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113 Cards in this Set

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Caused by HIV infection in the brain or HIV-related central nervous system problems that are caused by lymphoma, toxoplasmosis, CMV, herpes virus, Cryptococcus, progressive multifocal leukoencephalopathy (PML), dehydration, or drug side effects:

a) VIREMIA
b) AIDS DEMENTIA COMPLEX
c) CLADES
d) RETROVIRUS
AIDS DEMENTIA COMPLEX
Drugs that work by inhibiting the activity of reverse transciptase are:
TRANSCIPTASE CARINII PNEUMONIA
Families of HIV-1 that exist around the world are called?
CLADES
The number of HIV particles in the blood:

a) VIREMIA
b) VIRAL LOAD
c) CLADES
d) RETROVIRUS
VIRAL LOAD
A period of time of at least two months after infection that a individual will not test HIV-antibody positive is referred to as:

a) VIREMIA
b) VIRAL LOAD
c) CLADES
d) WINDOW PERIOD
WINDOW PERIOD
An Epstein-Barr virus infection causing painless, white raised lesions on the lateral aspect of the tongue. They may be an earliest indication of the HIV infection & also is an indicator of the progression of the disease:

a) VIREMIA
b) AIDS DEMENTIA COMPLEX
c) PNEUMOCYSTIS CARINII PNEUMONIA
d) ORAL HAIRY LEUKOPLAKIA
ORAL HAIRY LEUKOPLAKIA
Term used when an individual is a carrier of the HIV virus:

a) HIV POSITIVE
b) CLADES
c) VIREMIAL
d) CARRIER
HIV POSITIVE
Contains only RNA genetic material and “take over” human DNA:

a)TRANSCIPTASE CARINII PNEUMONIA
b)VIREMIA
c)RETROVIRUS
d)TRANSCRIPTASE INHIBITORS
RETROVIRUS
An opportunistic cancer, can occur anywhere, purple- pink- red nodules, firm and non blanching for which an individuals course of tx is Palliative care:

a)TRANSCIPTASE CARINII PNEUMONIA
b)VIREMIA
c)RETROVIRUS
d)KAPOSI’S SARCOMA
KAPOSI’S SARCOMA
Type of pneumonia only seen in immunocomprimised patients such as those with HIV/AIDS and some chempotherapy recipients. Tx is same as for other types of pneumonia:

a)TRANSCIPTASE CARINII PNEUMONIA
b)VIREMIA
c)RETROVIRUS
d)KAPOSI’S SARCOMA
PNEUMOCYSTIS CARINII PNEUMONIA
What inhibits reverse transcriptase?
TRANSCRIPTASE INHIBITORS
Term used for large amounts of virus in the blood:

a) VIREMIA
b) AIDS COMPLEX
c) CLADES
d) VIRAL LOAD
VIREMIA
Protease inhibitors are:

1) Saquinavir AKA: ____
2) Indinavir AKA: ____ (don’t take w/grapefruit juice)
3) Ritonavir AKA: ____
4) Nelfinavir AKA: ____
5) Amprenavir AKA: ____ (oral solutions & capsules NOT intercahgable)

***Refrigerate all capsules----
1) Saquinavir - Fortovase
2) Indinavir - Crixivan (don’t take w/grapefruit juice)
3) Ritonavir - Norvir
4) Nelfinavir - Viracept
5) Amprenavir - Agenerase (oral solutions & capsules NOT intercahgable)
Nucleoside reverse transcriptase inhibitors (NRTI’s):

1)Zidovudine aka: ___, ___, ___
2) Didanosine aka: ___, ___ (tabs must be chewed or dissolved)
3) Zalcitabine - d4T, Zerit
4) Lamivudine - 3TC, Epivir
5) Abacavir - Ziagen
6) Emtricitabine - Emtriva, FTC
7) Combivir - Lamivudine & zidovine combo
8) Trizivir - Lamivudine, Zidovudine & Abacavir combo
1)Zidovudine aka: AZT, ZDV, Retrovir
2) Didanosine - ddt, Videx-tabs must be chewed or dissolved
3) Zalcitabine - d4T, Zerit
4) Lamivudine - 3TC, Epivir
5) Abacavir - Ziagen
6) Emtricitabine - Emtriva, FTC
7) Combivir - Lamivudine & zidovine combo
8) Trizivir - Lamivudine, Zidovudine & Abacavir combo
Fusion inhibitors- Entry inhibitor:

