Immunity Chpt.8

Risk for infection of HIV is greater for the partner who receives or who produces the semen?

The partner who receives the semen is more at risk because the receiver has prolonged contact with infected fluids.

T/F All persons with HIV should be started on antiretroviral treatment regardless of whether the CD4 count is high or low.

True

T/f Does the presence of lesions from other sexually transmitted diseases increase the risk of transmission?

True

When does the acute stage of HIV occur?

about 2 to 4 weeks after infection and can last for 1 to 2 weeks or several months

HIV infections are divided into different stages which include?

acute, asymptomatic, symptomatic, and AIDS

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.

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

HIV can be transmitted through contact with infected

blood, semen, vaginal secretions, breast milk, saliva, rectal fluid, cerebrospinal fluid. <- from book. Powerpoint says blood, semen, vaginal secretions, and breast milk.

The nurse is caring for a client with acquired immunodeficiency syndrome and detects early infection with Pneumocystis jiroveci by monitoring the client for which clinical manifestation? 1. Fever 2. Cough 3. Dyspnea at rest 4. Dyspnea on exertion

cough

Kaposi sarcoma is caused by ?

human herpesvirus 8.

The most common infection associated with the symptomatic infection phase of HIV infection ?

is oropharyngeal candidiasis or thrush.

The nursing student conducted a clinical conference on the role of B lymphocytes in the immune system. Which statement by a fellow nursing student indicates successful teaching? 1. "They activate T cells." 2. "They produce antibodies." 3. "They initiate phagocytosis." 4. "They attack and kill the target cell directly."

"They produce antibodies."

Acute stage of HIV

-2-4 wks after newly infected -Can have mononucleosis-like syndrome of fever, swollen lymph nodes, sore throats, headache, malaise, nausea, muscle and joint pain, diarrhea, and/or diffuse rash -Some people have neurologic complications -Aseptic meningitis, peripheral neuropathy, facial palsy, Guillain-Barre syndrome -High viral load -CD4+ T cell counts fall temporarily but quickly return to baseline or near-baseline -Often mistaken for bad case of flu

The nurse works with high-risk clients in an urban outpatient setting. Which groups should be tested for human immunodeficiency virus (HIV)? Select all that apply. 1. Injection drug abusers 2. Prostitutes and their clients 3. People with sexually transmitted infections (STIs) 4. People who have had frequent episodes of pneumonia 5. People who recently received a blood transfusion for a surgical procedure

1. Injection drug abusers 2. Prostitutes and their clients 3. People with sexually transmitted infections (STIs)

The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS) who is experiencing night fever and night sweats. Which nursing interventions would be helpful in managing this symptom? Select all that apply. 1. Keep liquids at the bedside. 2. Place a towel over the pillowcase. 3. Make sure the pillow has a plastic cover. 4. Keep a change of bed linens nearby in case they are needed. 5. Administer an antipyretic after the client has a spike in temperature.

1. Keep liquids at the bedside. 2. Place a towel over the pillowcase. 3. Make sure the pillow has a plastic cover. 4. Keep a change of bed linens nearby in case they are needed.

The nurse is conducting allergy skin testing on a client. Which postprocedure interventions are most appropriate? SATA 1. Record site, date, and time of test. 2. Give the client a list of potential allergens if identified. 3. Estimate the size of the wheal and document the finding. 4. Tell the client to return to have the site inspected only if there is a reaction. 5. Have the client wait in the waiting room for at least 1 to 2 hours after injection.

1. Record site, date, and time of test. 2. Give the client a list of potential allergens if identified.

When an infected mother uses antiretroviral therapy the risk of transmission drops to less than ____ % ?

2%

A client has requested and undergone testing for human immunodeficiency virus (HIV) infection. The client asks what will be done next because the result of the enzyme-linked immunosorbent assay (ELISA) has been positive. Which diagnostic study should the nurse be aware of before responding to the client? 1. No further diagnostic studies are needed. 2. A Western blot will be done to confirm these findings. 3. The client probably will have a bone marrow biopsy done. 4. A CD4+ cell count will be done to measure T helper lymphocytes.

