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HIV/AIDS
pn 141 test 3 book burke pg 237
| Question | Answer |
|---|---|
| what is results when function of either the B or T cells are impaired | immunodeficiency disorder |
| HIV leads to what | AIDS |
| when was it identified | in 1981 |
| it is number ________ in leading causes of death in the US | fifth |
| who gets it age wise | adults 35-44 |
| what men get is | AA and hispanic, homosexuals, bisexials, prisoners,durgs, hetersexual contact |
| why is the life expectancy decreasing in africa | due to aidss |
| what are the three routes of transmission | 1) direct person to person through sex 2) direct injection with contaminated blood, blood products or needles 3) mother to fetus |
| what fluids is HIV transmitted through | blood, semen, vaginal secretions, placenta, breast milk |
| what is a major risk factor | sex w/o condom w/ infected person |
| what does it mean that HIV is a Retrovirus | it reproduces in a backward manner, instead of reproduces from DNA to RNA it uses RNA to make DNA copies |
| what happens after the virus enters the boodstream | it attaches to CD4+ T4 helper cells |
| what happens once the virus is inside the CD4+ cell | sheds its protein coat and releases an enzyme called reverse transcriptase |
| what does reverse transcriptase do | it converts RNA to DNA |
| after the conversion of RNA to DNA what does the viral DNA do to the host cell DNA | is inserts itself into the host cell DNA and duplicates during normal cell division |
| the viral DNA can produce new RNA with the assistence of an enzyme called ________ | protease |
| the viral DNA nad the protease form what | very small virus particles called buds |
| what do the buds have the ability to do | to move to other CD4+ cells where they disrupt and eventually destroy the host cell |
| the loss of ________ leads to the immunodeficiencies seen with HIV infection | helper T cells |
| how long can it remain inactive in infected cells | for years |
| during the inactive time what can happen | B cell antibodies are produced in a process called seroconversion |
| the B cell antibodies can be detected when after infected | 6 weeks-6 months |
| dx is based on what | pt H&P, risk factors, labs and s/s, CD4+Tcells counts |
| it is classified according to whom | the CDC system |
| s/s : what do they range from | no s/s (after the initial monomucleosis-like onset) to severe immunodeficiency w/ multiple opportunistic infections |
| following the primary infection, what does the pt enter | a long lasting asymptomatic period |
| how long is the asymptomatic period | about 10 years |
| can the viurs be transmitted to others during the asymptomatic period | yes |
| what is the second stage | it is the acute phase |
| acute phase: what is it charecterized by | persisitant generalized lymphadenopathy lasting >3 months |
| it is unclear exaclty what causes the pt to prgress from HIV to _______ | AIDS |
| aIDS: the client is at risk for what when they are diagnosed with this | developing multiple opportunistic infections and cancer |
| opportunistic infections: what are they | they are infections that develop in clients with compromised immunity |
| opportunistic infections: pt is more likely to develop these when their CD4+ fall below _______ | 200 |
| opportunistic infections: what are the infections moastly | respiratory, GI, and neurologic systems |
| opportunistic infections: resp system: what is pneumocystis carinii PNA (PCP)- what is it | a fungus-like organism that rarely causes disease in pt with an intact immune system |
| opportunistic infections: what is the most common one | PCP |
| opportunistic infections: resp system: what is pneumocystis carinii PNA (PCP)- what is used to tx; what does tx do | HAART highly active antiretroviral therapy; they are meds that reduce incidence of PCP |
| opportunistic infections: resp system: what is pneumocystis carinii PNA (PCP)-what does pcp do to the body | it settles in the lungs and damages the lung alveoli |
| opportunistic infections: resp system: what is pneumocystis carinii PNA (PCP)- s/s | fever, nonproductive cough, SOB, dyspnea, tachypnea, crackles, decreased breath sounds, cynosis |
