chapter 20 nursing care of patients with HIV/AIDS – Flashcards
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Acquired immunodeficiency syndrome (AIDS)
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- late phase of a chronic immune function disorder caused by the HIV virus (Human immunodeficiency virus) - fatal if not treated - the cdc specifies the criteria for determining when HIV infection has developed into AIDS
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First Antiretroviral (ARV)
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- first drug was introduced in 1987 and highly active therapy (HAART) began in 1996 - both greatly reduced the death rates from AIDS - as a result the number of people living today with with HIV/AIDS is at the highest level ever
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HIV
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- this disease is no longer characterized as a life ending illness - with ARV therapy, hiv disease is a chronic, sometimes progressive immune disorder
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statistics of knowledge
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- for every 100 people living with HIV - 80 are aware of their infection - 62 are linked to HIV care - 41 stay in HIV care - 36 get antiretrovrial therapy - 28 have a very low amount of the virus in their body
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HIV history
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- first reported by CDC in June 1981 - increased rapidly in the 80's and decreased in later 1990's - more than 1.1 million people are infected with HIV in united states - African Americans are estimated to have an incidence rate of new HIV infections that is EIGHT times higher than of Caucasians
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older adults
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- increasingly contracting HIV - 11% of infections are those aged 50 and older
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HIV pathophysiology
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- destruction of immune cells and limits functions of immune system causing cancer to take over and AIDS results -HIV Viral Particle Taken into Human Cell -Reverse Transcriptase Forces Human Cell to Produce New DNA from Viral RNA -HIV Particles Spread via Lymphoid System HIV Attracted to CD4+ T-lymphocytes -CD4+ T-lymphocytes Function Abnormally ?Busy Replicating More HIV -Impairment of Immune System Results
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2 Strains of HIV
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- HIV-1 is found around the world - HIV- 2 is found mainly in a small area in west Africa - possible to become infected with both strains - same transmission and symptoms
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on teacher power point
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Every 11 Minutes Someone Infected in U.S. -1 in 5 Unaware of Infection Status -Cause of Exposure ?Men Who Have Sex with Men (52%) ?Heterosexual Contact (28%) ?Injection Drug Use (8%) -HIV Increasing in Those Over 50 Years
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HIV progression
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-Initial Infection -Clinical Latency: Symptom-free Period -CD4+ T-lymphocytes Decreasing -Varies: 8 to 12 Years Until Symptoms of HIV -Symptoms of Weakening Immune System -AIDS = Opportunistic Infections/Cancers
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HIV prevention
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- education and prevention is the best way to manage HIV/AIDS epidemic - should begin with older school age child and older adults
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modes of transmission
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- person to person through infected blood - vaginal secretions - semen - breast milk - bodily fluids containing blood - hugging, closed kissing, shaking hands, or sharing eating utensils, towels, or bathroom fixtures does not transmit HIV -transmission with in household from contact with fected blood or body secretions is also rare
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Pre- exposure
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- Prophylaxis with ARV is an effective way to prevent HIV to those who are at high risk - its a daily pill and should be used along with appropriate other HIV transmission precautions
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counseling
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- very important to reduce spread of HIV infection - recommends testing aged 13-64 , pregnant women, and those who have been sexually assaulted - confidential and anonymous
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sexual transmission
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- bodily fluids and mucus membranes - women more susceptible - oral and anal have high rates of transmission for both females and males
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safer sex practice
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- abstaining from sex is the only way to prevent sexual exposure to HIV - when monogamous both partners should be tested - use latex condoms, limit sex partners,
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parenteral transmission
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- do not inject drugs into arms and share needles - if unable to stop infecting drugs and not willing to seek help then use new sterile syringe and needle and clean sites before injecting - if not then boil and cleansed with bleach
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Autologous
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- ones own blood transfusion - when possible is the safest type of blood transfusion to prevent HIV infection - there is reported 1 in 1.8 million units chance of HIV transmission from donated blood that is infected but has not yet had time to develop antibodies
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perinatal transmission
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- pregnant women are recommended for testing - all women who are HIV positive during pregnancy can reduce the risk of perinatal HIV transmission to less than 1% by taking ARV therapy during pregnancy, labor, and delivery - after delivery the mother with HIV is giving AZT for 6 weeks
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health care providers and HIV prevention
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- occupational transmission is rare - performing hand hygeine after contact with bodily fluids, and using safety devices to prevent needle sticks or other injuries reduce the risk of HIV exposure
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Personal protective equipment
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- isolation precautions - know agency and hospital protocol - if exposed wash with soap and water immediately if mucous membranes flush immediately and report to closest emergency room
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HIV signs and symptoms
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- initially no symptoms develop - or acute retrovial syndrome can cause extreme fatigue, headache, fever, lymphadenopathy ( enlarge lymph nodes) diarrhea, sore throat - symptoms usually develop 6 to 12 weeks after HIV transmission and can last a few days to weeks - symptoms are usually mild and not attributed to the HIV infection
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untreated HIV
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- progresses to a symptomatic phase and can greatly impaired the immune system - patient can have shortness of breath, fever, weight loss, fatigue, night sweats, persistent diarrhea, oral or vaginal ulcers, dry skin, lesions, shingles, seizures, dementia
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AIDS
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- is diagnosed when the CD4+ T- lymphocyte is below 200 and their specific signs and symptoms - with HAART few complications are seen anymore such as kaposi's sarcoma a connective tissue tumor are rarley seen anymore
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AIDS wasting syndrome
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- involuntary loss more than 10% of baseline body weight plus chronic weakness or fever or chronic diarrhea for more than 30 days - decrease appetite - oral lesions - altered metabolism - absorption - GI infections - medication side effects - cognition impairment - the constant weight loss is what impairs the function of all body systems from malnourishment
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HIV associate neurocognitive disorder
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- HIV in brain or CNS can vary with degree of severity - HIV associated dementia - mild to severe and include memory impairment, personality changes, hallucinations, leg weakness, loss of balance, slower response
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nursing diagnosis
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- ineffective protection - acute or chronic pain - ineffective coping - risk for injury
