This site is 100% ad supported. Please add an exception to adblock for this site.

NU 246 (EXAM 3)-AIDS:STAGES OF HIV

Start Studying!

Terms

undefined, object
copy deck
STAGE A
ASYMPTOMATIC INFECTION IMMEDIATELY AFTER SEROCONVERSION TAKES PLACE
-FLU LIKE SYMPTOMS:
-NORMAL CD4 COUNT=800 TO 1200 OR 1000 TO 1500
-LEVEL 1=CD COUNT 500 OR MORE
STAGE B
SYMPTOMATIC BUT NOT WITH AIDS
-INDICATOR CONDITION
-LEVEL 2=CD4 COUNT 200-400
STAGE C
SYMPTOMATIC WITH AIDS INDICATOR CONDITION
-STAGE 2 LASTS 2-3 YEARS
-CD4 CELL COUNT IS BELOW 200
WHEN ARE HIV MEDS STARTED
AT THE TIME OF SEROCONVERSION WITH OR WITHOUT SYMPTOMS
ZIDOVUDINE-RETROVIR AZT OR ADT
ACTION:PREVENTS REVERSE TRANSCRIPTASE FROM TRANSCRIBING VIRAL RNA INTO THE DNA OF THE HOST CELL(AZT FOUND IN THE CNS-BLOOD BRAIN)
DOSE:LOWEST IS 300 MG EVERY DAY
ADVERSE EFFECT:N/V,MYALGIAS,H.E.(DISAPPEAR OVER TIME)
APLASTIC ANEMIA,BMS,HEPATOTOXICITY
STOP THERAPY IF <500(NEUTOPENIA)
PREGNANCY:PREVENTS IN BABY BY 60%
GIVE IV DURING LABOR,THEN TXT CHILD->C-SEC
DIDANOSINE-VIDEX DDI
ACTION:INHIBITS THE ENZYME REVERSE TRANSCRIPTASE FROM WORKING
-DOES NOT CROSS BLD BRAIN BARRIER
INDICATIONS:INTOLERANT TO AZT
DOSE:BY WT 5OO MG EVERY DAY
ADVERSE EFFECTS:PERIPHERAL NEUROPATHY(NUMBNESS,TINGLING IN HANDS)
PANCREATITIS(CHECK SERUMN AMYLASE)
S/S:ABD PAIN,N/V,DIARRHEA,FEVER
ZALCITABINE-HIVID ddc
ACTION:INHIBITS REPLICATION OF HIV BY INHIBITION OF VIRAL DNA SYNTHESIS
-PENETRATES BLD BRAIN BARRIER
DOSE:75 MG EVERY 8 HR
ADVERSE EFFECTS:PERIPHERAL NEUROPATHY,
PANCREATITIS
PROTEASE INHIBITORS
SAQUINAVIR MESYLATE-INVIRASE
ACTION:INHIBITS THE ACTIVITY OF HIV PROTEASE AND PREVENTS CLEAVAGE OF VIRAL PROTEINS ESSENTIAL FOR THE MATURATION OF HIV
DOSE:TID 600 MG
ADVERSE EFFECTS:NAUSEA,DIARRHEA,ABD DISCOMFORT,PANCYTOPENIA
KAPOSIS'S SARCOMA
S/S:GROSS APPREARANCE OF PURPLISH ERYTHMATOUS PLAGUE LIKE LESIONS
RED-PURPLE IN COLOR(APPEAR ON SKIN,MUCOUS MEMBRANES)
-CAN INVADE GI,LYMPHATIC,LUNGS,LIVER
-COMMON IN HOMOSEXUAL MALES
DIAGNOSIS:BIOPSY
TXT;CHEMO,PALLIATION,RADIATION
IF ON FACE;CURETTAGE,LIQUIDD NITROGEN
OR CYOTHERAPY,MAKE-UP
PROTOZOAL INFECTIONS:PNEUMOCYSTIS CARINII PNEUMONIA( PCP)
NORMALLY FOUND:IN LUNGS,AIR,FOOD,H20
SEEN WHEN CD4<200
PT MUST HAVE BOTTLED WATER
S/S:FEVER,FATIGUE,SOB,PRODUCTIVE COUGH
DX:BRONCHIAL WASHING SPUTUM SAMPLE
TXT:1.TRIMETHOPRIM/SULFAMETHOXOZOLE
2.BACTRIUM SEPTRA DAPSONE
3.PROPHYLACTIC THERAPY(CD4 ABOUT 300)
4.C&DB,INCREASE HOB 90,INCREASE FLUIDS,HUMIDITY 02,IPPB(RESP TXT0
TOXOPLASMA GONDII
NORMALLY FOUND:IN CATS,RAW/UNDERCOOKED MEATS AND VEGETABLES
S/S:HEADACHE,ALTERED MENTAL STATUS,IMPAIRED VISION AND SPEECH,MOTOR DYSFUNCTION,ATAXIA(UNSTEADY WALK)
TXT:CLINDAMYCIN-CLEOCIN
PREVENT FALLS
CRYPTOSPORIDIUM
NORMALLY FOUND:IN CONTAMINATED FECES,FOOD
S/S:PROFUSE WATERY DIARRHEA
ABD CRAMPING,N/V,WT LOSS
TXT:CORRECT FLUID/ELECTROLYTE IMBALANCE
MONITORS VS,I&O
