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Infection and HIV
Terms in this set (21)
To what is the increase in emerging and untreatable infection attributed (select all):
a. the evolution of new infection agents
b. use of antibiotics to treat viral infections
c. human population encroaching on wild areas
d. transmission of infectious agents from humans to animals
e. an increased number of immunosuppressed and chronically ill patients
a, b, c, e Infectious agents such as HIV have evolved to affect humans through closer association with animals as human populations push into wild animal habitats. The transfer of infectious agents from animals to humans has also resulted in West Nile virus and avian flu. Bacterial infections have also become untreatable as the result of genetic and biochemical changes stimulated by unnecessary or inadequate exposure to antibiotics. The increased number of immunosuppressed and chronically ill people also increase the emergence of untreatable infections
What are the recommended measures to prevent the transmission of health-care associated infection (select all):
a.empty bedpans asap
b. limit the fresh flowers in the patient's room
c. remove urinals from bedside tables
d. use PPE
e. hand washing or alcohol based sanitizing
f. have patients wear sandals in shower
d, e hand washing and the use of alcohol based sanitizers and PPE will prevent health care associated infections. Although the other interventions will not hurt a patient and they are good practice, they will not prevent HAIs
A patient with diarrhea is diagnosed with C. diff. Along with standard precautions, which kind of transmission-based precautions will be used when the nurse is caring for this patient?
b. Contact precautions are used with standard precautions when microorganisms can be transmitted by direct patient contact.
A 78 year old patient has developed Haemophilus influenzae. In addition to standard precautions, what should the nurse use to protect herself and other patients when working within 3 feet of the patient?
d. shoe covers
a. A mask will be worn even 3 feet from the patient to avoid droplet transmission. The gown and gloves will be used as with standard precautions, when working closely with the patient and there is a risk of contamination.
An 82 year old male patient with pneumonia who is in the ICU is beginning to have decreased cognitive function. What should the nurse first suspect as a potential cause of this change?
c. ICU psychosis
d. medication allergy
b. Infection in older adults often has atypical presentations, cognitive and behavioral changes occurring before fever, pain, or altered laboratory values. Fatigue and ICU psychosis (if the patient is in the ICU) could be occurring but these are not as dangerous for the patient as infection can be. Cognitive and behavioral changes are not typical manifestations of medication allergy.
The nurse realizes that the patient understands the teaching about decreasing the risk for antibiotic-resistant infection when the patient says which of the following?
a. I know I should take the antibiotic for one day after I feel better
b. I want an antibiotic ordered for my cold so I can feel better sooner
c. I always save some pills because I get the illness again after I feel better
d. I will follow the directions for taking the antibiotics so I will get over this infection
d. One of the most important factors in the development of antibiotic-resistant strains of organisms has been inappropriate use of antibiotics. Following directions regarding timing and completion of antibiotics will not allow antibiotic-resistant bacteria to develop. Antibiotics are not effective against viruses, which cause colds and flu. Not completing the antibiotic may allow the hardiest bacteria to survive and multiply and the potential development of an antibiotic-resistant infection.
In each of the following situations ID which option has the highest risk for HIV transmission?
a. transmission to women or men during sexual intercourse
b. hollow-bore needle used for vascular access or IM injection
c. first 2-6 months of infection or 1 year after infection
d. perinatal transmission from HIV infected mothers using no therapy
e. a splash exposure of HIV infected blood on skin with open lesion or a needle stick exposure to HIV infected blood
first 2-6 months of infection
HIV mothers using no therapy
needle stick exposure to HIV infected blood
What is the primary reason that the normal immune response fails to contain the HIV infection?
a. CD4 T cells become infected with HIV and are destroyed
b. the virus inactivates B cells, preventing the production of HIV antibodies
c. natural killer cells are destroyed by the virus before the immune system can be activated
d. monocytes ingest infected cells, differentiate into macrophages, and shed viruses in the body tissues
a. Activated CD4+T cells are an ideal target for HIV because these cells are attracted to the site of concentrated HIV in the lymph nodes, where they become infected through viral contact with CD4 receptors. CD4+T cells normally are a major component of the immune system and their infection renders the immune system ineffective against HIV and other agents. The virus does not affect natural killer cells and B lymphocytes are functional early in the disease, as evidenced by positive antibody titers against HIV. Monocytes do ingest infected cells and may become sites of HIV replication and spread the virus to other tissue but this does not make the immune response ineffective.
