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Questions and Answers

What is identified as a major nursing diagnosis related to nutritional status?

  • Impaired nutritional intake associated with decreased oral intake (correct)
  • Fear of social gatherings due to illness
  • Lack of knowledge about healthy eating habits
  • Social isolation due to loss of appetite

    • What can be a potential complication in patients with HIV according to the assessment?

  • Improvement in body image
  • Development of HAND (correct)
  • Temporary weight gain
  • Increased energy levels

    • Which goal is NOT included in the planning for patients with HIV?

  • Increased socialization
  • Promotion of dietary supplements only (correct)
  • Improved nutritional status
  • Absence of complications

    • Which of the following nursing interventions is aimed at managing grief in patients?

    <p>Encouraging expression of emotions and coping mechanisms</p> Signup and view all the answers

    What is an expected patient outcome regarding knowledge for those managing HIV?

    <p>Reports increased understanding of HIV infection and self-management</p> Signup and view all the answers

    What percentage of the global burden of HIV is accounted for by Sub-Saharan Africa?

    <p>70%</p> Signup and view all the answers

    Which population is NOT identified as being at higher risk for HIV infection?

    <p>Individuals with high educational background</p> Signup and view all the answers

    What is a primary method through which HIV is transmitted from mother to child?

    <p>During childbirth or breastfeeding</p> Signup and view all the answers

    Which age group accounts for a significant number of new HIV infections?

    <p>Adolescents and young adults (ages 15-24)</p> Signup and view all the answers

    Which factor is NOT contributing to the spread of HIV in vulnerable populations?

    <p>Access to quality healthcare</p> Signup and view all the answers

    What has contributed to the decline in new infections and AIDS-related deaths since the peak of the epidemic?

    <p>Antiretroviral therapy (ART) and prevention efforts</p> Signup and view all the answers

    In which region have some areas experienced rising numbers of new HIV infections?

    <p>Eastern Europe and Central Asia</p> Signup and view all the answers

    What remains a key preventive measure against HIV transmission?

    <p>Consistent use of condoms</p> Signup and view all the answers

    What is the main purpose of daily usage of Pre-exposure Prophylaxis (PrEP)?

    <p>To prevent HIV acquisition in high-risk individuals</p> Signup and view all the answers

    Which factor significantly increases the risk of HIV transmission?

    <p>Presence of other STIs</p> Signup and view all the answers

    In the HIV pathophysiology, which process occurs after viral entry into host cells?

    <p>Reverse transcription and integration</p> Signup and view all the answers

    What defines the symptomatic stage of HIV infection?

    <p>Presence of flu-like symptoms and high viral load</p> Signup and view all the answers

    What is a key consideration for women with HIV who are considering pregnancy?

    <p>Counseling about potential risks is essential</p> Signup and view all the answers

    Which of the following describes the HIV risk in LGBTQ populations?

    <p>Increased risk alongside specific cultural challenges</p> Signup and view all the answers

    Which protocol is important for healthcare workers to follow in case of a needle-stick injury?

    <p>Needle-stick Injury Protocol (PEP)</p> Signup and view all the answers

    What role do public health campaigns play in HIV prevention?

    <p>They help address misconceptions and promote healthy behaviors</p> Signup and view all the answers

    What is the male-to-female ratio of individuals diagnosed with primary immune deficiencies diseases?

    <p>5 to 1</p> Signup and view all the answers

    Which of the following is NOT a common clinical manifestation of primary immune deficiency diseases?

    <p>Frequent headaches</p> Signup and view all the answers

    What type of testing should be avoided in individuals with primary immune deficiency diseases?

    <p>Live vaccines</p> Signup and view all the answers

    Which of the following is a component of medical management for primary immune deficiency diseases?

    <p>Hematopoietic stem cell transplantation</p> Signup and view all the answers

    Which class of drugs is typically utilized in the pharmacologic therapy of infections for immune-deficient patients?

    <p>Prophylactic drugs</p> Signup and view all the answers

    What is a characteristic of acquired immune deficiency?

    <p>Develops at any age</p> Signup and view all the answers

    When was HIV infection first identified?

    <p>1981</p> Signup and view all the answers

    Which of the following statements about highly active antiretroviral therapy (HAART) is true?

    <p>It has helped in treating opportunistic infections as well</p> Signup and view all the answers

    Which of the following is a significant factor in managing patients with primary immune deficiencies?

    <p>Health teaching and continual monitoring</p> Signup and view all the answers

    Which of the following correctly states the global prevalence of individuals living with HIV?

    <p>Approximately 38 million</p> Signup and view all the answers

    Which of the following is a common respiratory manifestation associated with HIV/AIDS?

    <p>Pneumocystis Pneumonia</p> Signup and view all the answers

    What is a primary goal of nutrition therapy in individuals with HIV?

    <p>Maintaining a balanced diet</p> Signup and view all the answers

    Which neurologic manifestation is characterized by prolonged cognitive decline in HIV patients?

    <p>Progressive Multifocal Leukoencephalopathy</p> Signup and view all the answers

    Which of the following would most likely be included in assessing a patient for HIV-related nursing care?

