RN NURSING 2 UNIT #9

1. HIV/AIDS: -The complexity of HIV disease is related to its chronic nature. -As with most chronic and infectious diseases, primary prevention and health promotion are the most effective health care strategies. -Even with recent successes in HIV treatment, prevention remains a critical component to control the epidemic. 2.-Health promotion encourages_____ detection of the disease so that, if primary______ has failed,_____ interventions can be initiated. -Nursing interventions are based on and tailored to patient_____ at every ______of HIV disease and can be ______ in improving the ____ and ____ of the patient's life. -Care plans are ______ and change as new treatment protocols are ________and/or as HIV disease ________. 3. The goal is to develop___,____, and less _____ behaviors. These techniques can be divided into ___ ____ (those that eliminate ____) and ___-____activities (those that decrease, but do not _____, risk). You need to be prepared to discuss sensitive topics including ____ and ____ ____ Suggest a wide variety of _____ to reduce the risk of HIV infection so individuals can choose methods that best fit their ______ and _____ and individual ___ ___

1. - chronic nature - chronic, infectious, prevention, promotion - treatment, prevention, 2. early, prevention, early - needs, stage, instumental, quality, quantity, -indiviualized, development, progressess 3. safer, healthier, risky - safe activities, risk, risk-reducing -eliminate - sexuality, drug use -activites, - needs, circumstances, life patterns

1.HIV/ AIDs - HIV destroys about ___ _____ _____ __cells every day. -For many years the body can produce ___ _____ ____to replace the ____ ____. -However, over time the ability of HIV to ____ ____ cells exceeds the body's ability to __ the ____ -The decline in the ____ ___ count impairs ____ function. 2. -A point is eventually reached where so many CD4+ T cells have been ______that not enough are left to regulate _____ responses (Fig. 14-3). -This allows ____ ___ (___ and ____ that occur in _____ patients) to develop. are the main cause of _____, ____, and ____ in patients with HIV infection. 3. 2 major classeses of lymphocytes: in the initial stages of HIV infection, ___ cells and __ cells function _____ -**This____ ____ response is very important for___ ____ function and ___ ___ ____.

1. 1 billion, CD4 T - new CD4T cells, destroyed cells - destroy CD4 T, replace the cells - CD4 T cell, immune function 2. destroyed, immune - opportunistic disease,( infections, cancers, immunosuppressed - disease, disability, death, 3. B , T, normally - cellular, immune, normal immune, fighting off disease

HIV/AIDS 1. HIV was discovered in _____ In 1981, the Centers for Disease Control and Prevention (CDC) published a report about five previously healthy homosexual men becoming infected with _____ ____ , which is caused by the normally ____, _____ : ______ _____. This type of pneumonia, the CDC noted, almost never affects people with ____ ___ ____ 2. ___, ____, and other? are the population most affected by HIV. In 2018, gay and bisexual men accounted for ____% of the almost _______new HIV diagnoses and ___% of diagnoses among males. at end of 2016 __ in ___ people kney they have the virus. 3.The viral infection causes the person to be susceptible to _____that would normally be controlled through ____ ___. -The term HIV disease is used interchangeably with ___ ____. -In North America HIV has been is most prevalent among? -One staggering fact is that ___ in ___do not know they are positive for HIV

1. 1983 - pneumocystis pneumonia, harmless fungus, pneumocystis jirevoceii, uncompromised immune system 2. gay, bisexual, men who have sex with men, 69, 38,000 86 6 in 7 3. infections, immune response HIV infectin men who have sex with men - 1 in 7

1.HIV/AIDS clinical guidelines provide information on initial ____ regimens. However, one of the most important considerations for initiating therapy is patient ______ for treatment. Guidelines on when and how to _____ ART are based on the degree of ___ ___. Issues to consider when selecting an_____ drug regimen include the ability of the patient's HIV to______specific _____, potential medication ___ ____, existing _______, and dosing _____. This is a ____ ____, because the_____ ______ regimen is generally the patient's best chance for ____. 2. Example: The difficulty of______ consistently is probably clear to anyone who has tried to take a _____course of ______. Patients in treatment for HIV infection must take at least ___ pill a day (but most take ___ ____), and they must take those pills every day for the rest of their _____, even when______ ____ ____occur. _____ even a few _____ can lead to ____ ____. See Table 14-17 for strategies to improve adherence to ART. ______regimens. Use_____. Elicit_______.

1. HIV/AIDS: drug, readiness - ART, immune suppression - initial, resist, drugs, SE's, comorbidities, schedules - critical decision, first, treatment, success 2. adhering, 10 day, antibiotics - 1, many more, every day, lives, uncomfortable SE's missing, doses, drug resistance simplify reminders support

1. HIV/AIDS: Drug use, including ___ and ____ can cause _______ , ____ ____ and a host of ______ problems. However, drug use does not cause___ ____. The major risk for HIV related to using drugs involves sharing equipment or having unsafe ____ _____ while under the ______ of drugs. 2. Injecting equipment ("works") includes needles, syringes, cookers (spoons or bottle caps used to mix the drug), cotton, and rinse water. Equipment used to snort (straws) or smoke (pipes) drugs can also be contaminated with blood and should not be shared. Some communities have needle and syringe exchange programs (NSEPs) that provide sterile equipment in exchange for used equipment. Studies show drug use does not increase, rates of HIV and other blood-borne infections are controlled, and an overall cost benefit results in these communities. 3. Cleaning equipment before use can also reduce risk by decreasing the chance of blood contact. Providing support for patients with substance use and referring individuals to professionals who can assist patients manage the psychologic aspects of substance use is important. Other self-help programs (e.g., Narcotics Anonymous, Alcoholics Anonymous) may also be beneficial.