1) Enfuvirtide aka: ___ (inject sub Q bid)
Fuzeon inject sub- Q bid
Aids is the progressive impairment of the ____ response & gradual destruction of cells, specifically ___ cells. Immune deficiency makes the patient susceptible to ____ infections and unusual ____
immune

T

opportunistic

cancers
The age group of __ - __ yrs represented 27% of all HIV/AIDS cases diagnosed in 2003:

a)newborn to 24 yrs
b)25-34 yrs
c)35-54 yrs
d)>55 yrs
25-34
The incidence of HIV/AID's is increased in ___, ___, ___, and ___. HIV/AID's has remained stable among the __ & decreased in the ___ population. Blacks accounted for ___ of all HIV/AIDS cases diagnosed in 2003.
whites, hispanics, asians, and pacific islanders

American Indians/Alaska Natives

Black

50%
From 2000-2003, HIV/AIDS increased 5% among ___, decreased 2% among ___ & males accounted for ___ of all HIV/AIDS cases among adults & adolescents
males

females

72%
From 2000-2003, the number of HIV/AIDS cases increased each year among men who have sex with men (MSM) & among heterosexual adults & adolescents. The number of cases decreased among ____ (IDUs), MSM who were also IDUs, & among ___. MSM (45%) & heterosexual contact (34%) accounted for ___ of all HIV/IDS cases diagnosed in 2003
injection drug users

children

79%
AIDS is the progressive destruction of the ___ system causing deterioration & dysfunction in cell-mediated immunity. AIDS makes patient susceptible to ___ infections, causes slow and progressive ___ & is fatal.
immune

opportunistic

wasting
AIDS is caused by infection w/retrovirus HIV which only has ___ genetic material. Once the retrovirus enters the body & infects a human cell, ___ (reverse transcriptase RT) forces the human cell’s DNA to use the viral RNA for the pattern to make a duplicate DNA. This DNA is incorporated into the person’s cellular DNA & acts as the template for viral production. HIV then spreads throughout the ____ system, hides in macrophages & centers of ___ ___. HIV rapidly duplicates making up to ____ viral particles daily. After many rounds of replication, these numerous viral particles exhaust the immune system. HIV retrovirus attaches to, infects and destroys the immune system cells. HIV destroys ____ (helper T cells) that regulate the normal immune response, thus causing malfunction and suppression of the immune system. CD4+ antigen serves as a receptor for HIV and allows it to invade the cell, causing cell death. HIV can infect almost any cell that has the CD4+ ____ on its surface—monocytes, macrophages, bone marrow progenitors, & epithelial cells.
RNA

enzymes

lymphoid

lymph nodes

2 billion

CD4+cells

antigen
The causative agent for AIDS is HIV which is an ___ virus that infects the T-4 ____• T4 cells activate antibodies that produce ___ lymphocytes
& destroys the ability to fight infection. It replicates & spreads to other T-4 cells resulting in progressive & lethal deterioration of ___ system
RNA

lymphocytes

B cell

immune
The 3 main modes of transmission of AIDS are:

1- Contact w/___ ___

2- Contact w/infected blood/blood products during ___ or tissue transplantation

3- Across the ___ (verticle)
body fluids

transfusion

placenta
Transmission of AIDS occurs across the ____ of infected mothers to fetus or infant. In utero it occurs through circulating maternal blood (verticle) to the fetus & also occurs w/exposure of infant to infected maternal blood during labor & delivery (horizontal) as well as through infected ___ ___.
placenta

breast milk
Biohazard labels are:

a) yellow
b) orange
c) red
d) black
orange
The average time between HIV exposure & diagnosis of AIDS is ___ years:

a) 1-3 mo's
b) 1 mo - 3 yrs
c) 3-5 yrs
d) 8-10 yrs
8-10 yrs
The ACUTE retroviral infection begins w/the development of HIV-specific antibodies referred to as ____. This occurs _-_ wks post-exposure. A normal CD4 T count is ___-___ but after exposure will be apx. ___-___. The symptoms an individual will experience are called ___ ___ ___ which is marked by fever, malaise, HA, pharyngitis, erythematous rash, nausea, muscle & joint pain, & enlarged lymph nodes (lymphadenopathy) >1 cm in two more sites X 3 months. These symptoms are often misdiagnosed as ___ or mono. Symptoms may continue for ___. The time between the untreated HIV infxn & diagnosis of AIDS is approximately ___years. (EARLY CHRONIC INFECTION)
seroconversion
1-3 weeks

800-1200
750-1000

acute retroviral syndrome

flu
several months

10 years
Lymphadenopathy is?