    <p>History of risky sexual practices or injection drug use</p> Signup and view all the answers

    What is an important aspect of hydration in the management of HIV patients?

    <p>Ensuring adequate fluid intake to prevent dehydration</p> Signup and view all the answers

    Which type of oncologic manifestation is specifically linked to HIV/AIDS?

    <p>Sarcoma</p> Signup and view all the answers

    What role do registered dietitians play in the nutritional therapy of HIV patients?

    <p>They develop nutritional plans in collaboration with healthcare providers.</p> Signup and view all the answers

    What is a key aspect of the nursing process for patients living with HIV/AIDS?

    <p>Evaluating care with a focus on symptom management</p> Signup and view all the answers

    What is the primary goal of antiretroviral therapy (ART) for HIV treatment?

    <p>To suppress the HIV viral load and restore immune function</p> Signup and view all the answers

    Which CD4+ T cell count category defines an individual as having Stage 3: AIDS?

    <p>200-499 cells/mm3</p> Signup and view all the answers

    Which of the following statements about the HIV life cycle is true?

    <p>Stage 1 can be attacked by Fusion Inhibitors.</p> Signup and view all the answers

    What characterizes the Immune Reconstitution Inflammatory Syndrome (IRIS)?

    <p>Rapid reactivation of immune responses leading to exacerbation of infections</p> Signup and view all the answers

    Which class of antiretroviral drugs primarily targets the process of viral replication at an early stage?

    <p>Nucleoside/Nucleotide Reverse Transcriptase Inhibitors</p> Signup and view all the answers

    What does effective antiretroviral therapy (ART) aim to prevent in individuals with HIV?

    <p>Subsequent opportunistic infections and virus transmission</p> Signup and view all the answers

    Which factor contributes to drug resistance in HIV treatment?

    <p>Presence of drug-resistant HIV at initial infection</p> Signup and view all the answers

    What are the common goals of ART in the context of HIV treatment?

    <p>Maximally suppress viral load and restore immune function</p> Signup and view all the answers

    Study Notes

    NCM 105 Infectious, Inflammatory, and Immunologic Problems

    • Course covers infectious, inflammatory, and immunologic problems.

    Primary Immune Deficiencies Diseases

    • Rare inherited disorders impairing the immune system.
    • Commonly diagnosed in infancy.
    • Male-to-female ratio is 5:1.

    Pathophysiology

    • More than 200 forms of PIDDs.
    • More than 270 different genes associated with PIDDs.
    • Prevent the body from developing normal immune responses.

    Clinical Manifestations

    • Multiple infections despite aggressive treatment.
    • Infections with unusual or opportunistic organisms.
    • Failure to thrive or poor growth.
    • Significant family history.

    Assessment and Diagnostic Findings

    • Laboratory tests reveal cellular (T-cell) defects, neutrophil disorders, and complement deficiencies.

    Prevention

    • Avoid live vaccines.
    • Family planning is crucial.
    • Prenatal in-utero testing is recommended.

    Medical Management

    • Hematopoietic stem cell transplantation (HSCT).
    • Gene therapy, leveraging emerging technologies for precise DNA targeting.

    Pharmacologic Therapy

    • Treatment depends on the type and severity of infection.
    • Prophylactic drug treatment.
    • Empiric therapy.
    • Immunoglobulin (Ig) replacement therapy.

    Nursing Management

    • Essential: appropriate hand hygiene and infection prevention precautions.
    • Adherence to institutional policies and procedures related to infection prevention.
    • Continual monitoring of the patient's condition.
    • Education and health teaching.

    Acquired Immune Deficiency

    • Acquired from chemotherapy and pathogens like HIV.

    HIV Infection and AIDS

    • First identified in 1981.
    • First decade focused on recognition and treatment of opportunistic infections.
    • Second decade focused on highly active antiretroviral therapies (HAART).
    • Third decade focused on preventing new infections, adhering to antiretroviral therapy (ART), developing second-generation combination medications, and the need for an effective vaccine.

    Epidemiology

    • Global prevalence: approximately 38 million people worldwide living with HIV.
    • Approximately 1.5 million new infections and 650,000 AIDS-related deaths reported in 2021.
    • Sub-Saharan Africa accounts for about 70% of the global burden of HIV.

    Modes of Transmission

    • Primary routes: unprotected sexual contact, sharing contaminated needles, blood transfusions, mother-to-child transmission (during childbirth or breastfeeding).
    • Vulnerable populations: men who have sex with men (MSM), sex workers, people who inject drugs (PWID), and transgender people.

    Demographic and Social Determinants

    • Gender: Women and young girls disproportionately affected in some regions due to gender-based violence, limited access to healthcare, and economic dependence.
    • Age: Adolescents and young adults (15-24) account for a significant number of new infections, necessitating youth-targeted interventions.
    • Socioeconomic Factors: Poverty, lack of education, stigma, and discrimination limit access to prevention, testing, and treatment services.
    • Decline in new infections and AIDS-related deaths since the peak of the epidemic, due to antiretroviral therapy (ART) and prevention efforts.
    • Geographical variation: some regions experience significant declines, while others, like Eastern Europe and Central Asia, face rising numbers due to limited ART coverage and increased intravenous drug use.

