HIV - AIDS
• Human Immunodeficiency Virus (HIV)
and Acquired ImmunoDeficiency
Syndrome (AIDS) is a chronic condition
that requires daily medication.
• HIV- 1 is a retrovirus isolated and
recognized as the etiologic agent of
AIDS.
• HIV-2 is a retrovirus identified in 1986
in AIDS patients in the West.
Causes
• Sharing infected drug use equipment
such as needles.
• Having sexual relations with infected
individuals (both male and
female).
• Blood transmission: Receiving
HIV-infected blood or blood products
especially before blood screening.
• Maternal HIV: Infants born to mothers
with HIV infection.
• The body fluids that contain enough
HIV to infect someone are:
❖semen
❖vaginal fluids, including menstrual
blood
❖breast milk
❖blood
❖lining inside the anus
Fast Facts
❖HIV is not Passed on Through:
❖spitting
❖kissing
❖being bitten
❖contact with unbroken, healthy skin
❖being sneezed on
❖sharing baths, towels or cutlery
❖using the same toilets or swimming
pools
❖mouth-to-mouth resuscitation
❖contact with animals or insects like
mosquitoes
Stages
1. Acute HIV Infection
2. Clinical Latency (Chronic
HIV Infection)
3. AIDS
Stages and Clinical
Manifestations
1. Acute HIV Infection:
❖This stage occurs within the first 2 to
4 weeks after exposure to the virus.
❖Many individuals experience flu-like
symptoms, such as fever, fatigue,
muscle
aches, and swollen lymph nodes.
❖The virus replicates rapidly, and the
immune system mounts an initial
response.
❖The amount of virus in the blood (viral
load) is usually very high.
2. Clinical Latency (Chronic HIV
Infection):
❖This stage is often asymptomatic, and
individuals may not be aware of their
HIV
status.
❖The virus continues to replicate at
lower levels, but the immune system
can control
to some extent.
❖Clinical latency can last for 10 years
but may vary from person to person.
During
This time, HIV may not cause significant
symptoms.
❖Regular testing is crucial during this
phase to monitor the progression of the
Infection.
3. AIDS:
❖AIDS is the final and most severe
stage of HIV infection.
❖The immune system is severely
damaged, and individuals become
highly
susceptible to opportunistic infections
and certain cancers.
❖AIDS is diagnosed when the CD4
T-cell count drops below 200 cells per
cubic millimeter of blood or if certain
opportunistic infections or cancers
develop.
❖Without treatment, individuals with
AIDS typically survive for only a few
years.
❖Symptoms may include weight loss,
chronic fever, diarrhea, and other
severe illnesses.
Assessment
• Medical History
• Physical Examination: skin lesions,
oral thrush, and lymphadenopathy.
• HIV Antibody Test: The most common
initial test is an enzyme immunoassay
(EIA) to
detect antibodies to HIV. A positive
result is usually confirmed by a more
specific test
like a Western blot or an HIV nucleic
acid test (NAT).
• Antigen/Antibody Test:
Fourth-generation tests detect both HIV
antibodies and p24
antigen. These tests can diagnose HIV
infection earlier than antibody-only tests.
• Viral Load Test: Measures the amount
of HIV genetic material (RNA) in the
blood. It
indicates the level of virus replication
and helps monitor the effectiveness of
antiretroviral therapy (ART).
• CD4 Cell Count: Measures the number
of CD4 T cells, which are a type of
immune
cell. A lower CD4 count indicates a
weakened immune system.
• Screening for Opportunistic Infections
• Chest X-ray
Prevention
•Safe sex: Other than abstinence,
consistent and correct use of
condoms is the only effective method to
decrease the risk of sexual
transmission of HIV infection.
•Male circumcision can reduce a man's
risk of acquiring HIV
infection by 50% to 60% during sex with
HIV-infected female
partners.
•Avoid sexual contact with multiple
partners or people who are
known to be HIV positive or IV/injection
drug users.
•People who are HIV positive or who
use injection drugs should be
instructed not to donate blood or
share drug equipment with
others. synthetic analog of somatostatin, has
been shown to be effective in managing
severe chronic diarrhea.
Complications
• Antidepressant therapy: Treatment for
• Opportunistic infections: Patients who
depression in patients with HIV
are immunosuppressed
infection involves psychotherapy
are at risk for opportunistic infections
integrated with imipramine, desipramine
such as pneumocystis
or
pneumonia which can affect 80% of all
fluoxetine.
people infected with HIV.
