INCREASED LYMPHOCYTES AND MONOCYTES

DECREASED NEUTROPHILS (GRANULOCYTES)

NORMAL NEUTROPHIL RANGE

AN INCEASE IN NEUTROPHILS INDICATES

VIRAL INFECTION

DIET RECOMMENDATIONS FOR IMMUNOCOMPROMISED PATIENTS

INCREASED CALORIES - PROTIEN - IRON - FOLIC ACID - VIT B 12

SENSITIZING DOSE

BALLOONS - DISHWASHING GLOVES - CONDOMS/DIAPHRAGMS - TELEPHONE CORDS - BOTTLE NIPPLES - RUBBERBANDS

EPI 1:1000 (.3 - .5 SQ q 5-10MIN)

ANTIHISTAMINE IM OR IV(BENADRYL OR LIQUID ZANTAC (H2 ANTAGONIST)

STEROID IM OR IV

VASOPRESSOR (DOPAMINE) (Adrenergic - increases bp- bronchodilator)

AMINOPHYLLINE (bronchodilator)

TX FOR HYPERSENSITIVITY TYPE I REACTION

ANTIHISTAMINES - DECONGESTANTS - CORTICOSTEROIDS ADRENALINE (EPI) - AMINOPHYLINE

NURSING CONSIDERATIONS WITH DECONGESTANTS

2 PATIENT IDENTIFIERS

BLOOD SHOULD BE DEEP RED (NO BUBBLES - BACTERA) OR SERUM SEPARATION (GAS OR DARK PURPLE = CONTAMINATED)

PT CONSENT

5 RIGHTS

BASELINE VS

GIVE BLOOD THROUIGH MICRON MESH FILTER & 18 GAUGE

ASSESS SENSATIONS THROUGHOUT TRANSFUSION

ADMINISTER SLOWLY FIRST 15 MINTUES

STAY WITH PATIENT FIRST 15 MIN - SEVERE REACTION OCCUR IN 1ST 15 MIN OR 50 ML

INFUSE NO LONGER THAN 4 HRS

RETURN BLOOD BAG AND TUBING TO LAB IF REACTION OCCURS

CHANGE TUBING Q 1-2 UNITS

DISTINGUISHING S/S = BACKACHE AND HYPOTENSION

FEVER - CHILLS, FLUSHING

TACHYCARDIA, TACHYPNEA

VASCULAR COLLAPSE - LOSS OF BLOOD OR BLOOD IN URINE

ACUTE RENAL FAILURE - CARDIAC ARREST - SHOCK - DEATH

STOP INFUSION

KVO W. NS

CALL DR.

OBTAIN 2 BLOOD SMAPLES DISTAL TO INFUSION SITE

GET UA TO LAB TO TEST FOR HEMAGLOBINURIA

MANNITOL WITH SUSPECTED RENAL INVOLVEMENT (OSMOTIC DIURETIC - RENAL VASODILATOR)

MONITOR F/E BAL

EVALUATE SERUM CA+ LEVELS

STOP INFUSTION

CALL DR

BENADRYL OR TYLENOL FOR FEVER

RESTART TRANSFUSION

Risk factors for Lupus

WHAT ARE THE CARDIAC COMPLICATIONS FOR LUPUS

DECREASED WBC, RBC AND PLATELETS - THROMBOCYTOPENIA, NEUTROPENIA, ANEMIA

TREATMENT FOR LUPUS

ANTIMILARIALS

CORTICOSTEROIDS

IMMUNOSUPPRESSANTS (METHOTREXATE, CYTOXIN)

NSAIDS (HYDROCHLOROQUINE SULFATE

PLASMOPHORESIS

TYLENOL FOR FEVER

INCREASE MOVEMENT

INCREASED ESR

INCREASED ASA

INCREASED E LUPUS ANTIBODIES

PANCYTOPENIA - DECREASE IN WBC, RBC AND PLATELETS

COMPLETE ASSESSMENT

MUTUAL GOAL SETTING 

MINIMIZE STRESS AND FATIGUE

PREVENT INFECTION - UTI

ENCOURAGE ACTIVITY BUT ALLOW AMPLE REST PERIODS

AVOID PEOPLE THAT ARE ILL

DIET - DECREASE CHOLESTEROL - INCREASE CALORIES, AND PROTEIN IF NO RENAL PROBLEMS - INCREASE IRON, FOLIC ACID

ASSESS BUN/CREATININE

ASSESS URINE FOR PROTEINURIA

MAINTAIN F/E BALANCE

MANAGE PAIN

AVOID SUNLIGHT

ADEQUATE PERFUSION

RENAL FUNCTION

PSYCHOLOGICAL EQUILIBRIUM

WHAT ARE THE STAGES OF HIV

INITIAL EXPOSURE

PRIMARY HIV

ASYMPTOMATIC HIV INFECTION (SEROPOSITIVITY) - EARLY HIV DISEASE

ADVANCED HIV DISEASE (AIDS)

DESCRIBE PRIMARY HIV

OCCURS AFTER EXPOSURE TO THE HIVIRUS.