1. alcohol, tobacco - immunosuppression, poor nutirion, psychosocial, HIV infection, sharing equipment, sexual experiences, influence 2. needles, syringes, cookers, spoons bottle caps, cotton rinse water. snort, straws, smoke pipes, blood, shared - exchange, sterile ,used - increase, HIV, blood, cost benefit 3. cleaning, use, blood contact - substance, professionals, psychologic, naractocis ananoymous alcoholic anonymous

1. Chylamidia PID: ___ and ____ cells appear to be ____ away from norm ____ ___ ___. large ____ in mucosal surface and ___ ____ that can impair ___ ____ and ____ _____ that increase ___ ___ risk. - ___ can treat it but doesn't ____ the _____ that has been done. 2. Chylamidia Salpingitis: - indicative of ____ ____ ___ - __ and ___ can increase risk for PID the conseq. of this can be _____ or ___ ___. - can cause ____ rarel can have ___ and ____ in _____ caused by infection in the ____. very ___ and ____ ____ area. - Chymydia: alot of __ for these tests it has very good _____ and that is bc its using ____ to test for __ or ____. is very ____. 3. regular screening for hihg risk populations due to increased risk for ___ ___ so don't know ___ ____ to prevent ___ and __ transfer just bc ____ transfer can happen. -EPT: ___ doesn't have to have ____ to get ___ to get ___ for it. legality varies between ___ to ___ few states actaully prohibit not recomm. for __ who have sex with ____ espec. ____ ___ or _____ want high risk get ___ and not just ___ without getting ____.

1. cilia, epithelial, breaking, intact mucosal surface, cracks, spare cilia, egg fertilization, egg transport, ectopic prego - antibiotics, repair, damage 2. PID - chylamidyia, gonorrhea - infertility, ecotopic prego - epiditimitis, pain, swelling, testicles, epidymis, red, swollen, scrotal - money, sensitivty, sample, RNA, DNA - specific 3asymptomatic transfer, have it partner, exam, meds, treated - state, state - men, men, undiagnosed, Syph, HIV, screenings, med, screeened

1. Trich: if left untreated can lead to ____ - not much assoc. if theres not an ____ ___ so more likely with that. repeat testing related to increased risk for _____ or if become ____ again. barrier methods with ___ ____ ___ - Genital herpes: ___ more likely to get it then ____, and more ___ effected as well HSV1 more primarly known as ___ ___ or ___ ___. 2. ___ ____ where period before ____ appear,happens at every ___ , __ and ____ - stages occur at site of _____ clients may miss ___/__ of ___ stage and if have __/___ willl follow through ___ of ___. first initial epsidoe is ___. 3. Vesicular stage: ___ not ____ , ____. ____, _____ often ____ vescicles are ____ may appear on ____, ____ ___, ____, _____, ___, _____ region, ___ or ___. contain large quanities of ___ , ___ ___.

1. complications HIV contact - reoccurance, symptomatic - every sexual contact - GH: women, men, negatively - fever blisters, cold sores 2. prodromal stage, lesions, stage, primary, reoccurance - enoculation, S/S, prodromal, S/S, rest, stages - primary 3. vesciesls, open, red, multiple, small, painful, blisters, appear: butotck, inner thigh, penis, scrotum,vulva, perineal, cervix, vag - infectious viral particles

1. ___ and ____ best way to decrease risk of STI transmission then we have besides ____. - nothing ___ ___ , ___ is only way to not get STI. 2. STIs these have __ or _____, ______ of some sort, either on ____ or ____. - Chlamydial: many ____ of this, males don't need to ____ to spread this, its spread through ____, ___, or _____ routes. -___-___ week incubation period, at this time if having ___ ___ or ____ ___ could be transmitting it wihtout even - treatment doesn't confer immunity from ___ ____ bc can be ______ with it. - vagina is natural resevior why? 3. Chlamidia cervicits: ____, ____, _____ drainage. - chlamydia cell ____ the ___ and causes the ___ ____ can ___ and ____ that ___ site. - increased risk for other ____ when you have bc the ___ ___ ____ its a better ______ for other ____ to come on in.

1. condoms, barriers, absitnence - fool proof, abstinence 2. discharge, infection, redness, cervix, urethra - strains, ejaculate, oral, anal, vaginal 1-3, unprotected sex, risky behavior, - future infections, reinfected - warm, dark, nice, environment 3. edema, erythemic, mucopurulent - invades, cell, cell death, damage, scar, infection - STI's, tissue breaks down, enivornment, STI's

1. Viral STI's are not ____ only can ___ ____ can be treated. many STI's treatments are _____ and ___ ___. - most commonly diagnosed STI's ___ ___ and other related probelems not on test. due to ___ cause infection or infectious disease syndromes. contacted primarily through ___ ___. 2. STI's mucosal tissues in genitals, rectum, and mouth, especially susceptible bc so _____ easily passed through __ ____ to ____ and ___. can't be spread by inanimate objects like? autoinoculation is? have 1 high risk for? can have ____ at one time. Incubation is _____ period increeased chance of _____ don't ____ they have it. infected person to ____ without _____ theres anything amiss. 3. know ___ laws based off off what is mandated as a ___ infection or disease. - to control STI spread can build ____ with our pts. and make them feel comfortable enough to talk to us. - to decrease spread we want open ____ for adolescents espec. when first starting out ____ about____, ___ it, and have ___ ___ to go and talk to someone and get help if need.

1. curable, symptoms are, simple, straight forward - hep B 30 organisms 2. fragile, fragile tissue, bacteria, viruses toilet seats transfer to another part of body through placenta or L and D. - another multiple - asymptomatic, spreading, know, another, knowing 3. state, reportable - enviorn, learning, sex, having, safe place

1. HIV/ AIDS: HIV cannot be ______, but ART can delay ___ ___ by decreasing ___ ___. When taken ____ and _____ , ART can reduce ____ ____ by ___ to ____%, which makes ______ to treatment regimens extremely important. -The major advantage of using drugs from ____ ____ is that _____therapy can inhibit ___ ___ in several different ways, making it more difficult for the virus to______ and _____ the likelihood of ____ ____. -A major problem with most drugs used in ART is that_______ develops _____ when they are used _____ or taken in______ doses. Thus, combinations of____or more should be used. 2. Many ART drugs have ____ and potentially______ interactions. Be sure to ask patients about____ and ____ drugs as well as _____products and ______. 3. Management of HIV is complicated by the many ___ ___ that can develop as the___ ___ deteriorates. -________ is the preferred approach to opportunistic diseases. -A number of opportunistic diseases associated with HIV can be ____ or _____with adequate _____, vaccines (including ___ ___ ____), and disease-specific______measures. -Although it is usually not possible to eradicate opportunistic diseases once they occur, ____ ____ can significantly decrease____ and ____ rates. -Advances in the_____, ____, and ____ of opportunistic diseases have contributed significantly to increased____ ____.

