NUR 2058 N2 EXAM 3 STUDY GUIDE
Week 6 [Ch. 42]
1. HIV
a. How can it be transferred?
i. Pregnancy (vaginal secretions), Breast milk, In Utero, Semen, blood, Sex
(rape, multiple partners, prostitution). [
1. Risk of infection is greater in the “receiving” partner due to prolonged
contact with semen]
ii. Ability to transfer is life long…
b. Increased Risk of Acquiring When…
i. Needle is hollow (IM, SQ, Insulin needles)
ii. Risk not as bad with suture needles (solid needles)
iii. Blood is visible on the needle
iv. Pt. diagnosed with AIDS dies w/in 60 days of exposure
c. I’ve been exposed…Now What?
i. WASH HANDS & BLEED OUT NEEDLE STICK SITE
ii. Exposed person is tested immediately to establish baseline
iii. 4-Week Prophylactic Therapy with anti-retroviral rx
iv. Get tested at 3-months & at 6-months (should show up by 6 months if
positive for HIV)
d. HIV Signs/Symptoms
i. Early Signs: (like mono) chills, fever, myalgia, malaise, sore throat, nausea,
photophobia, maculopapular rash and H/A.
ii. Late Signs: night sweats, cough, SOB, lethargy, confusion, seizures, H/A,
unexplained weight loss, blindness, diarrhea, lesions
iii. PCP Pneumonia: fungal pneumonia, only HIV
patients/immunocomprimised patients have this.
iv. CMV, Shingles (Herpes – Type 1 or Varicella-Zoster), Kaposi’s Sarcoma
e. Tests/Diagnostics
i. CD4 Count: (drops during initial infection, while Viral Load is high)
1. Count OVER 200 = HIV
2. Count UNDER 200 = AIDS
3. Patients with HIV may test positive for TB due to their lower CD4
count.
ii. ELISA: checks for HIV antibodies, Lyme’s Disease, Lupus. If this is
positive, Western Blot Test is done to confirm HIV diagnosis (pg. 1174).
iii. Western Blot Test: (+) result means HIV positive
iv. Viral Load:
1. High Viral Load = closer to HIV
2. Less the Viral Load = no HIV
f. Treatment & Patient Education
i. HAART (highly active antiretroviral treatment): use of multiple drugs to
target different phases of the viral cycle.
, ii. Patient should adhere to drug regimen (meds are expensive and side effects
are many and )
iii. Do not have unprotected sex with your partner, even if you both have HIV.
There are different strains and you can each have a different Viral Load,
which can increase your chance of having AIDS.
2. Autoimmune Disorders
Autoimmune Type 1 Hypersensitivity (Type 4) Autoimmune (Type 2)
AIDS Allergies SLE
Scleroderma Asthma Scleroderma
Irritable Bowel Disease Contact Dermatitis Sjogren’s Syndrome
Type 1 Diabetes RA
Organ Transplant Myasthenia gravis
Rejection
a. Rheumatoid Arthritis
i. Symptoms:
1. Early Symptoms: Pain, low grade fever, weight loss
2. Late Symptoms: Joint Stiffness (especially in the AM), fatigue,
diminished function after activity, pain, anorexia, joint deformity
(symmetrical joints), contractures, nodules over bony prominences
ii. Tests/Labs/Diagnostics
1. RF Factor (most common test)
2. CRP & ESR: inflammatory markers
3. X-Ray & Bone Scans
iii. Medications
1. NSAIDs (decrease inflammation): Ex: ibuprofen, Celebrex
2. DMARDs (immunosuppressant/anti-inflammatory): Ex: Infliximab,
Methotextrate
3. Corticosteroids (immunosuppressant/anti-inflammatory)
iv. Patient Education
1. Increase monounsaturated fats (olive oil, avocados)
2. Omega 3 fatty acids (fish, eggs, walnuts, grass-fed beef)
3. Heat & Cold application helps w/pain
4. Do NOT massage area (aggravates inflammation)
5. ROM activities, water therapy, TENS treatment, hand paraffin baths
b. SLE Lupus (damage to: skin, kidney, heart, brain, connective tissues)
i. Causes/Risks
1. Females ages 15-40 (women in childbearing years)
2. Those with Glomerulonephritis
3. Genetics
4. Can cause pregnancy complications, miscarriages, preterm birth
Week 6 [Ch. 42]
1. HIV
a. How can it be transferred?