• Nutrition therapy: For all AIDS patients
• Respiratory failure: Impaired breathing
who experience unexplained weight
is a major complication that
loss, calorie counts should be obtained,
increases the patient’s discomfort and
and appetite stimulants and oral
anxiety and may lead to
supplements are also appropriate.
respiratory and cardiac failure.
• Nucleoside Reverse Transcriptase
• Cachexia and wasting: Wasting
Inhibitors (NRTIs)
syndrome occurs when there is
• Non-Nucleoside Reverse
profound involuntary weight loss
Transcriptase Inhibitors (NNRTIs)
exceeding 10% of the baseline
• Protease Inhibitors (PIs)
body weight and it is a common
• Integrase Strand Transfer Inhibitors
complication of HIV infection and
(INSTIs)
AIDS.
• Entry Inhibitors
❖Fusion Inhibitors
Medical Management ❖CCR5 Antagonists
• Treatment of opportunistic infections: • Pharmacokinetic Enhancers
For Pneumocystis pneumonia,
sulfamethoxazole and trimethoprim Nursing Management
(TMP-SMZ) is the treatment of choice; - Nursing Skin Integrity
for mycobacterium avium complex, - Promote usual bowel patterns
azithromycin or clarithromycin are - Prevent Infection
preferred prophylactic agents; for - Improve Activity Intolerance
cryptococcal meningitis, the current - Maintain Thought Process es
primary treatment is IV amphotericin B. - Improve Airway Clearance
• Prevention of opportunistic infections: - Relieve Pain And Discomfort
TMP-SMZ is an antibacterial agent - Improve Nutritional Status
used to treat various organisms causing
infection.
• Antidiarrheal therapy: Therapy with
octreotide acetate (Sandostatin), a

ADULT INFECTIONS
Pneumonia
• Pneumonia is an inflammatory
condition of the lung affecting the
alveoli, typically caused by infection.
• It can result from various pathogens,
including bacteria, viruses,
fungi, or parasites.
• Pneumonia can range from mild to
severe and can be a life-
threatening condition, especially in
vulnerable populations.
Pneumonia, Etiology
• Bacteria
• Virus
Sources
• Community-acquired pneumonia
(CAP)
• Hospital-acquired pneumonia (HAP)
• Health care-acquired pneumonia
• Aspiration
Bacterial Pneumonia,
Etiology:
• is caused by bacteria that
works its way into the lungs
and then multiplies.
• Streptococcus pneumonia
• Haemophilus influenzae
• Mycoplasma pneumoniae
• it can occur on its own or
develop after another illness,
like a cold or the flu.
Risk factors
• weakened immune systems
(due to age, diseases, or
malnutrition)
• respiratory diseases
• recovering from surgery
• smoking
• working in an environment
with a lot of pollution
• living or working in a hospital
setting or nursing facility
• People over the age of 65 and
children 2 and younger
Viral Pneumonia,
Etiology:
•Many cases of viral
pneumonia clear up on their
own within a few weeks.
However, severe cases can be
life-threatening.
• Adenoviruses
• Varicella zoster virus
• Influenza viruses
• Respiratory syncytial virus
Risk factors
• weakened immune systems
(due to age, diseases, or
malnutrition)
• respiratory diseases
• recovering from surgery
• smoking
• working in an environment
with a lot of pollution
• living or working in a hospital
setting or nursing facility
• People over the age of 65 and
children 2 and younger
Pneumonia,
Clinical Manifestation:
• Cough: Often producing phlegm or COVID-19
pus. • Coronavirus disease an infectious
• Purulent sputum disease caused by the SARS-CoV-2
• Tachypnea virus.
• Fever: May be high and • A series of acute atypical respiratory
accompanied by sweating and infections ravaged the Wuhan city
chills. of Hubei province of China in December
• Shortness of breath: Especiallywith 2019.
exertion. • Most people infected with the virus will
experience mild to moderate
• Pleuritic Chest pain exacerbated by respiratory illness and recover without
deep breaths or coughing. requiring special treatment.