Seroconversion is?

An acute retroviral syndrome is marked by?
– Enlarged lymph nodes

- development of HIV-specific antibodies

- fever, malaise, HA
- pharyngitis
- erythematous rash
- nausea
- muscle & joint pain
- enlarged lymph nodes >1 cm in two more sites X 3 mo's
During the ____ chronic HIV infxn, between the untreated infection & diagnosis of AIDS (10yrs), CD4 T lymphocyte counts remain above ___ cells & the viral load will be ___. Although referred to as the "asymptomatic disease" symptoms such as fever, HA, low-grade fever, night sweats, lymphadenopathy & other symptoms often occur.
EARLY

500

low
With early chronic HIV infection (asymptomatic) all of the following are true EXCEPT:

a) symptoms are vague & patients are unaware

b) Pt's continue high risk activities

c) Pt's can transmit HIV w/no apparent symptoms

d) CD4 T counts remain above 500

e) viral load is high
viral load is LOW not high !
The INTERMEDIATE chronic HIV infxn is referred to as ____ HIV. During this phase the CD 4 T cell count drops to ___-___ cells & the viral load ___. Earlier symptoms worsen w/persistent fever, drenching night sweats, chronic diarrhea, recurrent HA's, & fatigue severe enough to interfere w/ ADL's. During this phase additional problems develope such as herpes simplex, candida albicans both orally & vaginally, cachexia, herpes zoster, & Kaposi's sarcoma. Oral hairy leukoplakia & ___ lesions may provide the earliest indication of HIV infxn.
Symptomatic

200-500
rises

Oral
When CD4 T cell counts are decreased symptoms of HIV/AIDS:

a)decrease
b)increase
increase
Normal CD4 T cell counts are __-__:

a) 200-500
b) 500-800
c) 800-1200
800-1200
Seroconversion occurs:

a) within 10 years
b) when CD4 T is below 500
c) during acute infxn
d) with late chronic infxn/AIDS
during acute infxn

when infected with the virus & during the acute retroviral syndrome (1-3 wks after exposure)
During the early chronic HIV infxn CD4 T cell counts:

a) remain above 500
b) fall below 500
c) 800-1200
remain above 500
During this time, a high level of HIV in the blood is present & CD4 T cell counts fall temporarily but quickly return to baseline. Normal CD4 T cell counts are generally between 800-1200 and during the ACUTE phase CD4 T count is just a little low at __-___.

a) Acute /750-1000
b) Early Chronic /500
c) Intermed. Chronic /200-500
d) Late Chronic-AIDS
Acute /750-1000
Which statement best describes the initial infection of HIV:

a) low amounts of HIV in blood followed within a few weeks by
high amounts of HIV in blood

b) viremia lasting for 10-12 years

c) viremia followed within a few weeks by a prolonged period of low amounts of HIV in blood
c) viremia followed within a few weeks by a prolonged period of low amounts of HIV in blood AND ... may last for 10-12 years
The earliest indication of HIV infxn may be:

a) Kaposi's sarcoma
b) thrush
c) Oral lesions

Another indicator of disease progression is?
Oral lesions

Oral Hairy Leukoplakia
Wasting is defined as:

a) 10% of body weight
b) 20% of body weight
c) 10% of ideal body mass
d) 20% of ideal body mass
10% of ideal body mass
The diagnosis of AIDS cannot be made until?
CD4 T 200 cells/micoliter or less

Development of at least one of the following opportunistic conditions:
– wasting syndrome
– dementia
Late Chronic HIV infxn or AID's will present CD4 T lab values:

a) 750-1000
b) 500-800
c) 200-500
d) 200 or less
200 or less
Patient presents w/ fever, dyspnea, tachypnea, & dry cough:

a)histoplasma capsulatum
b)Non-focal encephalopathy
c)molluscum contagiosum
d)Pneumocystis Carinii Pneumonia
PCP (tell tale sign of AIDS)

