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Nursing Care of the Individual with HIV/AIDS

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* 12. What are nursing interventions and patient teaching related to the care of the patient with HIV/AIDS including preventive measures? – PowerPoint PPT presentation

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Title: Nursing Care of the Individual with HIV/AIDS


1
Nursing Care of the Individual with HIV/AIDS
2
What is HIV?
3
Transmission
  1. What is the most common mode of HIV transmission?
  2. How else is HIV transmitted?
  3. What is the most common mode of work related
    transmission?

p. 241
4
How is HIV transmitted? Select all that
apply.
  • Vaginal secretions
  • Kissing
  • Semen
  • Urine and feces
  • Breast milk
  • Coughing, sneezing
  • Using the same comb as person with HIV

5
HIV / AIDS
  • What is the main receptor to which the HIV virus
    must bind in order to gain entry into the hosts
    body?

6
Pathophysiology
  • Viruses cannot reproduce /replicate without a
    host, what is the host, target cell for HIV?
  • What is the function of T-cells?
  • The normal CD4 cell count in an adult is ______?

7
HIV / AIDS
  • What is the difference between HIV and AIDS?
  • How long does it take for HIV to become AIDS?

8
When is a person said To have AIDS?
9
Timeline for Untreated Illness
10
Signs and Symptoms
  • Flu-like symptoms
  • Fatigue
  • Sore throat
  • Enlarged lymph nodes
  • Headache
  • Muscle and joint pain
  • Goes through stages

11
Oral Hairy Leukoplakia
Which stage does this occur?
12
Signs and Symptoms
  • Swollen lymph glands
  • Thrush
  • Muscle and joint pain
  • Low-grade fever
  • Oral hairy leukoplakia
  • Sore Throat
  • CD4 T cells drop to 200 to 500 cells/µl
  • Localized infections
  1. Acute Stage
  2. Early Chronic
  3. Intermediate Chronic
  4. Late Chronic/ AIDS

13
Diagnosis
What is major problem rt diagnosis?
14
Acquired Immunodeficiency Syndrome (AIDS)
  • Diagnostic CDC criteria
  • CD4 T cell count below 200 cells/µl
  • Specific opportunistic infection or cancer
  • Wasting syndrome
  • AIDS dementia complex (ADC)
  • Must meet CDC criteria outlined in Table 15-10 in
    textbook

15
What tests are used in diagnosis
  • Enzyme immunoassay (EIA) to detect serum
    antibodies
  • If test is negative what do they do?
  • If test is positive what do they do?
  • If re-test is positive what do they do?
  • A confirming test (Western blot)
  • If this test is positive reported as

16
Testing used to Monitor Treatment Effectiveness
  • Progression monitored by
  • CD4 T cell counts
  • viral load
  • Abnormal blood tests common
  • Neutropenia, thrombocytopenia, and anemia

17
HIV Viral Load
  • Measures amount of HIV specific RNA,
  • Viral load correlates strongly with stage of
    disease
  • HIV RNA levels during course of infection
  • or at the time of seroconversion 5 million
    copies
  • 5 yrs 25, 000 copies
  • 8 yrs 300,000 copies

18
What is the Major Goal of Care?
19
Treatment and Nursing Care
20
HAART - Highly Active Antiretroviral Therapy
  • When should Therapy be Started?

21
Antiretroviral Therapy
  • Adherence to drug regimens is critical to prevent
  • Disease progression
  • Opportunistic disease
  • Viral drug resistance

22
Antiretroviral Therapy
  • Non-nucleoside reverse transcriptase inhibitor
    (NNRTIs) ex efavirenz (sustiva)
  • Nucleoside/nucleotide reverse transcriptase
    inhibitor (NRTIs/NtRT)
  • ex zidovudine (retrovir, AZT,
  • SDV), tenovir DF (viread, TDF)
  • Work by inhibiting viral replication

23
Antiretroviral Therapy
  • Protease inhibitors disable protease, a protein
    that HIV needs to make more copies of itself ex
    darunavir (prezista)
  • Entry/Fusion inhibitors blocks HIV entry into
    cells ex enfuvirtide (FuzeonT-20)

24
Antiretroviral Therapy
  • Integrase inhibitors disable integrase, a
    protein that HIV uses to insert its viral genetic
    material into that of the infected cell ex
    raltegravir (isentress)
  • Fixed dose combination contain 2 or more meds
    from 1 or more drug classes
  • ex.- efavirenz, tenofovir (atripla)

25
Side Effects Toxicities
  • Common physical problems
  • Depression
  • Diarrhea
  • Peripheral neuropathy
  • Pain
  • Nausea/vomiting
  • Fatigue

26
Side Effects Toxicities
  • Common metabolic disorders
  • Lipodystrophy
  • Hyperlipidemia
  • Insulin resistance
  • Bone disease
  • Lactic acidosis
  • Cardiovascular disease

27
  • If the side effects occur what would the nurse
    expect to happen next?

28
Medication Therapy
  • What is the major problem encountered in treating
    with ART primarily when one drug alone is being
    used?
  • What to do about it?

29
What strategies are Used to improve adherence To
ART?
30
  • How would the nurse know that ART is effective?

31
Summary of Opportunistic Infections

32
Health Promotion / Prevention
  • Major goal Prevention
  • Four CDC strategies
  • Use testing as routine health care
  • Use rapid testing
  • Work to modify risky behaviors
  • Offer tests universally to pregnant women

33
Health Promotion/ Prevention
  • What is important to teach to decrease the risk
    of spread via
  • Sexual intercourse?
  • Drug use?
  • Perinatal transmission?

34
Nursing Care
  • Ways to promote a healthy immune system (slow
    disease progression)
  • Nutritional support
  • Moderation or elimination of alcohol, tobacco,
    and drug use
  • Mental health counseling
  • Vaccines
  • Rest, exercise, and stress reduction
  • Avoid exposure to infectious agents

35
HIV Transmission to Healthcare Workers
  • Source of
    Exposure HIV
  • Needlesticks (open bore needle) or cuts
  • Skin contact (intact)
  • Splashes in mucous membrane
  • (eye, nose or mouth)
  • 0.3-0.4
  • lt0.1
  • 0.1

36
And the research continues
  • The End
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