Factual information promotes

recognition of distorted thoughts; CBT and medications are highly effective

Chancre

red, round, superficial ulcer with a yellowish serous discharge that is a sign of primary syphilis

Memory-

refers to the retention and recall of past experiences and learning; it is not a single ability but a series of different experiences and learning.

*NTK Brain stem -

regulates cardiac and resp function - cranial nerves; has critical roles in regulating cardiac and respiratory function, helping to control heart rate and breathing rate as well as the main motor and sensory nerve supply to the face and neck w cranial nerves

Constructive coping

relatively healthful efforts that people make to deal with stressful events; helps a person thrive. i.e. "I am going to do what I can until i cannot do it any longer then I will do something else"

Exemplar: healthy adaptive coping

relaxation and integrative care

Compulsions are

ritualistic behaviors an individual feels driven to perform to reduce anxiety or prevent an imagined calamity. The act temporarily relieves anxiety but must be repeated again and again.

Symmetrical rash accompanied by malaise, fever, anorexia, and headache is indicative of

secondary syphilis

*NTK Piaget: Birth to 2 years

sensorimotor; uses senses and motor skills, items known by use; object permanence learned

Gonorrhea

severe pain along with diarrhea and greenish yellow discharge

Genotypes

small variations ( used to describe large groups who share common physical characteristics.

*Antidepressants

soothing effect when serotonin and norepinephrine are kept in the synapses

The nurse is teaching parents of toddlers why children receiving specific medications should not receive varicella vaccines. Which medications would the nurse include in the discussion?

steroids Rationale: Steroids have an immunosuppressive effect.

mental health

successful adaptation to stressors in the internal and external environment

Therapeutic management of the mumps

symptomatic - NO aspirin, general rash care; droplet precautions For orchitis (swollen testes) bed rest, scrotal ice packs, emotional support, neuro checks

liver function tests (LFTs) are done frequently when a pt. is

taking ART drugs

Herpes Zoster prodromal phase

tenderness along nerve route and surrounding skin for 2 weeks

Many medications, particularly antibiotics, that tx the mother have _____ effects on the fetus.

teratogenic (cause birth defects)

Panic level anxiety is associated with

terror, loss of control, and disorganized thoughts. The client would not be able to complete the injection.

Resilience

the ability to adapt to and 'bounce back' from adversity; stress is actively used for growth and improved problem-solving; can be learned and supported by others.

Displacement

the client refers to another as the cause of the behavior (Transfers feelings to others: "She made me do this.").

reaction formation

the client uses conscious attitudes or behaviors opposite to the desired behavior (Complements staff: "This food is great!").

Trauma Informed Care (TIC) is

the current model for offering dignity and respect to promote healthy coping and recovery; "Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being."

denial

the person refuses to acknowledge the presence of a problem.

Stress is determined by

the person's perception

triangulation

the tendency, when two-person relationships are conflicted, to draw in a third person to stabilize the system through formation of a coalition in which the two join the third

Coping

the use of cognitive processes and behaviors to manage internal/external stressors perceived as difficult; action oriented; can be adaptive (healthy) or maladaptive (unhealthy).

Healthy adaptive coping is the use of _____ to manage perceived difficulties which reduces the stress response.

thinking and behaviors

Phenotypes

those small variations that account for those observable differences( visible representation of the genotype)

obsession =

thought

What is the usual drug regimen for HIV?

to take 3 antiviral drugs from 2 different classes; this is an effort to aid in controlling the virus and to protect the pt. immune system

Exemplar: resilience

trauma informed care; recovery

Abacavir medication

treats HIV infection and is a reverse transcriptase inhibitor

Maladaptive coping includes

unhealthy cognitive processes and behaviors that lead to ego defense mechanisms, illness and death.

Mumps

viral disease commonly seen in children between the ages of 5 and 15. Symptoms include: swelling of the parotid gland accompanied by local pain and tenderness.

Mumps

viral infection caused by paramyxovirus; manifestation: fever, myalgia, headache, malaise, swelling of parotid gland

*NTK: HPV

viral; Immunizations available; related to cancer; tx: antivirals and removal of lesions

*NTK: genital herpes

viral; not curable - must take antiviral medication forever

*NTK Cerebrum -

voluntary activity; integration of complex sensory and neural functions and the initiation and coordination of voluntary activity in the body.

Personal resilience

when internal environment protects the person and is the key to thirving during adversity; the ability to bounce back after adversity

linear question

when, what, where

circular

who, how

Post-exposure prophylaxis (PEP) drugs should be taken as soon as possible after exposure to a needle stick that's contaminated with blood or other body fluids. It is recommended that this happens:

within 6 hours and no later than 48 hours after exposure

Intact cognition

within normal limits for the persons age and culture

Communicable Diseases

· caused by attack of pathogen · brought about by external factors. · can pass from diseased person to healthy person · infection occurs through direct contact and other medium

Noncommunicable Diseases

· caused by factors of other than living pathogen · mostly brought by internal factors · cannot pass one to another · transmission is absent

Consequences of stress, coping, & resilience (or lack of)

Ø Immune response - bolstered or dampened Ø Self-esteem - supported or diminished; "I did it!" or "I am a failure." Ø Ego defense mechanisms - adaptive short-term or maladaptive long-term Ø Physical effects - alertness & problem-solving enhanced or exhaustion, illness, & death » Anxiety, eczema, hypertension, insomnia, irritable bowel syndrome, tension headaches

Down Syndrome (Trisomy 21) Facial and Head features

• Brachycephaly - wide flat bk of head • Flat profile • Epicanthal folds • Wide, flat nasal bridge • High arched palate • Protruding tongue • Small, short low set ears

Down Syndrome (Trisomy 21) issues

• Short stature • Short, broad hands • Simian crease on palm and soles of feet • Wide gap between 1st and 2nd toes • Short, broad neck • hyperextensibility with hypotonic muscles • Cardiac abnormalities • Problems with vision and hearing • Childhood leukemia