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UPH- DR JOSE G. TAMAYO MEDICAL UNIVERSITY Sto.

Nio Bian, Laguna


COLLEGE OF NURSING

In Partial Fulfillment of the Requirements in NCM 102 (Related Learning Experience)

Presented by Group 13

Marcellana, Patrisha Ann Matignas, Bernice Matubis, Kathleen Moreno, Renz Christian Mumpar, Tobeth Obal, Ma. Crisandra Omalin, MarJohn Pantig, Antonio Pascual, Mariel Pe Benito, Cherrilyn Pelayo, Ruscel Janna

Presented to Dra. Montales

What Is HIV?
To understand what HIV is, lets break it down: H Human This particular virus can only infect human beings. I Immunodeficiency HIV weakens your immune system by destroying important cells that fight disease and infection. A "deficient" immune system can't protect you. V Virus A virus can only reproduce itself by taking over a cell in the body of its host. Human Immunodeficiency Virus is a lot like other viruses, including those that cause the "flu" or the common cold. But there is an important difference over time, your immune system can clear most viruses out of your body. That isn't the case with HIV the human immune system can't seem to get rid of it. We know that HIV can hide for long periods of time in the cells of your body and that it attacks a key part of your immune system your T-cells or CD4 cells. Your body has to have these cells to fight infections and disease, but HIV invades them, uses them to make more copies of itself, and then destroys them. Over time, HIV can destroy so many of your CD4 cells that your body can't fight infections and diseases anymore. When that happens, HIV infection can lead to AIDS .

About the Infection


HIV attacks white blood cells of the human Immune system. The virus destroys the ability of the infected cells to function correctly in the immune system. The body loses the ability to fight many other viruses. The immune systems are weakened because of the virus, making it harder for people with HIV to fight off many infections.

The Life of HIV

What Is AIDS?
To understand what AIDS is, lets break it down: A Acquired AIDS is not something you inherit from your parents. You acquire AIDS after birth. I Immuno Your body's immune system includes all the organs and cells that work to fight off infection or disease. D Deficiency You get AIDS when your immune system is "deficient," or isn't working the way it should. S Syndrome A syndrome is a collection of symptoms and signs of disease. AIDS is a syndrome, rather than a single disease, because it is a complex illness with a wide range of complications and symptoms. Acquired Immunodeficiency Syndrome is the final stage of HIV infection. People at this stage of HIV disease have badly damaged immune systems, which put them at risk for opportunistic infections (0Is). You will be diagnosed with AIDS if you have one or more specific OIs, certain cancers, or a very low number of CD4 cells. If you have AIDS, you will need medical intervention and treatment to prevent death.

Where Did HIV Come From?


Scientists believe HIV came from a particular kind of chimpanzee in Western Africa. Humans probably came in contact with HIV when they hunted and ate infected animals. Recent studies indicate that HIV may have jumped from monkeys to humans as far back as the late 1800s.

How Do You Get HIV?


HIV is found in specific human body fluids. If any of those fluids enter your body, you can become infected with HIV.

Which Body Fluids Contain HIV?


HIV lives and reproduces in blood and other body fluids. We know that the following fluids can contain high levels of HIV: Blood Semen (cum) Pre-seminal fluid (pre-cum) Breast milk Vaginal fluids Rectal (anal) mucous

Other body fluids and waste products-like feces, nasal fluid, saliva, sweat, tears, urine, or vomit-dont contain enough HIV to infect you, unless they have blood mixed in them and you have significant and direct contact with them.

Healthcare workers may be exposed to some other body fluids with high concentrations of HIV, including: Amniotic fluid

Cerebrospinal fluid Synovial fluid

How Is HIV Transmitted Through Body Fluids?


HIV is transmitted through body fluids in very specific ways: During sexual contact: When you have anal, oral, or vaginal sex with a partner, you will usually have contact with your partners body fluids. If your partner has HIV, those body fluids can deliver the virus into your bloodstream through microscopic breaks or rips in the delicate linings of your vagina, vulva, penis, rectum, or mouth. Rips in these areas are very common and mostly unnoticeable. HIV can also enter through open sores, like those caused by herpes or syphilis, if infected body fluids get in them.

During pregnancy, childbirth, or breastfeeding: Babies have constant contact with their mothers body fluids-including amniotic fluid and blood-throughout pregnancy and childbirth. After birth, infants can get HIV from drinking infected breast milk.

As a result of injection drug use: Injecting drugs puts you in contact with blood-your own and others, if you share needles and works . Needles or drugs that are contaminated with HIV-infected blood can deliver the virus directly into your body.

As a result of occupational exposure : Healthcare workers have the greatest risk for this type of HIV transmission. If you work in a healthcare setting, you can come into contact with infected blood or other fluids through needle sticks or cuts. A few healthcare workers have been infected when body fluids splashed into their eyes, mouth, or into an open sore or cut.

As a result of a blood transfusion with infected blood or an organ transplant from an infected donor

How Do You Get AIDS?


You can develop AIDS when HIV damages your immune system so badly that it can no longer protect you from infections and disease.

