INFECTION (HIV & VACCINATIONS)

hha post-quiz ambience

enfuvirtide (entry/fusion inhibitor)

can lead to injection site reactions. show extreme caution when giving this med in an effort to reduce the incidence of these reactions. let it warm to room temp before it is given, rotate injection sites, inject at the appropriate depth, and avoid giving the shot in a site that has a current injection site reaction. monitor sites of previous injections closely.

maraviroc (CCR5 antagonist)

can cause hepatitis injury that may be indicated by the presence of a rash. this should be taken very seriously and the provider should be immediately notified. a prescription for a lab evaluation of liver enzymes will determine if liver dysfunction is occurring. observe for jaundice, particularly in the sclera of the eyes, and ask the client about anorexia or itching of the skin.

zidovudine (NRTI)

can lead to medication resistance, which is less likely if clients strictly adhere to the therapeutic regimen their provider prescribes. when clients’ lab values indicate that their HIV is not being kept in check, a phenotype and/or genotype assay may be done to determine if the HIV is continuing to grow. be sure to reinforce to clients the importance of rigidly sticking to their prescribed regimen.

delavirdine (efavirenz, NNRTI)

can cause SJS, which manifests as a painful red to purple skin rash that spreads rapidly and includes the development of blisters on the skin and in the mouth. if observed, stop administering the med, apply cool compresses, antihistamines, and analgesics. early identification can increase clients’ chances of stopping the reaction in its early stages.

raltegravir (integrase inhibitor)

closely monitor HIV related lab values in order to identify if this med therapy is not effective. CD5 counts (should be high) and HIV viral load assays (should be low) are the main values used to identify effectiveness.

ritonavir (protease inhibitor)

has a negative effect on cholesterol and triglyceride levels in the body can can increase the risk for heart disease. client should have a strict schedule for having their lipid profile drawn and evaluated (every 3-4 months), with increases being reported to the provider. clients should also practice health promotion by using a heart healthy diet, exercising, and taking a vibrate antillipemic med that lowers cholesterol. liver function tests should also be monitored.

active immunity

immune system produces antibodies in response to the entry of antigens into the body

passive immunity

temporary, develops when antibodies are created by another human or animal and then transferred to the client.

birth-6 yrs vaccines

hep A and B (B at birth), rotavirus (RV), DTaP (first dose at 2 months, third at 6, fourth between 15-18 months) , Hib, PCV, MMR, varicella, and influenza in children older than 6 months.

7-18 yrs vaccines

Tdap booster at 11-12 yrs, 3 dose HPV series, meningococcal from 11-18, influenza, and any other vaccines the may have been missed at the younger age.

adults/elderly vaccines

influenza shot yearly, Tdap q10years, and pneumococcal if 65+ or younger if you have risks such as smoking. hep a/b, MMR, and varicella may be necessary. herpes zoster (shingles) is recommended for adults 50 years older.