NRS110 Exam #3

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NRS110 Exam #3
2010-05-08 18:27:14

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  1. What is HIV?
    How does the virus transmit?
    • Is a Fragile Virus
    • Contact with infected fluid-blood
    • Semen
    • Vagina Secretion
    • Breast milk
    • Sexual transmission
    • Contact w/ blood & blood product
  2. HIV Viral Load?
    • The numbers of virus in the plasma
    • Is the important variable in transmission
    • Large amount of the HIV can be found in the blood during the first 6 months of infection
    • And again during the late stage of the disease
  3. Transmission Routes of HIV?
    • Not spread casually
    • Not transmitted through tear, saliva, urine, emesis, sputum, feces, or sweat
    • Healthcare worker have a low risk of acquiring HIV at work even after a needle stick injury
    • Most common mode: sexual contact
    • Sharing of needles major means in large cities
    • Needle stick expoxure: 0.3%-0.4%
    • Perinatal transmission route of infection in children
  4. HIV disease?
    • HIV: Human Immunodeficiency Virus
    • Retrovirus: replicated in a backward manner RNA-DNA
    • B-cell: initially make HIV antibodies (to stop the disease)
    • T-4 (CD4) cell: T-helper cells-eventually the ability of HIV to destroy CD4+T cells exceed th ebody ability to replaces the cells
    • T8 cell: T-suppressor cell-AIDS -CD4+ to CD8 ratio of 2:1 reverse with AIDS
  5. HIV Acute Infection Stage
    Flu Like Symptoms which are? F, S, S, H, M, N, M &J, D, D, R
    • Fever
    • Swoolen Lympnodes
    • Sore Throat
    • Headache
    • Malaise
    • Nause
    • Muscle and joint pain
    • Diarrhea
    • Diffuse Rash
    • 1-3 week after initial infection-- and last for 1-2 weeks
    • High level of HIV in the blood is noted
    • CD4+T cells count FALLs temporarily
    and asypmtomatic parts of the disease:
    (fat, head, low glv, Ni, persis
    • CD4+T lymphocyte count remains above 500cells/ul
    • (normal or slightly decrease)
    • Viral load is LOW
    • Asymptomatic part of disease symptoms like:
    • Fatigue
    • Headache
    • Low grade level fever
    • Night sweats
    • Persistent generalized Lympphadenopathy

    These individual do not realize they are sick, and what impact does this have on the communicable of the disease
    and Most common infections: T,S,C,H,K,O
    • CD4+T ceels count drops from 500-200 cells/ul
    • Viral load RISES
    • Symptomatic stage
    • Symptoms from the early stage worsen
    • Persisten fever
    • Frenquent drenching night sweat
    • Chronic Diarrhea
    • Recurrent headache
    • Severe Fatigue
    • Most common infections:
    • Thrush (oropharyngeal candidiasis)
    • Shingles
    • Persistent Candian infection
    • Genital Herpes
    • Kaposi's sarcoma
    • Oral hairy leukoplakia EB virus indicateor of disease progression
  8. HIV Preventions?
    • Education
    • Culture Specific teaching intervention
  9. Late Chronic AIDS infection
    • CD4+T below 200 cells/ul
    • Development of an opportunistic infection (OI's):
    • Fungal-pneumocytis carinii pneumonia (PCP)
    • Bacteria-mycobacterium tuberculosis
    • Development of an opportunistic cancers:
    • Kaposi's sarcoma
    • Lymphoma
    • Wasting syndrome-loss of 10% of body weight
    • Dementia develops
  10. What are four basic questions for NR to ask?
    • Have You Ever?
    • 1) had a blood transfusion or clotting factor?
    • 2) shared drug-using equipment with an another person?
    • 3) had a sexual experience in which your penis, vagina, rectum, or mouth came into contact w/another person' s PVRM ?
    • 4) had a sexual transmitted disease?
  11. What lab finding may RN find with positive HIV?
    • Positive HIV assay (EIA or ELISA)
    • Detectable load levels by bDNA
    • PCR decrease CD4+T lymphocyte
    • Reversal of CD4: CD8 ratio (2:1)
    • Decrease WBC count
    • Lympopenia
    • Anemia
    • Thrombotopenia
    • Electrolite imbalanced
    • Abnormal liver function test
  12. Early Diagnose
    Diagnostic test
    • Pre and Posttest counseling
    • (if the test is (+) do you have anyone to talk to?)
    • ELISA test 2x, if positive then
    • Western blot (standard test of HIV)
    • Retest schedule
  13. What are Goals of Antiretroviral Drug Therapy?
    • Decrease HIV RNA levels to less than 50 copies/ul
    • (undetectable levels are preferred)
    • Maintain or raise CD4+T cells count >200 cels/ul immune reconstitute
    • Delay the develop of HIV related symptoms
  14. What is acute HIV intervention?
    • Initial Response to diagnosis
    • Antiviral therapy -3-20 pills/day
    • Beepers
    • Timers
    • Pillboxers
    • 2-4 weeks after the start on drug therapy (or change therapy)
  15. Antiretroviral drugs mechanism?
    Work by affecting different points of the replication cycle
  16. Nonnucleoside Reverse Transcript Inhibitors (NNRTIs) mechanism?
    • Inhibit the ability of the virus to make a DNA copy in replication
    • Block the process to convert HIV RNA into HIV DNA
  17. NRTIs Mechanism?
    Inhibits the abilty of the virus to reproduce production of the new HIV DNA incomplete
  18. Nucleotide Reverse Transcript Inhibitor mechanism?
    Inhibit the action reverse transcriptase
  19. Protease Inhibitors (PIs) mechanism?
    Interfere with the activity