| opportunistic infections: resp system: what is pneumocystis carinii PNA (PCP)- how is Dx made | by chest xray or branchoscopy |
| opportunistic infections: resp system: what is pneumocystis carinii PNA (PCP)- what will a chest xray reveal | diffuse infiltrates |
| opportunistic infections: resp system: what is pneumocystis carinii PNA (PCP)- why is a bronchoscopy used | to obtain sputum for a culture |
| opportunistic infections: resp system: TB- what is the cause | mycobacterium TB |
| opportunistic infections: resp system: TB- what does it do to the lungs | it invades the lungs but can also be found in the bone marrow, lidneys and CNS |
| opportunistic infections: resp system: TB- how is it Dx | the manoux test, chest xray |
| opportunistic infections: resp system: TB- when may they not react to the manoux test | when CD4+ counts are below 200 |
| opportunistic infections: resp system: TB- s/s | persistant cough ngiht sweats, fever, fatigue, wt loss |
| opportunistic infections: resp system: mycobacterium avium complex (MAC)- what is the cause | by a bacterial organism found in the food, water and soil |
| opportunistic infections: resp system: mycobacterium avium complex (MAC)- what is it | it effects nearly every organ and has a high mortality rate |
| opportunistic infections: resp system: mycobacterium avium complex (MAC)- s/s | high fever, diarrhea and wt loss |
| opportunistic infections: resp system: what are the three | mycobacterium avium complex (MAC), TB, PCP |
| opportunistic infections: GI system: what are the three | candidiasis, cryptosporidiosis, wasting syndrome |
| opportunistic infections: neurologic system: what are the two | cryptococcosis, toxoplasmosis |
| opportunistic infections: other infections: what are they | herpes simplex 1&2, herpes zoster, cytomegalovirus (CMV), pelvic inflammatory disease, HPV |
| opportunistic infections: secondary cancers: what are they | kaposi's srcoma, non-hodgkin's lymphoma |
| opportunistic infections: GI system: candidiasis- what is thrush | oral, a fungal infection caused by candida albicans |
| opportunistic infections: GI system: candidiasis- s/s of thrush | white patches in the mouth that may extend to the esophagus and stomach |
| opportunistic infections: GI system: candidiasis- if they have thrush what may they c/o | mouth soreness and an unpleasant taste |
| opportunistic infections: GI system: candidiasis- what can esophagitis lead to | painful swallowing and inability to eat and malnitrution |
| opportunistic infections: GI system: candidiasis- what do wm get | vaginal candidiasis |
| opportunistic infections: GI system: cryptosporidiosis- who is it usually found in | birds, reptiles, fish and humans |
| opportunistic infections: GI system: cryptosporidiosis- how does transmission occur | from ingesting cantaminated water or food from human to human contact |
| opportunistic infections: GI system: cryptosporidiosis- where does the organism settle | in the small intestines |
| opportunistic infections: GI system: cryptosporidiosis- s/s | large watery nonbloody diarrhea, dehydration electrolyte imbalances and malnutrition |
| opportunistic infections: GI system: cryptosporidiosis- how is it Dx | by sending a stool sample for ova and parasites |
| opportunistic infections: GI system: wasting syndrome- when in the AIDS process does this develop | in the later stages of AIDS |
| opportunistic infections: GI system: wasting syndrome- what is it | an unplanned wt loss of 10% along with chronic diarrhea or an unexplained fever |
| opportunistic infections: GI system: wasting syndrome- s/s | fatigue, N/V, and oral lesions poor food intake, chronic diarrhea, malabsorbtion of nutrients, emaciated |
| opportunistic infections: Neuro system: toxoplasmosis- what is the cause | parasitic infection with toxoplasma gondii |
| opportunistic infections: Neuro system: toxoplasmosis- what can it cause | encephalitis |
| opportunistic infections: Neuro system: cryptococcus - cause | cryptococcus neoformans |
| opportunistic infections: Neuro system: cryptococcus - what does it do | it settles int he lungs but can travel to the brain or meninges causing meningitis |