1. cured, disease progression, viral replication, consistently, correctly, viral loads, 90-99, adherence, - dif. classes, combo, viral replication, recover, decreasing, drug resistance - resistance, rapidly, alone, inadequate, 3 2. dangeorous, lethal - prescribed, OTC, herbal, supplmenets 3. opp., immune system, prevention, delayed, prevented, ART, Vaccines, hep B, influenza, pneumococcal, prevention - prophylactic meds, morbidity and mortalitiy -prevention, diagnosis, treatment, life expectancy.

1. HIV/AIDS: -As the disease progresses, the number of CD4+ T cells usually ______(Fig. 14-3). -The normal range for CD4+ T cells is __ to ____ cells/µL. -Viral loads are reported as ___ ____ (e.g., 1260 copies/µL). The goal of treatment is to____ the ___ ___ to the _____level possible, which is below the level of _____ on a ___ ____. -This is often referred to as "_______." -"Undetectable" does not mean that the virus has been ______from the body or that the individual can no longer _____ ___ to ____. Rather, it refers to the fact that the amount of ___ ____ in the_____ is below the level of _____ of the test. 2. Decreased ____) counts, especially below-____numbers of _____ (_____) and _____ (_____), are often seen. Low ____counts (____) may be caused by ____, ___ ____, or ___ therapy. Anemia is associated with the___ ___ process and with adverse effects of ____. Altered____function, caused by ___ infection, ____ therapy, or _____ with a _____ virus, is common. Early identification of ____ with___ __virus ) or ____ __ virus is extremely important because these infections have a more _____ course in patients with ____, may ultimately limit options for ____, and can cause ____-related____ and ___

1. decreases - 800-1200 -real numbers, supress, viral load, lowest, detection, commercial assay - undetectable -eliminated, transmit HIV, others, Circulating HIV, blood, below, detection 2.WBC normal, lymphocytes,lymphopenia, neutrophils, neutropenia - platlet, thrombocytopenia, HIV,antiplatlet anttibodies, drug - chronic disease, ART - liver, HIV, drug, hept, coinfection, hep B, hep C, serious, HIV, ART, liver, morbidity, mortality.

1.Gonorrhea: For women making ___ of gonorrhea on a basis of ____ is difficult so most women are ___ or have ___ that may be confused with other ___ such as ___ or ___. -____ aren't as accurate as ___ ___ - for men ___ diagnosis of gonorrhea is made if their is a history of __ ___ with a ___ or ___ partner followed within a ___ ___ by ___ ____ so that ___ ____. 2. Drug therapy started before results come back bc of ___ ____ pd. and high rates of ____ treatment with gonorrhea are often started without ____ for ____ test results. - 2 antibiotics related to ____ ____ possible ____ infections along with it. - can also have increased ___ ____ - ___ from ____ for ___ ___ after _____ even if ____ 3. Trich: transmitted even without ___ can be ____ is a ___ ____ ___. Signs ___ ____, ___ -like can be _____ ___ partners should also be tested and no ____ till ____. vast majority of ppl with trich don't have _____ men might report ___ with _____ or ____ or ___ ___. on speculum exam we see ____ can have ___ appearance. women have ___ ___.

1. diagnosis, symptoms, asymptomatic, complaints, diseases, chlymidia, UTI - NAAT's, gram stains - men: presumptive, sexual contact, new, infected, few days, urethral dsicharge, yellow creamy 2. shorter incub, infertility, waiting, pos. - coexisitng chlymidia - antibiotic resistance - abstain, sex, 1 week , treatment, aysmptomatic 3. ejaculation reinfected single, anerobic protozoan - signs: cervical petechaie, strawberry - asymptomatic - male, intercourse, cured - symptoms, burning, urination, ejaculation, urethral discharge - cervix, strawberry - more symptoms

1. - HPV: are ____ , ____ or ____, _____growth that are ____ or ___ and ____ ____ colored can be ___ or ___ skin types may ____ and ______ to form ____, ____ like masses most pt. ___-___ genital warts. - in men warts occur on ___ and ____, inside or around ___, or _____. in women warts occur on ___ ___, the ____, ___or _____ in ____ area including ___ ____ ___. - usually no other ___/___ - ___ may occur with ____ genital warts and ____ upond defectation may occur with ___ warts. 2. during prego genital warts tend to ____ ____ and increase in _____ think its related to ___. - Gardasil-9: protects against __, ____, ___, ____ approved for girls aged ___-____ and boys ___-____. may be possible to ____ some of the ___ ____ types over next few decades parciulatrly of both on girls and boys are ___. can use ___ interventions , _____, and ____. - ___ or _____ can be used for treatment as well.

1. discreet, single, multiople, pappilary, white, gray, pink flesh - brown, darker, grow, cales, large, calliflower like, - 1-10 - men: penis, scrotum, anus, urethra - women: inner thigh, vulva, vagina, cervix, perianal, internal anal canal - S/S - itching, anogenital, bleeding, anal 2. grow rapidly, size, hormones - 6,11,16,18, 9-26, 9-15 irradicate, oncogenic HPV, vaccinated - surgical, lazers, cauterization - gels, ointments

1. The nursing assessment in HIV disease should focus on _____detection of ____ , ___ ____and _______problems. They will be confronted with complex treatment _____; ___ of ___, _____, _____, _____, and _____; ___ ____; altered concepts of the ____, ____l, _____, and ____ ____; the possibility of _____; and/or thoughts of ______. Patients and their family members, friends, and caregivers must also deal with associated ___ ___ and ___. 2. These factors can contribute to problems with _____ to treatment, a ____ ______ because of the high risk of developing ____ ____. Interventions you may provide include teaching about (1) __ and ___ of new treatments, (2) dangers of poor adherence to ________ regimens, (3) how and when to take each _____, (4) ____ ____ to avoid, (5) ___ ___ that must be reported to the HCP.

1. early, symptoms, opp. disease, psychosocial decision, feelings, loss, anger, powerlessness, depression, grief, social isolation, physical, socail, emotional , creative self, death, suicide, social stigma, discrimination. 2. adherence, dangerous situation, drug resistance - advantages, disadvantages, theraputic - drug drug interactions - SE's

1. Gonococcal opthalmia: - can be infection in _____ ___ ___/ ____ ____ exudate. - ___ of it very ____. 2. Gonorrhea: - men: often ____ and seek treatment _____ in courase of infection __ likely to develop serious complications then ____. the complications that occur are ____, which can result in ____. - whats infection in the bartholins gland? located on ___, __ ___ of vagina. ____ can be very __ when infected can result in ____, increased risk for ___ ___, ___, and ___ ___ ___. - bc women who are ____ seldom seek treatment ___ ____ are more common and usually reason for seeking ___ __. 3. Although ___ both men and women can develop ___ ( not in ___ __) assoc. with ___ ____, _____, ____, ____, and/or _____. ( ____ ____ ___) - Opthlamia neonatrum because of improved ___ __ and ___ ___ treatment its relatively ____.

