Infectious Fun
What 2 labs will be monitored when diagnosed with HIV to watch the progression of the disease and/or the success of treatment? What are the goals for each?
CD4+ T cell count above 500 and Viral load undetectable
List 4 nursing interventions for preventing pressure ulcers
1. turn/change position at least every 2 hours
2. Protect bony joints/prominences (foam dressing works well) over bony joints
3. Keep skin from moist surfaces or clothing, including incontinence
4. Moisturize dry intact skin
What is the test used to diagnose allergic reactions on the skin?
Patch test;
Bonus: if a patient suspects allergic dermatitis, what should they try eliminating to see if it improves?
fabric softeners, trialing different laundry detergent and skin products, look at diet (elimination diet?)
Nursing interventions when you assess a wound is red, warm, swollen, and painful to touch
document findings and notify provider, RICE if possible
Bonus: is this wound inflammed or infected?
priority when treating infections or unknown skin conditions
work with interdisciplinary team to determine underlying cause (ie. viral, bacterial, fungal infections, etc)
A mom, who has HIV, is pregnant and asking about whether she will give it to her baby. What should the nurse say?
If viral load is DETECTABLE, there is a possibility of passing it to the baby
If viral load is UNDETECTABLE, there is no chance of passing it to the baby
ART therapy is not teratogenic
*Undetectable=untransmissionable
What are the nursing interventions for a twisted ankle that is swollen and sore?
RICE!!
Rest
Ice
Compression
Elevate
Nursing interventions/pt edu for decreasing itchiness of skin?
1. Treat the underlying cause
2. Promote comfort by: NOT SCRATCHING; apply cold wet compresses or take a cold/tepid bath or shower, take antihistamines over the counter or as prescribed
3. Prevent tissue injury and infection
symptoms of a systemic infection
chills, shaking, elevated body temperature, malaise, muscle weakness
types of infections elderly patients are at increased risk for
UTI, pneumonia, skin
What is a priority teaching that the nurse must discuss with a client prior to starting ART therapy?
The nurse should explain and discuss barriers to complying with the ART therapy regimen (they can NOT skip doses and MUST take it as prescribed for treatment to be successful)
Best ways to prevent antibiotic-resistant infections.
1. finish antibiotics
2. throw away unused antibiotics
3. LIMIT use of antibiotics - avoid prophylactic antibiotics as much as possible.
4. Frequent hand washing with soap and water.
5. Use PPE when in contact with potentially infectious materials
If a patient has allergic dermatitis, what should they try eliminating to see if it improves?
fabric softeners, trialing different laundry detergent and skin products, look at diet trialing an elimination diet
What does “the WBCs are high with a shift to the left" mean?
There are more immature white blood cells (especially bands, a type of young neutrophil) in your blood.
This happens when: Your bone marrow is releasing WBCs early & Because your body needs them quickl
What to do when changing a dressing of a deep wound?
Give pain meds 30-60 minutes before starting, use a wet to dry dressing, saturate old dressing in sterile saline 10-15 minutes prior to removing (so it removes easily and doesn't pull up healing tissue
List 4 conditions that suggest HIV has advanced to AIDS
Kaposi Sarcoma
Wasting syndrome
Candida (Thrush)
Oral hairy leukoplakia
What are 2 expected signs of normal inflammation in a surgical wound on the first postop day?
Redness & warmth
What should you do with this finding?
sun protection instruction
wear light protective clothing (long sleeves, hat, etc), apply sunscreen regularly and after swimming, avoid direct sun between high UV hours (10am-2pm)*
Patient eduction for antibiotic therapy
take antibiotics recommended length of time- do not stop taking doses prematurely if pain resolves. do not double up missed doses, do not take antibiotics that are expired, intended for another patient, and are not prescribed for you.
nursing interventions/pt edu for covid 19 vaccine
cold compresses to the site to promote comfort, rest, light activity and mobility, pain should relieve in a few days (notify provider if it still hurts after a few days).
Barriers for compliance with ART for HIV
SE (fatigue, nausea, etc), complying with regiment and not skipping doses, expense
What is dehiscence?
when the patient's wound opens back up (stitches/sutures come undone). Common with hip and midline abdominal surgeries.
Bonus: what is evisceration? What should the nurse do and not do while waiting for the patient to go down to surgery?
What is the best way to prevent itching when exposed to skin poisons?
Wash all exposed areas well several times to remove the poison.
The patient's wound is red, warm to touch, edematous, and painful, with copious amounts of purulent exudate. What nursing interventions should be done for this patient?
document assessment findings and report to provider. we suspect this wound is infected. Other orders we will want to make sure we do include obtaining a wound culture prior to starting antibiotic therapy and monitoring the wound for infection (improvement, or getting worse)
What lab is almost always drawn if an infection is suspected? What is the normal range?
WBC >10,000 indicated infection
(normal range 5,000-10,000/mm3)
Bonus: What does it indicate if WBC is <5,000