Pneumocystis Carinii Pneumonia
Patient presents w/pink-red-purple nodules or plaques that are firm, non-tender, non-blanching:

a)histoplasma capsulatum
b)Kaposi’s Sarcoma
c)molluscum contagiosum
d)Pneumocystis Carinii Pneumonia
Kaposi’s Sarcoma
Patient presents w/cognitive, motor & behavior changes such as forgetfulness, poor concentration, decreased spontaneity, flat affect, & depression:

a)histoplasma capsulatum
b)Kaposi’s Sarcoma
c)Non-focal encephalopathy
d)Pneumocystis Carinii Pneumonia
Non-focal encephalopathy
Patient presents w/ painful lesions of the GI tract, anorexia, nausea, & weight loss:

a)histoplasma capsulatum
b)Candida albicans
c)Cryptosporidium muris
d)Human papilloma virus
BOTH ...
histoplasma capsulatum & Candida albicans
Patient presents w/ watery diarrhea, abd pain, weight loss & nausea:

a)histoplasma capsulatum
b)Candida albicans
c)Cytomegalovirus (CMV)
d)Cryptosporidium muris
Cryptosporidium muris
Patient presents w/ stomatitis, esophagitis, gastritis, colitis, bloody diarrhea, pain, weight loss:

a)histoplasma capsulatum
b)Candida albicans
c)Cytomegalovirus (CMV)
d)Cryptosporidium muris
Cytomegalovirus (CMV)
Patient presents w/pneumonia, fever, cough, weight loss, dissemenated disease:

a)histoplasma capsulatum
b)Candida albicans
c)Cytomegalovirus (CMV)
d)Cryptosporidium muris
histoplasma capsulatum
Patient presents w/shingles,erythematous maculopapular rash along dermatomal planes causing pruritis & pain &/or progressive retinal necrosis & vision loss:

a)histoplasma capsulatum
b)Candida albicans
c)Cytomegalovirus (CMV)
d)Varicella zoster virus
Varicella zoster virus
Patient presents w/ ulcerative lesions in mouth, nose:

a)type 1 herpes simplex
b)type 2 herpes simplex
c)Candida albicans
d)Varicella zoster virus
type 1 herpes simplex
Patient presents w/ulcerative lesions on genitals & perianal areas:

a)type 1 herpes simplex
b)type 2 herpes simplex
c)Candida albicans
d)Varicella zoster virus
type 2 herpes simplex
Tx for Pneumocystis Carinii Pneumonia is?
Bactrim (antibiotic)

Acetaminophen

Bronchodilators
The major problem with diagnostic tests that detect HIV-specific antibodies is there is a median delay of ____ after infection before the antibodies can be detected which creates a ____ period:

a) 1-3 weeks
b) 2 weeks
c) 1-3 months
d) 2 months
2 months

window
During the ___ ___ an infected individual will not test HIV-antibody positive. This window period if for ___ __.
window period
2 months
HIV testing can now be done on oral fluids & ___ & newer tests allow rapid 20 minute ___ tests for HIV in an office. These tests are ___ reliable.
urine
blood

highly
All infants born to HIV-infected mothers will be positive on the HIV-antibody test.

true or false
true
All infants born to HIV-infected mothers will be positive on the HIV-antibody test because maternal antibodies cross the ___ barrier (verticle). These antibodies remain present in the infant for up to ___ months.
placental
18 months
The progression of HIV infection is monitored by ___ which is the marker for decreased ___ fxn. However, laboratory tests that measure ___ activity allow better assessment of the clinical status & disease progression. These lab tests count the number of particles in a sample of blood called the ___ ___.
CD4 T cell counts
immune
viral

viral load
Collaborative management of HIV Pt's focuses on:

a) monitoring disease progression
b) immune fxn
c) initiating & monitoring antiretroviral drug therapy
d) preventing opportunistic diseases
e) detecting & tx of opportunistic disease
f) managing symptoms of opportunistic disease
g) preventing & decreasing the complications of tx.
all are correct
Two types of tests commonly used to test for HIV infxn is a enzyme-linked immunosuppresant assay (ELISA, ELA) & a polymerase chain reaction test (PCR). If the individual tests positive a ___ blot test is used to confirm.
western blot test confirms HIV
For infants born to HIV-positive mothers, serologic test (PCR) are performed within ___ of birth & repeated in ___ months and again in ___ months. After ___ consecutive negative results w/ ELISA the child is considered free of HIV.
48 hours