| opportunistic infections: Neuro system: cryptococcus & toxoplasmosis- s/s | HA, fever, stiff neck, altered mental status and seizures |
| other infections: herpes type 1&2- where do they involve | 1-oral cavity, 2- in the genital and anal regions |
| other infections: cytomegalovirus: what is it | part of the herpesvirus family, it can effect the retina the GI tract or lungs |
| other infections: cytomegalovirus: it is the primary cause of what in AIDS pt | blindness |
| other infections: HPV: woman have a high risk for what | cervical cancer |
| HIv encephalopathy: what is the cause | HIV acting directly on the brain |
| HIv encephalopathy: what happens | progressive deterioration of cognitive motor and behavioral functioning |
| HIv encephalopathy: s/s | forgetfulness, difficulty concentrating, confusion, leg weakness and clumsiness later tremors ,incontinence and paraplegia |
| cancers: kaposi's sarcoma- it is the most common what | cancer assoc with AIds |
| cancers: kaposi's sarcoma- what happens | tumors develop in the lining of small BV, causing reddish purple lesions on the skin and MM |
| cancers: kaposi's sarcoma- are the lesions painful at first; are they painful later | no; yes as the disease prgresses |
| cancers: kaposi's sarcoma-tumors with in the body organs can cause what | distrupt function or cause bleeding |
| cancers: lymphomas- what are they | malignancies of the lymphocytes, lymph nodes athe spleen and bone marrow |
| since there is no cure,. what is important | prevention |
| what is education focused on | sex education |
| diagnostic tests- ELISA -why is it done; when could they test negative; or postive | first screeing test to determine the presence of HIV antibodies (not the virus itself); during window period |
| diagnostic tests- ora quick rapid HIV 1 antibody test -why is it done; | it provides results in 20 minture by obtaining blood sample from finger stick |
| diagnostic tests- western blot assay-why is it done; | a reliable test that is used to confirm that the pt is HIV seropositive |
| diagnostic tests- viral load test -why is it done; | measures the amount of HIV virus activity, to monitor the disease progrssion and response to antiviral meds |
| diagnostic tests- CD4+ cell counts -why is it done; | used to confirm progression from HIV infection to aids |
| meds: why are antivirals given | to reduce the t wiral load, maintain CD4+ cell counts above 500 and treat opportunistic infections and malignancies |
| if or when an HIV infection progresses to AIDS depends on what 3 factors | whether a person is prescribed the appropraite meds, whether the meds are taken as prescribed, how well the meds works for that person |
| what kind of precautions are needed with HIV/AIDS pt | standard precautions; higher precautions when pt is immunocompromised to protect pt |
| HIV virus RNA replicates itself into the host DNA and lies dormant until when | until the host cell activates an immune response to sickness, illness and infection |
| when are inactive Bcell antibodies able to be detected | from 6 wks- 6 months after the initial exposure |
| acute retroviral syndrome is also known as | Primary HIV infection (PHI) |
| Primary HIV infection (PHI): what is this period; when is this period | the time between the initial exposure to the virus and the appearence of HIV antibodies; 6wks-6 months |
| Primary HIV infection (PHI) what does the immune system produce in response to HIV | HIV antibodies |
| Primary HIV infection (PHI): what s/s occur | flu like that develop with in days to weeks of exposure, many may not get sick |
| seroconversion: what is this; when is this period | when specific antibodies detectable in blood; 6wks-6 months after exposure |
| if pt is postive of any of the rapid tests ( finger stick, uni gold, saliva) what is done next | ELISA to confirm |
| ELISA: what does it screen for | HIV antibodies not the virus |
| Elisa: when could pt who is really postive could show negative | when they are tested too early (before 12 weeks) |
| if elisa is positive what is the next test | a western blot |
