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Hiv/ Human Immunodeficiency Virus/Aids-Acquired Immunodeficiency Syndrome

1) Around 1 in 4 people with HIV in the US are women, and HIV/AIDS is a leading cause of death for women ages 25-44. 2) Risk factors for HIV infection include having multiple sexual partners, bisexual partners, or intravenous drug use. 3) Early symptoms can include fatigue, anemia, diarrhea, and weight loss. 4) HIV progresses through initial infection, seroconversion, asymptomatic period, and symptomatic period marked by opportunistic infections as CD4 counts fall below 200. 5) Diagnostic tests include ELISA and Western blot analysis. Effects on pregnancy include low birth weight, preterm birth, and 20-50% of infants developing AIDS in the first year.

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Raquel Monsalve
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159 views2 pages

Hiv/ Human Immunodeficiency Virus/Aids-Acquired Immunodeficiency Syndrome

1) Around 1 in 4 people with HIV in the US are women, and HIV/AIDS is a leading cause of death for women ages 25-44. 2) Risk factors for HIV infection include having multiple sexual partners, bisexual partners, or intravenous drug use. 3) Early symptoms can include fatigue, anemia, diarrhea, and weight loss. 4) HIV progresses through initial infection, seroconversion, asymptomatic period, and symptomatic period marked by opportunistic infections as CD4 counts fall below 200. 5) Diagnostic tests include ELISA and Western blot analysis. Effects on pregnancy include low birth weight, preterm birth, and 20-50% of infants developing AIDS in the first year.

Uploaded by

Raquel Monsalve
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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HIV/ HUMAN IMMUNODEFICIENCY VIRUS/AIDS- ACQUIRED IMMUNODEFICIENCY SYNDROME

 US- ¼ of nearly one million people in the US are infected- female


 Leading cause of death in women 25-44 yrs of age
 1% -2% of every women giving birth

Risk factors
1. Multiple sexual partners of the individual or sexual partner
2. Bisexual partners
3. Intravenous drug used by the individuals or sexual partner

Assessment
EARLY
 Fatique
 Anemia
 Diarrhea
 Weight loss

Stages of HIV
1. Initial invasion of the virus with mild, flulike symptoms
2. Seroconversion- a woman converts from HIV serum negative to HIV serum positive
3. Asymptomatic period – disease-free except for symptoms-weight loss, fatique
◦ The virus is replicating
◦ 3-11 yrs
4. Symptomatic period
◦ Presence of opportunistic infection and malignancies
◦ CD4 count : below 200 cells/mm3
◦ Toxoplasmosis
◦ Oral and vaginal candidiasis
◦ GI illness
◦ Herpes simplex
◦ P carinii pneumonia
◦ Kaposi sarcoma
 Higher risk of developing toxoplasmosis and cytomegalovirus infections
 HIV positive woman may invade the cerebrospinal fluid and cause extreme neurologic
involvement.
 Tuberculosis

Diagnostic Test
1. ELISA
2. Western blot analysis

Effects of HIV to pregnancy


 Low birth weight
 Preterm birth
 20-50% of infants will develop AIDS in the first yr of life

Issues to be addressed when HIV+


 Safer sex practices
 testing of sexual contacts
 Continuations or termination of pregnancy

Therapeutic Management
 HIV positive women are advised to avoid pregnancy
 Monitoring of the CD4 cell counts and viral load level
 Goal of therapy
To maintain the CD4 cell count at greater than 500 cell/mm3 by administering
oral ZVD + one or more protease inhibitors: ritonavir (Norvir) or
indinavir(Crixivan) in conjunction with NRTI(nucleoside
reverse transcriptase inhibitor drug
 Zidovudine (ZVD) - administerd to the woman beginning with the 14 th week of pregnancy and
newborns receives antiviral therapy beginning with birth and a follow- up of 6 weeks
 Advised not to be pregnant
 Trimethoprin with sulfamethoxazole (bactrim)- with pneumonia
 Teratogenic in early pregnancy
 Sulfamethoxazole (Gantanol)- may lead to increase bilirubin levels in newborn if administered late
in pregnancy
 Chemotherapy for those with Kaposi’s sarcoma- contraindicated during early pregnancy because
of potential for fetal injury but can be used later in pregnancy to halt the malignant growth.
 CS delivery
 P carinii pneumonia – trimethoprim with sulfamethoxazole (Bactrim) or Pentamidine (Pentam)
 Kaposi’s sarcoma – skin cancer in AIDS; treated with chemotherapy late in pregnancy
 Thrombocytopenia – platelet transfusion close to birth to restore coagulation ability
 CS – to reduce the risk of mother-to-newborn transmission
 Follow-up testing of newborns being treated with zidovudine for the first 6 weeks
◦ 2 (-) HIV culture at 4 mos of age: HIV infection is excluded

Nursing Diagnoses
 Risk for infection related to dysfunction of the immune system secondary to invasion of HIV
o Administer acyclovir (Zovirax) for Herpes simplex, clotrimazole troches (Mycelex) for oral
thrush, pyrimethamine (Daraprim) and sulfadiazine for toxoplasmosis and trimethoprim w/
sulfamethoxazole (Bactrim) for PCP
o Immunization against pneumonia, influenza and hepatitis B
o During labor – internal fetal monitor, scalp blood sampling, forceps and vacuum extraction are
avoided to prevent bleeding
o At birth – episiotomy and breastfeeding are avoided
o Educate that patient about the mode of HIV transmission and safer sex practices
o Use standard infection precautions to protect against the spread of HIV

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