MAY BE ASYMPTOMATIC OR HAVE SYMPTOMS OF ACUTE INFECTION: FLUE LIKE SYMPTOMS THAT ARE EASILY TREATED

LYMPHADENOPATHY (ENLARGED LYMPHNODES) WILL PERSIST REGARDLESS OF TREATMENT

TIME DURING DEVELOPMENT OF HIV ANTIBODIES

4 - 12 WEEKS (1-6 MONTHS) TO DEVELOP ANTIBODIES

PT WILL HAVE POSITIVE HIV TEST DURING THIS PHASE

MAY BE COMPLETLEY ASYMPTOMATIC FOR SEVERAL MONTHS UP TO 10 YEARS

VIRAL LOAD INCREASES

PT IS SYMPTOMATIC: PERSISTANT FEVER, NIGHT SWEATS, WEIGHT LOSS, UNEXPLAINED DIARRHEA FOR A WEEK - FATIGUE, LYPHADENOPATHY

SYMPTOMS MAY NOT OCCUR FOR UP TO 10 YEARS AFTER EXPOSURE

VIRAL REPLICATION IS STEADY

CD4&T CELL COUNT IS GREATER THAN 500

DX TESTS FOR HIV

ELISA - DETERMINES CELLLULAR REACTION TO DEAD HIV VIRUS - + HIV TEST

WESTERN BLOT TEST - DETECTS HIV ANTIBODIES - CONFIRMS ELISA

VIRAL LOAD - DETERMINES PLASMA HIV RNA LEELS - REFLECT VIRAL REPLICATION

CD4 CELL COUNT - NORMAL 500 - 1400 (<200 = AIDS) BASELINE q 3-4 MONTHS

T CELL SIBSET - STAGES HIV INFECTION AND PROGNOSIS - CD4 DECREASES AND CD 8  INCREASES INITIALLY

HAART (HIGHLY ACTIVE ANTIRETROVIRAL THERAPY)

INCLUDES: 1 NNRTI AND 1 PI OR 2 NRTI

BRM'S (BIOLOGICAL RESPONSE MARKERS) INCREASE PRODUCTION OF RBC'S, MACROPHAGE OR NEUTROPHILS

PI'S

FUSION INHIBITORS

VIT C AND E

MISC RX FOR EACH POSSIBLE OPPORTUNISTIC INFECTION

PROTEASE INHIBITORS

USED FOR HIV

REDUCE VIRAL LOAD 

HALT REPLICATION OF HIV CELLS

"AVIR'

NURSING INTERVENTIONS PRIOR TO ADMINISTRATION OF HAART TX

WASTING SYNDROME S/S

WEIGHT LOSS

DIARRHEA (EXCESSIVE)

NIGHT SWEATS

FEVER

MARION OR MEGACE TO INCREASE APPETITE

DIET - LOW RESIDUE, NO FIBER, NO SEEDS, NO MILK PRODUCTS

PROTIEN 1 - 1.5GM/KG

HIGH CALORIE

MYCOBACTERIUM AVIUM COMPLEX (MAC)

MYCOBACTERIUM TUBERCULOSIS

CANDIDIASIS

CRYPTOCOCCSIS

HISTOPLASMOSIS

PNEYMOCTIS CARINII PNEUMONIA (PCP) 

CRYPTOSPORDIDIUM ORGANISMS

TOXOPLASMSA GONDII

AMPHOTERICIN B

FLUCONAZOLE

ITRACONAZOLE

KETOCONAZOLE

MEPRON

NEUTREXIN

PENTAM

AZITHOMYCIN

BACTRIM 

CLARITHOMYCIN

SEPTRA

ACYCLOVIR

GANCICLOVIR

FOSCAVIR

MARINOL

MEGASE

BIOLOGICAL RESPONSE MODIFIERS

PROMOTE PRODUCTION OF RED BLOOD CELLS MACROPHAGES OR NEUTROPHILS

MOST COMMON BACTERIAL OPPORTUNISTIC INFECTION

CAUSES ANEMIA

S/S RESEMBLE NORMAL HIV S/S

HEPATOSPLENOMEGALY - RISK FACTOR FOR WASTING SYNDROME

BACTERIAL OPPORTUNISTIC INFECTION

REPORT +5 RESULT ON TB TEST FOR HIV PTS

ACID FAST CULTURE IN SPUTUM OR TISSUE SAMPLE = DEFINITIVE DX

THRUSH

FUNGAL OPPORTUNISTIC INFECTION

WHITE CURD MOUTH, VAGINA

FUNGAL OPPORTUNISTIC INFECTION

S.S LIKE MENINGITIS - AFFECTS CNS AND LUNGS

SKIN LESIONS SIMILAR TO KAPOSIS SARCOMA

HISTOPLASMOSIS

FUNGAL OPPORTUNISTIC INFECTION

OCCURS MAINLY IN LUNGS

DX - BONE MARROW BIOPSY AND CULTURES

PROTOZOAL OPPORTUNISITIC INFECTIO

INFECTS SMALL INTESTINES

DEATH FROM ELEC IMBALANCE, MALABSORBTION

PNEUMOCYCTITI CARINII PNEYMONIA

PROTOZOAL OPPORTUNISTIC INFECTION

AVEOLAR INJURY

DX DYSPNEA ON EXERTION AND NONPRODUCTIVE COUGH

PROTOZOAL OPPORTUNISTIC INFECTION

HOST = CAT

INGESTION OF MEAT AND VEGGIES

MAJORE CAUSE OF ENCEPHALITIS W/AIDS

DX BRAIN LESIONS

KAPOSIS CARCOMA - MOST COMMON - LESIONS - DARK BLUE, PURPLE OR RED PAPULES