A3 EX 4 HIV/AIDS ONCOLOGY PREP U HELP
Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS?
Liquids
The nurse teaches the client that reducing the viral load will have what effect?
Longer survival
HIV is harbored within which type of cell?
Lymphocyte Because HIV is harbored within lymphocytes, a type of white blood cell, any exposure to infected blood results in significant risk of infection. HIV infection is not harbored in platelets, erythrocytes, or nerve cells.
Autoimmunity
The normal protective immune response attacks the body, damaging tissues.
pneumocystis pneumonia
pneumonia caused by the Pneumocystis carinii organism, a common opportunistic infection in those who are positive for the human immunodeficiency virus (HIV)
contact precautions
practices used to prevent spread of disease by direct or indirect contact
Airborne precautions protective equip
private room neg pressure mask & respirator N95 for TB
A child has just been diagnosed with a primary immune deficiency. The parents state, "Oh, no. Our child has AIDS." Which response by the nurse would be most appropriate?
"Although AIDS is an immune deficiency, your child's condition is different from AIDS."
he nurse receives a phone call at the clinic from the family of a client with AIDS. They state that the client started "acting funny" and reported headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?
"The client may have cryptococcal meningitis and will need to be evaluated by the health care provider."
function of spleen
- forms monocytes & lymphocytes - stores RBC & releases into circulation if needed - filters old RBC's from blood REMOVES BACTERIA FROM CIRCULATION WITHOUT SPLEEN PT IS SUSEPTIBLE TO INFECTION
Basophils
A circulating leukocyte that produces histamine. increase in number during allergic reactions and stress responses.
AIDS
A serious (often fatal) disease of the immune system transmitted through blood products especially by sexual contact or contaminated needles .It results from infection with the human immunodeficiency virus (HIV)
Cytotoxic T cells
A type of lymphocyte that kills infected body cells and cancer cells Attack antigen directly by altering the cell membrane and causes cell lysis
Lymphocyte
A type of white blood cell that make antibodies to fight off infections PROVIDES HUMORAL IMMUNITY
HIV
A virus that attacks and destroys the human immune system.
AIDS dementia complex (ADC)
ADC, a neurologic condition, causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking
A fungal infection, Cryptococcus neoformans is another common opportunistic infection among clients with
AIDS
What would the nurse identify as the most common secondary immunodeficiency disorder?
AIDS
When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following?
Antibodies to HIV are not present in his blood. A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which take from 3 weeks to 6 months or longer).
Patient teaching when immunosuppressed
Avoid sick people Avoid alcohol-containing products Avoid people who just had vaccines
What is humoral immunity mediated by
B and T lymphocytes Can be acquired active or passive
humoral immunity
B cells produce antibodies after exposure to specific antigens; type of adaptive immunity recognition OF A FOREIGN ANTIGEN AND FORMATION OF MEMORY CELLS AGAINST THE ANTIGEN
What tests would be given if the patient has decreased UOP after retroviral therapy
BUN AND CR
Artificially aquired immunity
Body has formed antibodies in response to a vaccine
What treatment option does the nurse anticipate for the patient with severe combined immunodeficiency disease (SCID)?
Bone marrow transplantation Stem cell transplant
contact precautions
C. diff, herpes simplex, salmonella, shingellosis, staphylococcus, scabies
Sign of hypersensitivity reactions AKA Anaphylactic reactions
Fever and rash Bronchopulmonary issues Bronchial constriction
Which of the following indicates that a client with HIV has developed AIDS?
CD4 T-cell count drops below 200 cells and develops one of the opportunistic diseases, such as Pneumocystis carinii pneumonia, candidiasis, cytomegalovirus, or herpes simplex.
Which is usually the most important consideration in the decision to initiate antiretroviral therapy?
CD4+ counts
The nurse is discussing childhood immunization recommendations with a pediatric patient's parent. Where would the nurse find the most current information on this topic?
CDC
A nurse is monitoring the client's progression of human immunodeficiency virus (HIV). What debilitating gastrointestinal condition found in up to 90% of all AIDS clients should the nurse be aware of?
Chronic diarrhea Chronic diarrhea is believed related to the direct effect of HIV on cells lining the intestine.
Which of the following describes microorganisms present without host interference or interaction?
Colonization
Which term refers to a state of microorganisms being present within a host without causing host interference or interaction?
Colonization "Colonization becomes infection when the host and organism interact."
What type of allergen is animal dander
Complete protein antigen
Which alternative treatments would the nurse recommend to reduce the likelihood of HIV transmission?
Dental dam Polyurethane female condom Pre-exposure prophylaxis
anaphlaxis
Difficulty breathing is a life-threatening symptom of anaphylaxis and requires help right away. Peripheral tingling is a symptom of anaphylaxis reaction. R
A client with an allergic disorder is in treatment for their disorder. What might their treatment be?