1. eye, eye irritation, purulent conjunctive - sclera, red 2. symptomatic, ealry, less, women, epidimitis, inferility - internally, either side, opening, painful, PID, ectopic prego, inferility, chronic pelvic pain. - asymptomatic, serious complications, med attention 3. rare, dissemintated, normal spots, lesions, fever, arthralgia, arthirits, endocarditis ( Disseminated gonococcal infections) - prenatal screening, gonorrhea prophylactic - rare

1.HIV/AIDS Women need to have information about ___ ___ methods, ____, ___-____testing, and_____ if infected. Pregnant HIV-infected women need information about _____, how to _____ the pregnancy, and using _____ to decrease the risk of ____. If HIV-infected pregnant women are appropriately treated during pregnancy, the rate of perinatal transmission can be decreased from 25% to less than 2%. ART has significantly decreased the risk for ____ ____to HIV-infected women, and more of these women are now becoming ____. 2. The risk of infection from occupational exposure to HIV is _____ but real. ______ wounds from ____ ____ most common Should the nurse be exposed to HIV-infected fluids, ____-____ , ____with combination _____ can significantly decrease the risk of ______. The treatment begins within _____hours of exposure and consists of ___-___ ____ ____ that must be taken for ____ days The ____ determines what the ___ are, ____ _____ ____ and what _____ is required. 3. The goal is to ______ the ____, decrease the ____ related to HIV_____, find ___ ____, get infected individuals into _____, and _____new cases of infection.

1. family planning, HIV, HIV antibody, ART - abortion, maintain, ART, transmission - 25, 2 - infants, born, moms 2. small, puncture , needle sticks - post exposure, prophlaxis, ART, infection, 72, 2-3, Antiretroviral meds, 28 - doc, meds, follow up app, testing 3. normalize, test, stigma, Testing, hiddencases, care, prevent

1.Systemic flu like symptoms Genital herpes include? both primary and secondary epidoses are both ___ ___. complications enecphalitis is ____ of the ____ aseptic meningitis inflmmation of _____ of the ____. can be transmitted through mom to baby during birth through __ ____ as infant passes through ___ ___. - highest risk during primary epidose and not ____ or ___. -no ___ for viral infections 2.genital herpes antiretroviral meds- inhibit ___ ___ ____ - wear loose ___ __ - ___ during __ -not reportable in most states varies __ by ___ -Genital warts: about ___% transmitted ____. - unclear if ___ genital warts helps a person to clear a ____, ____ it, ore reduce persons ability to ____ the virus. majority ____ ___. 3. most inviduals who have HPV don't know their ______ bc ___. - most often areas of ___ related to decreased ____ ___. - some virus type can cause ____ of ___ ___ or ____. - most sexually active men and women will get some ____ of HPV at some point.

1. fever, HA, tiredness transmittable stages - inflammation, brain - lining, brain -viral shedding, birth canal - recurrent, secondary -cure 2. herpatic viral replication - cotton underwear - void, shower -genital warts: - state, state - 40, sexually -removing, virus, cure, transmit - resolves spont. 3. infected, asymptomatic - friction, skin integirty - cancer, genital tract, oropharynx - type

1. STI nursing Asessments: cont: Integumentary: - any symptoms systemic ( ____, ___ ____problems) - primary: _____, ____, ___, _____or ____ lesions. - 2ndary: _____, _____, ___ on ___, ____, or ____ ___. _____ ___ onn ___ or ___ and also _____. genital warts: ___ or ___ , ___/____ , ___ or __ warts genital herps: ______ , ____ or ___ , ___ lesions. 2. 5 P's practices like? prevention of prego what ____ using or ____? ____ b4 it happens!! we want to address special populations like? - teach pts to inspect partners genitals: know what __/___ to look for, S/S ____ , ____, ____, and ___. -___ are ok but have to weight ___ and ____. nonoxynol 9 is? 3. nursing management acute care STI: encourage pt. to ____ _____ -couples and marries in commited relationshiip ___ with added prob when STI diagnosed if they must face implication of possible sexual activity ___ the ____. - STI raises other concerns about ____ and may serve as an incentive for furhter _____ ____ and referral for ___ ___ to explore _____ of STI in relationship may be indicated. - see more in _____coming in for ____, ____ ____ ___. - voiding after sex won't ____ but ___ risk maybe. - dont douche why?

1. fever, lymph node - prim: painless, indurated, genital, oral, perianal - 2ndary: bilat systemic, rash, palms, soles, entire body - mucus pathces, mouth, tongue, alopecia - Gential warts: single, multiple, gray/white, genital, anal herpes: painful, genital, anal, vesicular 2. do drugs or exchange alcohol, money, drugs for sex - BC, barrier methods - prevention -men with men, women with women, and trans - S/S, rash, sores, blisters, lesions, canchers - spermicide, benefits, risks - spermicide 3. verbalize feelings - confonted, outside, relationship - relationship, problem solving, profess. counseling, reimplification - clinics, physicals, reg. doc app. - prevent, decrease - pushes bacteria up in reproductive tract

1. Syphilis: called the ____ ___ - ____% of cases are related with men and men - can be easily ____ don't know they have it. - caused by a ____ __ - transmission occurs with ___, ___ or ____. sex. 2. enters through __ or ___ ___ during ___ ___. - can also transfer through __ during ____. - can be treated during ___ - transmitted through ___ ____ with ____ ____ called a ______ that can occur externally _____, ____, or ___ or internally ____, _____, ____, or ___. - can spread depend on bodys ___ __ - ___ and ___ stage can be ____ by ___ but can ____. - if allergic to ____ can treat with ___ or ___ for __ weeks with this. -complications for syph: cardiovascular including: can have _____, ___ ___, or ___ ___ also a rare extremem manifestesations include __ ___, ___ ____ ____, and _____. - can invade CNS at any ____ - Chancres on genitalia enhance HIV transmission increases risk for ____ ______ and may need ____ ___. 3. Travels via ___ ___ throughout body cause ______ of the _____ can cause loss of ____ , sense of _____ related to __ and ___ ( ___ ___ ___). - can occur a __ __to a ____ after infection occurs.