HERPES SIMPLEX VIRUS 1 AND 2
VIRUSE 1:CONTACT W/ ORAL OR GENITAL SECRETIONS
-AUTOINOCULATIONS IS POSSIBLE
S/S:PAINFUL VESICULAR LESIONS ON TONGUE,MOUTH LIPS, GENITALS
TXT:ACYCLOVIR-ZOVIRAX,SAFE SEX,GOOD HAND WASHING
CYTOMEGALOVIRUS CMV-HERPES VIRUS FAMILY
S/S:VISUAL CHANGES-BLINDNESS
ESOPHAGITIS-DYSPHAGIA
COLON-DIARRHEA,ABD PAIN,WT LOSS
TXT:IV GANCICLOVIR-CYTOVENE
MYCOBACTERIUM AVIUM COMPLEX (MAC)
NORMALLY FOUND:IN H2O,EGGS,RAW DAIRY PRODUCTS
S/S:FEVER,ANEMIA,NIGHT SWEATS,WT LOSS,DIARRHEA,GOUGH
TXT:AMIKACIN IV FOR 2 WKS
TUBERCULOSIS-PULMONARY
NORMALLY FOUND:IN AIR-CAN INFECT FAMILY MEMBERS
S/S:DYSPNEA, **HEMOPTYSIS (BLOODY PHLEM),CHILLS,CHEST PAIN
TXT:IF + RESULT 5MM INDURATION:ISONIAZID-INH RIFAMIPIN FOR 12 MONTHS
-PPD SCREENING OF PT/FAMILY DOESNT EFFECT LIFE EXPECTANCY
-LIFE EXPECTANCY-DETERMINED BY CD4 COUNT (<200=DETERIORATION)
CRYPTOCOCCUS NEOFORMANS
NORMALLY FOUND:AIRBORNE (CAN BE FATAL)
CAN CAUSE CRYPTOCOCCAL MENINGITIS ON CRYPTOCOCCAL PNEUMONIA
S/S:FEVER,H.E.,N/V,ALTERED MENTAL STATUS
DX:LUMBAR PUNCTURE
TXT:AMPHOTERICIN B IV THERAPY
CRYPTOCOCCAL PNEUMONIA
S/S:COUGH,SOB,FEVER,CHEST (PLEURATIC PAIN)
CANDIDIASIS
NORMALLY FOUND:IN NORMAL FLORA
S/S:THRUSH,ESOPHAGEAL,DYSPHAGIA,VAGINITIS
TXT:1.NYSTATIN-SWISH AND SWALLOW 2.CLOTRIMAZOLE-MYCELEX-SUPPOSITORY
3.FLUCONAZOLE-DIFLUCAN
4.VISCOUS LIDOCAINE TO DECREASE PAIN
AIDS RELATED DEMENTIA IS
NOT CAUSED BY OPPORTUNISTIC INFECTION
AIDS RELATED DEMENTIA
S/S:COGNITION:IMPAIRED MEMORY,POOR CONCENTRATION,SLOWED THOUGHT PROCESS
BEHAVIORAL:LOST THEIR SPARKLE,WITHDRAWN
MOTOR:WEAKNESS IN LOWER EXTREMITIES,UNSTEADY GAIT,**MOST COMMON NEUROLOGICAL EFFECT FROM HIV**
DX AND TXT FOR AIDS RELATED DEMENTIA
DX:BY COMPLETE NEUROLOGICAL EXAM, RULE OUT OTHER CONDITIONS,LAB WORK INCLUDING:A WESTERN BLOT IF NOT ALREADY DIAGNOSED, AND MRI
TXT:ZIDOVUDINE-RETROVIR (MAY REVERSE SOME NEUOR-PSYCHOLOGICAL IMPAIRMENT IN CHILDREN
2.NORTRIPTYLINE-PAMELOR
3.RITALIN
4.HALDOL
NSG CARE:
1.EARLY COPING
2.CRITICAL DECISIONS:LIVING WILL
3.SET ACHIEVEABLE GOALS
4.TEACH USE OF ASSISTED DEVICES
5.SAFETY
6.DIGNITY
HIV WASTING CYCLE
AND AIDS DEFINING DISEASE/SYNDROME THAT DOES SHORTEN SURVIVAL
-DEPLETES MUSCLE MASS
-HALTING WASTING CYCLE WILL NOT REVERSE THE COURSE OF AIDS BUT WILL DECREASE INCIDENCE OF OPPORTUNISTIC INFECTION
CAUSES OF HIV WASTING CYCLE
A DECLINE IN BODY CELL MASS
-VITAMIN DEFICIENCIES
-INCREASED METABOLISM
-ENERGY DEMAND
-OTHER GI DISEASE
-HIV RELATED PROBLEMS
ASSESSMENT OF HIV WASTING CYCLE
-NUTRITIONAL EVALUATION:HOSPITALIZED EVERY 3 DAYS(ASYMPTOMATIC EVERY 3 MONTHS)
-BASE LINE WT
-FOOD DIARY
-LAB WORK:**CHECK SERUM ALBUMIN NORMAL= 3.2-4.5
DEPLETION OF PROTEIN IF < 3.0
TREATMENT FOR HIV WASTING CYCLE
-BOOST CALORIE AND PROTEIN
-VITAMIN SUPPLEMENT
-TAILORING MEALS TO FIT S/S:LESIONS,N/V
-NUTRITIONAL SUPPLEMENT(HAL,ENTERAL FOOD)
Start Studying!

Deck Info

27

permalink