3 months

6 months

2
CD4 T cell count monitors ____ of the disease & viral load measures the ___ ___ in the body allowing for better assessment of clinical status & disease progression.
the progression

viral activity
In addition to CD4 T & viral load diagnostic testing, other lab values that may be abnormal in HIV/AIDS Pt's are:

name 5
Low wbc

Low neutrophil/neutropenia

Low platelet/thrombocytopenia

Low rbc, hgb or hct (indicating anemia)

Altered liver fxn tests
With advanced (late) chronic infxn CD4 T count will be < ___ & Pt will exhibit confusion, vacant starring, disorientation, seizures, incontinence, hemiparesis, blindness, delerium, & coma. Albumin & choloesterol levels ___ & Pt will have anemia & neutropenia. When albumin is low ___ is present.
50

drop

edema
Altered liver fxn tests may be due to what 2 things?
May be due to some of the anti-viral drugs

May be due to HepB or HepC
There is no cure for HIV/AIDS & the Pharmacology-National Institutes of Health have published guidelines on when to initiate treatment. The major goal is to prevent ___ ___.

ART-antiretroviral therapy:

The action of AZT, ZDV, & Retrovir is ___ ___ ___(very expensive) & Interferon which ___ ___ ___ ___.
drug resistance

Blocks HIV replication

Boosts the immune system
Management of Pt's w/ HIV/AIDS is:

recognize there is NO cure

follow guidelines on when to initiate treatment

prevent drug resistance (Major goal)

ART (antiretroviral therapy)

Block HIV replication
– AZT, ZDV, Retrovir (very expensive)

Boost immune system
– Interferon

Combat opportunistic infections

Early diagnosis & pharmacological intervention

Nutritional status-dietary supplements

Infection control-prevent infections in the patient & prevent spread to others

Managed at home

Managed in hospital

Managed in group homes/colonies

Health care team includes:
– Home health
– Hospice
– Social worker
– Case manager
– Family
– Patient
all are correct
Goals for Nursing Care are:

Keep ___ load as low as possible for as long as possible

Maintain or restore functioning of ___ system

Improve Pt’s quality of ___

Reduce ____ disease, disability & deaths

NDXs & interventions will change based on ____ of illness
viral

immune

Life

HIV-related

stage
Goal of nursing interventions:

Adhere to ___ regimens

Promote healthy ____

Prevent ____ disease

Protect ____ from HIV

Maintain/develop healthy, supportive _____

Maintain ADLs & ____

Consider issues related to spirituality, disease and ___
drug

lifestyle

opportunistic

others

relationships

productivity

death
Infection control guidelines are to ___ hands with direct care & when preparing foods & wear latex ____ with blood & body fluids. Always wear ___Rubber gloves for cleaning up spilled body fluids & use 1 part bleach to ___ parts water & use a new solution ___. Keep port of entry cuts/abrasions ___ & take all needle precautions. Pt’s dishes should be washed w/hot, ___ water & separating dishes
is ___. Do NOT share personal items such as Razors & Toothbrushes & wash clothes in regular manner. Avoid exposure to active infection.
wash
gloves

Rubber
10
q 24 hours

covered

soapy
uneccessary
Things to avoid introducing infection to an immune compromised patient:

Raw or ____ meat, poultry, fish, shellfish, or eggs

Wash ____ between food preparation

Do not mix raw food or juices with ____ foods

Use ____ cutting boards

Wash fruit and vegetables

In late stages: avoid fresh ___
undercooked

utensils

other

plastic

flowers
Reducing risks for drug users includes abstinence & not sharing injecting equipment such as needles, syringes, cookers, & cotton. Access sterile equipment from community resources if available such as needle & syringe exchange programs often found in larger cities. If you must reuse equipment thoroughly clean equipment by rinsing ___ with tap H2O, fill syringe w/full strength ___ & shake for ___ seconds & then squirt out. Rinse equipment twice with tap H2O & do not share ___ or rinse water.
twice
bleach
30

bleach
Reducing risks for Prenatal transmission includes:

Prevent HIV in mother.

