NUR 426 FINAL EXAM
HIV - answer this conditions is called retroviruses because they replicate in a backward
manner going from RNA to DNA-- targets the CD4+ T cell and binds through cell fusion
using reverse transcriptase enzyme-- causes major signs and symptoms and includes
multiple infections despite aggressive treatment, failure to thrive or poor growth
CD4+ t lymphocyte - answer these cells are helper cells the normally recognizes
antigens and signal body to develop an immune attack
virus fuses with CD4 cell receptor, HIV inserts its RNA into cell using reverse
transcriptase, the CD4 cell synthesizes HIV virus and the viruses are assembled and
released - answerwhat is the life cycle of HIV?
through contact with certain body fluids such as blood, semen, rectal and vaginal
secretions and breast milk and amniotic fluid - answerhow is HIV transmitted?
tears, saliva, urine, emesis, sputum, feces, sweat, bugs/ mosquitos, respiratory droplets
or enteric routes such as eating after someone or drinking after someone - answerhow
is HIV not transmitted?
black male to male sexual contact - answerwhat population is at most risk for HIV?
the rectum has a single layer of epithelial cells versus vagina and mouth having multiple
layers - answerwhy is anal sex more risky than male to female vaginal intercourse?
true - answerT/F: the patient must know you are testing them for HIV
the time frame where an HIV positive patient will not test positive even if they are
infected with the virus-- around 2-3 weeks-- may show a false negative - answerwhat is
the window period for HIV?
enzyme linked immunosorbent assay (ELISA) test or 4th generation HIV antibody
antigen test-- the antigen will turn positive after day 13-- the antibody will turn positive
around day 30 (2-6 weeks) - answerwhat test is recommended for HIV testing? how
does it work?
HIV viral load test (NAAT) - answerif the 4th generation HIV antibody antigen test turns
positive, what test is used to follow up?
CD4 monitoring at 3 weeks, 3 months and 6 months of treatment-- goal is 800-1500
cells/mm3-- viral load is monitored every 6 months - answerhow is HIV monitored?
, reveal the news in person, beneficial to bring a support person if possible, draw follow
up labs at first visit, explain treatment plan at next visit so they have time to cope and
fully understand their options - answerhow do we tell a patient that they are HIV
positive?
true - answerT/F: a patient who takes their HIV medications daily and obtains an
undetectable viral load will not transmit the virus through sex and live a normal lifespan
stage 0 - answerthis stage of HIV is early infection-- the pt has just been exposed-- may
experience flu like symptoms such as rash, fever, muscle/ joint pain, fatigue, sore
throat, headache, swollen lymph nodes-- the disease is highly contagious at this point
and viral load is high
stage 1 - answerthis stage of HIV is the acute infection to the development of antibodies
where the destruction of CD4 T cells drops the t cell count-- other immune cells
increase to attempt to kill off virus-- may develop into a chronic persistent phase where
the body cannot rid the virus-- may last 8-10 years and is fairly asymptomatic
viral set point - answerthis is the set point the body settles at within a few weeks to
months after infection with HIV. the body is killing off HIV at a similar rate to replication--
physicians look at this and if viral load is still high, pt have poorer prognosis because the
body is not ridding the virus
stage 2 - answerthis stage of HIV occurs when the T lymphocyte count is between 200-
499-- symptoms resurface due to drop in immune fighting cells
stage 3 - answerthis stage of HIV occurs when t lymphocyte counts are less than 200
cells/mm3 of blood. Pt are considered to have AIDS for surveillance purposes and may
receive disability, benefits, housing and food stamps
combination anti retroviral drugs-- compliance with medications - answerhow is HIV tx?
what is an important teaching point for pt?
to prevent resistance to the drug and to target the virus at different stages of cell cycle -
answerwhy is combo therapy for HIV used?
opportunistic infections - answerthis occurs when a patient is infected by an organism
when they are immunocompromised that a healthy person would not be affected by-- pt
may experience SOB, dyspnea, cough, chest pain, fever, TB, cytomegalovirus,
pneumonia, loss of appetite, N, V and oral and esophageal candidiasis, chronic
diarrhea, hairy leukoplakia, muscle wasting-- pt needs 6 small meals a day with
adequate fluid, follow BRAT diet, prophylactic atbx, stool cultures
pneumocystis jiroveci pnuemonia - answerthis condition is known as PCP-- S&S include
acute onset of dyspnea, fever, no productive cough, pain, tachypnea, tachycardia, rales/
crackles with exertion-- common co-infection is oral thrush-- if CD4 is less than 200,
HIV - answer this conditions is called retroviruses because they replicate in a backward
manner going from RNA to DNA-- targets the CD4+ T cell and binds through cell fusion
using reverse transcriptase enzyme-- causes major signs and symptoms and includes
multiple infections despite aggressive treatment, failure to thrive or poor growth
CD4+ t lymphocyte - answer these cells are helper cells the normally recognizes
antigens and signal body to develop an immune attack
virus fuses with CD4 cell receptor, HIV inserts its RNA into cell using reverse
transcriptase, the CD4 cell synthesizes HIV virus and the viruses are assembled and
released - answerwhat is the life cycle of HIV?
