module 7 (HIV/AIDS, precautions for airborne, droplet, standard,ambulatory aids, gait patterns, W/C, AFOs, Cardiacpulm like ECG and abnormal and interventions)

What causes HIV/AIDS?

HIV-1 or HIV-2, a retrovirus that causes immune suppression.

What happens to CD4 helper T cells in HIV?

CD4 cells decrease → CD4 T lymphocytopenia → impaired immune function.

Why does decreased CD4 count cause opportunistic infections?

CD4 cells help coordinate immune responses; fewer CD4 cells → reduced ability to fight infections and certain cancers.

What is AIDS?

Advanced HIV disease characterized by severe immune suppression and symptomatic disease.

Why is HIV called a retrovirus?

Its RNA is transcribed into DNA.

What are the 2 major types of HIV transmission?

Horizontal and vertical transmission.

What is horizontal HIV transmission?

Person-to-person transmission through sexual contact or exposure to infected blood/body fluids.

What is vertical HIV transmission?

Mother → child during pregnancy, labor, delivery, or breastfeeding.

What body fluids can transmit HIV?

Blood, semen, CSF, cervical fluid, and vaginal fluid.

What must happen for HIV-containing fluid to transmit infection?

It must contact a mucous membrane/damaged tissue or be directly injected into blood.

What are high-risk routes of HIV transmission?

Blood transfusion, needle sharing, needlestick injury, and repetitive anal intercourse.

Can HIV spread through sharing food, towels, cups, or toothbrushes?

No. HIV is not spread through casual contact.

Can HIV spread through social/close-mouthed kissing?

No.

What are major high-risk behaviors for HIV transmission?

Unprotected sex with someone with HIV, sharing injection equipment, mother-to-child transmission, and contaminated needlestick injuries.

What occurs during Stage 1 HIV?

Acute HIV infection → flu-like symptoms + lymphadenopathy, typically 2-4 weeks after infection.

What occurs during Stage 2 HIV?

Asymptomatic HIV infection → can last 10+ years; HIV antibodies are present.

What occurs during Stage 3 HIV?

AIDS/symptomatic HIV disease → severe immune suppression and inability to fight infections effectively.

What is the normal CD4 count range listed in your notes?

500-1200 cells/mm³.

How is HIV diagnosed/monitored?

Antigen/antibody testing, CBC, CD4 count, and drug-resistance testing.

What is the only way to know if someone has HIV?

HIV testing.

What are common early symptomatic HIV findings?

Fever, sweats, chronic diarrhea, fatigue, headache, rash, cough/SOB, oral infections, and vaginal candidiasis.

What skin finding is classically associated with advanced HIV/AIDS?

Kaposi sarcoma → purple blotches/bumps on the skin.

What respiratory symptoms may occur with advanced HIV?

Dyspnea, syncope, fatigue, chest pain, and nonproductive cough.

What neurologic complications can occur with advanced HIV?

HIV-related dementia and distal symmetrical polyneuropathy.

What happens to wound healing with advanced HIV?

Poor wound healing may occur because of immune suppression.

What is the primary medical treatment for HIV?

Antiretroviral therapy (ART).

What is the purpose of ART?

Reduce viral load and maintain immune function.

Is ART a cure for HIV?

No. It controls HIV and helps prevent progression to AIDS.

How is ART typically administered?

In combination therapy, commonly 3 or more antiretroviral drugs.

When should ART generally be started?

Immediately/as soon as possible.

What are common adverse effects of ART?

Nausea, vomiting, rash, diarrhea, headache, dizziness, fatigue, and pain.

What precautions should PT use with a patient with HIV?

Standard precautions.

Should a patient exercise during an acute infection?

No. Avoid exercise during acute infections.

What type of exercise is recommended for people with stable HIV?

Moderate-intensity aerobic + resistance exercise.

How should aerobic exercise progress in HIV?

Start around 10 min → progress to 30-60 min, 3-5 days/week.

What is the recommended resistance training frequency?

2-3 days/week, moderate intensity.

What is a typical resistance-training prescription for HIV?

2-3 sets of 10-12 exercises, targeting large muscle groups.

What type of exercise should be avoided in HIV?

High-intensity exercise and contact sports.

Why avoid very high-intensity exercise in HIV?

It may suppress immune function.

What energy-management strategy should PT teach patients with HIV?

Activity pacing and energy conservation → balance activity with rest.

What other PT interventions may benefit patients with HIV?

Skin care, endurance training, functional mobility, respiratory management, nutrition/lifestyle education, and emotional support.

What is one major benefit of exercise in HIV?

Exercise can have positive effects on immune function and reduce stress.

What CD4 count is diagnostic of AIDS?

< 200 cells/mm³

What are the major features used to identify AIDS?

CD4

What does a very low CD4 count indicate?

Severe immune suppression and increased risk for opportunistic infections.

What are common opportunistic infections associated with AIDS?

Pneumocystis pneumonia, candidiasis, CMV, and toxoplasmosis.

What opportunistic infection commonly affects the lungs in AIDS?

Pneumocystis pneumonia (PCP).

What opportunistic infection can cause CNS toxoplasmosis?