• Rapid and bounding pulse However, some will become seriously ill
• Confusion: Particularly in older and require medical attention.
adults. • Older people and those with underlying
• Cyanosis medical conditions like
• Loss of appetite cardiovascular disease, diabetes,
• Nausea and vomiting chronic respiratory disease, or cancer
are more likely to develop serious
Pneumonia, illness. Anyone can get sick with
Medical Management: COVID-19 and become seriously ill or
• Antibiotic die at any age.
• Antiviral
• Symptomatic COVID-19, Etiology
• Chest Tube Thoracostomy • Virus
• Pneumococcal vaccine. This vaccine
can prevent pneumonia in • Sources
healthy patients with an efficiency of • Community-acquired
65% to 85%. • Hospital-acquired
• Health care-acquired
Pneumonia,
Nursing Management: COVID-19, Clinical Manifestation:
• Assessment and Monitoring • Fever
• Effective Airway Clearance • Cough
• Patient Education • Tiredness
• Fluid and Nutrition Management • Early symptoms of COVID-19
• Preventive Measures and Infection may include a loss of taste or
Control smell.
• Shortness of breath or difficulty • Keep hands off your face: Avoid
breathing touching the eyes, nose, and mouth with
• Muscle aches unwashed hands.
• Chills • Maintain social distancing: Avoid close
• Sore throat contact with people at least 3 feet (1
• Runny nose meter) who are sick, and stay at home
• Headache when you are sick.
• Chest pain • Proper cough and sneeze etiquette:
• Pink eye (conjunctivitis) Cover your cough or sneeze with a
• Nausea tissue,
• Vomiting then throw the tissue in the trash.
• Diarrhea • Supportive care: People infected with
• Rash COVID-19 should receive supportive
care to help relieve symptoms.
COVID-19, Diagnosis: • Severe cases: For severe cases,
• Nasopharyngeal swab .
• Throat swab COVID-19, Nursing Management:
• Saliva test • Assessment and Monitoring
• Effective Airway Management
• signs and symptoms of respiratory • Patient Education
tract infection • Fluid and Nutrition Management
• Psychosocial Support
COVID-19, Medical Management: • Infection Control Measures
• Vaccines
Tuberculosis
• Tuberculosis (TB) is a contagious
bacterial infection caused by
Mycobacterium tuberculosis.
• TB is caused by Mycobacterium
tuberculosis, a slow-growing
bacteria that can be transmitted through
the air when an infected
a person coughs or sneezes.
• It primarily affects the lungs
COVID-19, Prevention and Care: (Pulmonary TB) but can also target
• Hand hygiene: Wash hands often with other parts of the body, such as the
soap and water for at least 20 kidneys, spine, and brain
seconds; if water and soap are not (Extrapulmonary TB).
available, use an alcohol-based hand
sanitizer.
Tuberculosis, Clinical Manifestation:
• Persistent cough lasting more
than three weeks
• Chest pain
• Hemoptysis
• Fatigue and weakness
• Unintentional weight loss
• Night sweats
• Fever and chills
Tuberculosis, Complications:.
• Miliary TB: Dissemination of the
bacteria throughout the body.
• Pleural Effusion: Accumulation of
fluid in the pleural space.
• Cavitary TB: Formation of cavities
(holes) in the lungs.
Tuberculosis, Diagnosis:
• Tuberculin Skin Test (TST) (AKA?
Test),
Tuberculin Purified Protein Derivative
(PPD) is injected.
• Chest X-ray
• Sputum Culture
Tuberculosis, Medical Management:
• Antibiotic Therapy: A combination of
antibiotics is often used
for an extended period to eliminate the
bacteria.
➢Rifampin (RIF), Isoniazid
(INH),Pyrazinamide (PZA), Ethambutol
(EMB)
• Directly Observed Therapy (DOT):
Ensures patients take their
medication regularly, promoting
treatment adherence.
• Contact Investigation: Identifying and
testing individuals who
have been in close contact with a TB
patient to prevent
further transmission.
Tuberculosis, Nursing Management:
• Infection Control Measures
• Medication Management
• Patient Education
• Psychosocial Support
• Monitoring and Assessment
MERS COV
• Middle East Respiratory Syndrome
Coronavirus (MERS-CoV) is a viral
respiratory illness that emerged in 2012.
• It belongs to the coronavirus family, the
same family as the common cold and
Severe Acute Respiratory Syndrome
(SARS).
• MERS-CoV was first identified in the
Arabian Peninsula, and it primarily
affects the respiratory system.