1. great intimidator - 75 - spread - singular bacteria - vaginal, anal, oral 2. skin, mucous membrane , sexual contact -placenta, prego -prego -direct contact, syphitic lesion, chancre - penis, lips, anus, int: mouth, rectum, vag., tongue -1st, 2nd, separated, weeks, overlap - penicillin, deoxycycline, tetracycline, 2 - cadio: anurysm, valve failure, heart failure, vision impairment, progressive locomotor ataxia, dementia - stage - CNS involvement, intensive treatment 3. cirulatory system, degeneration, brain, vision, position, leg, foot, ( progressive locomotor ataxia) - few months, year

1. HIV/ AIDS: It is important to remember that (1) disease progression is highly ______, (2) treatment can significantly alter this______, (3) an individual's prognosis is _______. The information depicted in this figure represents data from___ ___ of people and should not be used to predict an ____ ____. 2. ACute infection HIV Some people also develop ______ complications, such as ____ ____, ___ ___, ___ ___, or ____-___ syndrome. During this time a high____ ____ (the amount of ___ ____ in the _____) is noted, and _____ ____ counts fall temporarily but quickly return to ___ or ___ -_____ levels (Fig. 14-3). Many people, including ____, mistake acute HIV symptoms for_____ ____ of the ___. -Individuals are most infectious during the ___ ____ stage because of the high amounts of ____ __. 3. -Because most of the symptoms during early infection are___ and ____ for HIV, people may not be ___ that they are infected. -_____ behaviors become a public health problem because infected individuals can transmit ____ to others even though they have ___ ____. -___ _____ is also affected because people who do not know that they are _____ have little_____ to seek _____ and are less likely to make _____ changes that could improve the _____ and _____of their ____

1. individualized - pattern unpredictable -large groups, indivuals prognosis 2 neurologic, aseptic meningitis, peripheral neuropathy, facial palsy, guillian barre - viral load, HIV, circulating, blood, CD4 T cell, baseline, near baseline - HCPs, bad case flu - acute infection , circulating HIV 3. vague, nonspecific, aware, infected - risky, HIV, no symptoms - personal health, infcted, reason, treatment, less, behavioral, quality, legnth, lives.

1. Syphilis: ulcerating gumma occur in __ __, is ____ ___ to ____, ____ or ___. - can mimic ____. - if ___ positive need more ____. - always need __ __ if positive ___. - bc those with HIV so _____ bc of ___ ___ to getting other ___ and ____ infections. -can get___ during ____. - if ___ containdicated for treatment such as ____ can use ____ or _____ but ___ gold standard. 2. STI nursing management: - looking at potential ___ for contracting STIs - plan our teaching related to ___ to these ___. - ___ skills nec. for interview we want to be ____ , show ___, and be ______. want to tailer counseling to ___. - Nursing assessment STI's: - GI look at ____ ___or ___ ___ GU: look at ____ ___ or ____ 3. reproductive: look at _____ the __ ___ , any ___ ____, ___ ___, ____ ___ drainage, _______, ____ or ___ __. - diagnostic findings: - chylamidia: positive ____ and_____. or ___, ____, ____, ____, or ___ samples. - Gonorrhea positive _____ and _____. -Genital Herpes: postivie serum _____ test - Syph: positive finding on ___ and ___ - Trich: increased ____ and positive ____ ____ on ___ ___ of ____.

1. late syphilis, irreperable damage, skin, bone, liver - cancer - screen, testing - more testing, screen - prone, immune deficiency, bacteria, virus -penicillin, allergy, deoxycyline, tetracycline, penicillin 2. risks - responses, questions - interpersonal, respectful, compassion, nonjudgemental - individual - GI: rectal discharge, rectal lesions, GU: urethral discharge, erythema 3. repro: cervical, mucopurulent discharge, cervical erythema, cervical bleeding, penile purulent, epidimitis, proctitis, genital lesions - Chyl: culture, NAAT, cervical, urethral, anal, oropharyngeal, urine - gon: cultures, NAAT - Genital herps: antibody -Syph: VDRL, RPR - trich: PH, motile protozoa, wet mount, discharge

1. HIV/AIDS: PATHO -HIV cannot replicate unless it is in a ___ ___. -The HIV virus binds to the ____ receptors on the ______ of the cell This binding process is called ____. -HIV is surrounded by an _____ made up of _____, including ____. this is a _____that attaches to the ___ and ____ _____ and _____ receptors on the surface of the ____ cell. This allows the ___ _____ to enter the ____ and perform ____ ___ -HIV virus contains a core of ___ ____ and ____. 2. Once HIV is ___ and ___ with specific _____ receptors on the outside of the ____ ___ cell, HIV_____enters the ____. -This triggers the release of ____ ____ , an enzyme that transforms ____ ___ into a ____ ___ of ____. -This strand _____ itself, becoming ____-____ ___ ___. -Another enzyme, called _____, allows the newly formed ____ ____ ___ to integrate itself into the host's ____ ____ . 3.______, another enzyme involved in the replication process______the newly formed strands of ___ _____ material into ____ ___. New ___ _____ are then ___ and ____ The _____ _____ is then _______after the HIV virions are ____.

1. living cell - protein, outside, fusion - envelope, protein, GP120, glycoprotein, CD4, Chemokine, CXCR4, CCR5, CD4, RNA virus, cell, Reverse transcriptiase - Viral RNA, proteins 2. attached, fused, protein, CD4 T, RNA, cell - reverse transcriptinase, HIV RNA, single strand DNA -copies, double standed, viral DNA -integrase, double stranded DNA, genetic structure 3. protease, cleaveres, HIV, genetic, smaller pieces - HIV virons, formed, released - CD4 T cells, destroyed, released

1. Chlamydial infections: want to encourage barrier methods like? have high risk for ___ espec if ______ increased risk for it __ and ___ or to new ____ have increased risk for ____. 2. Gonorrhea: alll partners within last __ days should be ____ to seek ___ espec. with ___ and ___. - incubtation pd alot ___ pd than Chylmidia. - can get ___ 3. Neisseria gonorrhea:: +_____, not quite right ______ get _____ , _____, or ____ can cause ____ very ___ one of __ ___ or ____ of it. Endocervical gonorrhea: - can see ____ , most women who have are ______ or have ___ ___. that are often ____. - common symtpoms for women: increased ___ ___, _____, frequent ___ or ___ after _____ , ___ and _____ occur at ___ or ___ along with ____ ___.

