Stages of HIV Infection and Their Symptoms

• Stages of HIV and their symptoms vary depending on the progression of the virus in the body.

Stage I: Acute HIV Infection

• This stage begins with the initial infection and the body's acute response.
• Typically short, it can progress to stage II, chronic HIV infection.
• Most adults develop an acute infection reaction within 4 weeks of being infected.
• Symptoms resemble any viral infection, including fever, sore throat, rash, night sweats, chills, headache, and muscle aches.
• Infected adults may not recognize these generalized symptoms as HIV.
• Characterized by high viral numbers in the blood and genital tract, increasing the risk of sexual transmission.
• The progression from stage I to stage III can range from months to years, influenced by how HIV was acquired.

Stage II: Chronic HIV Infection

• Adults often seek medical care, get diagnosed, and start drug therapy after seroconversion.
• Drug therapy suppresses viral reproduction, protecting immunity.
• Some patients may achieve undetectable levels of the active virus and can live for decades.
• HIV RNA quantification laboratory tests, or HIV viral load tests, may be performed which is more accurate in determining the course of the disorder than CD4 T-cell counts.
• Results provide a basis for prognosis, disease progression, and response to antiviral treatment.
• Specific symptoms may be absent, but HIV remains active, reproducing at low levels, with a gradual decline in CD4+ T cell count.

Stage III: Acquired Immunodeficiency Syndrome (AIDS)

• Individuals who don't receive treatment progress to this severe stage as more CD4+ T cells are infected and cannot function.
• The CD4+ T-cell count decreases, leading to impaired immunity.
• Leukopenia is decreased numbers of circulating white blood cells.
• Lymphocytopenia indicated decreased numbers of lymphocytes.
• Production of incomplete and nonfunctional antibodies, along with abnormally functioning macrophages, occurs.
• Diagnosis requires HIV positivity and a CD4+ T-cell count of less than 200, or specific opportunistic infections (OIs).
• AIDS-defining conditions include Candidiasis, invasive cervical cancer, Cryptococcosis, Cytomegalovirus, Kaposi sarcoma, and Interstitial cryptosporidiosis (chronic).
• Additional conditions are Mycobacterium avium complex, Non-Hodgkin lymphoma (certain types), Pneumocystis jirovecii pneumonia, and Toxoplasmosis.
• Further AIDS symptoms are Tuberculosis, rapid weight loss, pneumonia, recurring fever or night sweats, swollen lymph glands, diarrhea (lasting over a week), and sores or lesions on the mouth, anus, or genitals.
• Memory loss, depression, and neurological disorders may also arise.

Preventing HIV Spread

• Wash hands thoroughly with antimicrobial soap before eating or drinking, after touching pets or shaking hands, upon returning home, and after using the toilet.
• Avoid crowds and large gatherings.
• Use an N95 or KN95 mask in crowded areas.
• Refrain from gardening or handling houseplants.
• Take prescribed medications precisely as directed.
• Avoid traveling to areas with poor sanitation.
• Monitor temperature daily and whenever feeling unwell.
• Immediately report symptoms such as temperature above 100°F (37.8°C), persistent cough, pus or foul-smelling discharge, skin lesions, mouth ulcers, or cloudy/foul-smelling urine, or pain on urination.
• Never share razors, toothbrushes, toothpaste, washcloths, or deodorant sticks.
• Bathe daily using an antimicrobial soap, washing armpits, groin, genitals, and anal area twice daily if total bathing isn’t possible.
• Brush and floss teeth daily for at least 2 minutes.
• Clean toothbrushes with hot water after brushing and allow to air dry; replace toothbrushes every 3 months or after illness.
• Visit the dentist every 6 months for checkups.
• Avoid consuming undercooked meat, fish, and eggs.
• Wash dishes, glasses, silverware, and cookware thoroughly after each use, using hot, soapy water or a dishwasher.
• Avoid changing pet litter boxes, but if unavoidable, use gloves and wash hands immediately afterward.
• Do not keep turtles or reptiles as pets, and avoid feeding pets raw or undercooked meat.

