NUR 211 exam #2 HIV/AIDS

How is HIV 1 transmitted?

Bodily fluids (blood, vaginal secretions, seminal fluid, amniotic fluid, breast milk, cerebral spine fluid), blood transfusions, organ transplant, unprotected sex

What are risk factors for HIV?

Infected bodily fluids, same sex partners (men), sex with an infected partner, sharing needles, mother to baby( 25% not on drug therapy, 8% on drug therapy), infected client to health care worker (0.3-0.4%)

What are the best ways to prevent HIV?

Abstinence & latex condoms

What is stage 1?

CD4 count is 500-1500, Symptomatic, acute, primary infection (cough, fever, headache, muscle pain, joint pain, swollen lymph nodes, mouth ulcers, rash, sore throat, N/V, diarrhea, abdominal cramps) transmission is riskier

What is stage 2?

CD4 count is 200-499, A symptomatic → symptomatic, chronic (fatigue, breathing problems, skin rashes) can have initial symptoms but go away, most are unaware that they are infected, progression to AIDS takes 8-11 years

What is stage 3?

AIDS (high fever, night sweats, pneumonia, memory loss), CD4 count is less than 200, very severe immunocompromised, viral load increases and decreases in lymphocytes, once diagnosed 2-3 life expectancy, but still on meds to prolong death

Diagnostic testing?

Elisa (if positive) then western blot assay

What is Elisa?

An antibody test

What is western blot assay?

An antigen (confirmation) test done after a positive antibody test

What are antibody test?

They detect antibodies to HIV, but not HIV itself

What are antigen tests?

They detect HIV

What is RNA test?

The most common, detects HIV, can be used on neonates

What are other diagnostic testing?

CDC recommendation tests for HIV antigens and HIV nucleic acids, blood tests faster than oral tests, CD4 tests viral load

Planning for implementation?

Prevention is key, early detection, promote health maintenance, prevent opportunistic infection, provide emotional/psychosocial support (reduce fear, anxiety, depression)

What are the medications?

Antiretroviral therapy classes( ART therapy), Nucleoside reverse transcriptase inhibitors, non-Nucleoside reverse transcriptase inhibitors, protease inhibitors, integrate strand transfer inhibitors, fusion/entry inhibitors, multi drug combination products

What is ART therapy?

Use of 3 active drugs from 2 or more drug classes, usually Retrovir (AZT), one or two NRTIs and a PI

ART therapy considerations?

Must be compliant and on schedule, prevents HIV from making copies of itself, suppressed the virus to less harmful levels, usually given daily (PO), may have side effects

What are concerns and challenges with drug therapy?

Build up resistance rapidly if only using one drug, side effects, psychological barriers, cost, time consuming and requires a strict regimen

What are HIV/ AIDS complications?

HIV encephalopathy, opportunistic infections, secondary cancers

What are opportunistic infections?

Pneumocystis pneumonia (common, caused by environmental factors: fever, nonproductive cough), tuberculosis, candidiasis, mycobacterium avium complex (when CD4 is less than 50), HIV wasting syndrome (loss of muscle mass/fat, involuntarily loses more than 15% of body weight)

What are secondary cancers?

Kaposi’s sarcoma (lesions of skin, oral cavity, GI tract and the lungs: reddish purple to dark blue macules, plaques, or nodules) & lymphomas (neoplasms of cells of lymphoid origin, spleen, GI tract, liver or bone marrow

What should you educate about?

Standard precautions (hand hygiene, environmental control, needles), prevention, safe sex/needle practice, keeping appointments, symptom management (nutrition, rest, exercise), don’t donate blood or share needles

Nursing interventions?

Improve nutritional status, decrease sense of isolation, coping with grief, improve knowledge of HUV, monitor and manage potential complications