NU 170
EXAM 2 STUDY GUIDE
Maternal-Child Nursing
Galen College of Nursing
,IMMUNE DEFICIENCIES
HIV
- Virus “retrovirus”, attacks CD4 T cell “helper T cell”
- HIV vs AIDS
o Based on # of CD4 T cells
o Presence of opportunistic infections
Pneumocystis pneumonia, toxoplasmosis, tuberculosis, histoplasmosis
- Transmission
o Sexual (semen, vaginal secretions), caused by genital, anal or oral sex
o Parenteral (sharing of needles or equipment contaminated with infected blood
o Perinatal (placenta, contact with maternal blood and body fluids during birth,
breast milk
No breastfeeding, on meds while pregnant to decrease viral load
- Prevention
o Condoms, cleaning/sterilizing drug paraphernalia, needle exchange programs,
blood products screened for the HIV antibody, drug therapy for pregnant
mothers, use of standard precautions with HCP
May double glove
- Diagnostics
o Antibody test
Elisa – most inexpensive, if positive they do western blot to confirm
Western Blot – 4 antigens, if pt has 2/4 they are considered positive
• May be negative for up to 6 months
- Classifications
o Progression depends on health, age, risk factors
o A diagnosis of AIDS requires that the person be HIV positive and have either a
CD4+ T cell count of less than 200 or an opportunistic infection
o The person with HIV infection can transmit the virus to others at all stages of
disease, but the recently infected person with a high viral load and those at
end stage without drug therapy can be particularly infectious.
o Stage 1
Confirmed HIV and CD4 count >500 or 29% or >
o Stage 2
Confirmed HIV and CD4 count of 200-499 or 14-28%
o Stage 3
Confirmed HIV, CD4 count <200 or <14%, and has a documented AIDS
defining illness
o Stage 4
Confirmed HIV, no information about CD4 count and has an AIDS defining
illness
1
,- Manifestations
o Early (4 weeks from infection): Fever, night sweats, chills, headache, muscle
aches, rash, sore throat
- Treatment
o Antiretroviral meds
HAART (highly active retroviral therapy) – never miss a dose!
o Treat complications
PCP “pneumocystis Carnii pneumonia
• Sulfamethoxazole/trimethoprim
o Pt can have adverse reaction such as nausea, comiting,
hyponatremia, rashes, fever, leukopenia,
thrombocytopenia, and hepatitis
• Bronchodilators
• Spread out activities, elevate HOB, give O2
Pain
• Enlarged lymph nodes
o Compressing nerves
• Peripheral neuropathy
o Side effects of meds
• Reposition, distraction, breathing exercises, pressure relieving
mattress, hot and cold compress
Imbalanced nutrition
• Thrush – don’t want to eat
o Give high calorie high protein diet. Give foods they like,
softer foods, and provide good oral care.
Diarrhea
• Side effects of meds
o Provide skin care, use a flexoseal to stop diarrhea from
coming in contact with skin, give fluids to maintain
hydration, and avoid spicy food to prevent bowel
irritation
Skin Integrity
• Kaposi’s sarcoma
o Lesions, can cause pain if large
o Anti-retrovirals, radiation, chemo, analgesics
• Herpes
o Anti-retrovirals
• Shingles – Varicella zoster
o If they had chicken pox or live vaccination
2
, - Opportunistic Infections
o PCP (pneumonia that only people with aids acquire)
One of most common infections in AIDS
Dry cough, difficulty breathing, tachypnea, crackles
o Toxoplasmosis
(Bird or cat feces) decreased LOC, headache, fever, possible seizure
o Cryptosporidiosis
Intestinal infection (mild severe wasting), electrolyte imbalances
o Fungal Infections
Mouth, nails, yeast infections, assess ability to swallow, risk for
aspiration
• Early sign: food may taste funny
o Cryptococcosis
Can cause meningitis, + brudinskis/kernigs, seizures, decreased LOC
o Histoplasmosis
Respiratory infections (cause systemic problems)
Fever, cough, weight loss
o Tuberculosis
PPD may be false negative, chest x-ray positive + sputum culture
If suspected TB put them in negative pressure room, private room
o Kaposi’s sarcoma
Skin biopsy
- Patient teaching
o Don’t share anything with anyone
o Bathe daily with antimicrobial soap
o No eggs, undercooked meat, fish, wash all fruits and veggies, use proper
refrigeration
o Don’t drink or eat anything that has been left out over an hour
o Avoid gardening, no house plants, no reptiles or turtles
o Don’t change litter boxes
o Don’t touch animals or children
o Wash hands with antimicrobial soap
o Watch for signs and symptoms of infection
o Inspect mouth q8hrs for thrush do good oral care
o TB/PCP
Monitor temp q4hrs, WBC, CD4 count (will tell you how susceptible
they are)
o Limit visitors to healthy adults
o Stay away from large crowds
o Use dedicated equipment on this patient