Toxoplasmosis → focal encephalitis.

What infection causes cryptococcal meningitis in AIDS?

Cryptococcus infection.

What viral infection can occur as an opportunistic infection in AIDS?

Cytomegalovirus (CMV).

What fungal infection commonly occurs in AIDS?

Candidiasis.

What malignancies are associated with AIDS?

Kaposi sarcoma, non-Hodgkin lymphoma, and primary CNS/brain lymphoma.

What cancer causes purple skin lesions in AIDS?

Kaposi sarcoma.

What lymphatic malignancy is associated with AIDS?

Non-Hodgkin lymphoma.

What CNS malignancy can occur with AIDS?

Primary brain lymphoma.

What neurological conditions are associated with AIDS?

Focal encephalitis, cryptococcal meningitis, AIDS dementia, and herpes zoster.

What is HIV encephalopathy also called?

AIDS dementia.

What cognitive/behavioral changes occur with AIDS dementia?

Poor concentration, memory problems, personality changes, irritability, apathy, lethargy, confusion, and depression.

What physical impairments are associated with AIDS dementia?

Poor balance, poor coordination, and frequent falls.

An AIDS patient has poor memory, personality changes, poor coordination, and frequent falls. What complication should you suspect?

HIV encephalopathy/AIDS dementia.

Who gets standard precautions?

EVERY patient — assume anyone can be contagious.

What do standard precautions apply to?

Blood + all body fluids/secretions/excretions (except sweat) + nonintact skin + mucous membranes.

When are gloves required under standard precautions?

When touching blood, body fluids, secretions, excretions, contaminated items, mucous membranes, or nonintact skin.

When is a gown/protective clothing needed under standard precautions?

When blood/body fluid splashing or contact with clothing/exposed skin is anticipated.

When should a mask/eye protection/face shield be used?

When procedures may cause splashes or sprays of blood or body fluids.

What should be used during CPR to prevent contact with oral secretions?

Barrier ventilation devices such as a mouthpiece, resuscitation bag, or other ventilation device.

When should hand hygiene be performed?

Before and after patient care, immediately after glove removal, and after contact with body fluids or contaminated items.

What should you avoid when removing gloves?

Touching the contaminated outer surface of the gloves.

Why avoid artificial fingernails?

They can create areas where pathogens can grow.

What should you NEVER do with used needles?

Bend, recap, break, or manipulate them.

How should used sharps be disposed of?

Immediately into a puncture-proof sharps container.

If recapping a needle is unavoidable, what technique is used?

One-handed scoop technique.

What should symptomatic patients do when coughing/sneezing?

Cover nose/mouth, use tissues, dispose of tissues in a no-touch receptacle, and perform hand hygiene.

What can a symptomatic patient wear to reduce respiratory transmission?

Surgical mask, if tolerated.

If a symptomatic patient cannot wear a mask, what spatial separation is recommended?

>3 feet, if possible.

What are the 3 transmission-based precautions?

Contact, droplet, and airborne.

When are transmission-based precautions used?

In addition to standard precautions when a patient has a known or suspected highly transmissible infection.

How are pathogens spread under contact transmission?

Direct contact (skin-to-skin) or indirect contact with contaminated surfaces/equipment.

What PPE is required for contact precautions?

Gloves + gown.

When should gloves be put on for contact precautions?

Before entering the room.

When should the gown be worn for contact precautions?

When direct contact with the patient, environment, or patient-care items is expected.

What happens to the gown before leaving a contact-precautions room?

Remove it before leaving.

What type of room is used for contact precautions?

Private room or cohort with another patient who has the same infection.

What should happen to patient-care equipment under contact precautions?

Keep it in the room; if removed, disinfect it or place it in a biohazard bag.

What conditions commonly require contact precautions?

MRSA, VRE, C. difficile, excessive wound drainage, fecal incontinence, and certain GI/respiratory/skin/wound infections.

How are pathogens transmitted by droplets?

Through large respiratory droplets from coughing, sneezing, talking, or procedures.

How far do typical respiratory droplets travel?

Approximately 3 feet from the source.

What PPE is most important for droplet precautions?

Surgical mask.

What type of room is generally used for droplet precautions?

Private room.

What should the patient wear during necessary transportation under droplet precautions?

Surgical mask, if possible.

What should be minimized under droplet precautions?

Patient transportation.

What classic diseases require droplet precautions?

Influenza, pertussis, mumps, rubella, meningococcal disease, and diphtheria.

What respiratory viruses commonly require droplet precautions?

Influenza, RSV, and adenovirus.

How are airborne pathogens transmitted?

Through small particles that remain suspended in the air and can travel long distances via air currents.

What PPE is required for airborne precautions?

N95 respirator or higher-level respirator.

When should the N95 be put on?

Before entering the room.

What type of room is required for airborne precautions?

Private negative-pressure room (airborne infection isolation room).

What should happen to the door during airborne precautions?

Keep the door closed.

What should the patient wear if transportation is absolutely necessary?

A mask.

Which healthcare workers should not care for patients with vaccine-preventable airborne diseases?

Nonimmune healthcare workers.