If Pt is infected, discuss modes of transmission, reproductive desires, & not to ____. Discuss early tx with ZDV, AZT or Retrovir to ____ rate of transmission to the child.
breastfeed

decrease
Clinical manifestations that need to be reported immediately:

Change in LOC
HA with severe ___

Visual changes such as black areas, floaters

SOB related to ____, not relieved with short rest periods

N/V w/____ pain & dehydration

Bleeding from ___

Flank pain w/fever
Inablity to void >6 hrs

New onset of weakness, numbness, difficulty speaking

Chest pain, not r/t cough

Seizures, Rash w/fever

New oral lesions with fever

Severe depression, anxiety, hallucinations, delusions

Suicidal tendency

Threat of harm to others

Jaundice
N/V

activity

abdominal
rectum
Complications to report report within 24 hours:

New HA, constant HA not relieved w/ASA or Tylenol

HA w/fever, congestion, cough

Burning, itching, discharge from eyes

Productive cough

Vomiting 2-3 times per day

Vomiting accompanied by fever

Watery diarrhea > 6 times per day

Painful urination, hematuria, urethral discharge

Rash-widespread, itchy

Difficulty eating related to mouth lesions

Vaginal discharge, pain or itching
Complications to report report within 24 hours:

New HA, constant HA not relieved w/ASA or Tylenol

HA w/fever, congestion, cough

Burning, itching, discharge from eyes

Productive cough

Vomiting 2-3 times per day

Vomiting accompanied by fever

Watery diarrhea > 6 times per day

Painful urination, hematuria, urethral discharge

Rash-widespread, itchy

Difficulty eating related to mouth lesions

Vaginal discharge, pain or itching
Pediatric considerations include four populations effected:

Exposed in utero via infected mother—”___ transmission”

Maternal transmission during delivery or breastfeeding ”____ transmission”

Children who have received ___ products (hemophilia)

Adolescents through sexual activity and ___high risk behaviors
vertical

horizontal

blood

high
Manifestations in children:

All children:
– Failure to ____
– Hepatosplenomegaly
– Chronic interstitial ___

Infants:
– Oral ___
– Respiratory distress

Toddlers:
– Parotitis
– Lymphadenopathy
– Recurrent ___infxns
– Neurologic disease
– Developmental ___
thrive
pneumonitis

candida

bacterial
abnormalities
Nursing care for children w/ HIV/AIDS includes the Educator, ___ provider, case ___, advocate, emotional & ethical concerns for ___ & confidentiality.
care

manager

nurses
Perinatal transmission:
– Mother may ___
– Grandparent ___
– Surrogate ___
– Foster ___

Health care team includes:
– Social ___
– Home ___
– Nutrition ____
– School ___
die
support
parents
care

worker
health
services
nurse
Children with HIV/AIDS should not go to day care.

true or false?
true

children w/ HIV/AIDS are subject to opportunistic infections & diseases
Nurses can help individuals assess risks by asking 4 basic questions. What are they?
1- have you ever had a blood transfusion or used clotting factors; if so-was it before 1985?

2- have you ever shared needles or other injecting equip w/ another person

3- have you ever had a sexual exp. in which your penis, vagina, rectum, or mouth came in contact with same?

4- Have you ever had an STD?
The most effective prevention tools for HIV are?
education & behavior changes
Use only condoms that are made out of ___ or ____. "Natural Skin" condoms have ___ that are large enough for HIV to penetrate.
latex
polyurethane

pores
Lubricants used with condoms should be ___ ___ b/c ___ based lubricants increase risk of tearing or breaking.
water soluble

oil
Pretest counseling includes determining the Pt's risk factors & when the last risk occured, providing education to decrease risk of ___, problems related to the delay between infection & an accurate test, repeated testing at intervals for up to ___ w/ea possible exposure, possibility of ____ tests, how a positive test is for HIV & not AIDS & assess Pt's support systems.
exposure
6 months
false-negative
Post test counseling when the Pt is found negative for HIV is to reinforce pretest counceling & ___ education & remind the Pt that the test needs to be repeated at intervals for up to ___ ___ after the most recent exposure risk. If the Pt tested positive understand they may be in shock & not hear what you say. Evaluate ___ risk, determine need to test others who have had risky contact w/ the Pt, discuss retesting to ___, encourage optimism about effective tx available, review health habits to improve immune system, arrange meetings for Pt to meet w/ other HIV people, discuss test is positive for HIV & doesn't mean Pt has AIDS, educate to prevent infections, & other modes of transmission.
prevention
6 months

suicide
verify
Nursing assessment in HIV disease should focus on 3 things. What are they?
1- early detection of symptoms

