Chapter 85 Hiv/aids Objectives

Front 1

(2) define the following retrovirus, HIV and AIDS

Back 1

Retrovirus is a virus that overtakes the biosynthesis of living cells to duplicate itself.

HIV is human immunodeficienty virus which leads to AIDS or acquired immunodeficiency syndrome.

Front 2

(3) State at least four routes of transmission for HIV

Back 2

Transmission is through infected body fluids: (1) IV drug use/needles, (2) unprotected sex (vaginal, oral, anal), (3) accidental exposure of a health-care worker (4) transmission from an infected pregnant to her fetus and breastfeeding

Front 3

(4) Discuss the critical nature of T cells and B cells in the immune system

Back 3

T cells are lymphocytes that mature in the thymus. B cells originate in bone marrow. T cells and B cells function to fight infection and to produce antibodies for specific immune responses. HIV specifically invades and depletes the helper T4 lymphocytes.

Front 4

(5) Describe how HIV targets and invades CD4 cells

Back 4

HIV will target and deplete the T4 lymphocyte and as a direct consequence of the invasion, the person is at risk for many opportunistic infections (infections that would not affect or cause the normal person to become sick)

Front 5

(6) Differentiate between EIA testing and Western blot assay testing for HIV

Back 5

Blood Test to detect HIV:
EIA testing (enzyme immunoassay and it detects antibodies to HIV proteins. Test saliva and blood; if positive a second test is also used. EIA is less specific and can have a false/positive reaction; less expensive so it is used first.

WESTERN BLOT assay which is done to confirm the presence of antibodies. Expensive and more specific testing. Seropositive testing (confirmation of the existence of the virus) is done using the Western Blot test.

Front 6

(7) State at least eight common signs and symptoms of HIV and at least four signs and symptoms of HIV specific to women

Back 6

HIV can be asymptomatic for many years: S/S of HIV are persistent enlargement of lymph nodes, fever, night sweats, diarrhea, general malaise, anorexia, weight loss, oral thursh, herpes zoster infection or shingles.
S/S of HIV specific to women: recurrent vaginal candidiasis, menstrual abnormalities including amenorrhea, abnormal pap tests, cervical cancer.

Front 7

(8) Name the three classes of antiretroviral drugs used to treat HIV

Back 7

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
abacavir - Ziagen
(ah-back-ah-veer)
+ cannot be used with lamivudine; side effect hypersensitivity. Theraupatic effect is to slow the progression of HIV infection and decreases the occurrence of its sequel. Increases CD4 cell counts and decreases viral load.
RECHALLENGE MAY BE FATAL


didanosine - Videx ddl
(dye-dan-oh-seen)
= monitor for s/s pancreatitis (abdominal pain, nausea, vomiting, increaed amylase and lipase in blood work)
Lamivudine - Epivir 3TC
(la-mi-vyoo-deen)
Stavudine - Zerit d4T
Zidovudine - Retrovir AZT
(zye-doe-vue-deen)
Zaicitabine - HIVID, ddC

Non-nucleoside Reverse Transcriptase Inhibitors
nevirapine - Viramune
(na-veer-a-peen)
efavirenz - Sustiva
delavirdine - Rescriptor

Protease Inhibitors
indinavir - Crixivan
saquinavir - Fortovase
nelfinavir - Viracept
ritonavir - Norvir
amprenavir - Agenerase
lopinavir/ritonavir - Kaletra

Front 8

(9) Define viral load and differentiate between technical diagnoses of HIV and AIDS.

Back 8

HIV-RNA or Viral load is measured to determine how virulent the virus is.
HIV is the virus and once the person gets the virus they become infected with the syndrom called AIDS.

Front 9

(10) Discuss at least six opportunistic infections associated with HIV/AIDs

p. 1290

Back 9

(1) candidiasis - yeast-like fungus that overgrows, causing infections of the mouth (thursh), respiratory tract, and skin.
(2) cryptococcus - yeast-like fungus causing fungus infections of the lung, brain and blood
(3) Cytomegalovirus CMV is one-celled parasitic infection of the gastrointestinal tract causing diarrhea, fever and weight loss
(5) herpes simplex - viral infection causing colitis, pneumonitis, retinitis
(6) pneumocystis carinni pneumonia PCP is one-celled organism causing infection of the lungs, with cough, fever, chest pain and sputum production

Front 10

(11) Identify dietary modifications for the client withi HIV/AIDS

Back 10

x

Front 11

(12) Identify commom medications for the client withi HIV/AIDS

Back 11

Infections/Meds on p. 1289
ANTIVIRAL FOR CHRONIC HERPES SIMPLEX INFECTIONS AND FOR SHINGLES
acylovir - Zovirax

ANTIFUNGAL FOR SEVERE ORAL THURSH, CANDIDA [kan-di-duh]ESOPHAGITIS, VAGINAL CANDIDIASIS
[kan-di-dahy-uh-sis]
fluconazole (Diflucan)

ANTIFUNGAL FOR MILD ORAL THRUSH, VAGINAL CANDIDIASIS, CANDIDA SKIN INFECTIONS
clotrimazole (Mycelex) troche, cream, and vaginal suppositories

ANTIVIRALS TO TREAT CMV RETINITIS (one-celled parasitic infection of the GI-tract s/s wt loss, fever, diarrhea)
cidofovir (Vistide)
[sye-doe-foe-veEER]
foscarnet Na (Foscavir)
ganciclovir Na (Cytovene)
[gan-sye-kloe-vir]

TO TREAT TUBERCULOSIS OR FOR PROPHYLAXIS
isoniazid (INH, Nydrazid)
rifampin (Rifadin)
rifabutin (Mycobutin)
Pyrazinamide (Tebrazid)
ethambutol
streptomycin

Front 12

(12) Page Two
Identify commom medications for the client withi HIV/AIDS

Back 12

To Treat Diarrhea:
Loperamide (Imodium)
(lo-PER-a-mide)

To treat Mycobacterium Avium (MAC) Infections or for M. avium Prophylaxis

azithromycin (Zithromax)
---respiratory infections
clarithromycin (Biaxin)
rifabutin (Mycobutin)
(rifff-a-byoo-tin) side effect:
brown-orange tint of tear/saliva
ethambutol (Myambutol)

To prevent or Treat Pneumocystis carnii Pneumonia

Trimethoprim/sulfamethoxazole (Septra, Bactrim)
dapsone (Avlosulfan)
aerosolized pentamidine (Nebupent)
(PEN-tam-i-deen)
concern for arrhythmias

Front 13

(13) Discuss general client and family teaching for clients with HIV/AIDS, include ages across the lifespan

Back 13

Education ways of transmitting the disease (wear gloves, do not use tooth brushes) Take infection control measures; know the possible side effects of medications; community resources for support