through contact with certain body fluids such as blood, semen, rectal and vaginal
secretions and breast milk and amniotic fluid - answerhow is HIV transmitted?
tears, saliva, urine, emesis, sputum, feces, sweat, bugs/ mosquitos, respiratory droplets
or enteric routes such as eating after someone or drinking after someone - answerhow
is HIV not transmitted?
black male to male sexual contact - answerwhat population is at most risk for HIV?
the rectum has a single layer of epithelial cells versus vagina and mouth having multiple
layers - answerwhy is anal sex more risky than male to female vaginal intercourse?
true - answerT/F: the patient must know you are testing them for HIV
the time frame where an HIV positive patient will not test positive even if they are
infected with the virus-- around 2-3 weeks-- may show a false negative - answerwhat is
the window period for HIV?
enzyme linked immunosorbent assay (ELISA) test or 4th generation HIV antibody
antigen test-- the antigen will turn positive after day 13-- the antibody will turn positive
around day 30 (2-6 weeks) - answerwhat test is recommended for HIV testing? how
does it work?
HIV viral load test (NAAT) - answerif the 4th generation HIV antibody antigen test turns
positive, what test is used to follow up?
CD4 monitoring at 3 weeks, 3 months and 6 months of treatment-- goal is 800-1500
cells/mm3-- viral load is monitored every 6 months - answerhow is HIV monitored?
, reveal the news in person, beneficial to bring a support person if possible, draw follow
up labs at first visit, explain treatment plan at next visit so they have time to cope and
fully understand their options - answerhow do we tell a patient that they are HIV
positive?
true - answerT/F: a patient who takes their HIV medications daily and obtains an
undetectable viral load will not transmit the virus through sex and live a normal lifespan
stage 0 - answerthis stage of HIV is early infection-- the pt has just been exposed-- may
experience flu like symptoms such as rash, fever, muscle/ joint pain, fatigue, sore
throat, headache, swollen lymph nodes-- the disease is highly contagious at this point
and viral load is high
stage 1 - answerthis stage of HIV is the acute infection to the development of antibodies
where the destruction of CD4 T cells drops the t cell count-- other immune cells
increase to attempt to kill off virus-- may develop into a chronic persistent phase where
the body cannot rid the virus-- may last 8-10 years and is fairly asymptomatic
viral set point - answerthis is the set point the body settles at within a few weeks to
months after infection with HIV. the body is killing off HIV at a similar rate to replication--
physicians look at this and if viral load is still high, pt have poorer prognosis because the
body is not ridding the virus
stage 2 - answerthis stage of HIV occurs when the T lymphocyte count is between 200-
499-- symptoms resurface due to drop in immune fighting cells
stage 3 - answerthis stage of HIV occurs when t lymphocyte counts are less than 200
cells/mm3 of blood. Pt are considered to have AIDS for surveillance purposes and may
receive disability, benefits, housing and food stamps
combination anti retroviral drugs-- compliance with medications - answerhow is HIV tx?
what is an important teaching point for pt?
to prevent resistance to the drug and to target the virus at different stages of cell cycle -
answerwhy is combo therapy for HIV used?
opportunistic infections - answerthis occurs when a patient is infected by an organism
when they are immunocompromised that a healthy person would not be affected by-- pt
may experience SOB, dyspnea, cough, chest pain, fever, TB, cytomegalovirus,
pneumonia, loss of appetite, N, V and oral and esophageal candidiasis, chronic
diarrhea, hairy leukoplakia, muscle wasting-- pt needs 6 small meals a day with
adequate fluid, follow BRAT diet, prophylactic atbx, stool cultures
pneumocystis jiroveci pnuemonia - answerthis condition is known as PCP-- S&S include
acute onset of dyspnea, fever, no productive cough, pain, tachypnea, tachycardia, rales/
crackles with exertion-- common co-infection is oral thrush-- if CD4 is less than 200,