2- opportunistic diseases

3- psychosocial problems
Resistance to ____ drugs is a major problem in tx of HIV infxn. To decrease risk of developing resistance the Pt should take at least __ different antiretroviral drugs at a time, know what you are taking & how to take them, take full dose on schedule, take all drugs prescribed, do not take other meds without discussion w/Dr. & pharmacist, understand the goal is to reduce the ___ ___, comply w/ lab testing, understand that if viral load becomes so low it is not detected that this does not mean you are no longer able to transmit the disease.
antiretroviral
3
viral load
What is ART?
Antiretroviral drug Therapy
Why is it critical that HIV Pt's do not miss a dose of medication?
missing a dose can lead to viral mutations that allow HIV to become resistant to the drug
Pneumocystis carinii pneumonia (PCP)is caused by a common ___ that most people have been exposed to since age 3 & a healthy immune system prevents from becoming a disease. HIV Pt's are at risk for PCP when CD$ T count is less than ___. Trimethoprim-sulfamethoaxole antibiotics such as ___, NebuPent, Cleocin, & Mepron, for PCP are a part of prevention protocol for HIV Pt's. Common signs are SOB, fever, night sweats, fatigue & weight loss. PCP is frequently accompanied by ___ ___ infxn & non-productive cough that can lead to a productive cough. Acute cases require ____ nursing interventions.
fungus
200
Bactrim
oropharyngeal candidal
intensive
Cryptococcal menigitis is a ___ infxn that causes disease in 6-10% of all HIV Pt's & when it causes ___ the symptoms are vague & include a waxing/waning period of fever, HA,& malaise followed w/N & V, altered mental status, stiff neck, visual disturbances, papilledema, ataxia, seizures, aphasia & sensitivity to light. Nursing care includes providing ___ such as Fungizone, Diflucan, & Sporanox, for acute episodes & ensuring Pt's understand the need for continued ___ ___ after episodes have resolved. Without maintenance therapy as suggested, 50-75% of Pt's w/ history of this infxn will relapse with a ___. Nursing interventions also include freq. ___ ___to detect subtle changes.
yeast
menigitis

drugs
maintenance therapy
year

neuro assessments
Cytomegalovirus retinitis (CMV) causes esophagitis, colitis, pneumonia, & neuro problems to include ____. This generally does not appear until there is ___ immune suppression. Signs of retinal disease include decreased vision, black spots, & floaters. Medications include Cytovene, Foscavir, Vistide, Valcyte & Vitrisert. Untreated will lead to ___ & periodic eye examinations are recommended. The goal is to ___ loss of vision but there may be progression despite tx. Nursing interventions include assistance to cope by altering ___, referrals for agencies providing assistance for vision-impaired Pt's, teaching about ___ devices, & providing support for loss-related grief.
retinitis
severe
blindness
prevent
ADL's
assisstive
Mycobacterium avium complex (MAC) is a mycobacterial disease causing ___ problems for HIV Pt's. It also may cause widely disseminated infxn by invading the blood, spleen, lymph nodes, bone marrow, & liver. S/S are chronic ___ & ABD pain, fever, malaise, weight loss, anemia, neutropenia, malabsorbtion, & jaundice. Tx is ___, Cipro, Rifadin, & Zithromax. Focus of nursing care is is to teach ___ ___ ___ & help Pt's deal w/problems caused by ___.
GI
diarrhea
Biaxin
complicated drug therapy
diarrhea
Kaposi's sarcoma (KS) is a common ___ seen in HIV Pt's especially those who were infected as a result of unprotected ___. It is thought to be caused by a sexually transmitted human herpes virus. It affects many or all organ systems but frequently seen on skin & oral mucosa as flat or raised, various shapes, sizes, colors, & not usually ___. These generally do not cause additional problems unless they occur in __ or __ causing bleeding & respiratory distress. Care is ___. Tx with ART can resolve lesions. Drugs include ____ & chemotherapy. Nurses help by providing infm. about tx options, assist w/ decision making, & support.
neoplasm
MSM
painful

GI
lungs

palliative
Interferon
AIDS dementia complex is caused by HIV infxn of the ___ or HIV-related ___ problems. Tx is ART. Nursing focus is on ___, encourage self care, prevention of ___, & a major emphasis on providing support to family & sig. others.
brain
CNS

safety
confusion
Transmission of HIV from an infected person to another person occurs:

a) most commonly from sexual contact
b) in all infants born to women w/HIV
c) only when viral load is high
d) frequently in HCP w/ needle stick exposures
most commonly from sexual contact
Following infxn w/ HIV the immune system is impaired predominantly by ____ & destruction of ___.
infection

CD4 T cells
Untreated HIV infection can remain in the early chronic stage for a decade or more.

