Dr. Mabry-Med Surg-HIV Infection-Test 4

Technically yes because there is a chance blood can be mixed in their saliva and enter the other persons

Can HIV be spread from deep kissing?

That the person only has one partner, ask how many partners they have

Concerning a person's sexual partners, we should never assume what?

symptomatic Asymptomatic

Concerning gonorrhea, males are typically __________ and females are typically _______________

False, AIDs is the end result of this process, they have HIV then AIDs because of HIV

True or False: HIV is the same as AIDs

True

True or False: If a woman is infected with HIV, she can get free medical treatment to prevent transmission to her unborn infant for free from the government.

True

True or False: You should report ANY and ALL punctures at work, even if you think your patient is "clean".

Proven prevention intervention

Truvada is used in conjunction with what?

d.onset of Pneumocystis jiroveci pneumonia.

A diagnosis of AIDS can be made for a patient with HIV with a.a CD4+ T-cell count <500/µL. b.a WBC count <3000/µL (3 × 109/L). c.development of influenza. d.onset of Pneumocystis jiroveci pneumonia.

You need to know all of their partners because this is a reportable disease which means if someone is tested positive for this disease we must notify the health department

A.O. is a 20-year old Hispanic male college student who comes to the student health center complaining of pain on urination. His urine test is positive for Neisseria gonorrhea. What should you do?

His risk would go up because we cannot know for sure that he hasn't performed risky behaviors

A.O. tells you he drinks at weekend parties and has smoked pot but "not recently." He reports no regular use of injection drugs, tobacco, or anabolic steroids but that sometimes he gets so drunk he doesn't remember. How would you rate his risk and why?

Catholics do not believe in condom use because they think they are preventing the aspects of their religion He may have grow up believing the man is in control and by using condoms they are in less control

As you talk to A.O. about barrier methods of protection, he begins to look away and seems to lose interest. He finally says, "I don't know if I can do this." What are some cultural considerations that may be a factor here?

200 OR less than 14% (if that is how the test shows up)

For someone to be diagnosed with AIDs, their T cells have to be below what?

1. CD4+ T-cell counts (CD4+ T-cell count provides a marker of immune function) 2. Viral load (The lower the viral load the less active the disease)

HIV progression is monitored by:

It works to destroy T cells in order to attack the rest of the body and immune system

HIV works to destroy what?

Blood Semen Vaginal secretions Breast milk

How can HIV be transmitted?

Oral hairy leukoplakia does not scrape off and thrush does and the tongue will be very red and tender underneath

How do we determine between thrush and oral hairy leukoplakia?

It can occur during pregnancy, delivery, or breastfeeding

How does perinatal transmission occur?

Gather baseline data Begin to establish rapport and use patient input to develop a plan of care Initiate teaching about spectrum of HIV, treatment, preventing transmission, improving health, and family planning Monitor disease progression, immune function, and manage symptoms Initiate and monitor ART Prevent, detect and/or treat opportunistic infections

In the initial patient visit for someone diagnosed with HIV, what should be done?

He has AIDS that has led him to contract TB

One year later A.O. returns to the clinic with complaints of night sweats and a productive cough for 1 week. His CD4+ lymphocyte count is 76 cells/µL. He has lost 13 pounds in the last month. His record shows a history of a positive PPD. What do you think is happening?

At under 500 T-cells

Opportunistic infections in HIV infected patients occur when?

The mono virus

Oral Hairy Leukoplakia is caused by what virus?

It means it is harder to transmit the virus to others but it does NOT mean they are cured and are unable to transmit the virus to others

People who take their medications exactly how they are supposed to, they can actually get their viral load down to undetectable, what does this mean?

Eliminate Reduce

Safe activities for HIV ____________ the risk and risk reducing activities for HIV __________ the risk

HIV

Retrovirus that causes immunosuppression making persons more susceptible to infections

Compliance with drug regimens Adopting a healthy lifestyle Beneficial relationships Spiritual well-being in regard to life and death Coping with the disease and its treatment

The goals for patients with HIV are what?

semen blood

The lowest viral load of HIV is in ______________ and the highest load of HIV is in ___________

a. all of the supplied antibiotics should be taken even when symptoms have resolved.

The nurse informs the patient with a bacterial pneumonia that the most important factor in antibiotic treatment is a. antibiotics should have been used to prevent pneumonia. b. all of the supplied antibiotics should be taken even when symptoms have resolved. c.enough antibiotics for 2 days' treatment should be reserved in case symptoms recur. d. patients should request antibiotics for upper respiratory infections to prevent development of streptococcal-related diseases.

a.Decreased viral load

The nurse is caring for a patient who is receiving antiretroviral therapy (ART) for treatment of AIDS. Which assessment best indicates that the patient's condition is improving? a.Decreased viral load b.Increased drug resistance c.Decreased CD4+ T-cell count d.Increased aminotransferase levels

d."Once my viral load is undetectable I don't have to worry about taking my medication every day."

The nurse is teaching a newly diagnosed 34-year-old male about his HIV infection. Which statement by the patient would indicate the patient needs additional education? a."I will need to take my HIV medication daily for the rest of my life." b."Although I only take one pill, it has multiple medications combined into a single tablet." c."I should notify my HIV provider if I get fevers that do not go away with Tylenol or aspirin." d."Once my viral load is undetectable I don't have to worry about taking my medication every day."

