NUR 424 MEDSURG QUIZ on Immune Deficiency (chapter 36)

The nurse is teaching the client who has an immunodeficiency disorder how to avoid infection at home. Which statement indicates that additional teaching is needed?

"I will be sure to eat lots of fresh fruits and vegetables every day."

▪A patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) develops an oral Candida infection. When teaching the patient, the healthcare provider will include which of the following instructions?

"Select foods that are soft or pureed."

The healthcare provider is teaching a patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) about the need for multi-drug therapy. Which of the following best explains the rationale for using more than one antiretroviral medication to treat AIDS?

"This is intended to keep the virus from developing resistance to the medications."

A client is considering beginning sexual relations and wants to know the best way to be protected from a sexually transmitted infection and HIV. What is the best response by the nurse?

"Using a condom (latex) and spermicidal jelly is one of the most effective ways to decrease the risk of transmission of an STI and HIV."

A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when scheduling a return visit for viral load testing at which time?

6 weeks

The healthcare provider is teaching a patient who has a diagnosis of acquired immunodeficiency syndrome (AIDS) about food safety. Which of the following foods should the patient avoid to prevent foodborne illnesses?

Deli meats

what is stage three of HIV infections?

AIDS, less than 200 CD4

A patient who has been receiving antiretroviral therapy (ART) to manage infection with human immunodeficiency virus (HIV) has an undetectable viral load. How would the healthcare provider interpret this information?

ART has been effective in decreasing viral load.

A client who has AIDS reports having diarrhea after every meal, and wants to know what can be done to stop this symptom. What should the nurse advise?

Avoid fibrous foods, lactose, fat, and caffeine.

what group (irrespective to sexual behavior or gender) continue to experience the most severe burden of HIV?

Black americans

what is stage 2 of HIV infections?

CD4 count between 200 and 499

what kind of cell does HIV target?

CD4 receptors

what does a viral load test look for?

measures the quantity of HIV RNA in the blood

what are some HIV antibody tests?

EIA (enzyme immunoassay) ELISA (enzyme linked immunosorbent assay) Western blot

A nurse is preparing to give a client an infusion of gamma globulin. The nurse knows to stop the infusion if the client experiences which symptoms? Select all that apply.

Flank pain Tightness in the chest Shaking chills

The nurse is preparing a teaching plan for a client with an immunodeficiency. What aspect would the nurse emphasize as most important?

Frequent and thorough handwashing

The healthcare provider is teaching a student about the disease process. Which of the following information should the healthcare provider include?

HIV RNA is transcribed into DNA

When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic?

HIV-1 is more prevalent than HIV-2 subtypes

Which of the following indicates that a client with HIV has developed AIDS?

Herpes simplex ulcer persisting for 2 months

A nurse is preparing an in-service presentation about primary immunodeficiencies. When describing these conditions, what would the nurse need to integrate into the presentation?

Most cases are typically diagnosed in infancy.

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?

Primary infection

The healthcare provider is assessing the skin of a patient who is at risk for becoming infected with the human immunodeficiency virus (HIV). Which of the following findings requires immediate follow-up by the healthcare provider?

Purplish-red raised lesions

A client with HIV will be started on a medication regimen of three medications. What drug will the nurse instruct the client about?

Reverse transcriptase inhibitors

What test will the nurse assess to determine the client's response to antiretroviral therapy?

Viral load

A client with suspected human immunodeficiency virus (HIV) has had two positive enzyme-linked immunosorbent assay (ELISA) tests. What diagnostic test would be run next?

Western Blot

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.

The majority of patient with primary immunodeficiency are in which age group?

