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NUR2571 Exam 3 Module 9 Content Guide Professional Nursing II / PN 2
Exam 3 (Module 9) - CONTENT GUIDE
HIV
– Etiology – Transmitted by blood, semen, vaginal secretion, breast milk, Not spread through casual
contact likehugging, kissing, sharing eating utensils, or toilet seats.
Pathophysiology: HIV is a ribonucleic acid virus – it’s called a retrovirus because it moves backward
going from RNA to DNA. Binds to CD4 specific cells (macrophages, lymphocytes, Helper T cells,
astrocytes and oligodendrocytes) and chemokine receptors
risk factors: needle sticks, sharing needles, contact with blood products, drug users, multiple sex
partners. diagnostic tests: ELISA: Rapid- screening used to detect development of antibodies to HIV:
results positive or negative – Western Blot: used to confirm HIV infection, detects both HIV antibodies
and individual viral components that cause reactive bands, results are positive or negative – PCR –
detects proviral DNA, Tests 3-6 months after exposure
disease progression – When PT CD4 drops below 200 or below 500 with opportunistic infection.
Treatment beings with counts drop below 500.
AIDS
– CDC diagnostic criteria: Normal CD4 800-1200. CD4 (Helper T lymphocytes) less than 200 diagnosis of
AIDS OR less than 500 with infection (Kaposi Sarcoma, Pneumonia Jiroveci, Pneumonia Carnii)
S/S: Acute infection: Flulike symptoms (swollen lymph nodes, sore throat, headache) occurs 2-4 weeks
afterinfection. Lasts 1-2 weeks. Asymptomatic infection: fatigue, headache, low-grade fever, night
sweats.
Symptomatic infection: when CD4 drop 200-500. Symptoms become worse.
therapeutic communication. Be sensitive
Medication Goals for HIV/Aids: ART therapy, decrease viral load, increase CD4, prevent infections
SLE
– Etiology: Caused by development of antibodies that fight body’s own tissue, cells. Multi-system
disease. Pathophysiology: A combination of factors is involved in the development of ANAs. The
hyperactivity of B cells and a defect in the body’s T suppressor cell that normally protects the body
from developing ANAs triggers theinflammatory cascade of events that result in systemic tissue
damage.
diagnostic studies: ANA Titer
PT education – Avoid Sun (UV light), Infection, Triggers (environmental & emotional stress), Oral
contraception (estrogen level), Skin care, nutrition, minimize infections,
, 2
Rheumatoid Arthritis –
Nursing assessment: Symmetrical join deformity. Pain, stiffness and low grade fever. Worse in AM.
3+ joints S/S: Symmetrical joint deformity. Worse in the morning. Pain, stiffness, low grade fever
medication management: NSAIDS, ASA, DMARDS. Apply heat or cold. AVOID massages.
possible side effects of medications used in RA management. ?
Types of hypersensitivity reactions –
Type 1 (anaphylactic -Hypersensitivity – immediate reaction). Through contact, inhalation, ingestion, or
injection ofallergen. Allergic reaction mediated by IgE antibodies, release of histamine from cells,
causing local or systemic reaction. Anaphylaxis, hay fever, atopic eczema, drug allergy!
Type 2 (Blood transfusions – Hypersensitivity – Cytotoxic reaction) – Antibody is directed against an
individual’s own cells or foreign body, can be life threatening. Blood transfusions, myasthenia gravis,
autoimmune hemolyticanemia
Type 3 (Immune complex – Hypersensitivity – Immune complex reaction) – Immune complexes are
deposited into the tissue, causing local tissue damage & inflammation. Pneumonitis, SLE, RA, post-
streptococcal glomerulonephritis.
Type 4 (Delayed Hypersensitivity – Hypersensitivity – Cell-mediated reaction) - Also called delayed
hypersensitivity – Most common skin reaction after exposure to an ointment or cream. Crohns,
transplant rejection, leprosy, tuberculosis.
Nursing considerations when giving a leukotriene modifier to an Asthma patient. –
Inhibits the allergic process – an anti-inflammatory. NOT used for ACUTE attacks, used to
PREVENT inflammation – must be taken even when feeling good.
Contact dermatitis – Type 4 allergic reaction or delayed hypersensitivity.
S/S: itching, redness, swelling, small blisters.
medication management: Moisturizing creams, topical steroid ointments, antibiotics. Prednisone,
Benadryl.Moisturize right after bath
Anaphylactic reactions – Occurs w/in mins of exposure – progresses
rapidly & can result in anaphylactic shock & death w/in 15 mins. Concerns: recognize & maintain patent
airway,prevent spread of allergen, Admin Meds, Place pt in recumbent pos, elevate legs, keep pt warm,
admin oxygen,administer epinephrine, Benadryl & diphenhydramine used to prevent – IV fluids to
maintain BP & prevent hypovolemic shock = irreversible tissue damage and death. Treatment: Epi pen.
Cellulitis –
Potentially serious bacterial infection often due to streptococcus or staphylococcus organisms enter the
wound through an insect or animal bite, or an injury with a break in the skin. Can occur anywhere but
most common onlegs, arms or fact. If not treated it can lead to systemic sepsis.
Assessment: Cardinal signs: heat, redness, swelling, pain, glossy or stretched look, flu like symptoms,
fever,headache, aching, and malaise. Monitor for spreading – change dressing frequently!!!
Risk Factors: PVD, diabetes, obesity, lymphedema, chronic steroid or immunosuppressant meds and
Edema.Treatment: antibiotics, silver sulfadiazine cream, analgesic, rest, elevate,
Types of wound debridement exemplar (mechanical). –
Wet-to-dry dressing – dressing change painful, bleeding common during gauze removal.
Impetigo.
