Nursing Application: Antivirals: HIV Infection and AIDS

Which of the following are important instructions for HIV/AIDS antiretroviral medication administration? Select all that apply.

*Administer in evenly spaced intervals around the clock to ensure steady-state levels *Instruct the patient to remain upright while administering the medication and for up to 30 minutes afterward to prevent esophageal ulceration *If the patient experiences trouble breathing, fever, changes in oral mucosa (opportunistic infection), notify the prescriber immediately

Why are labs monitored during various stages of HIV antiretroviral treatment?

Monitor viral load

What is the goal of antiretroviral therapy for an HIV patient?

Prolong life by decreasing the viral load

Your patient is a 35-year-old pregnant woman who just received lab results that she is positive for HIV. What is the most important intervention at this time?

Starting prophylactic antiretroviral treatment

What is the best response to Omar?

"You will need to return frequently to check your labs for medication success. We will monitor your viral load and CD4 counts throughout therapy to ensure the medications are working properly. I hear you are upset about the diagnosis. May I share with you the goals and benefits of treatment?"

What information is essential to communicate to a newly diagnosed HIV patient who is starting antiretroviral therapy? Select all that apply.

*Do not donate blood *Follow up frequently to determine progress and monitor side effects *Avoid sharing needles *Consult your health care provider before taking additional medications or herbal supplements *Antiretroviral therapy does not cure HIV

When administering ointments to a patient that is HIV positive, what precautions should you take? Select all that apply.

*Wash hands before and after administration of the medication *Wear gloves *Avoid exposure of medication on your skin or in your eyes

1. Take on an empty stomach. 2. Remain upright when taking medications and for 30 minutes afterward to prevent esophageal ulceration. 3. Take medications exactly as indicated, around the clock, but do not interrupt sleep. 4. Follow up exams, including taking blood are essential to monitor for side effects and determine if the medication regimen is working. 5. Avoid taking other medications, including over the counter medications and herbal supplements, until speaking about them with your provider. 6. Do not discontinue any medications without talking with your provider. 7. Change positions slowly as the medications may cause dizziness and syncope. 8. Take missed doses as soon as you remember, unless it is time for the next dose. 9. If you miss a dose, take a double dose next time. 10. Take medications with food to prevent GI upset.

1. Do not include 2. Include 3. Include 4. Do not include 5. Include 6. Include 7. Include 8. Include 9. Do not include 10. Include

Fusion inhibitors bind to the virus proteins 1.______________ and prevent HIV from binding to and entering 2.____________________. CCR5 Antagonists 3.________________ the proteins from entering the cell.

1. Gp120 or Gp41 2. CD4 cells 3. coat and block

1. Take the medications with food. 2. Take medications on an empty stomach. 3. Store medications out of sunlight and at room temperature. 4. If you experience trouble breathing, fever, changes in your mouth/oral mucosa, notify the prescriber immediately. 5. You may crush or break capsules if needed to tolerate the medication better. 6. Remain consistent and ensure to take in evenly spaced intervals to ensure therapeutic benefits. 7. Lay down for 30 minutes after taking your medications to prevent dizziness. 8. You may note changes in your mouth/oral mucosa, this is normal. 9. Remain upright when taking your medication and for 30 minutes to prevent esophageal ulcers.

1. Include 2. Do not include 3. Include 4. Include 5. Do not include 6. Include 7. Do not include 8. Do not include 9. Include

1.___________ Inhibitors stop the enzyme from bringing viral DNA into the nucleus. 2._____________ Inhibitors prevent protease from binding to the viral polyprotein which blocks it from maturing.

1. Integrase 2. Protease

1.____________________ act as a decoy to nucleosides, which is missing a component that prevents it from attaching to another nucleoside. 2.___________________ gum up the reverse transcriptase enzyme which inhibits reverse transcriptase from occurring.

1. Nucleoside Reverse Transcriptase Inhibitors (NRTIs) 2. Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

1.________________ are more challenging to treat than 2._______________ because replication occurs 3.___________________ the host cells, so medications must 4._________________.

1. Viruses 2. Bacteria 3. Inside 4. Enter the cell

"Great! Patients that are treated with 1.______________ medications, that you are going to be prescribed, often do not even make it through to the last stage. Progression is drastically 2.__________________ by taking your medications."

1. antiretroviral 2. slowed

"Antiretroviral therapy 1.______________ cure HIV" "Antiretroviral therapy 2.________________ decrease disease progression" "3._______________ wear a condom during sex" "4._______________ avoid sharing needles" "5.________________ donate blood" "Antiretroviral therapy 6.______________ eliminate the risk of transmission of HIV to others"

1. does not 2. does 3. Do 4. Do 5. Do not 6. Does not

Yes, the medication is working because the viral load is less than 1.__________ copies/mL, which is the goal of antiretroviral therapy.

50

Is the medication therapy working for Omar?

yes