or false?
true
Screening for HIV infection generally involves:

a) lab analysis of blood to detect HIV antigen
b) electrophoretic analysis of HIV antigen in plasma
c) lab analysis of blood to detect HIV antibodies
d) analysis of lymph tissues for presence of HIV RNA
lab analysis of blood to detect HIV antibodies
Antiretroviral drugs are used to:

a) cure acute HIV infxn
b) treat opportunistic disease
c) decrease viral RNA levels
d) suppliment radiation & surgery
decrease viral RNA levels
Opportunistic diseases in HIV infection:

a) usally occur one at a time
b) are generally slow to develop & progress
c) occurr in the presence of immuniosuppresion
d) are curable w/ proper pharmacologic interventions
occurr in the presence of immuniosuppresion
Which of the following statements about the metabolic side effects of ART is false?

a) they are an annoying set of symptoms that are untimately harmless
b) changes in the body shape & size are often difficult for Pt's to accept
c) Lipid abnormalities include increases of triglycerides & decreases high-density cholesterol
d) insulin resistance & hyperlipiemia can be tx w/drugs to control blood glucose & decrease cholesterol
a) they are an annoying set of symptoms that are untimately harmless
Which of the following eliminates the risk of transmission of HIV?

a) using sterile equip to inject drugs
b) cleaning equip to inject drugs
c) taking zidovudine (AZT, ZDV, Retrovir) during pregnancy
d) using latex barriers to cover genitals during sexual contact
a) using sterile equip to inject drugs
Of the following, which is the most appropriate nursing intervention to help an HIV Pt adhere to the tx regimen?

a) give Pt a videotape & brochure to read at home
b) volunteer to set up a drug pill box for a week at a time
c) inform Pt that the side effects of the drugs are bad but they go away after a while
d) assess the Pt's lifestyle & find adherence cues that fit into Pt's lifestyle
c) inform Pt that the side effects of the drugs are bad but they go away after a while
A 3 yrs old child has shown normal growth & development desppite the occurance of frequent colds. In talking w/ concerned parents the nurse should:

a) reassure parents this is typical for this age group due to the fact the immune system is not fully developed until 6 or 7 yrs of age
b) advise parents they need to have the childs B-T cell lymphocyte counts checked immediatly
c) advise parents their child needs to have a PPD test as soon as possible
d) instruct the parents that if child continues to have frequent colds a chest x-ray needs to be done to assess the lungs & thymus size
a) reassure parents this is typical for this age group due to the fact the immune system is not fully developed until 6 or 7 yrs of age
The nurse should advise parents of child w/severe combined immunodeficiency disease not to have the child immunized with:

a) varicella
b) Haemophillus B conjugate
c) Diptheria, pertussis & tetanus
d) Hepatovalent pneumococcal
a) varicella
A pregnant woman who w/HIV is administered zidovudine (AZT). She asks the nurse why she received this drug & the nurse would respond:

a) to prevent transmission of the virus to your infant
b) to treat your HIV infxn
c) AZT supplements your other antiviral meds to prevent post-partal infxns
d) b/c the other antiviral meds are teratogenic
a) to prevent transmission of the virus to your infant
A mother expresses concern regarding allergies in her toddler who has been diagnosed w/several food allergies. In teaching parents about food allergies the nurse would explain to parents the food allergy most frequently assoc. w/ anaphylaxix in the U.S. is:

a) shellfish
b) peanuts
c) eggs
d) milk
b) peanuts
Routinely given to pregnant women who are HIV-positive to prevent perinatal transmission:

a) Hydrea (Hydroxyurea)
b) Viracept (nelfinavir)
c) AZT (zidovudine)
d) Norvir (Ritonavir)
c) AZT (zidovudine)
Protease inhibitors used to fight HIV infxn's (check all that apply)

a) Hydrea (Hydroxyurea)
b) Viracept (nelfinavir)
c) AZT (zidovudine)
d) Norvir (Ritonavir)
b) Viracept (nelfinavir)

d) Norvir (Ritonavir)
A ribo reductase inhibitor & an antineoplastic drug used in combination w/reverse transcriptase inhibitors to treat HIV infections:reverse transcriptase inhibitor

a) Hydrea (Hydroxyurea)
b) Viracept (nelfinavir)
c) AZT (zidovudine)
d) Norvir (Ritonavir)
a) Hydrea (Hydroxyurea)