Drug therapy
Which blood test confirms the presence of antibodies to HIV?
Enzyme immunoassay (EIA)
reportable communicable diseases
Gonorrhea and chlamydia
enteric precautions
Gowns and gloves required, masks not required, protection from feces and urine.
Neutrophils
Most abundant white blood cell., The most abundant type of white blood cell. Phagocytic and tend to self-destruct as they destroy foreign invaders, limiting their life span to a few days. first cells to arrive at the site where inflammation occurs
Mild systemic, anaphylactic reactions
Onset of symptoms begins within the first 2 hours after exposure.
The nurse completes a history and physical assessment on a client with acquired immune deficiency syndrome (AIDS) who was admitted to the hospital with respiratory complications. The nurse knows to assess for what common infection (80% occurrence) in persons with AIDS?
Pneumocystis pneumonia one of the first and most common opportunistic infections associated with AIDS. It may be present despite the absence of crackles.
Contact precautions have what 5 things?
Private room - door can be open Gloves Gown- if giving direct care Handwashing Disposable supplies Dedicated equipment
Droplet precations have what 6 things?
Private room- door can be open Gloves Mask- #1 in this group Handwashing Pt wears mask when leaving room Disposable/dedicated equipment
A patient asks the nurse if it would be all right to take an over-the-counter antihistamine for the treatment of a rash. What should the nurse educate the patient is a major side effect of antihistamines?
Sedation
immunodeficiency disorder
occurs when the immune response is compromised Chronic diarrhea Chronic or recurrent severe infections Poor response to treatment of infections
A client develops contact dermatitis in response to adhesive tape used to secure a dressing. The nurse interprets this reaction as an example of which type of hypersensitivity?
Type IV
Western blot
a test that detects HIV antibodies and confirms the results of earlier EIA tests
EIA
a test that screens for the presence of HIV antibodies in the blood test 1 and if positive the n western blot
Hairy Leukoplakia
a white rough patch that arises on the LATERAL tongue. Usually seen in immunocompromised and is due to EBV induced squamous cell hyperplasia. NOT pre-malignant. INDICATION OF ORAL CANCER
A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include
adrenal suppression.
isolation precautions
airborne, droplet, contact, and protective environment
IgE
allergic reactions Promotes release of vasoactive chemicals such as histamine and bradykin in allergic reactions
Impetigo
bacterial skin infection characterized by isolated pustules that become crusted and rupture From staph Contact precautions
Normally, serum IgE levels
below 1.0 he patient's level is significantly elevated suggesting allergic reaction.
Kaposi sarcoma (KS) is diagnosed through
biopsy
enzyme-linked immunosorbent assay (ELISA)
blood test for antibody to acquired immunodeficiency syndrome (AIDS) virus; positive result means the person has been exposed to virus n initial HIV screening test, is positive when there are sufficient HIV antibodies; it also is positive when there are antibodies from other infectious diseases. TESTS IS GIVEN TWO TIMES IF POSITIVE THEN WESTER BLOT
most common form of allergic rhinitis,
plant pollen
Kaposi's sarcoma
malignant tumor of the blood vessels associated with AIDS
Airborne precautions
measles, varicella, tuberculosis
Bacterial Meningitis
droplet precautions gloves, a mask, and eye protection Patients wear mask when around others or out of the room
Eosinophils
elevated in asthma and helminth reactions increase in number during allergic reactions and stress responses.
Cryptococcal meningitis is characterized by
fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures.
Manifestation of KARPOSIS SARCOMA
flat, purplish lesions on the back and trunk.
Which condition is an early manifestation of HIV encephalopathy?
headache, memory deficits, difficulty concentrating, progressive confusion, psychomotor slowing, apathy, and ataxia
anaphlactic shock
hives, itching, skin rash, rapid swelling of the mouth and throat- give epi quick in the thigh- benadryl can be given for hives or rash. epinephrine is the only thing that can treat anaphlyaxis. if you have any kind of hx of severe allergic reaction then you should always carry an epi pen.
lATE MANIFESTATION OF HIV ENCEPHALOPATHY
hyperreflexia, a vacant stare, and hallucinations.
Neutropenic precautions
immunocompromised, strict hand washing, private room, no raw veggies/fruits, daily baths, visitors are restricted
passive immunity
the short-term immunity that results from the introduction of antibodies from another person or animal. ACQUIRED WHEN READY-MADE ANTIBODIES ARE GIVEN TO A SUSCEPTIBLE PERSON
Diseases are considered autoimmune disorders when
they are characterized by unrelenting, progressive tissue damage without any verifiable etiology
TB skin test
tuberculin skin test is test is considered positive if the induration is 10 mm or greater in persons with no known risk factors for TB
stem cells
unspecialized cells that are able to renew themselves for long periods of time by cell division
Colonization
used to describe microorganisms present without host interference or interaction STAPH IN NARES
allergic disorder
"It is a hyperimmune response to something in the environment that is usually harmless."