Has no cure Continues for life Causes physical disability Impairs social, emotional, economic, and spiritual wellbeing Ultimately leads to death

What are factors of an HIV infection?

Bone disease Lactic acidosis Renal disease Cardiovascular disease Lipodystrophy Hyperlipidemia Insulin resistance Hyperglycemia

What are side effects of the ART medications?

The person will experience many opportunistic infections: Shingles Persistent vaginal candidal infections Herpes Bacterial infections Thrush Kaposi sarcoma Oral hairy leukoplakia

What are some clinical manifestations of HIV?

Condom use, needle exchange programs, don't share straws for cocaine Use barriers in intercourse Don't have sexual intercourse under the influence of any impairing substance

What are some risk reducing activities we can teach someone to help prevent HIV?

Masturbation (solo), hugging, touching, dry kissing Abstinence Don't use drugs at all

What are some safe activities we can teach someone to help prevent HIV?

There is a quick swab test that tests the saliva or can be blood that tests for the antibodies or antigens If the test comes back positive, it needs to be sent off for longer to test further If it comes back negative, we need to ensure they comes back in 3-6 weeks

What are some screening tests we can use to detect HIV-specific antibodies and/or antigens?

Dry kissing Hugging Sharing Food Insect bites Toilet seats Bathing Sneezes and coughs Sweat

What are some ways HIV CANNOT be transmitted?

Sharing drug using paraphernalia such as straws for cocaine, needles, or syringes Trauma from sex Accidental puncture wounds It can be transmitted from contaminated blood transfusions and organ transplants

What are some ways a person can be put at risk for HIV concerning coming into contact with blood?

Perinatal transmission Family planning Prevent HIV in women Appropriately medicate HIV-infected pregnant women Decrease risk at work

What are some ways we can decrease the risks of passing along HIV?

Oral thrush Kaposi sarcoma Oral Hairy Leukoplakia

What are the big warning signs of AIDs?

Opportunistic infections Malignancies (kaposia sarcoma) Wasting (person lost 10% of their body weight AND have chronic diarrhea for 30 days AND they take in all kinds of nutritional supplements but are not gaining weight) HIV-related cognitive changes (specific dementia R/T AIDs)

What are the clinical manifestations of AIDs?

Decrease viral load Maintain/increase CD4+T counts Prevent HIV-related symptoms and opportunistic diseases Delay disease progression Prevent HIV transmission

What are the main goals of drug therapy for HIV?

Primary prevention Health promotion

What are the most effective strategies for diseases of a chronic nature, including HIV?

ART

What can significantly slow HIV progression?

Pneumocystis jiroveci Pneumonia This is NOT a common type of pneumonia that you will see in the general public because their immune system will take care of it so if they do have it, they have AIDs, hands down

What is a FOR SURE tell-tale sign of AIDs?

People think the drug rate goes up BUT the drug rates do not increase but HIV rates do decrease. People think they will get in trouble. Patients bring in their old needles and no quested asked, they give them new, clean needles without getting them in trouble.

What is a common misconception of needle exchange programs?

Do not make assumptions about who may be at risk (Not only younger adult patients, it is also older adults or middle aged) Candid conversation is important for effective management of HIV Ask at-risk patients Assess diagnosed patients thoroughly

What is a important in the nursing assessment of an HIV patient?

It is described for a person who has lost 10% of their body weight AND has chronic diarrhea for 30 days AND they take in all kinds of nutritional supplements but are not gaining weight

What is meant by a wasting in a person with AIDs?

Compliance, because the medications must be taken everyday at the same time so if they are not compliant the medications won't be as effective

What is the biggest factor in HIV medication?

Unprotected sex with an infected partner

What is the most common mode of transmission of HIV?

3 weeks after exposure OR mainly after acute infection such as flu like symptoms or diarrhea (very general symptoms that present after you are exposed to HIV)

What is the most vital time to get testing for HIV?

Testing

What is the only sure method of determining HIV infection?

Reverse transcriptase Integrase Protease

What is the order of the enzymes HIV uses to replicate?

Lipodystrophy ART medications

What is this a picture of? What is this a side effect of?

Effective treatment

What leads to a significant drop in death rates with patients with HIV?

The hollow bore needle is more at risk because it has a hole in it for injections so more blood can be found on it The surgical needle is less risk because it it just like a sewing needle

What poses more risk for transmitting HIV, a surgical needles or a hollow bore needle?

No, they must come in every 3 months to get tested for HIV so we can see if they are positive and change their medications

When a patient is on pre-exposure prophylaxis medication for HIV, can they just stay on it forever as long as they feel fine?

Within 2-4 weeks after exposure

When is an HIV viral load detectable in testing?

African Americans male to male

Who has the highest incident of HIV infection?

The partner who receives the semen

Who is at a greater risk for becoming infected with HIV due to unprotected sex?

It is used for patients who are at risk for HIV but they do not have it yet but they participate in risky behaviors so they want to protect themselves

Why is truvada used?