Complex HIV test
You can acquire HIV through skin to skin contact
False
What types of fluid is HIV transmitted by
Blood and blood products, seminal fluid, vaginal secretions, mother to child (amniotic fluid and breast milk) not through casual contact
HIV-1 nucleic acid amplification test
Tests directly for virus
HIV-1 p24 antigen test
Tests directly for virus
HIV-1/HIV-2 immunoassay test
Tests for both HIV-1 and antibodies
Types of antiretroval therapy
1) Nucleoside reverse transcriptase inhibitors (NRTI's) 2) Nonnucleoside reverse transcriptase inhibitors (NNRTI's) 3) Protease inhibitors (PI) 4) Fusion inhibitors 5) Integrase Strand Inhibitor 6) Multiclass Combination Products
Normal live span of CD4+ cells normal vs HIV infected
100 days vs 2 days
Treatment of HIV and AIDS
Antiretroviral therapy-ART
Strageties to protect against HIV- pregnacy and conception
Artigical insemination in some cases, Benefits of ART, refrain from breastfeeding.
Clinical manifestions of HIV
Asymptomatic during first stage or may exhibit fatigue or skin rash Later stages have variety of symptoms related to immunosuppressed state Respiratory Manifestations Shortness of breath, dyspnea, cough, chest pain Pneumocystis pneumonia, Mycobacterium avium complex, TB
HIV-1 differentiation assay
Differentiates HIV1 from 2
How is immune deficiency acquired with HIV
Due to medical treatment such as chemotherapy, infection agents such as HIv
First manifestations of HIV
Fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle and joint pain, diarrhea, diffuse rash sometimes, neuro complications sometimes (aseptic meningitis, peripheral neuropathy, facial palsy, Guillain-Barre syndrome).
Primary Immune deficiency disorders pathophysiology
Genetic ( mostly diagnosed at infancy but some later, male to female ratio 5 to 1)
Gynecologic manifestions
Genital ulcers, persistant, recurrent vaginal candidiasis, Pelvic inflammatory diseas, menstrual abnormalities
is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV infection:
HIV encephalopathy
HIV pathophysiology
HIV is in the subfamily of lentiviruses and is a retrovirus because it carries its genetic material in the form of ribonucleic acid (RNA) rather than deoxyribonucleic acid (DNA) HIV targets cells with CD4+ receptors, which are expressed on the surface of T lymphocytes, monocytes, dendritic cells, and brain microglia
Oncologic manifestions of HIV
Kaposi sarcoma classic cancer know, AIDS related lymphomas
Gastronintestional manifestions of HIV
Loss of appetitie, N and V, oral candidiasis, diarrhea, wasting syndrome
Other strategies to prevent HIV
Medical male circumcision, female condom
Community resources- Home healthcare nursing
Monitory adherence to therapeutic regimen, Complex wound care and resp care
Clinical Manifestastions of PIDD
Multiple infection despite treatement, infection with unusual organisms, failure to thrive, positive family history
Strategies to protect against HIV - Injection drugs
Needle exchange, may use bleach to clean used needles and syringes, avoid sharing syringes
Unknown stage
No information on CD4+ T-lymphocyte count or percentage
Nursing management of PIDD
Nursing care meticulos and reduce risk of infection
Stage 2
Occurs when T-lymphocyte cells are between 200-499
Collaborative Problems/potentioal complications
Opportunistic infetions, impaired breathing or resp failure, wasting syndrome and fluid and eleytrolye imbalance, adverse effects of medications
Antiretroviral therapy
Overarching goal to suppress HIV replication Reduce HIV-associated morbidity and prolong duration and quality of life Restore and preserve immunologic function Maximally and durably suppress plasma HIV viral load Prevent HIV transmission
Stage 1 (primary/acute)
Period from infection with HIV to the development of HIV-specific antibodies Dramatic drops in CD4+ T-cell counts normally 500 to 1500 cells/mm3 of blood 8-10yrs can pass before any real complications occur based from the HIV
PLWHA stands for
Persons living with HIV or Aids
Treatment accompanying infecions
Pneumocystic pneumonia, mycobacterium avium complex, Tuberculosis, Candidiasis, Wasting syndrome, Kaposis sarcoma, B-cell lymphoma, Peripheral neuropathy, HIV encephalopathy, herpes simplex or zoster
Other golas for pt with HIV
Resumption of usual bowel patterns Absence of infection Improved airway clearance Improved nutritional status Increased socialization and expression of grief Increased knowledge regarding disease prevention and self-care
How do we rduce risk of transmission to Health care providers
Standard precautions (main), hand hygiene, post exposure prophylaxis ( antiroviral meds within 72 hours of exposure, 2-3 drugs prescrivbed for 28 days
What do community programs help with
Transoporation, shopping, legal and financial assistance
HIV is a blood borne pathogen
True
Teh majority of PIDDS are diagnosed in infancy
True
The human immune system is complex and multidimensional
True
Most effective way to control with meds
Use of at least 3 drugs from at least 2 different classes at full dose
Is HIV a retrovirus (genetic material on RNA) disease
Yes
polymerase chain reaction
a sensitive laboratory technique that can detect and quntify HIV in a persons blood or lymph nodes
retrovirus
a virus that carries genentic material in RNA instead of DNA and contains reverse transcriptase
Viral set point
amount of virus present in the blood after the initial burst of viremia and the immune response that follows
enzyme immunoassay (EIA)
blood test that can determine the presence of antibodues to HIV in the blood or salivia
HIV encephalopathy
clinical syndrome charachterized by a progressive delcine in cognitive, behabvioral or motor functions
Pneumocystis pneumonia (PCP)
common opportunistic lung infection, pathogen implicated is most commonly a fungus
peripheral neuropathy
disorder characterized by senosry loss, pain, muscle weakness, and wasting of muscles in the hands or legs and feet
reverse transcriptase
enzcyme that transforms single stranded RNA into a double stranded DNA
candidiasis
funtal infection usually of ski or mucous membranes
Opportuistic infection
illnesse caused by various organisms, some of which usually do not cause disease in people with normal immune systems
wasting syndrome
involuntary weight loss consisiting of both lean and fat body mass
Kaposi sarcoma
maliganancy that involves the epithelial layer of blood and lymphatic vessels
viral load test
measurews the quantitiy of fHIV RNA or DNA in the blood
Mycobacterium avium complex (MAC)
opportunistic infection cuaed by mycobacterial organisms that commonly causes a resp illness but can also infect other body systems
progressive multifocal leukoencephalopathy
opportunistic infection that infects brain tissue and causes damage to the brain and spinal cord
pre exposure prophylaxis
prevention method for HIV negative people who are at high risk for HIV infection, involving taking a specific combo of HIV medicaines daily , use with condoms and other prevention tools
How many stages is HIV classified in
5 stages - 0,1,2,3,unknown
Antiretroviral medications as post exposure prophylaxis for health care workers are started within ____ hours of exposure:
72 hours
A client who has AIDS is being treated in the hospital and admits to having periods of extreme anxiety. What would be the most appropriate nursing intervention? A)Teach the client guided imagery. B)Give the client more control of her antiretroviral regimen. C)Increase the client's activity level. D)Collaborate with the client's health care provider to obtain an order for hydromorphone.