    Prevention Strategies

    • Condom Use: Consistent condom use remains a crucial preventive measure.
    • Pre-exposure Prophylaxis (PrEP): Daily PrEP use by high-risk individuals exhibits significant efficacy in preventing HIV acquisition.
    • Education and Awareness: Public health campaigns, community engagement, and comprehensive sex education are important to address misconceptions and promote healthy behaviors.

    Modes of HIV Transmission

    • Sexual transmission.
    • Blood and blood products.
    • Mother-to-child transmission (MTCT).

    Factors Increasing Transmission Risk

    • Viral load.
    • Presence of other STIs.
    • Unprotected sexual practices.
    • Type of sexual contact.

    Special Considerations for Healthcare Workers

    • Standard precautions.
    • Needle-stick injury protocol (PEP).
    • Family planning considerations for women with HIV.
    • Risks for discordant couples (one partner HIV-positive).
    • Counseling for women considering pregnancy.
    • Findings from the ECHO Trial on contraception and HIV risk.
    • Breastfeeding recommendations for HIV-infected women.

    HIV Prevention in LGBTQ Populations

    • Increased HIV risk among LGBTQ individuals.
    • Social challenges faced by LGBTQ communities.
    • Cultural competence in healthcare.

    Pathophysiology of HIV

    • The Human Immunodeficiency Virus (HIV) targets and destroys the immune system, specifically CD4+ T cells, which have a crucial role in immune defense.

    HIV Life Cycle

    • Seven key drug classes interfere with different stages of the HIV life cycle: binding/attachment, fusion, reverse transcription, replication, assembly, budding, and protease.

    Stages of HIV Infection

    • Primary infection: flu-like symptoms, high viral load.
    • Symptomatic stage: immune system weakens, CD4 count is between 200-499 cells/mm3.
    • AIDS: severe immune suppression, opportunistic infections, and life-threatening complications.

    Assessment Findings

    • Health history.
    • Physical examination.
    • Psychosocial assessment

    HIV Diagnostic Findings

    • HIV testing.
    • CD4+ T cell count.
    • Viral load testing.
    • Other laboratory tests.
    • Genotypic and phenotypic resistance testing.

    Treatment of HIV Infection

    • Antiretroviral therapy (ART) is the cornerstone, focusing on viral suppression, immune system recovery, and prevention of complications.
    • Aims to prolong survival, quality of life, and prevent transmission.

    Antiretroviral Therapy (ART)

    • Over 30 FDA-approved antiretroviral (ARV) drugs, organized into seven classes, are available for HIV treatment.
    • Combination therapy.
    • Goals: reduce HIV-associated morbidity, prolong survival, restore immune function, suppress plasma HIV viral load, and prevent HIV transmission.

    ART Drug Resistance

    • Transmission of drug-resistant HIV during initial infection.
    • Selective drug resistance in patients on nonsuppressive regimens.

    Immune Reconstitution Inflammatory Syndrome (IRIS)

    • Rapid restoration of organism-specific immune responses to infections.
    • Can result in deterioration of a treated infection or new presentation of a subclinical infection.

    Clinical Manifestations

    • Respiratory: Pneumocystis pneumonia, Mycobacterium Avium Complex (MAC), Tuberculosis.
    • Gastrointestinal: Candidiasis, HIV wasting syndrome.
    • Oncologic: Kaposi sarcoma, AIDS-related lymphomas.
    • Neurological: Subcortical neurodegenerative disease, peripheral neuropathy, HIV encephalopathy, Cryptococcus Neoformans, Progressive Multifocal Leukoencephalopathy, other neurological disorders.

    Nutrition Therapy

    • Maintaining a balanced diet, managing symptoms and side effects of medications, supporting immune function, and addressing comorbidities.
    • Crucial for optimizing health outcomes and quality of life.
    • Important for adherence and optimizing treatment responses.

    Goals of Nutrition Therapy

    • Optimization for health outcomes and quality of life.
    • Addresses common nutritional needs, symptoms, comorbidities, and side effects.
    • Nutritional needs are often assessed and managed in collaboration with a dietitian.

    Nursing Process

    • Systematic approach to assessing, diagnosing, planning, implementing, and evaluating care for HIV/AIDS patients.
    • Focus on supporting immune function, managing symptoms, preventing infection, and promoting overall well-being.

    Nursing Assessment

    • Identifying potential risk factors (risky sexual practices and injection drug use).
    • Assessing overall physical and psychological status.
    • Evaluating nutritional status (dietary history, factors interfering with oral intake).

    Nursing Diagnoses

    • Impaired nutritional intake.
    • Social isolation.
    • Grief.
    • Lack of knowledge.

    Collaborative Problems/Potential Complications

    • Adverse effects of medications.
    • Development of HAND (HIV-associated neurocognitive disorder).
    • Body image changes.

    Planning and Goals

    • Patient goals include improved nutritional status, increased socialization, grief expression, increased knowledge of disease prevention, self-care, and absence of complications.

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