A3 EX 4 HIV/AIDS ONCOLOGY PREP U HELP

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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)


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