Card Set Information
Adult MedSurg 2
What is Scleroderma?
“Turning to Stone” d/t excessive production of collagen
A rare chronic disorder of diffuse fibrosis (thickening and hardening) of the skin, arteries, joints and internal organs including the lungs, and kidneys
--Lungs usually go first, so Dx is usually done with PFTs and CX.
What is CREST as it relates to scleroderma?
C=calcinosis (calcium lumps)
S=sclerodactyly ( tapering deformity of the bones)
T=Telangiectasias=small red spots on the skin of the fingers, face and inside of mouth
80% end up with CREST syndrome
Diffuse (20%)—rapid progression of visceral organ disease and death within a few years
Tx is largely supportive and symptomatic.
Risks of acquiring HIV
The higher the viral load greater the risk
Blood and blood products greatest risk when injected
Mucosal exposure to blood 90% less risky than needle stick
Dx with ELISA or Western Blog. Blot is more accurate, but more expensive.
What can nurses do with regard to HIV testing?
Provide pre/post testing information
Perform Point of care HIV testing
What are some markers for infection of HIV?
CD4 counts and viral load
: 200-500 = moderate immunosuppression. <200--> ^opportunistic nfxn.
goal is for viral load to be undetectable.
When it reaches ~10K, time to rethink treatment.
In HIV/AIDS pts, both markers are check every 4-6 weeks.
What is nursings' role in managing HIV?
Centers around keeping the immune system functional
Assisting the client in coping with a chronic disease, and maintaining emotional and spiritual well-being.
This requires early assessment and intervention, comfort with asking about high risk behaviors and developing sensitive teaching and counseling skills
Definition and SnSs of AIDS after HIV.
Presence of HIV infection and a CD4 count of less than 200 or HIV infection or diagnosis or indicator disease with no other cause of immunodeficiency
: Flat, pink turning to dark violet or black
White out: RAISE head of bed, assess LOC (hypoxia) etc.
Many unrelated pathologies all present simultaneously or in succession.
What other non-obvious symptoms will AIDS pts have?
lethargy, withdrawal, depression
wasting syndrom (TPN)
--Not always successful since the body saves fat when it needs protein.
--Nutritional supplements high in protein and well-balanced meals with multiple vitamin/mineral supplementation (NO IRON) and adequate calories and adequate fluids
--Recombinant human growth hormone may be helpful
Nursing diagnoses are going to be pretty much all of them