The Natural Occurrence of HIV


HIV infection (3-8 weeks)

Acute illness (fever,rash,joint and muscle pain, sore throat)

(months to years) Chronic Illness

Opportunistic infections Weight loss, diarrhea Lympadenopathy, fatigue

AID

Kaposis sarcoma Pneumocystisis carinii pneumonia Cryptococcal meningitis

Modified Classification (Stages) of HIV Infection


CLINICAL STAGE 1: AYSMPTOMATIC Generalized lymphadenopathy

CLINICAL STAGE 2: EARLY (MILD) Weight loss greater than 10% of body weight. Minor mucotaneous manifestations, like:

Seborrrhic dermatitis

Fungal nail infection

Recurrent oral ulceration

Angular cheilitis

CLINICAL STAGE 3: INTERMEDIATE (M0DERATE) Weight loss greater than 10% Severe bacterial infection, like pneumonia

Oral hairy leukoplakia CLINICAL STAGE 4: LATE (SEVERE) AIDS Toxoplasmosis of the brain Disseminated endemic mycoses

oral candidiasis

HIV wasting syndrome

cryptosporidiosis with diarrhea for more one month

Herpes simplex virus infection

Progressive multifocal leukoencephalopathy

Pneumocystis carinii pneumonia

The Symptoms of HIV/AIDS

Minor Signs: 1. Persistent Cough for one month 2. Generalized pruritic dermatitis 3. Recurrent herpes zoster 4. Oropharyngeal candidiasis 5. Chronic disseminated herpes simplex 6. Generalized lymphadenopathy Major Signs: 1. Loss of weight 10 percent of body weight 2. Chronic diarrhea for more than one month 3. Prolonged fever for one month

Common Opportunistic Infections 1. Pneumocystis carinii pneumonia 2. Oral candidiasis 3. Toxoplasmosis of the CNS 4. Chronic diarrhea/wasting syndrome 5. Pulmonary/extra-pulmonary tuberculosis 6. Cancers a. Kaposis sarcoma affects small blood vessels and internal organs b. Cervical dysplasia and cancer. Researchers found out that women with HIV have higher rates of this type of cancer. Cervical carcinoma is associated with Human Papilloma Virus (HPV). c. Non-Hodgkins lymphoma cancerous tumor of the lymph nodes. This is usually a late manifestation of HIV infection.

Diagnostic Examination:
1. 2. 3. 4. 5. 6. 7. 8. ELA or ELISA Enzyme link immunosorbent assay Particle agglutination (PA) test Western blot analysis confirmatory diagnostic test Immunofluorescent test Radio immuno-precipitation assay (RIPA) Many people are unaware that they are infected with HIV. HIV tests are usually performed on venous blood. Many laboratories use fourth generation screening tests which detect anti-HIV antibody (IgG and IgM) and the HIV p24 antigen. 9. The detection of HIV antibody or antigen in a patient previously known to be negative is evidence of HIV infection. 10. Individuals whose first specimen indicates evidence of HIV infection will have a repeat test on a second blood sample to confirm the results.

Treatment Modalities:
1. AIDS Drugs are medicines used to treat but not to cure HIV infection. 2. These drugs are sometimes referred to as anteroviral drugs. 3. These work by inhibiting the reproduction of the virus. There are two groups of anteroviral drugs: 1. Reverse trancriptase inhibitors they inhibit the enzyme called reverse transcriptase which is needed to copy information for the virus to replicate. These drugs are: a. Zedovudine (ZDV) Retirvir b. Zalcitabine Havid c. Stavudine Zerit d. Lamivudine Epivir

e. Nevirapine Viramune f. Didanosine Videx g. 4. Protease inhibitors. They work by inhibiting the enzyme protease which are needed for the assembly of viral particles. These drugs are: a. Saquinavir Invarase b. Ritonavir Norvir c. Indinavir Crixivan

Nursing Management:
1. Health education The healthcare worker must: a. Know the patient b. Avoid fear tactics c. Avoid judgmental and moralistic messages d. Be consistent and concise e. Use positive statement f. Give practical advice 2. Practice universal/standard precaution a. There is a need for a thorough medical handwashing after every contact with patient and after removing the gown and gloves, and before leaving the room of an AIDS suspect or known AIDS patient. b. Use of universal barrier or Personal Protective Equipment (PPE) e.g., cap, mask, gloves, CD gown, face shield/goggles are very necessary. 3. Prevention a. Care should be taken to avoid accidental pricks from sharp instruments contaminated with potentially infectious materials form AIDS patient. b. Gloves should be worn when handling blood specimens and other body secretions as well as surfaces, materials and objects exposed to them. c. Blood and other specimens should be labeled with special warning AIDS Precaution. d. Blood spills should be cleaned immediately using common household disinfectants, like chlorox. e. Needles should not be bent after use, but should be disposed into a puncture-resistant container. f. Personal articles like razor or razor blades, toothbrush should not be shared with other members of the family. Razor blades may be disposed in the same manner as needles are disposed. g. Patients with active AIDS should be isolated.

The Four Cs in the Management of HIV/AIDS


1. Compliance giving of information and counseling the client which results to the clients successful treatment, prevention and recommendation. 2. Counseling/education a. Giving instruction about the treatment b. Disseminating information about the disease c. Providing guidance on how to avoid contracting STD again d. Sharing facts about HIV and AIDS 3. Contact tracing a. Tracing out and providing treatment or partners 4. Condoms a. Promoting the use of condom, giving instructions about its use, and giving away available condoms