i. Pregnancy (vaginal secretions), Breast milk, In Utero, Semen, blood, Sex
(rape, multiple partners, prostitution). [
1. Risk of infection is greater in the “receiving” partner due to prolonged
contact with semen]
ii. Ability to transfer is life long…
b. Increased Risk of Acquiring When…
i. Needle is hollow (IM, SQ, Insulin needles)
ii. Risk not as bad with suture needles (solid needles)
iii. Blood is visible on the needle
iv. Pt. diagnosed with AIDS dies w/in 60 days of exposure
c. I’ve been exposed…Now What?
i. WASH HANDS & BLEED OUT NEEDLE STICK SITE
ii. Exposed person is tested immediately to establish baseline
iii. 4-Week Prophylactic Therapy with anti-retroviral rx
iv. Get tested at 3-months & at 6-months (should show up by 6 months if
positive for HIV)
d. HIV Signs/Symptoms
i. Early Signs: (like mono) chills, fever, myalgia, malaise, sore throat, nausea,
photophobia, maculopapular rash and H/A.
ii. Late Signs: night sweats, cough, SOB, lethargy, confusion, seizures, H/A,
unexplained weight loss, blindness, diarrhea, lesions
iii. PCP Pneumonia: fungal pneumonia, only HIV
patients/immunocomprimised patients have this.
iv. CMV, Shingles (Herpes – Type 1 or Varicella-Zoster), Kaposi’s Sarcoma
e. Tests/Diagnostics
i. CD4 Count: (drops during initial infection, while Viral Load is high)
1. Count OVER 200 = HIV
2. Count UNDER 200 = AIDS
3. Patients with HIV may test positive for TB due to their lower CD4
count.
ii. ELISA: checks for HIV antibodies, Lyme’s Disease, Lupus. If this is
positive, Western Blot Test is done to confirm HIV diagnosis (pg. 1174).
iii. Western Blot Test: (+) result means HIV positive
iv. Viral Load:
1. High Viral Load = closer to HIV
2. Less the Viral Load = no HIV
f. Treatment & Patient Education
i. HAART (highly active antiretroviral treatment): use of multiple drugs to
target different phases of the viral cycle.
, ii. Patient should adhere to drug regimen (meds are expensive and side effects
are many and )
iii. Do not have unprotected sex with your partner, even if you both have HIV.
There are different strains and you can each have a different Viral Load,
which can increase your chance of having AIDS.
2. Autoimmune Disorders
Autoimmune Type 1 Hypersensitivity (Type 4) Autoimmune (Type 2)
AIDS Allergies SLE
Scleroderma Asthma Scleroderma
Irritable Bowel Disease Contact Dermatitis Sjogren’s Syndrome
Type 1 Diabetes RA
Organ Transplant Myasthenia gravis
Rejection
a. Rheumatoid Arthritis
i. Symptoms:
1. Early Symptoms: Pain, low grade fever, weight loss
2. Late Symptoms: Joint Stiffness (especially in the AM), fatigue,
diminished function after activity, pain, anorexia, joint deformity
(symmetrical joints), contractures, nodules over bony prominences
ii. Tests/Labs/Diagnostics
1. RF Factor (most common test)
2. CRP & ESR: inflammatory markers
3. X-Ray & Bone Scans
iii. Medications
1. NSAIDs (decrease inflammation): Ex: ibuprofen, Celebrex
2. DMARDs (immunosuppressant/anti-inflammatory): Ex: Infliximab,
Methotextrate
3. Corticosteroids (immunosuppressant/anti-inflammatory)
iv. Patient Education
1. Increase monounsaturated fats (olive oil, avocados)
2. Omega 3 fatty acids (fish, eggs, walnuts, grass-fed beef)
3. Heat & Cold application helps w/pain
4. Do NOT massage area (aggravates inflammation)
5. ROM activities, water therapy, TENS treatment, hand paraffin baths
b. SLE Lupus (damage to: skin, kidney, heart, brain, connective tissues)
i. Causes/Risks
1. Females ages 15-40 (women in childbearing years)
2. Those with Glomerulonephritis
3. Genetics
4. Can cause pregnancy complications, miscarriages, preterm birth
