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EOP final lecture
HIV/AIDS
| Question | Answer |
|---|---|
| What is HIV | RNA virus replicates backwards to DNA taking over CD4 T-cells |
| What is Aids | Immune incompetence and develop one of the following: CD4 T cell <200 OI OC Wasting syndrome AIDS Dementia |
| Common OI's in Aids are | Viral, Fungal, Bacterial Protozoa Candida Albicans thrush Mycobacterium pneumonia CMV, VSV, HSV Coccidiodides/ Pneiumonia PCP Flu Kaposi Sarcoma |
| What is wasting syndrome | loss of 10% or more of body mass |
| How is HIV diagnosed? | First an EIA is done- if pt has risky behavior re-resting is recommended at 3wks/6wks/3mo. If positive, another EIA is done. If repeated EIA is positive then a Western blot test is performed. |
| Normal T-cell range is | 800-1200 |
| What level do immune problems begin with t-cell levels? | when they drop below 500 |
| What are the early signs of HIV infection? | Mono-flu like symptoms, malaise, headache, fatigue, and seroconversion |
| Seroconversion is | (when HIV-specific antibodies develop) accompanied by a mono-like syndrome of fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle and joint pain, diarrhea, and/or a diffuse rash |
| Transferrable methods of HIV are what | sexual intercourse with an infected partner, exposure to HIV-infected blood or blood products, and perinatal transmission during pregnancy, delivery, or breastfeeding |
| Most common form of transmission is | sexual anal or vaginal |
| Highest incidence rate of HIV is in what kind of men? | Gay and African American |
| Metabolic s/e of ART are | body changes like fat accumulation, peripheral wasting, lipid abnormalities ↑Trig ↓HDL, ↑ insulin resistance, and hyperlipidemia |
| Opportunistic Cancers | KAPOSI SARCOMA, lymphoma, cervical cancer |
| What happens in the acute phase? | Seroconversion shows up 2-4wks after infection and lasts 2 weeks. High viral load and low t-cell occurs but return to baseline at the end of this stage. |
| What would you see in an acute exacerbation of HIV in a patient who has had the disease for years? | Sharp decrease in CD4 count |
| Early chronic infection is | Asymptomatic, T-cells remain above 500, BUT fatigue, headache, low-grade fever, night sweats, persistent generalized lymphadenopathy (PGL) can occur |
| Intermediate chronic infection is... | Symptomatic, CD4 200-500, viral load ↑, fever, night sweats, chronic diarrhea, recurrent headaches, fatigue, localized infections, lymphadenopathy, and nervous system issues can occur. |
| Most common infection in intermediate chronic is | Thrush/Candida. Zoles. |
| Other infections that can happen in the intermediate phase are | Kaposi sarcoma, caused by human herpesvirus 8 (Fig. 15-6). Oral hairy leukoplakia, an Epstein-Barr. |
| Late chronic phase or AIDS occurs... | 10 years plus after initial infection |
| Diagnostic tests for HIV are | EIA, western blot (only done after 2 positive EIA's), oral fluid test not saliva home test, urine test. rapid tests blood or oral 20 min test. |
| What is ART | Antiretroviral therapy drugs and it reduces viral load have interactions and don't work for everyone. Increases life span by 20yrs. |
| When do we start ART? | To avoid burnout and nonadherence, treatment is recommended when immune suppression is great and the pt is ready. |
| What are some antiretroviral agents? | Reverse Transcriptase InhibitorsNucleoside – NRTI (AZT) Non-Nucleoside – NNRTI (Sustiva) Protease Inhibitors / PI (Norvir) Fusion Inhibitors / Entry Inhibitors (Fuzeon) HAART – Highly Active Antiretroviral therapy |
| Entry Inhibitors | Prevent binding of HIV to cells, thus preventing entry of HIV into cells where replication would occur |
| Protease Inhibitor | Prevent the protease enzyme from cutting HIV proteins into the proper lengths needed to allow viable virions to assemble and bud out from the cell membrane |
| NuceloSIDE reverse inhibitor | Prevent the protease enzyme from cutting HIV proteins into the proper lengths needed to allow viable virions to assemble and bud out from the cell membrane |
| NuceloTIDE reverse inhibitor | Inhibit the action of reverse transcriptase |
| Non-nucleoSIDE reverse inhibitor | Combine with reverse transcriptase enzyme to block the process needed to convert HIV RNA into HIV DNA |
| Integrase inhibitor | Binds with the integrase enzyme and prevents HIV from incorporating its genetic material into the host cell |
| Treatment for candida | Treatment: fluconazole (Diflucan), clotrimazole (Lotrimin), nystatin (Mycostatin); if fluconazole refractory, amphotericin B (Fungizone) 2° Prophylaxi: fluconazole (Diflucan), itraconazole (Sporanox) |
| Side effects of Drug therapy are | Rash, GI symptoms, N & V, Diarrhea, Headache, Malaise, Lactic Acidosis, Hepatotoxicity, Hyperglycemia, Fat maldistribution, lipodystrophy |
| Overall nursing care plans are | encourage health promotion, manage health problems/ infections caused by HIV/, maximize quality of life (rx's financial family), discuss end of life issues |
| How to promote immune system planning | Adhere to drugs Promote healthy life Prevent OIs/STI’s Prevent transmission- condoms, PrEP, ART moral support relationships Maintain activity living with disease, death, and spirituality |
| What is PrEP | prophylaxis drugs for not transmitting the disease- 2 pills are taken- high risk individuals tenofovir and emtricitabine |
| What is the nursing collaborated care? | Gather baseline data Education about spectrum of HIV, treatment, preventing transmission, improving health, and family planning Decrease viral load Maintain/raise CD4+ counts Delay HIV-related symptoms and opportunistic infections |
Created by:
matthew0116
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