Adult health HIV Awareness and Nursing Interventions

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Questions and Answers

Which of the following practices is NOT recommended for maintaining good hygiene?

Frequent hand washing

Avoiding bathing for extended periods (correct)

Washing dishes in hot water

Using antibacterial soap daily

What is one of the key components to help prevent HIV transmission?

Abstinence or safe sex practices (correct)

Using non-latex condoms exclusively

Increased travel to high-risk areas

Engaging in alcohol consumption

What should be done if an individual suspects symptoms of infection?

Consult only with a non-medical professional

Stop all medications to see if symptoms resolve

Wait for several weeks to see if symptoms improve

Report the symptoms immediately (correct)

Which of the following interventions is suggested to reduce stress?

Engage in regular exercise Signup and view all the answers

What is a significant risk factor for HIV transmission during sexual activity?

Forceful sexual activity Signup and view all the answers

What is the most common opportunistic disease in patients with HIV?

Pneumocystis jiroveci pneumonia Signup and view all the answers

Which symptom is NOT associated with Mycobacterium tuberculosis in HIV patients?

Purple lesions on skin Signup and view all the answers

What nursing intervention is essential to manage anxiety in patients with PCP?

Positioning to facilitate breathing Signup and view all the answers

What defines HIV wasting syndrome?

Loss of 10% of body weight with diarrhea or fever Signup and view all the answers

Which treatment is NOT typically included in the management of HIV wasting?

Recreational drugs Signup and view all the answers

What psychosocial issue is often faced by patients with HIV?

Isolation Signup and view all the answers

Which of the following is NOT a nursing intervention for managing respiratory status in PCP?

Monitoring fluid intake Signup and view all the answers

What is the primary target of the Human Immunodeficiency Virus (HIV)?

T-helper cells (CD4 cells) Signup and view all the answers

In which stage of HIV infection do symptoms typically manifest within 2-4 weeks?

Stage I: Initial infection Signup and view all the answers

Which treatment is recommended for Kaposi's Sarcoma?

Interferon alpha Signup and view all the answers

What is a common characteristic of Stage II in HIV infection?

Prolonged asymptomatic period Signup and view all the answers

When does Acquired Immunodeficiency Syndrome (AIDS) usually occur in terms of CD4 count?

200 cells/mm3 or lower Signup and view all the answers

Which of the following is a proven method of HIV transmission?

Sexual contact Signup and view all the answers

What is the role of nucleic acid tests in diagnosing HIV?

Determining if HIV is present and viral load Signup and view all the answers

What symptom is commonly associated with HIV that involves a persistent increase in lymph nodes?

Lymphadenopathy Signup and view all the answers

What may occur with effective medication during HIV Stage II?

Prolonged asymptomatic period Signup and view all the answers

Which symptom is commonly associated with neurological complications in patients undergoing antiviral treatment?

Headaches Signup and view all the answers

What is the primary treatment for oral candidiasis in patients with HIV?

Nystatin Signup and view all the answers

Which hematologic abnormality indicates a decrease in white blood cells?

Leukopenia Signup and view all the answers

What is a common symptom of AIDS dementia complex (ADC)?

Impaired motor function Signup and view all the answers

Which factor is associated with an increased severity of recurrent herpes simplex outbreaks?

Low CD4 count Signup and view all the answers

What treatment approach is typically used to manage HIV in a patient?

Combination antiretroviral therapy Signup and view all the answers

Which condition is characterized by increased sensitivity to pain or altered sensation?

Peripheral neuropathy Signup and view all the answers

In patients with AIDS, which gastrointestinal complication frequently arises?

Malabsorption Signup and view all the answers

Study Notes

HIV & AIDS Definition

HIV is a human immunodeficiency virus that destroys the immune system, primarily targeting T-helper cells (CD4 cells).
These lymphocytes coordinate the immune system.
HIV is a parasitic, obligate virus, meaning it cannot reproduce on its own and uses the host cell's DNA for replication.
Stage 1 of HIV infection is characterized by flu-like symptoms (rash, night sweats, sore throat) within 2-4 weeks of infection. Viral load rapidly increases during this stage.
Lymphadenopathy (swollen lymph nodes) persists throughout the HIV infection.

AIDS

AIDS is the acquired immunodeficiency syndrome. It occurs when the immune system damage is severe enough that opportunistic diseases appear.
HIV-positive individuals don't transmit the virus by casual contact such as sharing toilets, eating utensils, or swimming pools.

Stage II: Chronic HIV Infection

This stage can last 10 years or more, and is typically asymptomatic.
The number of CD4+ cells progressively decreases over time. Without medications, viral loads continue to increase slowly in this stage.
Individuals in this stage may never progress to Stage III with proper medication use.
During this stage a marked loss of immunity begins.

Stage III: Acquired Immunodeficiency Syndrome

Significant damage is caused by the virus, to the point that opportunistic diseases develop and become evident.
CD4 cell count is 200mm³ or lower.
Viral load is elevated and the disease is very contagious.
Symptoms include fever, chills, diaphoresis (sweating), swollen lymph nodes, weight loss, and weakness.
The average survival time following diagnosis at this stage is 1 1/3 years.

HIV Transmission

Transmission occurs through sexual contact (vaginal, anal, oral) and direct exposure to infected blood or blood products.
Occupational exposure is a mode of transmission.
IV drug use can transmit HIV through sharing needles.
Prenatal and postnatal transmission from an infected mother is possible; through breastfeeding or during delivery.

Diagnostic Tests

Nucleic acid tests determine the presence of HIV and viral load. They provide earlier detection of HIV compared to other tests but are more expensive than other diagnostic tests.
Antigen-antibody tests detect antibodies and antigens for HIV. They are used to detect the presence of HIV antibodies in blood or oral fluid.
HIV antibody tests (oral or blood) or home HIV tests are available; that detect antibodies from the virus.
Complete CD4 counts and CD4% determine disease stage and risk of complications/need for prophylaxis.

