nursing care of patients with HIV

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created 8 months ago by Akosua_Ruby
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updated 8 months ago by Akosua_Ruby
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1

transmission of HIV

  • can be transmitted within a few days of becoming infected
  • unprotected sex with infected individual is most common!!!
  • exposure to infected blood or blood products
  • pregnancy, delivery, breast feeding
2

highest risk of HIV transmission

  • anal: highest risk
  • vaginal: second highest
  • oral: less common, unless ejaculation in mouth
3

exposure to blood and blood products

  • sharing IV drug use needles or equipments
  • needle or other sharp object injury (HCP)
  • blood transfusion, blood products, organ transplant
  • blood to mucosa or open wound
4

normal T cell life span. HIV infected T cell life span

  • 100days
  • 2 days
5

normal CD+4 count. immune system compensates for how long if untreated?

  • 500-600cells/ul
  • ~10 years or more
6

initial infection

  • increased viral load, followed by long period (years) of low viral load
  • most infectious when viral load is high
  • can transmit HIV at any time even during periods of low viral load
7

clinical manifestations of acute HIV infection

  • flu-like symptoms 2-4 weeks after infection
  • high viral load
  • most infectious during acute infection stage
8

flu-like symptoms 2-4 weeks after infection

fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle/joint pain, diarrhea or diffuse rash

9

clinical manifestation of chronic HIV infection: asymptomatic infection

  • vague/nonspecific symptoms
  • may not be aware of infected status
  • continue high risk behaviors
10

vague/nonspecific symptoms during asymptomatic infection of chronic HIV

fatigue, headache, lymphadenopathy, low grade fever, night sweats

11

symptomatic infection of chronic HIV infection

  • CD+4 200-500 cells/ul (viral load starts to increase)
  • HIV infection to more active state
  • symptoms develop
12

symptoms that develop in the symptomatic infection of chronic HIV infection

  • persistent fever, drenching night sweats, chronic diarrhea, recurrent headaches
  • severe fatigue
  • candida (oral- thrush/vaginal - yeast infection)
  • oral hairy leukoplakia
  • shingles, herpes outbreaks, bacterial infections
13

diagnostic criteria for AIDS

at least one of the following:

  • CD4 <200 (severe immunosuppression)
  • one of the opportunistic infections
  • one of the opportunistic cancers
  • wasting syndrome
14

routine HIV testing should be provided to who?

everyone, ages 13-64yrs

15

HIV antigen or antibody screening tests are performed on___

  • performed on blood or saliva
16

HIV antigen are detected as early as

2 to 3 weeks after infection

17

HIV antibodies are detected when?

3 to 8 weeks to be detected and 6 months in few cases

18

antigen is higher at first but taper down in what stage of diagnostic test

  • fourth generation
  • antigen/antibody blood test detect HIV earlier
19

CD4 count and viral load tells what in a diagnostic test

  • CD4 tell us their immune function
  • viral load tells how active virus is
20

CBC is looking for what conditions

neutropenia, thrombocytopenia, anemia

21

nursing care of HIV

  • progression and immune function
  • opportunistic disease prevention and treatment
  • preventing transmission to others
22

antiretroviral therapy (ART)

  • decrease viral load, maintain/raise CD4 counts
  • take at full strength and full compliance!!
  • delay HIV symptoms and opportunistic infections
23

pre-exposure prophylaxis for high-risk individuals

emtricitabine and tenofovir

24

HIV disease and drug side effects on musculoskeletal

  • bone disease
  • lipodystrophy
  • peripheral neuropathy
  • pain
25

HIV disease and drug side effects on GI

  • diarrhea
  • N/V
  • insulin resistance
  • hyperlipidemia
26

HIV disease and drug side effects on cognitive

  • depression
  • fatigue
27

HIV disease and drug side effects on heart and lymph

  • cardiovascular disease
  • lymphadenopathy
28

do not assume patients are not at risk because

  • too young or too old
  • married
  • religious
  • person looks clean/healthy
29

health promotion/prevention

  • HIV test part of routine health care
  • work to modify risky behaviors
  • offer tests universally to pregnant women
  • decrease risk at work
30

ways to work to modify risky behaviors

  • abstinence
  • safe sex (latex condoms!!)
  • no sharing drug needles or other equipment
31

ways to decrease risk of HIV at work

  • universal precaution!!!
  • other safety measures
  • post-exposure prophylaxis with ART
32

social stigma about HIV

  • perceived as "brought it on to themselves" by behaviors.
  • social isolation
33

end of life care

  • patient comfort
  • spiritual issues (acceptance of end of life)
  • help significant others deal with loss
  • maintain a safe environment