CH 36 HIV

What type of medication is atazanavir?

Protease inhibitors

The CDC estimates __________ people living with HIV in the US are prescribed antiretroviral therapy (ART) and that among these individuals, only ________ have suppressed viral loads.

36%, 76%

What type of medication is dolutegravir?

Integrase inhibitors (INSTIs)

A patient is diagnosed with pneumocystis pneumonia. What medication does the nurse anticipate educating the patient about for treatment? a. TMP-SMZ b. Cephalexin c. Azithromycin d. Garamycin

a. TMP-SMZ

A patient with HIV has been on antiretroviral therapy for six months. The patient comes to the clinic with all medications, and the nurse observes that there are too many pills in the container. Which factors are associated with non-adherence to antiretroviral therapy? (Select all that apply.) a. Lives alone b. Active substance abuse c. Taking other medications d. Depression e. Lack of social support

b. Active substance abuse d. Depression e. Lack of social support

What type of medication is maraviroc?

CCRS anatgonist

What serves as the major laboratory indicator of immune function and prophylaxis for opportunistic infections, and is the strongest predictor of subsequent disease progression and survival?

CD4+ count

Patient that have neutropenia are at risk of what problem?

Patients with neutropenia are at increased risk for developing severe infections.

What laboratory test should the nurse review first to identify antibody deficiencies?

Complete blood count with manual differential should always be analyzed first

What type of medication is enfuvirtide?

Fusion inhibitor

What type of medication is efavirenz?

Non-nucleoside reverse transcriptase inhibitors

What type of medication is abacavir?

Nucleoside reverse transcriptase inhibitors (NRTIs)

Discuss the assessment findings for a patient who has developed pneumocystis pneumonia (PCP).

The most common manifestations of PCP or subacute onset of progressive dyspnea, fever, nonproductive cough, and chest discomfort that worsens within days to weeks. In mild cases, pulmonary examination usually is normal at rest. With exertion, tachypnea, tachycardia, and diffuse dry rales may be auscultated. Oral thrush is a common coinfection. Fever is apparent in most cases and may be the predominant symptom. Hypoxemia is the most characteristic laboratory abnormality, along with elevated lactate dehydrogenase levels.

A patient with AIDS is having a recurrence of 10 to 12 loose stools a day. What medication may help this patient to control the chronic diarrhea? a. Octreotide b. Rifaximin c. Bismuth subsalicylate d. Atropine diphenoxylate

a. Octreotide

A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in? a. Primary infection b. Secondary infection c. Tertiary infection d. Latent infection

a. Primary infection

A patient develops gastrointestinal bleeding from a gastric ulcer and requires blood transfusions. The patient states to the nurse, "I am not going to have a transfusion because I don't want to get aids." What is the best response by the nurse? a. "I understand what you mean, you can never be sure if the blood is tainted" b. "I understand your concern. The blood is screamed very carefully for a different viruses as well as HIV" c. "If you don't have a blood transfusion, you may not make it through this episode of bleeding" d. "No one has gotten HIV from blood in a long time. You have to have the transfusion"

b. "I understand your concern. The blood is screamed very carefully for a different viruses as well as HIV"

An older adult widowed woman informs the nurse that she notices vaginal dryness now that she has become sexually active again. She is not using barrier protection because it makes the dryness worse. What education should the nurse provide to the patient? a. Use a lamb skin condom instead of latex b. Vaginal dryness is common in post menopausal women, and there are creams that can be used, but she should use a latex condom c. Because the patient is older, it is not likely that she will acquire HIV d. She should abstain from sexual activity because she is at greatest risk for acquiring HIV

b. Vaginal dryness is common in post menopausal women, and there are creams that can be used, but she should use a latex condom

A patient is infected with HIV after sharing needles with another IV drug user. Upon infection with HIV, the mean system response by making antibodies against the virus, usually within how many weeks after infection? a. 1 to 2 weeks b. 3 to 6 weeks c. 3 to 12 weeks d. 6 to 18 weeks

c. 3 to 12 weeks

A patient is on ART for the treatment of HIV. What does the nurse know would be an adequate CD4+ count to determine the effectiveness of treatment for a patient per year? a. 1 mm3 to 10 mm3 b. 10 mm3 to 20 mm3 c. 20 mm3 to 45 mm3 d. 50 mm3 to 150 mm3

d. 50 mm3 to 150 mm3

Five disorders of common, primary immunodeficiencies are:

Humoral immunity, T-cell defects, combined B- and T-cell defects, phagocytic diseases, complement production

What results from rapid restoration of organism-specific immune responses to infections that cause either the deterioration of a treated infection or new presentation of a subclinical infection?