HIV Symptoms (S/S)

Recurring, severe night sweats.
Chills/rash
Headaches/sore throat
Unexplained weight loss
Chronic diarrhea
Persistent unexplained fever
Fatigue
Possible paresthesia in extremities
These symptoms occur when CD4 count is less than 500/mm³. This list is not exhaustive.

Neurological Signs/Symptoms

Peripheral neuropathy: Results from antiretroviral agents. Includes numbness, tingling, and loss of proprioception, plus changes in pain sensitivity. (Higher/lower sensitivity)
Headaches
Aseptic meningitis
Cranial nerve palsies
Myopathies
AIDS dementia complex (ADC): Dementia and motor function impairments, and behavioral changes.

Oral Signs/Symptoms

Candidiasis (fungal infection): Treated with antifungal medications (Nystatin, Mycelex Troches, Diflucan).
Hairy Leukoplakia: White thickening on oral mucosa that is difficult to wipe off. Also characterized by fissured edges, and treated with acyclovir (Zovirax).

Genital Signs/Symptoms

Recurrent Herpes simplex 2: The lower the CD4 count, the longer and more severe outbreaks. This can affect both oral and genital areas.
Syphilis: More difficult to eradicate. High risk of developing neurosyphilis. Requires prompt treatment.

Hematologic Signs/Symptoms

Anemia
Leukopenia
Lymphopenia
Neutropenia
Thrombocytopenia
Pancytopenia

Musculoskeletal Signs/Symptoms

Joint or muscle pain
This may result from the disease or medication (e.g., AZT).
CPK (creatine phosphokinase) may rise if caused by medication. If so, the medication may be stopped.
Nonsteroidal anti-inflammatory drugs (NSAIDs) and nonnarcotic analgesics may be prescribed.

GI Signs/Symptoms

Diarrhea
Hepatitis B and C (liver complications)
Malabsorption, especially lactose (digestive problems).
Liver function tests may be abnormal.

HIV Treatment

Antiretroviral therapy (ART) interrupts HIV at different stages of infection. Multiple medications are used.
Combination pills may improve compliance.
Treatment with three or more ART medications slows progression and reduces resistance.
Opportunistic infections are addressed with specific medications and methods.

AIDS-Defining Opportunistic Conditions

Pneumocystis jiroveci pneumonia (PCP): Most common opportunistic infection for HIV patients.
Kaposi's sarcoma: Rare malignancy, characterized by purple lesions on the skin. Treated with interferon alfa and vincristine.
Mycobacterium Tuberculosis: Major cause of death in HIV patients due to drug-resistant strains, characterized by night sweats, fever, weight loss, and hemoptysis (coughing up blood).

HIV Wasting

Loss of lean body mass due to the illness.
Metabolic disturbances prevent effective nutrient use, leading to lean muscle loss.
Increased opportunistic infections and decreased quality of life are complications.
Weight loss of 10% or more, combined with diarrhea, fever or weakness for more than 30 days, is a severe indicator of HIV wasting.

Psychosocial Issues

Fear of abandonment and isolation
Depression
Providing education and realistic goals
Minimizing social isolation
Assisting with grieving processes
Coping strategies such as talk therapy, relaxation, and meditation may be useful.
Mental health assessment/support are part of the treatment process.

HIV Counseling

Pre- and post-test HIV counseling
Counseling resources may include educational materials from 1997.

Nursing Interventions

Nonjudgmental and empathetic care is provided.
Confidentiality and psychosocial needs are prioritized.
Support systems and referrals are provided.
Standard precautions are observed.
Patient beliefs should not interfere with care. Understand modes of transmission.

Education Programs

Practice good hygiene, including frequent handwashing.
Avoid crowded areas and countries with poor sanitation.
Keep the home clean. Avoid colds/flu
Avoid smoking, drug use and alcohol
Stress reduction techniques
Mental health counseling (including relaxation techniques)
Adherence to medication schedules
Frequent follow-up care with lab tests
Report symptoms of infection promptly.
Avoiding exposure to new infectious agents
Safer sex practices.

HIV Prevention

Encouraging early testing for early detection
Home testing availability
Abstinence
Male and female condoms/condom application
Dental dams
Clean needles and injection equipment
Avoiding unsafe sexual practices related to illicit drug use.

AIDS Transmission in Healthcare Settings

Standard precautions
Hand washing and hygiene
Protective barriers (gloves, masks, eye shields, gowns)
Do not recap needles/syringes.
Use universal precautions for all body fluids.
Proper cleaning up of spills.

HIV Testing and Prevention (additional details)

HIV-infected individuals cannot donate organs, blood, or semen. Don't share razors, toothbrushes or other items that may contain blood.
Post-exposure prophylaxis (PEP): Initiate ART within 72 hours (or sooner).
Use of multiple highly active antiretroviral therapy (HAART) medications (3 or more).
Monitor for new onset conditions such as diabetes, hyperglycemia, pancreatitis, elevated cholesterol and liver/kidney issues
Regular monitoring of immune status is important
Serial testing schedule (Immediately, 6 weeks, 3 months, 6 months post-exposure)
Monogamous sexual relationships with a partner who does not know their status should be avoided.
Unwanted sexual intercourse within 72 hours of exposure should be followed by ART for 28 days.

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Description

Test your knowledge on HIV transmission, symptoms, and nursing management strategies. This quiz covers essential practices and interventions needed for patients with HIV, focusing on hygiene, stress reduction, and respiratory care. Gain insights into the psychosocial challenges faced by individuals living with HIV.