Describe:
Acquired immunodeficiency syndrome (AIDS)
AIDS is a viral disease caused by human immunodeficiency virus (HIV), which destroys T cells.
This puts the client at risk for opportunistic infections.
How is HIV transmitted?
Direct contact with infected body fluids:
- blood, semen, breast milk
- sexual intercourse
- IV drug users
- babies born to infected mothers
What is the most common diagnostic test for HIV?
Check blood or saliva for antibodies.
Can take up to 12 weeks for antibodies to form after being infected.
At what CD4 T cell count does the immune system start to become compromised with HIV?
200 to 500 cells/L
At what CD4 T cell count is AIDS diagnosed?
< 200 cells/L
What are the most common opportunistic infections that occur with AIDS?
- Candidiasis
- Pneumocystis jiroveci pneumonia
- Cytomegalovirus
- Herpes simplex
What are the most common opportunistic cancers that occur with AIDS?
- cervical cancer
- Kaposi’s sarcoma
- several different types of lymphoma
Medications:
HIV
Antivirals - many have -vir- in the name
What are the precautions with HIV?
Use appropriate PPE if in contact with body fluids.
Since clients are not required to tell you if they are infected, treat everyone as if they are infected with HIV.
What are the precautions with AIDS?
Since clients with AIDS are severely immunosuppressed, implement neutropenic precautions:
- private room
- no fresh fruits or flowers in room
- fresh water for drinking
- avoid ill people
- meticulous hand hygiene and wear gloves
- no live vaccines
- avoid invasive procedures
- fruits and vegetables need to be washed and cooked before eating
- assess for signs and symptoms of infection
- WBC count and temperature
Describe:
Anaphylactic reaction
(Immediate complication)
An overactive response of the immune system to substances that can cause a rash or severe difficulty with breathing.
What types of substances or situations can cause an anaphylactic reaction?
- med reactions
- blood administration reaction
- food reaction
- bee stings
- vaccines
- latex allergy
What are the steps if a client has an anaphylactic reaction?
- assess respiration status and maintain a patent airway
- call HCP and rapid response team
- give oxygen
- start an IV and give normal saline, 0.9%
- prepare to give diphenhydramine and epinephrine
- possible intubation and ventilator
- document
What groups are a high risk of getting a latex allergy?
Health care workers
Those also at risk are:
- clients who had multiple surgeries
- spina bifida clients - from exposure to latex from multiple surgeries
- those who wear gloves a lot
A latex allergy can be mild (itching) to severe (anaphylactic).
What objects commonly contain latex?
Things that look plastic or rubbery:
- ACE bandages (the brown ones)
- Ambu bag
- balloons
- blood pressure cuff
- IV tubing and catheters
- gloves
- stethoscopes
- syringes
- condoms
Which foods have a cross-sensitivity with latex?
- banana
- avocado
- kiwi
- papaya
- fig
- potato and tomato
Describe:
Systemic lupus erythematosus
Connective tissue and collagen collects on organs and blood vessels causing inflammation of all major organs especially blood vessels, lympth nodes, GI tract, kidneys and lungs.
Cause is unknown.
What is the characteristic signs and symptoms of systemic lupus erythematosus?
- butterfly rash
- red palms
- fever
- weakness
- joint pain
- anorexia
- anemia
Diagnostic tests:
Systemic lupus erythematosus
- positive ANA test (antinuclear antibody test)
- increased ESR rate
- may get other tests depending on what organs are affected
Interventions:
Systemic lupus erythematosus
Focus care on all organs that are affected such as:
- lungs
- kidneys
- GI tract
- skin
Medications:
Systemic lupus erythematosus
corticosteroids, NSAIDS, and aspirin to decrease inflammation and pain
Describe:
Lyme disease
Infection caused by a tick bite.
What are the characteristic signs and symptoms of lyme disease?
A ring-shaped rash anywhere on the body and flu-like symptoms.
Some get no rash.
Diagnostic test:
Lyme disease
Blood test 4-6 weeks after bite to test if positive.
