Exam 4 - Study Guide PDF

Chapter -- HIV 1. Risk factor: a. Male b. Homosexual c. Healthcare workers d. Pregnancy i. Mom passes to baby through vaginal birth 2. Viral -- Retrovirus e. Needs host f. RNA to DNA g. CD4 cells attacked - ii. By billions every day...

Chapter -- HIV 1. Risk factor: a. Male b. Homosexual c. Healthcare workers d. Pregnancy i. Mom passes to baby through vaginal birth 2. Viral -- Retrovirus e. Needs host f. RNA to DNA g. CD4 cells attacked - ii. By billions every day h. Once virus is into cell; DNA; replicates 3. S/S i. 2-4 wks. after transmission -flu- like symptoms iii. Fever iv. Sweats v. malaise vi. Swollen nodes j. Progression of HIV s/s vii. Diarrhea viii. Flush in mouth -- immunosuppressed makes way for more cooties ix. Flare up of shingles x. Kaposi Sarcoma; lesions on skin xi. CD4 goes down 1. Worry about [pneumonia ] xii. Wasting syndrome -- loss of weight 4. Development of pneumonia (CARE) k. Fluid intake: 3000ml/ day xiii. Loosen up sputum l. Raise HOB -- 45 degrees xiv. Lung expansion m. Incentive spirometer / Cough/ Deep breath n. Sputum Culture xv. For abx o. Vital signs 5. Diagnostic p. CD4 cells -- 400 to 800 (normal value) xvi. Between 400 to 200 -- HIV stage xvii. Below 200 -- AIDS q. ELISA -- only if antigens are present xviii. Lets you know if they were exposed to HIV r. Western blot \*← xix. Definitive test for HIV; how its confirmed xx. Weeks until test comes back xxi. No cure for HIV 6. Treatment: focus on progression s. Antiretrovirals xxii. E.g. -vir drugs t. Patients that have AIDS xxiii. Teach prevention xxiv. Flu-like symptoms xxv. Prep for sex 2. Prophylactic meds, e.g. PREP xxvi. Needle users 3. New needles 4. Don't share xxvii. Lifelong meds; must remain 7. Emotional support for HIV u. Talk to patients but WEAR GOWN for: xxviii. Suctioning xxix. Diaper changes xxx. Speaking with patient Chapter - Organ Transplants 1. Type of donors: LIVE a. Tissue typing: Same blood type, not necessary the RH type i. Loved ones b. Transplant rejection: ii. Hyperacute -- within 24 hrs. of recveing organ 1. Body creates antigens and rejects organ 2. Must remove immediately iii. Acute -- with 6 mos. after transplant 3. Recipient lymphocytes attack the organ 4. TX: Placed on steroids and immunosuppressants a. Watch for infection: i. Safe food handling ii. High protein/High caloric meals iii. May be NPO in hospital for a few days iv. Liver failure: 5. AST, ALT elevated 6. Jaundice v. Kidney 7. Weight gain 8. Oliguria 9. Elevated BUN/Creatinine c. Chronic -- within a few years; irreversible vi. May see scarring 2. Immunosuppressant therapy: Life-long d. Corticosteroids added w/ immunosuppressants vii. Monitor for s/s of corticosteroids e. Tacrolimus / Myfortics viii. No grapefruit juice 3. Graft vs Host f. The organ rejects the recipient ix. Donors T-cells attacks the recipient 10. Liver, GI transplants x. Typically happens 30 days after transplant g. s/s: itching, rash, marks and sores on palms and soles of feet, elevated WBCs h. TX: xi. Immunosuppressant therapy