ATI Learning System RN 3.0-Medical-Surgical Care of Clients with HIV Disease and Other Immune Deficiencies Practice Questions & Answers-Updated for 2023 Pass Medical-Surgical Care of Clients with HIV Disease and Other Immune Deficiencies in First Attempt

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ATI Learning System RN 3.0-Medical-Surgical Care of Clients with HIV Disease and Other Immune Deficiencies Practice Questions & Answers-Updated for 2023 Human immunodeficiency virus (HIV) - Ans | Retro virus transmitted through blood and body fluids (semen, vaginal secretions) HIV targets - Ans | CD4+ lymphocytes, AKA T - cells or T- lymphocytes HIV is found in - Ans | Feces, urine, tears, saliva, cerebrospinal fluid, cervical cells, lymph nodes, corneal tissues, brain tissue which are usually unlikely sources of infection Three stages of HIV - Ans | Progressive,chronic asymptomatic infection, AIDS Progression of HIV infection - Ans | - Manifestation within 2 to 4 weeks of infection - symptoms similar to flu include rash and sore throat - rapid rise in HIV viral load, decreased CD4+ cells and increased CD8 cells -lymphadenopathy persist throughout the disease process Chronic asymptomatic infection - Ans | - Stage prolonged/Clinically silent ( 10 yrs or more) - Anti-HIV antibodies are produced (HIV-positive) - virus begins active replication (CD4+ cells are destroyed, viral load increases, dramatic loss of immunity begins) AIDS - Ans | - Characterized by life-threatening opportunistic infections - in stage of HIV infection, without treatment death occurs within five years - all people with AIDS have HIV but not all people with HIV have AIDS Health promotion and disease prevention - Ans | - Teach how virus is transmitted anyways to prevent infection i.e. condoms, abstinence, avoid sharing needles - encouraging maintaining immunizations including yearly flu and pneumococcal polysaccharide vaccine (PPSV) Assessment - risk factors - Ans | Unprotected sex - multiple sex partners - occupational exposure - prenatal exposure - blood transfusions - IV drug use with Contaminated needle -older adults more susceptible to fluid/electrolyte imbalances, malnutrition, skin alterations, wasting syndrome - older women experience vaginal dryness/thinning of vaginal wall, increasing their susceptibility to HIV infection Prof.Exams Assessment - subjective data - Ans | Chills, rash, anorexia, nausea, weight-loss, weakness/fatigue, headache/sore throat, night sweats HIV determination - Ans | -Positive result from HIV antibody screening test (ELISA) - confirm by positive results from supplemental HIV antibody test(western blot/indirect immunofluorescence) -positive result/report of detectable quantity from the following: HIV nucleic acid detection test(RT-PCR), branched DNA method(bDNA), nucleic acid sequence based assay(NASBA) Diagnostic procedures - Ans | - HIV determination - Liver profile, biopsies, testing of stool for parasites - brain or lung MRI or CT scan Brain or long MRI/CT scan - Ans | - Detailed image of brain/lung to detect abnormalities Nursing care - Ans | - Assess risk factors - monitor fluid intake/urinary output - obtain daily weights to monitor weight-loss - monitor nutritional intake - monitor electrolytes Nursing care continued - Ans | - Excess skin integrity - assess pain status - monitor vital signs - assess lung sounds/respiratory status - neurological status - encourage activity altered with rest periods - supplemental oxygen as needed - provide analgesia as needed - provide skincare Medications - Ans | Highly active antiretrovirals therapy (H AAR T) involves using 3 to 4 HIV medications in combination with other antiretrovirals medications to reduce medication, adverse effects and dosages Infusion inhibitors - Ans | Enfuvirtide (fuzeon) Blocks the fusionof HIV with the host cell Entry inhibitors - Ans | Maraviroc(selzentry) Nucleoside reverse transcriptase inhibitors (NRTIs) - Ans | Zidovudine(Retrovir) Interfere with the viruses ability to convert RNA to DNA Non- nucleoside reverse transcriptase inhibitors (NNRTIs) - Ans | Delavirdine(Rescriptor) Efavirenz(sustiva) Prof.Exams Inhibit viral replication in cells Protease inhibitors - Ans | Atazanavur(reyataz) Nelfinavir(viracept) Saquinavir(invirase) Indinavir(crixivan) Inhibit an enzyme needed for the virus to replicate Integrase inhibitors - Ans | Raltegravir(isrentress) Antineoplastic medication - Ans | Interleukin (interferon) Immunostimulant that enhances the immune response and reduces the production of cancer cells (used commonly with Kaposi's sarcoma) Nursing considerations - Ans | - Monitor lab results - CBC, WBC, liver function tests - Antiretrovirals medications may increase: alanine aminotransferase (ALT) Aspartate Aminotransferase (AST) Bilirubin Mean corpuscular volume (MCV) High density lipoprotein (HDLs) Total cholesterol and triglycerides Client education - Ans | - Educate about side effects of medications/ ways to decreased severity of side effects - Educate about need to take medications on regular schedule/do not miss doses/missed medication doses can cause drug resistance Teamwork/collaboration - Ans | - Infectious disease services maybe consulted to manage HIV - respiratory services to improve respiratory status - nutritional services for dietary supplementation - rehabilitation services for strengthening and improving level of energy Alternative therapy - Ans | Vitamins, products, shark cartilage may help alleviate symptoms of HIV - ask if patient taking herbal products, these can alter effects of prescribed medications Care after discharge- Referred to local AIDS support program - home health services for patients needing strengthening/assistance regarding ADLs - home health services may assist with IVs, dressing changes, total parental nutrition - Ans | - Referred to local AIDS support program - home health services for patients needing strengthening/assistance regarding ADLs - home health services may assist with IVs, dressing changes, total parental nutrition - Respiratory services for providing portable oxygen - long-term care facilities may be indicated for patients with chronic HIV - hospice services for patients in late stage of HIV - food services indicated for clients homebound/need meals prepared