CD4
Helper T cells
Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle
Histamine
Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle?
Histamine
The nurse is instructing the family on home care of a client with shingles. The family member asks whether their teenage children should stay in a different room. What is the best response by the nurse?
If the children have been vaccinated or had the disease, then they are immune and no precautions are needed.
The nurse is teaching a group of health care workers about latex allergies. What reaction will the nurse teach the workers to be most concerned about with laryngeal edema?
IgE-mediated hypersensitivity
A client with severe combined immunodeficiency is to receive a hematopoietic stem cell transplant. What would the nurse expect to be started?
Immunosuppression is started to ensure engraftment of depleted bone marrow.
Infection
Indicates a host interaction with an organism.
What can chronic diarrhea from HIV cause
It can cause profound weight loss and severe fluid and electrolyte imbalances.
After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which action?
Jabs the autoinjector into the outer thigh at a 90-degree angle he client should hold the device firmly in place for about 10 seconds, remove the device, and massage the site for about 10 seconds.
Airborne precautions
Methods of infection control that must be used for patients known or suspected to be infected with pathogens transmitted by airborne droplet nuclei.
most common cause of anaphylaxis, accounting for about 75% of fatal anaphylactic reactions in the United States each year
Penicillin
stem cell transplantation
Procedure used to replace cells destroyed by cancer treatment carried out in humans with certain types of immune dysfunction, and clinical trials using stem cells are underway in clients with a variety of disorders with an autoimmune component."
What test would be ordered if a deficiency or excess of immunoglobulins was suspected?
Protein electrophoresis
patient received epinephrine in response to an anaphylactic reaction at 10:00 AM. The nurse knows to observe the patient for a "rebound" reaction that may occur as early as:
Rebound reactions can occur from 4 to 10 hours after an initial allergic reaction. Therefore the patient needs to be assessed from 2:00 PM to 8:00 PM. Reference:
Which adverse effect(s) should the nurse closely monitor in a client who has secondary immunodeficiencies due to immunosuppressive therapy?
Respiratory or urinary system infections Because immunodeficiencies result in a compromised immune system and pose a high risk for infection, careful assessment of the client's immune status is essential. The nurse assesses and monitors the client for signs and symptoms of infection.
When receiving HAART how often should a patient follow up for viral load testing
Right after therapy and every 2-8 weeks
Candidiasis
The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. COMMON WITH AIDS
p24 antigen test and the polymerase chain reaction test determine
VIRAL LOAD
Which diagnostic test measures HIV RNA in the plasma?
Viral load
A client is placed in isolation for suspected tuberculosis. Which action should the nurse take when entering the client's room?
Wear an N95 respirator.
The nurse explains to a client that immunotherapy initially starts with injections at which interval?
Weekly
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. The next step for the nurse to explain to the client for confirmation of the diagnosis is to perform a:
Western blot test for confirmation of diagnosis.
Which allergic reaction is potentially life threatening?
angioedema
What happens after HIV enters the host cell
attachment occurs in which the glycoproteins of HIV bind with the host's uninfected CD4+ receptor and chemokine coreceptors followed by uncoating, in which HIV's viral core is emptied into the CD4+ T cell. Cleavage and budding occur as the last steps.
Cytotoxic T cells (killer T cells)
attack the antigen directly by altering the cell membrane and causing cell lysis (disintegration) and by releasing cytolytic enzymes and cytokines
Chain of infection
infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host
What types of cells are the primary targets of the healthy immune system
infectious cells foreign cells cancerous cells
bone marrow transplant
infusion of healthy bone marrow cells to a recipient with matching cells from a donor
SCID (severe combined immunodeficiency)
inherited disorder in which both T cells and B cells are absent or inactive
Antihistamines
medicines that reduce the production of histamines Makes you sedated and sleepy
IgG
most abundant crosses placenta Neutralizes bacterial toxins and accelerated phagocytocis
Droplet precautions
mumps
Naturally acquired active immunity
occurs as a direct result of infection by a specific organism EX IS MEASLES (DEVELOPS AFTER INFRECTION) MUST BE EXPOSED
What foods should pts. avoid if they are immunosuppressed
raw fruit raw vegetables COOK FOOD ALL THE WAY
Immunocompromised clients should avoid touching
sand or soil because of the high level of bacteria and increased risk of diseases such as toxoplasmosis.
SCID
severe combined immunodeficiency disease
Droplet precautions
spiderman! sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis, influenza, diptheria, epiglottitis, rubella, mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus (Private room and mask)