A
Planning and Goals Main goal
Absence of complications
Steps in the life cycle of HIV
Attachemnt/Binding-Uncoating/Fusion -DNA synthesis-Integration-Transcription-Translation-Cleavage-Budding
A hospital nurse has experienced percutaneous exposure to an HIV-positive patient's blood as a result of a needle stick injury. The nurse has informed the supervisor and identified the client. What action should the nurse take next? A)Flush the wound site with chlorhexidine. B)Report to the emergency department or employee health department. C)Apply a hydrocolloid dressing to the wound site. D)Follow up with the nurse's primary provider.
B
A nurse has created a plan of care for an immunodeficient client, specifying that care providers take the client's pulse and respiratory rate for a full minute. What is the rationale for this aspect of care? A)Respirations affect heart rate in immunodeficient clients. B)These clients' blunted inflammatory responses can cause subtle changes in status. C)Hemodynamic instability is one of the main complications of immunodeficiency. D)Immunodeficient clients are prone to ventricular tachycardia and atrial fibrillation.
B
HIV prevention testing
Behavioral interventions, HIV testing and linkage to treatment and care
Stage 3
CD4+ count drops below 200 cells/mm3 of blood and considered to have AIDS for surveillance purposes
What are stages 1,2,3 based on
CD4+T lymphocyte count
Nursing Intervention Priority
Decreased sense of social isolation (Assess pattern of social interaction Observe for behaviors indicative of social isolation Assist with identifying resources)
Priority nursing diagnosis
Diarrhea related to enteric pathogens Risk for infection related to immune deficiency Ineffective airway clearance related to Pneumocystis pneumonia, increased bronchial secretions Imbalanced nutrition: less than body requirements Deficient knowledge related to means of preventing HIV transmission Social isolation related to stigma of the disease, withdrawal of support systems, isolation procedures, fear of infecting others
Stage 0
Early HIV infection, inferred from labatory testing
HIV prevention
Edcuation on how to eliminate or reduce risks associated with HIV infections and aids.
Neurologic manifestions of HIV
Effects cogintion, motor funciton attention, visual memory, visospatical funcion, peripheral neuropathy, HIV encephaloopaty, fungal infection (cryptococcus neoformans), progressive multifocal leukencephalopathy, depression and apathy
Only HIV/Aids pt can get Kaposis sarcoma
False
Primary immune deficiency disorders result from external factors such as infection
False
HIV modes of Transmission
HIV-1 transmitted in body fluids that contain infected cells
Integumentar manifestions
Herpes zoster and seborrheic dermatitis
Assessment of PT with HIV/AIDS
Identification of potential risk factors Physical status Psychological status Immune system functioning Nutritional status Respiratory status Neurologic status Fluid and electrolyte balance Knowledge level
Priority nursing intervention
Improving knowledge of HIV (Instruct patient and family about routes of transmission and prevention Avoid sexual contact with multiple partners Use condoms Do not use IV/injection drugs)
What do PIDD cause
Prevent body from develping normal immune responses and may affect phagocytic function, B cells or T cells, or the complement system
Important aspects for care HIV
Prevention, early detection and ongoing treatment
Nursing interventions
Promoting usual bowel patterns, preventing infection, improving airway clearance, Improving nutritional status
Hospice nursing during termianal stages
Provides physical and emotional support
What is PrEP ( pre exposure prophylaxis)
Taking 1 pill containing 2 HIV Meds daily to avoid the risk of sexual HIV acquisition if one partner has HIV
HIV-1
retrovirus isolated and recognized as the etiologic agent of HIV disease
Immune reconstituition of inflammatory syndrom (IRIS)
syndrome tht results from rapid restoration of pathogen specific immune response to opportunistic infections
post exposure prophylaxis
taking antiretroviral medicines as swoon as possible but no more than 72 hours after possivle HIV exposure, 2-3 drugs are usually prescrive which must be taken for 28 days
HIV/1-HIV-2 antigen/antibody combo immunoassay test
tests for both antibody and virus for both HIV1 and HIV2
latent reservoir
the intergrated HIV provirus within CD4+T cell druing the resting memory state, does not express viral proteins and is invisible to the immune system and antiviral meds