Which characteristic corresponds with the acute stage of HIV infection?
a. Burkitt's lymphoma
b. temporary fall of CD4 T cells
c. persistent fevers and night sweats
d. Pneumocystis jiroveci pneumonia
b. The symptoms of acute HIV infection occur 2 to 4 weeks after initial infection and last for 1 to 2 weeks. The CD4+ T-cell counts fall temporally but quickly return to baseline levels. Burkitt's lymphoma and Pneumocystis jiroveci pneumonia are two of the opportunistic diseases that can occur is acquired immunodeficiency syndrome (AIDS). Persistent fevers and drenching night sweats occur in the symptomatic infection stage.
What finding supports the diagnosis of AIDS in an individual of HIV?
a. flu-like symptoms
b. oral hairy leukoplakia
c. CD4 T cells -200-500
d. cytomegalovirus retinitis
d. Cytomegalovirus retinitis could be an opportunistic infection that occurs when AIDS is diagnosed. Flu-like symptoms occur in the acute HIV infection stage. CD4+T cells drop to 200-500/ul and oral hairy leukoplakia are seen in the symptomatic infection stage of HIV.
Why do opprotunistic diseases develop in an individual with AIDS?
a. they are side effects of drugs of drug treatment of AIDS
b. they are sexually transmitted to individuals during exposure to HIV
c. they are characteristic in individuals with stimulated B and T lymphocytes
d. these infections/tumors occur in a person with an incompetent immune system
d. Organisms that are nonvirulent or that cause limited or localized diseases in an immunocompetent person can cause severe, debilitating, and life-threatening infections in persons with impaired immune function.
Which characteistic describes Pneumocystis jiroveci infection?
a. may cause fungal meningitis
b. diagnosed by lymph node biopsy
c. pneumonia with dry, unproductive cough
d. viral retinitis, stomatitis, esophagitis, gastritis, or colitis
c. Pneumocystis jiroveci infection is characterized by pneumonia with a dry, nonproductive cough. Cryptococcus infection may cause fungal meningitis. Non-Hodgkin's lymphoma is diagnosed by lymph node biopsy. Cytomegalovirus infection is characterized by viral retinitis, stomatitis, esophagitis, gastritis, or colitis.
Which opprotunistic disease associated with AIDS is characterized by hyperpigmented lesions of skin, lungs, and GI tract?
a. Kaposi sarcoma
c. herpes simplex type one infection
d. varicella-zoster virus infection
a. Hyperpigmented lesions of skin, lungs, and GI tract are seen in Kaposi sarcoma. Candida albicans is a common yeast infection of the mouth, esophagus, GI tract, or vagina. Herpes simplex type 1 infection has oral and mucocutaneous vesicular and ulcerative lesions. Varicella-zoster virus infection or shingles is a maculopapular, pruritic rash and is treated with acyclovir.
A patient comes to the clinic and requests testing for HIV. Before administering testing, what is most important for the nurse to do?
a. ask the patient to ID all sexual partners
b. determine when the patient thinks the exposure to HIV occurred
c. explain that all test results must be repeated twice to be valid
d. discuss prevention practices to prevent transmission to others
b. Because there is a median delay of several weeks after infection before antibodies can be detected, testing during this "window" may result in false-negative results. Risky behaviors that may expose a person to HIV should be discussed and possible scheduling for repeated testing done. Positive results on initial testing will be verified by additional testing. Identification of sexual partners and prevention practices are important but do not relate immediately to the testing situation
The "rapid" HIV antibody testing is performed on a patient at high risk for HIV. What should the nurse explain about this test?
a. the test measures the activity of HIV and reports viral loads as real numbers
b. test is highly reliable and in 5 minutes the patient will know if HIV is present
c. if results are positive another blood test and return appointment for the results will be necessary
d. test detects drug-resistant viral mutations that are present in vital genes to evaluate resistance to ARDs.
18. c. Although the "rapid" test is highly reliable and results are available in about 20 minutes, if results are positive from any testing, blood will be drawn for more specific enzyme immunosorbent assay (EIA) or Western blot testing and another visit will be necessary to obtain the results of the additional testing. CD4+T-cell counts are not used for screening but rather are used to monitor the progression of HIV infection and new assay tests measure resistance of the virus to antiviral drugs.
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