| Western blot: what is it | more detailed than the others, expensive, time consuming, blood is mixed with HIv proteins watch for antigen-antibody response |
| is blood that is donated tested | yes |
| Nucleic acid testing: what is it | used for donated blood to detect HIV and hep C |
| what does HIV viral laod measure | measures the amount of activity replicating HIV cells. |
| HIV viral load: what does it corralate with | progression of dx and response to antiviral meds |
| the HIV viral the CD4 count and the P24 assay are used to look at what | the immune system, helps to determine what meds to take |
| how often are the HIV viral the CD4 count and the P24 assay taken | 3-6 mo |
| HIV viral load: what count indicates the need for Tx | 5000-10000 |
| CD4 count: what is it | it correlates with immunodeficiency disorders in AIDS |
| CD4 count: what is norm | 500-1500 |
| P24 assay: what is it | it indicates active reproduction of HIV |
| what is the initial stage one like | flu loke s/s , wt loss, mono s/s, it is a few days to a week, ppl unsuspecting that they have HIV |
| what is the latent stage two like | in storage virus, virus clusters in lymph nodes, they are low in the blood stream, inner fighting, the virus is dormant, T4 cells decrease |
| latent stage two: how long does it last | 8-10 yrs |
| what is the thrid stage like | opportunistic infections, T4 cells are depleting, virus is in the blood now, |
| thrid stage: how long does it last | 2-3 years |
| what is the transformation, 4th stage like | helper cells are <200, this is when HIV transforms to AIDS, death occurs in about a year |
| AIDS: what dx it | HIV postiive and CD4 cell count <200 or HIV positve and AIDS defining ilness |
| PCP causes death in how many aids PT | 20% |
| PCP: what is the TC4 count with this infections | <200 |
| PCP: is it a fungus | yes |
| PCP: tx | bactrim septra |
| herpes simplex: pt gets this when TC4 levels are <______________ | 100 |
| Tx of toxoplasmosis | tx w/ sulfa drugs |
| cytomegalovirus: what are the TC4 cell counts | <50 |
| what is one of the first indicators that HIV turned to AIDS | the development of candidiasis |
| what type of aids pt seems to get kaposi's sarcoma | men with AIDS |
| what are the goals of HARRT therapy | significant reduction of HIV RNA in the blood (ideally and undetectable viral load), an increase in T cells, an appropriate clincal response (good well being, free of apportunistic infections |
| HARRT therapy; how much will the T cells rise in 1-2 months; how about in a year | 50; 100-200 |
| what is the average cost of meds | 15000/ year |
| meds: what are the three classic meds used | videx/DDL, AZT, Retrovir |
| what does HAART stand for | highly active antiviral therapy |
| what are the four classes of antiretroviral meds | nucleoside reverse transcriptase inhibitors (NRTIs), nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors and fusion inhibotrs |
| HAART therapy: what does it combine | three or four antiretroviral drugs |
| HAART therapy: when is tx started | when pt shows severe s/s of HIV infection or dx with AIDS, if the viral load is greater than 55,000 copies or the CD4 cell count is less than 350 |
| HAART therapy: why are single drugs not used | to prevent drug resistence |
| HAART therapy: if successful what will the viral load by less than in 2 weeks | 50 copies |
| protease inhibitors : action | they block the protease enzyme so the new viral particles connot mature |
| nucleoside reverse transcriptase inhibitors (NRTIs): what do they do | they block the reverse transcriptase enzyme so the HIV material can not change into DNA in the newcells |
| meds: videx- adverse reactions | HA, N, rash vomiting, peripheral neuropathy, abdom pain, diarrhea |
| meds: retrovir- adverse reactions | asthenia, malaise, weakness, HA, anorexia, diarrhea, nausea, abdominal pain, dizziness, insomnia, anemia, |
| meds: retrovir- use | HIV and prevention of HIV transmission from mother to fetus |
| antiretroviral- nursing considerations | if dose is missed call the MD, assess for bone marrow suppression, monitor CBC, monitor CD4 counts for effectiveness |
| what is given to treat anemia | neupogen |
Created by:
jmkettel
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