3
EXAM 2 STUDY GUIDE
Maternal-Child Nursing
Galen College of Nursing
,IMMUNE DEFICIENCIES
HIV
- Virus “retrovirus”, attacks CD4 T cell “helper T cell”
- HIV vs AIDS
o Based on # of CD4 T cells
o Presence of opportunistic infections
Pneumocystis pneumonia, toxoplasmosis, tuberculosis, histoplasmosis
- Transmission
o Sexual (semen, vaginal secretions), caused by genital, anal or oral sex
o Parenteral (sharing of needles or equipment contaminated with infected blood
o Perinatal (placenta, contact with maternal blood and body fluids during birth,
breast milk
No breastfeeding, on meds while pregnant to decrease viral load
- Prevention
o Condoms, cleaning/sterilizing drug paraphernalia, needle exchange programs,
blood products screened for the HIV antibody, drug therapy for pregnant
mothers, use of standard precautions with HCP
May double glove
- Diagnostics
o Antibody test
Elisa – most inexpensive, if positive they do western blot to confirm
Western Blot – 4 antigens, if pt has 2/4 they are considered positive
• May be negative for up to 6 months
- Classifications
o Progression depends on health, age, risk factors
o A diagnosis of AIDS requires that the person be HIV positive and have either a
CD4+ T cell count of less than 200 or an opportunistic infection
o The person with HIV infection can transmit the virus to others at all stages of
disease, but the recently infected person with a high viral load and those at
end stage without drug therapy can be particularly infectious.
o Stage 1
Confirmed HIV and CD4 count >500 or 29% or >
o Stage 2
Confirmed HIV and CD4 count of 200-499 or 14-28%
o Stage 3
Confirmed HIV, CD4 count <200 or <14%, and has a documented AIDS
defining illness
o Stage 4
Confirmed HIV, no information about CD4 count and has an AIDS defining
illness
1
,- Manifestations
o Early (4 weeks from infection): Fever, night sweats, chills, headache, muscle
aches, rash, sore throat
- Treatment
o Antiretroviral meds
HAART (highly active retroviral therapy) – never miss a dose!
o Treat complications
PCP “pneumocystis Carnii pneumonia
• Sulfamethoxazole/trimethoprim
o Pt can have adverse reaction such as nausea, comiting,
hyponatremia, rashes, fever, leukopenia,
thrombocytopenia, and hepatitis
• Bronchodilators
• Spread out activities, elevate HOB, give O2
Pain
• Enlarged lymph nodes
o Compressing nerves
• Peripheral neuropathy
o Side effects of meds
• Reposition, distraction, breathing exercises, pressure relieving
mattress, hot and cold compress
Imbalanced nutrition
• Thrush – don’t want to eat
o Give high calorie high protein diet. Give foods they like,
softer foods, and provide good oral care.
Diarrhea
• Side effects of meds
o Provide skin care, use a flexoseal to stop diarrhea from
coming in contact with skin, give fluids to maintain
hydration, and avoid spicy food to prevent bowel
irritation
Skin Integrity
• Kaposi’s sarcoma
o Lesions, can cause pain if large
o Anti-retrovirals, radiation, chemo, analgesics
• Herpes
o Anti-retrovirals
• Shingles – Varicella zoster
o If they had chicken pox or live vaccination
2
, - Opportunistic Infections
o PCP (pneumonia that only people with aids acquire)
One of most common infections in AIDS
Dry cough, difficulty breathing, tachypnea, crackles
o Toxoplasmosis
(Bird or cat feces) decreased LOC, headache, fever, possible seizure
o Cryptosporidiosis
Intestinal infection (mild severe wasting), electrolyte imbalances
o Fungal Infections
Mouth, nails, yeast infections, assess ability to swallow, risk for
aspiration
• Early sign: food may taste funny
o Cryptococcosis
Can cause meningitis, + brudinskis/kernigs, seizures, decreased LOC
o Histoplasmosis
Respiratory infections (cause systemic problems)
Fever, cough, weight loss
o Tuberculosis
PPD may be false negative, chest x-ray positive + sputum culture
If suspected TB put them in negative pressure room, private room
o Kaposi’s sarcoma
Skin biopsy
- Patient teaching
o Don’t share anything with anyone
o Bathe daily with antimicrobial soap
o No eggs, undercooked meat, fish, wash all fruits and veggies, use proper
refrigeration
o Don’t drink or eat anything that has been left out over an hour
o Avoid gardening, no house plants, no reptiles or turtles
o Don’t change litter boxes
o Don’t touch animals or children
o Wash hands with antimicrobial soap
o Watch for signs and symptoms of infection
o Inspect mouth q8hrs for thrush do good oral care
o TB/PCP
Monitor temp q4hrs, WBC, CD4 count (will tell you how susceptible
they are)
o Limit visitors to healthy adults
o Stay away from large crowds
o Use dedicated equipment on this patient
3