Caring for Immunocompromised Patients

• Place the patient in a private room to control factors such as personnel and cross contamination.
• Limit the number of personnel entering the room.
• Use evidence-based handwashing techniques or alcohol-based hand rubs before and after touching patients or their belongings.
• Restrict visitors to healthy adults.
• Ensure the patient's room and bathroom are cleaned daily.
• Dedicate equipment for the patient's use only, such as blood pressure cuffs, stethoscopes, and thermometers.
• Avoid using supplies from common areas.
• Maintain a dedicated box of disposable gloves in the room and do not share it.
• Use individually wrapped supplies and single-use utensils when possible.
• Monitor vital signs every 4 hours or more frequently as needed.
• Inspect the mouth, skin, and mucous membranes for fissures and abscesses at least once per shift.
• Inspect open areas like IV sites every 4 hours for infection signs.
• Change gauze-containing wound dressings daily.
• Obtain specimens from suspicious areas for culture and promptly notify the primary health care provider.
• Encourage coughing and deep-breathing exercises, and use strict aseptic technique for all invasive procedures.
• Monitor daily complete blood count (CBC) with differential and absolute neutrophil count (ANC).
• Inspect the mouth every shift for lesions and mucosal breakdown, and assess the lungs every 8 hours for crackles, wheezes, and reduced breath sounds.

Neutropenic Precautions

• For patients with a white blood cell (WBC) count of 2.5, implement neutropenic precautions to protect them until their WBC count recovers.
• Use strict hand hygiene and personal protective equipment such as masks and gowns, avoiding fresh flowers or plants in the room
• The patient should be placed on contact/airborne isolation precautions.
• Oral care supplies should be single-use and disposable, and high-risk procedures such as injections should be avoided when possible.
• Stress ways cross-contamination can occur and how to avoid it, such as private rooms whenever possible
• Use handwashing or hand rubs before touching the patient or belongings.
• Ensure the patient's room and bathroom are cleaned daily.
• Monitor vital signs, including temperature, every 4 hours.
• Skin and mucous membranes need inspection for fissures and abscesses per facility policy
• Look for IV site infection in addition to standard assessments
• Change wound dressings as ordered and use sterile technique for procedures
• Notify the health care provide, encourage activity, and dedicate equipment for the patient

Related Infections of HIV/AIDS

• Candidiasis causes difficulty swallowing and mouth pain.
• Invasive Cervical cancer can occur.
• Cryptococcosis is a fungal infection.
• Cytomegalovirus can target various body systems.
• Kaposi sarcoma presents pink, red, purple, or brown papular lesions with yellow halos.
• Recognizing KS and changes in lesions is essential.
• Chronic Interstitial cryptosporidiosis is caused by protozoan parasites in the intestines
• Mycobacterium Avium complex is bacterial in nature
• Non-Hodgkin lymphoma is white blood cell in nature
• Pneumocystis Jirovecii Pneumonia are wet lung infections
• Toxoplasmosis manifests changes in mental status, headache, fever, and neurological deficits and cause seizures
• Oral Candidiasis and Esophageal Lesions require antifungal medication administration
• HIV-associated Nephropathy rapidly deteriorates kidney function and result in proteinuria
• Monitor GFR, report any decrease to the health care provider
• Elevated metabolic abnormalities cause hyperlipidemia and hyperglycemia

Early HIV Symptoms

• Cough, fever, sore throat, rash, night sweats, chills, headache, and muscle aches (similar to other viruses)
• Weakness and nausea
• GI issues such as vomiting, diarrhea, and dysphagia
• Forgetfulness
• Skin changes with lesions
• Shortness of breath
• Vision changes
• Excessive perspiration
• Lymphadenopathy with swollen glands and nodes
• Weight Loss

Discharge Instructions (HIV/AIDS)

• Follow standard precautions and wash your hands
• Use clean gloves to address waste in the restroom or when doing laundry
• Never share hygiene products with those around you
• Wash all eating products with soap and water at a high temperature
• Use a disinfectant 1/4 cup bleach with 1 gallon of water will do
• Wear gloves and clean feces, urine, or any bodily fluid with the disinfectant
• Wash unsoiled clothing and linen with regular detergent
• Wear gloves if any blood or bodily fluid is on the respective clothing, also remove all waste and add to appropriate disposal
• Dispose of liquid waste in toilet
• Solidi fluid or needles should always be labelled and sealed
• Write down your questions
• Be preemptive, know that you can easier infections
• Be transparent about your health conditions
• Use condoms and wash your hands