1. male and female condom, diaphragm, sponge, - transmission, asymptomatic, back, forth, partners, reoccurance. 2. 60, notified, treatment, chylamidia, gonorrhea - shorter - reinfected 3. shiny, anatomoically - epidimitis, abscess, sepsis, inferilitiy, swollen, SE's, complications - endo: discharge, asymtpomatic, minimal symptonms -overlooked - common sytmpoms: vag. discharge, dysuria, urination, bleeding, sex, swelling, cervix, vagina, purulent exudate

1.HIV/AIDS Some HIV-infected patients, especially those who have been infected and on ART for a long time, may develop a set of ______disorders. _____ includes elevated_____, elevated ____, and decreased_____._____ abnormalities are generally treated with ____-____drugs, ____changes, and _____. . _____ resistance is treated with _____drugs and__ ___. Bone disease involves ____, ___ , ___ ___ ____ disease may be improved with ___ , ____ changes, and ___ and ___ ___ supplements. It's not ____ why these disorders ____, but it is probably from a combination of factors including: Long-term ___ with ____ ___ ___ of ART ____ predisposition Chronic____ 2. Lipodystrophy is changes in ___ ____ caused by a _____of ____ in the ___, ___ ___ and______ along with ____loss in the ___, ____, and ____. Management of these metabolic disorders focuses on _____detection, _____ management, and helping patients ____ with emerging____and changing ______regimens, especially to avoid potentially _____ complications. A frequent first intervention is to___ __ ___ because some ____are more often associated with these ____.

1. metabolic hyperlipidema, triglycerids, LDLS, HDLS, lipid, lipid lowering, dietary , excerise - insulin , hypoglycemic, wt. loss - bone, osteoporosis, osteopenia, avascular nercosis - bone, excerise, dietary, calcium, vit D - clear, develop, - infection, HIV -SE's Genetic stress 2. body shape, redistribution, fat, abdomen, upper back, breasts, fat, arms, legs, face -early, symptom, cope, problems, treatment, fatal - change ART meds, drugs, disorders

1.HIV /AIDS ____,____, _____, and other equipment may be contaminated with HIV or other______-borne organisms, and _____this equipment can result in disease transmission. -Routine____ of ___ ___ to identify at-risk individuals and testing ____ ___for the presence of HIV have improved the safety of the____ ___. 2. -The risk of infection after a needle-stick exposure to HIV-infected blood is ____ to ____% (or ___ to ___out of _____). The risk is higher if the exposure involves blood from a patient with a high level of ____ _____, a ____ _____e wound, a _____ with a ____ ____and _____ blood, or a device used for ____or ____ access. -Splash exposures of blood on skin with an ____ _____ present some risk, but it is much _____than from a _____ ____. -Health care workers have a_____risk of acquiring HIV at work, even after a ___--____ injury. 3. ______ transmission can occur from an HIV-infected mother to her infant. Fortunately, the risk of transmission can be reduced to___-__% in settings where pregnant women are routinely ______ for HIV infection and, if found to be infected, treated with ____ ____, a _____of ____used to _____ and ____ ___ ___. So the transmission is called ______transmission when the passage of a disease causing agent from ___ to ____ during the period immediately ___ and ____ ____.

1. needles, syringes, straws, blood, sharing - screening, blood donors, donated blood, blood supply 2. 0.3-0.4, 3to 4, 1000, circulating HIV, deep puncture, needle, hollow bore, visible blood, venous, arterial - open lesion, lower, puncture - low, needle stick 3.perinatal - 1-2, tested, ART therapy - combo, meds, control, suppress, HIV replication - vertical, mom to baby, before, after birth

1. HIV/AIDS Although HIV-infected patients share problems experienced by all individuals with chronic diseases, these problems are exacerbated by ___ ___ ____ and_____s surrounding HIV. Behaviors may be viewed as ___, ___ or reflect a lack of -__ ___. Even though ____according to the ADA,_____ surrounding the transmittable nature of the disease can lead to pervasive ___ and ___ 2.______problems related to HIV and/or its _____ can interrupt the patient's ability to maintain a desired____. Nursing interventions are ______ to those for patients who do not have HIV.

1. neg. social atttitude, beliefs - immoral, illegal, personal control - illegal, fear, stigma, discrimination 2. physical, treatment, lifestyle - similar

1.HIV/AIDS CDC criteria for diagnosing someone with AIDS they only have to have ___ of the following conditions -Organisms that do not cause ___ _____ in people with functioning ___ ____ can cause ___, ___, and ___-___ infections during this stage. -Several ____ ____ may occur at the same time, compounding the difficulties of ____ and ____. -Advances in HIV treatment have decreased the _____ of ____ ____. 2.- ______ diseases generally do not occur in the presence of a functioning _______ ____ -_____ ____is a type of pneumonia that can appear as an opportunistic disease associated with HIV infection. 3. diagnostics -Combination ____ and ____ tests decrease the_____ period to within ____ weeks ______ infection (Table 14-12). -___ ____-____ testing is highly accurate. -Inhome kits are done on____ -Follow a ____ test with a ___ ____ helps to determine_____testing -Postive ____ tests can be disclosed to the patient but follow up with standard _____ ___ testing is necessary to confirm. -____ rapid testing, need to do more ___ __.

1. one severe disease, immune systems, debilitating, disseminated, life threatening - oppor. diseases, same time, diagnosis, treatment - occurance, opp. diseases 2. opp. immune systems - Pneumocystis jiroveci 3. antiboyd, antigen, window, 3, following - rapid HIV, antibody - saliva - negative, risk assesssment, repeat -rapid, HIV assay, - positive, advanced testing

1. HIV/AIDS: Despite new developments in the treatment of HIV infection, many patients eventually experience disease progression, disability, and death. Sometimes treatments do not work for the patient. Sometimes the patient's HIV becomes resistant to all available drug therapies. In other cases, a patient may make a decision to forego further treatment, allowing the disease to progress toward death. (End-of-life care is discussed in Chapter 9.) 2. The number of persons over age ___ living with HIV is anticipated to ____. As a nurse, you need to be aware of the special health _____of the HIV-infected _____ adult. They are susceptible to the same diseases (___, __, ___, ____ disease, ____, ____, _____ disease, ___ ____) as ____-____-____ older people but may experience them at an __ ___. may be at higher risk of ____-____ due to the effects of the______used to treat HIV. _____ (taking multiple______s to treat a variety of conditions) is a concern because the multiple medications older adults may have to take could have _____ or be potentiated by ___ ____ It may be difficult for the older adult to get appropriate health ___ and ____if they are ashamed and hesitate to tell anyone they have ____. As a nurse, you need to recognize that HIV is a ____ disease that will affect an increasing number of ___ ___ and be prepared to help the ___ ____ who is living with HIV infection.