2. A Western blot will be done to confirm these findings.

A complete blood cell count is performed on a client with systemic lupus erythematosus (SLE). The nurse suspects that which finding will be reported with this blood test? 1. Increased neutrophils 2. Increased red blood cell count 3. Increased white blood cell count 4. Decreased numbers of all cell types

4. Decreased numbers of all cell types

Severe problems develop when CD4+ T-cell counts are?

< 200 CD4+ T cells/μL.

Immune problems start when CD4+ T-cell counts drop to ?

< 500 cells/μL.

Which stage of HIV does the patient have symptoms that mimic the flu?

Acute infection

During this time, CD4+ T cell counts remain above 500 cells/μL (normal or only slightly decreased), and the viral load in the blood will be low.

Asymptomatic infection stage:

An erythrocyte sedimentation rate (ESR) determination is prescribed for a client with a connective tissue disorder. The client asks the nurse about the purpose of the test. What should the nurse tell the client about the purpose of the test? 1. Determines the presence of antigens 2. Identifies which additional tests need to be performed 3. Confirms the diagnosis of a connective tissue disorder 4. Confirms the presence of inflammation or infection in the body

Confirms the presence of inflammation or infection in the body

an Epstein-Barr virus infection that causes painless, white, raised lesions on the lateral aspect of the tongue. It can occur when the asymptomatic disease stage goes to AIDS

Oral hairy leukoplakia

Symptoms seen in earlier phases become worse, leading to persistent fever, frequent drenching night sweats, chronic diarrhea, recurrent headaches, and fatigue severe enough to interrupt normal routines. Other problems, including infections, lymphadenopathy, and nervous system manifestations, may occur. HIV advances to a more active state.

Symptomatic infection stage

occurs as the CD4+ T-cell count drops to 200 to 500 cells/μL and the viral load increases.

Symptomatic infection stage

large viral levels in blood after initial infection

Viremia

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

a. Decreased viral load

The nurse working in an HIV testing and treatment clinic plans teaching about antiretroviral therapy for a. a patient who tested positive for HIV 3 years ago and has developed tuberculosis. b. male health care worker who is HIV negative but has unprotected sex with men. c. patient who was infected with HIV 10 years ago and has a CD4+ T-cell count of 650/μL. d. patient with persistent generalized lymphadenopathy who was exposed to HIV 2 years previously.

a. a patient who tested positive for HIV 3 years ago and has developed tuberculosis.

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 oral candidiasis (thrush). d. onset of Pneumocystis jiroveci pneumonia.

d. onset of Pneumocystis jiroveci pneumonia.

What is a major consequence of rapid replication in HIV?

errors can occur in the copying process, causing mutations that can contribute to resistance to ART and limit treatment options.

Other infections that can occur at this time include shingles (caused by the varicella-zoster virus), persistent vaginal candidal infections, outbreaks of oral or genital herpes, and bacterial infections.

symptomatic infection stage

The major concern related to immune suppression is?

the development of opportunistic diseases (infections and cancers that occur in immunosuppressed patients that can lead to disability, disease, and death).

Asymptomatic infection stage:

the interval between untreated HIV infection and a diagnosis of AIDS.

Goals of antiretroviral therapy (ART) in the treatment of a patient with HIV are to?

to decrease the viral load and maintain or increase CD4+ T-cell counts.

The most common mode of HIV transmission?

unprotected sexual contact with an HIV-infected partner.

When is transmission of HIV more likely?

when viral load is high.

Normal CD4 + T-cell count

800 to 1200 cells/μL.

In what stage of HIV does persistent generalized Lymphadenopathy develop?

Asymptomatic disease

The nurse is performing an assessment on a female client who complains of fatigue, weakness, muscle and joint pain, anorexia, and photosensitivity. Systemic lupus erythematosus (SLE) is suspected. What should the nurse further assess for that also is indicative of SLE? 1.Ascites 2. Emboli 3. Facial rash 4. Two hemoglobin S genes

Facial rash

HIV is killed by heat or cold?

HIV is killed by heat

A diagnosis of AIDS cannot be made until the HIV-infected patient meets criteria established by the CDC. Which include?

Severe immune system suppression and CD4+ T cell counts < 200 cells/μL An opportunistic infection An opportunistic cancer Wasting syndrome (loss of 10% or more of ideal body mass) AIDS dementia complex (ADC)