Medications to Treat HIV/AIDS

• Truvada (emtricitabine and tenofovir disoproxil fumarate) interferes with HIV reverse transcriptase and prevents replication for HIV-1 infection or pre-exposure prophylaxis (PrEP).
• Contraindications are hypersensitivity, severe renal impairment, untreated hepatitis B.
• Atazanavir (Reyataz) is a protease inhibitor that prevents viral replication as a part of HAART to address hepatic impairment and other existing conditions.
• Ritonavir slows viral replication and can be used within HAART with other protease inhibitors.
• Cabenuva (cabotegravir and rilpivirine) blocks HIV replication injectable regimen for HIV and addresses hepatitis B, and potential headache and fever.

CD4 Counts and Viral Load in HIV/AIDS

• Higher level tests occur during Stage II such as HIV RNA quantification laboratory and viral load tests in determining disorder progression.
• Stage III will present adults who have +HIV results and CD4 T-cell less than 200
• Healthy adults consist of 800-1000 CD4 T-cell amount while progressing it declines greatly at about 200
• Cell Surface Immunophenotyping consists of the same level of T-cells, HIV stages will also present lower CD4 T-cell
• Viral loads will measure HIV RNA particles in I mL of blood and determine if there is survivability or other factors
• Two tests should be conducted between 2-4 weeks within exposure, after which tests should be performed every 3 to 4 months

What is Rheumatoid Arthritis and how is treated?

• Rheumatoid Arthritis is diagnosed only if the person tests positive with specific disorders.

Nonpharmacologic Therapies for Rheumatoid Arthritis

• Balance activity with rest.
• Joint positioning.
• Apply heat or cold.
• Maintain weight.
• Use ambulatory (gait) aids.
• Structure an exercise program.
• Recommend aquatic exercises for knee issues.
• Remind patients about proper posture.
• Use supportive shoes.
• Heat helps with pain, whereas cold numbs nerves to relieve joint inflammations.
• Cannabis can be used
• Hip resurfacing, minimally-invasive surgeries and Hip Arthroplasty are all surgical tools to treat rheumatoid issues.

Important Note for Rheumatoid Issues

• Inquire regarding military history to treat obesity
• Patients will have some degree of arthritis after sixty years
• Assess the older adult such as their ability to handle hip adduction, pressure marks, and any decrease in their mental stability.
• Always anticipate pain and get them medicated

Medication treatments for RA

• Use Gold Salts
• Hydroxychloroquine
• Sulfasalazine
• Non steroidal anti-inflammatory
• Methotrexate
• Monitor blood and Liver

What happens during a rheumatoid flare up?

• Joint will become progressively worn
• Patient will have morning stiffening
• Muscle atrophy decreases

Key Points for Dexamethasone

• Give the patient only what is prescribed
• Notify about infection, bruising or bad vision if they occur
• Don't give them vaccines
• Do not take if the patient has high blood sugar

Medication such as NSAIDs

• Decrease Gl
• Treat fever
• Reduce inflammation
• Can cause nausea, diarrhea or vomiting
• Avoid Aspirin

System Erythmatossuss non-pharmacology treatments

• Minimize sun exposure
• Set reasonable goals
• Do not take anything with a high-impact

System Erythmatossuss Nursing inventions

• Have the patient check for physical differences like tissue or skin changes
• Assess patient history and drug use
• Check for skin changes, ulcers
• Perform Kidney Ultra-sonography or CT
• Reduce stress and improve overall mental and physical health

What Does SLE Medical treatment look like?

• Use of NSAIDS to target pain and inflammation, also can heal fever and joint issues
• Watch out for GI bleeding, Hepatic symptoms, and fluid retention
• Hydroxy-chloroquine use to target Retinal toxicity and visual issues
• Monoclonal therapy has also been used to target various parts such as the heart