1. progression, disability, death -work - resistant, drug - progress, death 2. 60, grow - concerns, older - heart, cancer, diabetes, bone, arthirits, HTN, kidney, cog. impairment,non HIV infected - earlier age - comorbidities, meds polypharm, meds, interactions, HIV meds - care, support, ashamed, HIV - chronic, older adults, older person

1. HIV/AIDS: -______tests can determine if a patient's HIV is ______ to _____used for ____. -Genotype and phenotype assays are similar to ___ and ____testing used for______selection. -An assay is an ______ ________ in _____ _____, ______, ____ ______ and ___ _____ for ____ assessing or ______measuring the_____, ____, or _____ activity of a ______entity. 2. Interprofessional care of the HIV-infected patient focuses on (1) monitoring HIV disease _____ and _____ function (2) initiating and monitoring _______ (3) preventing the development of ____ _____ (4)____ and _____ opportunistic diseases (5) managing _______ (6) preventing or decreasing ________ of treatment (7) preventing further _______ of HIV. To accomplish these goals, ongoing ________, clinician-patient ______, and patient ____ and _____ are required. focus on prevent further transmission of ______ have to look at _____ and supplying people ____ they need so they can prevent further ___. 3. Perform complete ___ and ____ examination. These findings will determine the patient's ____. -This is also a good time to ensure that ___ ____ required by the ____health department have been completed. -Determine the need for ____. -Remember that a newly diagnosed patient may not be able to____ or _____ information. Be prepared to ____ and ____ information over the course of ____ ____

1. resistance, resistant, drugs, ART - culture, sensitivty, antibiotic - investigative proceudre, lab med, pharmocology, enviorn biology, molecular biology, qualitively, quantitvely, presence, amount, functional, target 2. progression, immune - ART - oppo. diseases - detecting, treating - symptoms - complications - transmission - assessment, interactions, teaching support - HIV, teaching, tools, spread 3. history, phyiscal, needs - case reports, state - referrals - retain, understand , repeat, clarify , several months

1. HIV/AIDS: HIV positive prego women -a ____ , ____ --____ at ___weeks for a pregnant women with a viral load of >______ --______delivery at____ weeks with viral loads <____, _______, labor ____ ______ or _____, ____-____. 2._______ This medication is given ____ for all HIV infected pregnant women Given ____ hrs before a ____ ____--___ and continued after the ____ is ____. Avoid fetal ____ _____ and ____ _____ sampling as these procedures may result in_______of the virus into the ____. Avoid ____ or ____ _____ as well Avoid _____ 3. HIV infected individuals can transmit HIV to others within a___ ____ after becoming infected. After that, the ability to transmit is _____. -Transmission of HIV is subject to the same requirements of other microorganisms: a ____ enough ____ of the virus must enter the body of a ____ ____ , ___ and ____ of the ______, ____ of _____,____ and _____ of the organism, and host ___ ____ ." (Lewis) -"___ __or ___ exposure to an infected individual is more ____ during these periods, although HIV can be transmitted during all ______ of the disease."

1. schedule C section 38, 1000 - vaginal , 36 1000, ROM, progressing rapidly, declined C-section 2. Zidovuldine - IV, 3, scheduled, C-section, baby, born - scalp electrode, scalp, PH, inoculation, fetus - forceps, vaccum extraction - breast feeding 3. few days, lifelong - large amount, susceptible host, duration, frequency, contact, volume, fluid, virulence, concenrtation, immune status - unprotected sex, blood, risky, phases

1.HIV/AIDS: Safe sexual activities eliminate the risk of exposure to HIV in s___ and ___ ___. ______ is the most effective strategy. There are _____options for those who cannot or do not wish to abstain. 2. Safe sexual activities include ____, ___ ____("hand job"), and other activities that meet the "____ ____ requirements._______sex between ______ who are not infected with HIV and are not at risk of ______ ____ with _____ is also considered to be safe. 3. Risk-reducing sexual activities decrease the risk of ____with HIV through the use of ______. they should be used when engaging in _____ sexual activity (___,____, or ____) with a partner whose HIV status is___ ___or who is known to have_____. The most commonly used barrier is the ___ ___, which can be used for protection during ___, ___, and ___ intercourse. ___ ___ provide an alternative to male condoms. Squares of-___ (known as ___ ____ ) can be used as a barrier during ___ ____ ___.

1. semen, vag, secretions abstinence safe, 2. masturbation, mutual masturbation ( handjob), non contact, insertive, partners, HIV, becoming infect, 3. contact,barriers, insertive, oral, vaginal, anal, not known, HIV, male condom, anal, vaginal, oral - female condoms latex, dental dams, oral sexual activity

1. HIV / AIDS HIV transmission occurs through ____ ____ with an infected partner; exposure to HIV-infected ___ or __ ___ ; and ______ transmission during _____, at ____, or through ______ The virus cannot be transmitted through _____, dry ____, ___ ____, sharing _____ _____, using____ _____, or _____ ____ in any setting. It is not spread by ___, ____, ____, ____,____, ___,_____,_____ ____, or _____ routes. 2. Sexual activity involves contact with ____,_____ secretions, and/or _____, all of which have ______ that may contain HIV. -During any form of sexual intercourse (___, ____, or ____), the risk of infection is greater for the partner who receives the _____, although infection can also be transmitted to the _____ ____ . -Sexual activities that cause____ to ___ ___ can increase the risk of transmission. -____ _____ from other sexually transmitted infections (e.g., _____ and ____) significantly increase the likelihood of _____

1. sexual intercourse -blood, blood prodcuts, perinatal, prego, delivery, breastfeeding - hugging, dry kissing, shaking hands, eating utensils, toilet seats, casueal encournters - tears, saliva, urine emesis, sputum feces, sweat resp. droplets, enteric 2. semen, vaginal, blood, lymphocytes, - anal, vagina, oral, semen, inserting partner - trauma, local tissues - genital lesions, herps, syph, transmission.