Younger than 20

what are most perinatal infections usually caused by?

after exposure during delivery

what is the viral set point?

amount of virus present in the blood after the initial burst of viremia and the immune response that follows

▪Humoral immunity is a type of adaptive immunity that results in the circulation of which of the following throughout the blood?

antibodies

what is a contributing factor to becoming infected with HIV?

behaviors (rather than age or gender)

Kaposi sarcoma (KS) is diagnosed through

biospy

What are B cells responsible for?

cells that are important for producing a humoral immune response

what might immunodeficiency disorders be caused by?

defect in or deficiency of phagocytic cells, B lymphocytes, T lymphocytes or the complement system

What is HIV encephalopathy?

degenerative neurologic condition characterized by a group of clinical presentations including loss of coordination, mood swings, loss of inhibitions, and widespread cognitive dysfunctions, formerly referred to as AIDS dementia complex (ADC)

How is HIV-1 transmitted?

in body fluids (blood, seminal fluids, vaginal secretions, breast milk) - contain free virons and infected CD4 + T cells

what gives an increased probability that an HIV exposure will lead to infection?

inflammation and breaks in skin or mucosa

what is wasting syndrome?

involuntary weight loss consisting of both lean and fat body mass

what are helper t cells?

lymphocytes that attack foreign invaders directly

What are supressor T cells?

lymphocytes that decrease B cell activity to a level at which the immune system is compatible with life

what are natural killer cells?

lymphocytes that defend against microorganisms and malignant cells

What are cytotoxic T cells?

lymphocytes that lyse cells infected with the virus

▪Monocytes move from the systemic circulatory system into general connective tissues, where they differentiate into what phagocytic cell type?

macrophage

what are secondary immunodeficiencies frequently caused by?

occur as a result of underlying disease process or treatment of those disorders

who may take pre-exposure prophylaxis (PrEP) meds?

people at a very high risk for HIV, to lower their chances of getting infected

when should PEP be used?

post exposure prophylaxis should be used only in emergencies, must be started within 72 hours after recent exposure to HIV

what does PIDD stand for?

primary immune deficiency disorders (PIDD)

what is stage one of HIV?

primary infection latent reservoir

what are antibody proteins?

protein substances developed by the body in response to, and interacting with a specific antigen

what is HIV 1?

retrovirus isolated and recognized as the etiologic agent of HIV disease

HIV belongs to a group of viruses known as _____________

retroviruses

what is a complement protein?

series of enzymatic proteins in the serum, that when activated, destroy bacteria

what does post exposure prophylaxis (PEP) mean?

taking antiretroviral medicines after being potentially exposed to HIV to prevent becoming infected

what is the function of the immune system?

to defend against infection and invasion by other organisms

true or false. Secondary immunodeficiencies are more common than primary immunodeficiencies

true

true or false. The majority of primary immune deficiency disorders are diagnosed in infancy, or adolescence

true

true or false. To achieve sustained viral suppression, patients must take more than one antiretroviral medication

true

true or false. PrEP can stop HIV from taking hold and spreading throughout your body and is highly effective at preventing HIV

true, if used as prescribed

what are gerontologic risk factors for HIV?

- no condom use - don't consider themselves a risk - new relationships - iv drug users - age related changes can increase susceptibility

what are the goals of initiating ART?

- reduce HIV assoc morbidity - restore and preserve immunologic function - suppress plasma HIV viral load - prevent transmission

What are the two major components of anti-retroviral drug resistance?

- transmission of drug resistant HIV at the time of infection - selective drug resistance in patients who are receiving non suppressive regimens

what is natural immunity made up of?

-WBC action -inflammatory response - physical and chemical barriers - immune regulation

what are the cardinal symptoms of immunodeficiency?

-chronic or recurrent infection - infections caused by unusual organisms or organisms that are normal body flora - poor response to standard treatment for infection - chronic diarrhea

what are the strategies to reduce the risk of infection with people with PIDD?

-hand hygiene -infection prevention -monitor early symptoms - teach them how to admin meds at home - ongoing edu

what are some adverse effects of HIV treatment?

-hepatotoxicity -nephrotoxicity -osteopenia -inc risk of cardiovas disease -MI

what are the clinical manifestations of PIDD?

-multiple infection despite treatment - infection with unusual or opportunistic organisms - failure to thrive - positive family history

what is the medical management of HIV?

-treat opportunistic infections - prevent infections - antidiarrheal therapy - antidepressant -nutrition therapy

when is treatment recommended for HIV patients?

when CD4 counts are between 350 and 500

A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?

risk for injury