NUR 2571 Exam 3 PN 2 NUR 2571 Exam 3 PN 2 - Professional Nursing 1

NUR 2571 Exam 3 PN 2 NUR 2571 Exam 3 PN 2 - Professional Nursing 1 Exam 3 Rasmussen - NUR2571 KNOW DIABETES MANAGEMENT!!! • DKA AND HHNS Inflammation and Immunity HIV/AIDS (Review chart 19-3 in Iggy) • Transmitted via blood or body fluids. • HIV inserts in genetic material into host cells. o HIV enzyme reverse transcriptase coverts HIV RNA into DNA, making the viral genetic material he same as human DNA. ▪ Nucleoside reverse transcriptase inhibitors work on this level to prevent viral replication. o HIV enzyme intergrase gets the viral DNA into the CD4 T-Cell and inserts it into the host DNA. ▪ Integrase inhibitors work here to prevent viral DNA from integrating into host DNA. • Signs and symptoms o Flu-like symptoms o Low WBC and CD4 counts. ▪ CD4 <200 ▪ Non – HIV person will have 800-1000 o Poor wound healing o Lesions o Weight loss o Night sweats o Seizures. • HIV only becomes AIDS when CD4 cell count drops below 200. o Medications target viral replication to increase CD4 count, however the person still has HIV! o HIV cocktail, each medication acts on a different portion of the viral lifecycle. o Review chart 19-6 for antiretroviral therapies. (cHART/HHART) ▪ Nucleoside Reverse Transcriptase Inhibitors (Remember Reverse Transcriptase is an HIV enzyme that converts viral RNA to viral DNA) • Act as fake DNA bases for viral DNA to bind to, this inhibits viral DNA synthesis. • Avoid fatty and fried foods. ▪ Non-Nucleoside Reverse Transcriptase Inhibitors • Work by binding to Reverse Transcriptase and suppressing viral replication. • Anemia and liver toxicity are the most common side effects. ▪ Protease inhibitors • Block the HIV protease enzyme, preventing viral replication and release of viral particles. • DO NOT CRUSH ▪ Integrase inhibitors • Inhibit the HIV enzyme integrase which is responsible for inserting viral DNA into human DNA. • GI side effects such as N/V/D are common. ▪ Fusion inhibitors • Block the fusion of HIV with a host cell by fusing to the CD4 host cells surfaces. • SubQ injection ▪ Entry inhibitors • Prevent cellular infection with HIV by blocking receptors on the CD4 T cell. • DO NOT CRUSH o Knowing specific drugs is not necessary but know the concept for why the patient is on a cocktail. ▪ Decreases chance of drug resistance. • CDC recommends the use of HIV assays to detect HIV antibodies and antigens. HIV assays provide more accurate and early diagnosis. Earlier generations tests include the ELISA and Western Blot. • Education o Pneumonia is the most common infection; push education about the benefits of vaccination in infected persons. o Adhere to medication regimen to avoid resistance! ▪ Decreased CD4 count and increased VL (viral load) indicate likely non- compliance. • Once HIV has progressed to AIDS (CD4 count is now > 200) complications occur such as opportunistic infection, cancer, TB, etc. o Review chart 19-1 in Iggy ▪ Multiple bacterial infections ▪ Recurrent fungal infections ▪ Encephalopathy ▪ Lymphoma ▪ Pneumonia ▪ Septicemia ▪ Wasting syndrome o Low CD4, high VL. o Know S/S of TB and pneumonia. □ Contact precautions for AIDS patient? o Standard precautions. □ Nurse is stuck with a needle from and HIV patient, what is the procedure? o Within 3 days of exposure start 28-day regimen of Tenofovir, Emtricitabine, and Raltegravir. o Review 19-4 in Iggy for post-exposure prophylaxis.  Test question! o Exposed worker is given first dose of postexposure prophylaxis (PEP) while evaluation of exposure is underway. o Initiation of PEP should begin within 24-36 hours. o Tenofovir 300 mg PO daily, Emtricitabine 200 mg PO daily, and raltegravir 400 mg PO daily. o HIV testing of exposed worker should be complete within 3 days of initiating PEP. Give appetite stimulants and nutritional support