Immune reconstitution inflammatory syndrome (IRIS)

Why are live vaccines contraindicated in patients with antibody deficiency disorders?

Live vaccines are contraindicated in patients with antibody deficiency disorders because the patient is incapable of generating antibodies, and a live substance in the vaccine can cause disease.

Primary immunodeficiencies predispose people to three condition:

Severe infections, auto immunity, cancer

What are the two major components of antiretroviral therapy (ART) resistance?

The two major components of antiretroviral therapy resistance are transmission of drug resistant HIV at the time of initial infection and selective drug resistance in patients who are receiving nonsuppressive regimens.

The nurse is discussing sexual activity with a patient recently diagnosed with HIV. The patient states, "As long as I have sex with another person who has already infected, I will be okay." What is the best response by the nurse? a. "You should avoid having unprotected sex with a person who is HIV positive because you can increase the severity of the infection in both you and your partner" b. "Yes; because you are already infected, it won't make a difference if you have sex with a person who is HIV positive" c. "I am not sure why you would want to have sex with another person who is HIV positive. That person may have another sexually transmitted infection" d. "If you have sex with another person who is HIV positive, you will develop AIDS sooner"

a. "You should avoid having unprotected sex with a person who is HIV positive because you can increase the severity of the infection in both you and your partner"

A new nursing graduate is working at the hospital in the acute care unit. The preceptor observes the nurse emptying a patient's wound drain without gloves on. What important information should the preceptor share with a new graduate about standard precautions? a. Standard precautions should be used with all patients to reduce the risk of transmission of blood-borne pathogens b. Standard precautions should be used only with patients who are HIV-positive to reduce the risk of transmission of the HIV virus c. It is only necessary to use gloves when you are emptying reservoirs that have body fluids in them d. If you are careful and do not expose yourself to blood or body fluids, it is not necessary to use gloves all the time

a. Standard precautions should be used with all patients to reduce the risk of transmission of blood-borne pathogens

The nurse received a phone call at the clinic from the family member of a patient with AIDS. The family member states that the patient started "acting funny" after reporting headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse tell a family member? a. "The patient probably has a case of the flu, and you should give Tylenol" b. "The patient may have cryptococcal meningitis and will need to be evaluated by the physician" c. "This is one of the side effects from antiretroviral therapy and will require changing the medication" d. "The patient probably has pneumocystis pneumonia and will need to be evaluated by the physician"

b. "The patient may have cryptococcal meningitis and will need to be evaluated by the physician"

A patient with HIV develops a nonproductive cough, shortness of breath, fever of 101°F, and an 02 saturation of 92%. What infection caused by pneumocystis jiroveci does the nurse know could occur with this patient? a. Mycobacterium avium complex b. Pneumocystis pneumonia c. Tuberculosis d. Community-acquired pneumonia

b. Pneumocystis pneumonia

While caring for a patient with Pneumocystis pneumonia, the nurse assesses flat, purplish lesions on the back and trunk. What does the nurse suspect these lesions indicate? a. Molluscum contagiosum b. Tuberculosis of the skin c. Kaposi sarcoma d. Seborrheic dermatitis

c. Kaposi sarcoma

A patient in the clinic states, "My boyfriend told me he went to the clinic and was treated for gonorrhea." While testing for the sexually transmitted infection, what else should be done for this patient? a. Test for HIV without informing the patient b. Test for HIV, requiring the patient to sign a permit c. Inform the patient that it would be beneficial to test for HIV d. Administer treatment for the STI and discharge the patient

a. Test for HIV without informing the patient

A patient with acquired immune deficiency syndrome informs the nurse of difficulty eating and swallowing, and shows the nurse white patches in the mouth. What problem related to AIDS does the nurse understand the patient has developed? a. Molluscum contagiosum b. Wasting syndrome c. Kaposi sarcoma d. Seborrheic dermatitis

d. Seborrheic dermatitis