HIV Concept Map

1. HIV Concept Map Created by: Bethany Banakos Katherine Blackadar Crystal Guay Kevin Kenney

2. Nursing Interventions and treatment: • Patient teaching: • transmission, infection control measures, safe sex practices • maintenance of well-balanced diet • self administration of prescribed medication with potential side effects • signs and symptoms to be reported • need for frequent follow-up of CD4+ and viral load counts • Formula feeding (Avoid breastfeeding) • Identify factors that may interfere with nutrition (nausea, anorexia, mouth soreness) • Encourage activity with rest periods • Administer supplemental oxygen prn •  Provide analgesia prn •  Provide skin care prn •  Emphasize the importance of carefully complying with anti-retroviral dosing schedules (to mother and fetus) •  Encourage use of constructive coping mechanisms •  Assist patient with identifying primary support systems & refer patient to local AIDS support groups • Risk Factors/possible causes: • Transmission routes: • Unprotected vaginal, anal, or oral sex • Blood contact or blood transfusion • Mother to child in pregnancy (in utero, breast milk, delivery) • Increased risk with inflammation and breaks in the skin or mucosa • Exposure to HIV infected blood, vaginal fluid, semen, breast milk, amniotic fluid, perinatal exposure, shared needles of drug and steroid users. • Estrogen in oral contraceptives my increase women’s risk for infection and spread of infection if already HIV + • Occupational exposure: Health care providers • Patients with past Dx or Tx of: hepatitis, TB, or STD • Blood transfusion or clotting factor during 1978–1985 • Sex with multiple partners or a partner with any of the above RF • Risk to fetus: increased risk for preterm birth and low birth weight HIV HIV is a retrovirus that uses reverse-transcriptase to copy the viral RNA into cellular DNA with multiplies within the CD4 cell Signs & Symptoms: Fever Sore throat Head and muscle aches Rash Enlarged lymph nodes Malignant tumors Pneumonia Meningoencephalities Wasting syndrome Diarrhea. Nursing Diagnoses: Risk for infection Imbalanced nutrition: less than body requirements Fatigue Activity intolerance Fluid volume deficit Ineffective coping Ineffective therapeutic regimen management • Pathogenesis: • Three stage to HIV infection • Primary HIV infection: • rapid increase in HIV viral load, decrease in CD4, increase CD8 • flu-like symptoms w/in 2-4 weeks of infection • S/S decrease with a decrease in HIV transcription • Chronic Asymptomatic infection: • May remain in an asymptomatic state for 10 years or more • Meanwhile, body produces HIV antibodies indicative of + test results • Overtime, HIV positive patients have dramatic decrease in immunity • AIDS: • End stage of HIV with the onset of life threatening opportunistic infection Labs and Testing: EIA (Enzyme Immuno Assay) Western Blot Viral load CD4/CD8 ratio OraQuick OraSure CBC with differential Platelet counts are decreased Biochemical profile Abnormal lung or brain MRI or CT scan • Prevention: • No vaccine yet • Prevention is done by minimizing risky behaviors • Occupational: Post-exposure prophylaxis • Mother to fetus: • Newborn HIV testing: If antiretroviral are taken during pregnancy, labor and given to infant the transmission risk from mother to fetus can be reduced from 25% to less than 2%. • Scheduled C-section decreases risk of transmission from mother to infant • Early detection of HIV in mother

3. Works Cited (2007, October 10). Centers for Disease Control and Prevention. Retrieved March 30, 2008, from Pregnancy and Childbirth Division of HIV/AIDS Prevention Web site: http://www.cdc.gov/hiv/topics/perinatal/index.htm (2007, April 06). Centers for Disease Control and Prevention. Retrieved March 30, 2008, from Basic Information Web site: http://www.cdc.gov/hiv/topics/basic/index.htm

4. QUESTIONS