NUR2571 Exam 3 Module 9 Content Guide Professional Nursing II / PN 2
Exam 3 (Module 9) - CONTENT GUIDE
HIV
– Etiology – Transmitted by blood, semen, vaginal secretion, breast milk, Not spread through casual
contact likehugging, kissing, sharing eating utensils, or toilet seats.
Pathophysiology: HIV is a ribonucleic acid virus – it’s called a retrovirus because it moves backward
going from RNA to DNA. Binds to CD4 specific cells (macrophages, lymphocytes, Helper T cells,
astrocytes and oligodendrocytes) and chemokine receptors
risk factors: needle sticks, sharing needles, contact with blood products, drug users, multiple sex
partners. diagnostic tests: ELISA: Rapid- screening used to detect development of antibodies to HIV:
results positive or negative – Western Blot: used to confirm HIV infection, detects both HIV antibodies
and individual viral components that cause reactive bands, results are positive or negative – PCR –
detects proviral DNA, Tests 3-6 months after exposure
disease progression – When PT CD4 drops below 200 or below 500 with opportunistic infection.
Treatment beings with counts drop below 500.
AIDS
– CDC diagnostic criteria: Normal CD4 800-1200. CD4 (Helper T lymphocytes) less than 200 diagnosis of
AIDS OR less than 500 with infection (Kaposi Sarcoma, Pneumonia Jiroveci, Pneumonia Carnii)
S/S: Acute infection: Flulike symptoms (swollen lymph nodes, sore throat, headache) occurs 2-4 weeks
afterinfection. Lasts 1-2 weeks. Asymptomatic infection: fatigue, headache, low-grade fever, night
sweats.
Symptomatic infection: when CD4 drop 200-500. Symptoms become worse.
therapeutic communication. Be sensitive
Medication Goals for HIV/Aids: ART therapy, decrease viral load, increase CD4, prevent infections
SLE
– Etiology: Caused by development of antibodies that fight body’s own tissue, cells. Multi-system
disease. Pathophysiology: A combination of factors is involved in the development of ANAs. The
hyperactivity of B cells and a defect in the body’s T suppressor cell that normally protects the body
from developing ANAs triggers theinflammatory cascade of events that result in systemic tissue
damage.
diagnostic studies: ANA Titer
PT education – Avoid Sun (UV light), Infection, Triggers (environmental & emotional stress), Oral
contraception (estrogen level), Skin care, nutrition, minimize infections,
, 2
Rheumatoid Arthritis –
Nursing assessment: Symmetrical join deformity. Pain, stiffness and low grade fever. Worse in AM.
3+ joints S/S: Symmetrical joint deformity. Worse in the morning. Pain, stiffness, low grade fever
medication management: NSAIDS, ASA, DMARDS. Apply heat or cold. AVOID massages.
possible side effects of medications used in RA management. ?
Types of hypersensitivity reactions –
Type 1 (anaphylactic -Hypersensitivity – immediate reaction). Through contact, inhalation, ingestion, or
injection ofallergen. Allergic reaction mediated by IgE antibodies, release of histamine from cells,
causing local or systemic reaction. Anaphylaxis, hay fever, atopic eczema, drug allergy!
Type 2 (Blood transfusions – Hypersensitivity – Cytotoxic reaction) – Antibody is directed against an
individual’s own cells or foreign body, can be life threatening. Blood transfusions, myasthenia gravis,
autoimmune hemolyticanemia
Type 3 (Immune complex – Hypersensitivity – Immune complex reaction) – Immune complexes are
deposited into the tissue, causing local tissue damage & inflammation. Pneumonitis, SLE, RA, post-
streptococcal glomerulonephritis.
Type 4 (Delayed Hypersensitivity – Hypersensitivity – Cell-mediated reaction) - Also called delayed
hypersensitivity – Most common skin reaction after exposure to an ointment or cream. Crohns,
transplant rejection, leprosy, tuberculosis.
Nursing considerations when giving a leukotriene modifier to an Asthma patient. –
Inhibits the allergic process – an anti-inflammatory. NOT used for ACUTE attacks, used to
PREVENT inflammation – must be taken even when feeling good.
Contact dermatitis – Type 4 allergic reaction or delayed hypersensitivity.
S/S: itching, redness, swelling, small blisters.
medication management: Moisturizing creams, topical steroid ointments, antibiotics. Prednisone,
Benadryl.Moisturize right after bath
Anaphylactic reactions – Occurs w/in mins of exposure – progresses
rapidly & can result in anaphylactic shock & death w/in 15 mins. Concerns: recognize & maintain patent
airway,prevent spread of allergen, Admin Meds, Place pt in recumbent pos, elevate legs, keep pt warm,
admin oxygen,administer epinephrine, Benadryl & diphenhydramine used to prevent – IV fluids to
maintain BP & prevent hypovolemic shock = irreversible tissue damage and death. Treatment: Epi pen.
Cellulitis –
Potentially serious bacterial infection often due to streptococcus or staphylococcus organisms enter the
wound through an insect or animal bite, or an injury with a break in the skin. Can occur anywhere but
most common onlegs, arms or fact. If not treated it can lead to systemic sepsis.
Assessment: Cardinal signs: heat, redness, swelling, pain, glossy or stretched look, flu like symptoms,
fever,headache, aching, and malaise. Monitor for spreading – change dressing frequently!!!
Risk Factors: PVD, diabetes, obesity, lymphedema, chronic steroid or immunosuppressant meds and
Edema.Treatment: antibiotics, silver sulfadiazine cream, analgesic, rest, elevate,
Types of wound debridement exemplar (mechanical). –
Wet-to-dry dressing – dressing change painful, bleeding common during gauze removal.
Impetigo.