1.Nursing management nursing implification STIS: - pt can remain infective even with ___ ___ of ___. - use of barrrier methods to prevent ___, ___ and ___ ___. - many don't fully understand, ___, ___, and ___. - long termp complications can be ____ nad include future ____ issues as well make sure pts ____. - want pts to understand ___, mode of ____, ____ options for StI, long term pot. _____ of infection, demonstrate ___ with ___ regimens and follow up _____ , stressing need for ____ to take all ___ ____ as their ___ infected. - experience no reinfection and STI risk reducing ____ and ___ are encouraged. 2. what do we want if they have HPV ____, ___ test done because link between ___ and ___ __

1. single dose, treatment - spread, reinfection, future exposures - rick, incidence, reoccurance - costly, fertility, aware - course, transmission, treatment, complications, complicance, med, protocols, parnter, prescribed meds, presumed - behavior, practices 2.annual, pap smear, HPV, cervical cancer

1. HIV/SID: ______ assessments are needed for an individual who has been diagnosed with HIV infection. ______ recognition and treatment can _____ the ______ of HIV infection and prevent___ ___. A complete_____and thorough _____ review can help identify and address problems in a ____ ____ 2. Nursing interventions can help the patient to (1) adhere to ___ ____ (2) promote a ___ ____ that includes avoiding______ to other sexually transmitted and blood-borne diseases (3) protect______ from HIV (4) maintain or develop +____ and ___ relationships (5) maintain___ and ____ (6) explore _____ _____ (7) come to terms with issues related to ___, ___, and ____ (8) cope with ______caused by HIV and its_____.

1. specific - early, slow, progression, new infections, history, systmes, timely manner 2. drug regimens - healthy lifestyle, exposure - others - healthy, supporitve - activites, productivity - spiritual - disease, disability, death - symptoms, treatment

1.HIV/AIDS As the ___ ____ increases, symptoms such as ___ ____, frequent ___ ____, chronic _____, recurrent_____, and severe _____may develop. - One of the more common infections associated with symptomatic infection is _____ _____ (thrush). Candida organisms _____ cause problems in ____ ____, but are more common in ___-____ people. - Other infections that can occur at this time include ____ (caused by the ____-____ virus), persistent______ _____ infections, outbreaks of ____ or ____ ____, and ______ infections. 2. ___ ____ lesions such as ___ ____ lesions can appear _____ on the ___ ___ or on ___ ____. this is caused by ___ ____ ____. Lesions vary in____ from ___ to very ___ and may appear in a variety of ____. 3. Oral hairy leukoplakia, an ____-____ virus infection that causes ___, ___, ____ lesions on the___ ____of the ______, can occur at this ____ of the infection and is another indicator of____ ___.

1. viral load, persistant fever, night sweats, diarrhea, headaches, fatigue - oropharyngeal candidiasis, rarely, healthy adults, HIV infected - shingles, varicellar-zoster, vaginal candidial, oral, genital herpes, bacterial 2. malignant, vascular, kaposi sarcoma, anywhere, skin surface, internal organs human herpes virus 8 - size, pinpoint, large, shades 3. epstein barr, painless, white, raised, lateral aspect, tongue, phase, disease progression.

1. HIV/ AIDS: _____ should be used in conjunction with other proven prevention interventions such as____, ____ ____ counseling, and regular ____ ____. -______ in combination with ______, also known as ______, is used to reduce the risk of ___ _____ in ____ ____ who are at significant risk of acquiring HIV. -______/_____ is also currently used in ______ with other antiretroviral agents for the treatment of ___--___people. 2. Since HIV infection can be ______, nursing care for individuals not known to be infected with HIV should focus on _____disease transmission. The first step is to _____ the patient's individual ____ ____ , ______, and _____. Do not make ______about people or their behavior. Assess for_____ _____ on a regular basis - things can _____ 3. Ask if they have ever had sexual contact with someone known to have _____ These questions provide the ____ ____ needed to initiate a ____ ____. Follow-up a ______ response to any of these questions by an in-depth ______ of issues related to the identified risk. Based on the assessment, nursing interventions can then encourage the patient to adopt ___ , ____ and less ______ behaviors, particularly in regard to ____ ____, ____ ___, _____transmission, and ____ issues.

1.PrEP( pre-exposure orphylaxis), condoms, risk reducing, HIV testing - tenofovir, emtricitabine, truvada, HIV infection, uninfected inviduals - Tenovir/ emtricitabine, combo, HIV infected 2. prevented, preventing - assess, risk behaviors, knowledge, skills assumptions - risky behaviors, regular basis, change 3. HIV - minimum, info, risk assessment, pos., exloration - safer, healthier, risky - sexual intercourse, drug use, perinatal, work

1. HIV/AIDS: Supporting a healthy immune system can help delay HIV disease ______ whether or not the patient chooses to take ____ or not. Interventions include (1)____support to maintain___ ____ ____and ensure appropriate levels of ___ and ____. (2) moderation or elimination of ___, ___, and ___ use (3) keeping up to date with recommended ___ (4) getting adequate __ and ____ (5) reducing ____ (6) avoiding exposure to new ___ ___ (7) accessing_____ (8) getting involved in___ ___ and ___ ___ (9) developing a consistent relationship with ___s, including attendance at ____ ____ Teach patients to recognize ____ that may indicate disease _____and/or drug___ ____ s so that prompt medical care can be initiated. 2 Chronic diseases are characterized by ____ ____ Nursing care becomes more complex as the patient's immune system _____ and new _____ arise to compound existing _____. The best way to prevent _____ disease is to assure that the patient is _____to an effective_____ regimen and taking______ medications for ______ infections. Providing_____ care specific to the _____ disease, should it occur, is important nursing care.

1.progression, ART - nutritional, lean body mass, vitamins, micronutrients - alcohol, tobacco, drug - vaccines rest, excerise stress - infectious agents - counseling - support groups, community activites - HCPs, reg. app. - symptoms, progression, SE's 2. acute excerbations, deteriorates, problems, difficulties - opportunistic, adhering, ART, prophylactic, oppo. ,supportive, opp.