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HIV-AIDS

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cdunbar4's version from 2017-03-07 03:37

HIV timeline

Question Answer
EtiologyRNA virus; replicates inside a living cell, transcribes into DNA, which enters cell nuclei, becoming permanent part of genetic structure
initial infection is in blood (viremia), how is it transmitted?blood, semen, vaginal secretions & breast milk
HIV can remain dormant for8-10 years
Which human cells does HIV infect?human cells with CD4 receptors on them: lymphocytes, monocytes/macrophages, astrocytes, oligodendrocytes
Which cells are destroyed by HIV?CD4 + T cells
Acute phase HIV infection timeline ( if left untreated)1-3 weeks
HIV antibody test becomes positive 3weeks to 3months
Early chronic infection timeline (if left untreated)2 months to 8 years
Intermediate chronic infection timeline (if left untreated)8-10 years
Late chronic infection (AIDS) if left untreated 10-13 years
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Diagnostics

Question Answer
AIDSsyndrome with CD4/T-cell counts <200/ul
Diagnostic tests: ELISApositive HIV antibody on Enzyme-Linked Immunosorbent Assay
Dx test/assay to confirmWestern Blot assay or indirect immunofluorescence assay (at least 2-mo window b/t infection & detection
Other diagnostic testsviral load testing, t4:t8 ratio, antigen assays
Early diseaseCD4+ T cell count drops below 500-600/ul; oral thrush, h/a, aseptic meningitis, peripheral neuropathies, cranial nerve palsy
High risk groupshomosexual men w/ multiple partners; IV drug users; hemophiliacs via contaminated blood; blood transfusion prior to 1985; heterosexual partners of infected persons; children of infected women in utero or at birth
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Opportunistic Infections

Question Answer
pnuemoniagradual worsening chest tightness & SOB; dry nonprod cough; rales; dyspnea, tachypnea; low-grade/high fever; progressive hypoxemia & cyanosis
candida albicans; stomatitis or esophagitis changes in taste sensation; difficulty swallowing; retrosternal pain; white exudate & inflammation of mouth & back of throat
Cryptococcus neoformans (severe, debilitating meningitis)fever, h/a, blurred vision, n/v, stiff neck, mental status changes, seizures
cytomegalovirus-significant factor in morbidity & mortalityfever, malaise; weight loss; lymphadenopathy; retinochoroiditis; visual impairment; colitis; encephalitis, pneumonitis; adrenalitis, hepatitis, disseminated infection
Kaposi's sarcoma-most common malignancysmall, purplish-brown, nonpainful, nonpruritic, palpable lesions occurring on any part of the body; most commonly seen on skin; diagnosed by biopsy
AIDS-dementia complexonset of progressive dementia
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Drug therapy

Question Answer
Preventative measuresavoid IV drug needle-sharing; sex education; standard body fluid precautions
Nucleoside Reverse transcriptase inhibitorsZidovudine; didanosine; zalcitabine; stavudine; lamivudine; combivir
non-nucleoside reverse transcriptase inhibitorsnevirapine; delavirdine; efavirenz
Protease InhibitorsSaquinovir, indinavir, ritonivir, nelfinavir, amprenavir
fusion inhibitorsenfurivitide
integrase strand transfer inhibitorraltegravir
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Nursing Management

Question Answer
No effective cureantiretroviral agents; HAART-Highly Active Antiretroviral Therapy and combo agents
Tx specific to presenting condition: ex Kaposi's sarcomalocal radiation, single agent/combo therapy
Tx for fungal infectionsnystatin swish & swallow, clotrimazole oral solution, amphotericin B w/ or w/o flucytosine
Nutritionhigh protein & calories
Symptomatic relief, comfort measuresmaintain confidentiality, family support systems, minimize social isolation, encourage verbalization of feelings
Are isolation precautions necessary?not needed to enter room to talk to client
Client/family discharge teaching behaviors to prevent transmissionsafe sex, don't share toothbrushes/razors & other potentially blood-contaminated agents
Measures to prevent infectiongood nutrition, hygiene, rest, skin & mouth care, avoid crowds; avoid raw fruits/vegetables or undercooked animals products
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