MERS COV, Clinical Manifestation:
• Fever
• Cough
• Shortness of breath
• Chest pain
• Gastrointestinal symptoms
(nausea, vomiting, diarrhea)
• Pneumonia-like symptoms
\
 MERS COV, Complications:
• Acute Respiratory Distress Syndrome
(ARDS)
• Kidney failure
• Multi-organ failure
• Death (especially in individuals with
pre-existing health
conditions)
MERS COV, Diagnosis:
• Polymerase Chain Reaction (PCR)
test for MERS-CoV RNA
• Serologic testing to detect
antibodies against MERS-CoV
• Chest X-rays or CT scans to assess
respiratory involvement
MERS COV, Medical Management:
• Supportive care to alleviate symptoms
• Oxygen therapy to maintain adequate
blood oxygen levels
• Mechanical ventilation in severe cases
• Antiviral medications (no specific
antiviral treatment, but some may
be used experimentally)
• Isolation precautions
• Monitoring vital signs
• Symptom management
• Psychosocial Support
• Patient education
H1N1
• H1N1, also known as the swine flu, is
a subtype of the influenza A virus.
• It gained global attention during the
2009 pandemic.
• This virus is zoonotic, meaning it can
be transmitted from animals to humans
and vice versa.
• H1N1 is a respiratory illness with
symptoms ranging from mild to severe,
and it can lead to complications,
especially in vulnerable populations.
H1N1, Clinical Manifestation:
• Fever
• Cough
• Sore throat
• Fatigue
• Muscle aches
• Headache
• Shortness of breath
• Runny or stuffy nose
H1N1, Complications:
• Pneumonia
• Respiratory failure
• Secondary bacterial infections:
Opportunistic infections due to
weakened immune response.
• Worsening of chronic conditions: Such
as asthma or diabetes.
• Neurological complications: Rare but
can include seizures or encephalitis.
H1N1, Diagnosis: Causes
• Clinical evaluation: Based on ● Bacterial invasion
symptoms and physical ● Injury by physical or toxic
examination. chemical agents (e.g., drugs,
• Laboratory tests: Nasal or throat alcohol, industrial chemicals)
swabs to identify the ● Viral infections
influenza virus. ● Autoimmune response.
• Rapid influenza diagnostic tests
(RIDTs): Provide quick
results but may have limitations in
sensitivity.
• PCR tests

H1N1, Medical Management:

• Antiviral medications: Oseltamivir
(Tamiflu) and zanamivir (Relenza) SIGNS AND SYMPTOMS
can reduce the severity and duration of • Jaundice
symptoms. • Pale stools
• Supportive care: Adequate hydration, • Dark urine
rest, and over-the-counter pain • Malaise
relievers. • Anorexia
• Hospitalization • Nausea, vomiting
• Vaccination: Annual influenza • Abdominal pain
vaccination • Headache
• Myalgia
H1N1, Nursing Management: • Skin rash, pruritis
• Infection Control • Arthralgia, arthritis
• Patient Education • Fever
• Symptom Management
• Fluid and Nutrition Management Reducing the demands of the liver while
• Psychosocial Support promoting physical well-being

Preventing complications of hepatitis

HEPATITIS
Description
● Widespread inflammation of the
liver that results in degeneration
and necrosis of liver cells.
Enhance self-concept and acceptance
of the situation
Provide information about disease
process, prognosis, and treatment
needs
HEPATIC CIRRHOSIS GI system
Description • Anorexia
● End-stage of liver damage • Indigestion
● Chronic hepatic disease • Nausea
● Diffuse destruction of cells • Vomiting
● Fibrotic regeneration of hepatic • Constipation
cells • Diarrhea
Types and causes Respiratory system
● Laennec’s cirrhosis- The most • Pleural effusion
common type, this occurs in 30% • Limited thoracic
to 50% of cirrhotic patients, up to • Hypoxia.
90% of whom have a history of
alcoholism. Central nervous System
● Biliary cirrhosis- Biliary cirrhosis • Decreased levels of
results in injury or prolonged Consciousness
obstruction. • Slurred speech
● Postnecrotic cirrhosis- • Asterixis
Postnecrotic cirrhosis stems from • Peripheral neuritis
various types of hepatitis. • Paranoia
● Pigment cirrhosis- Pigment • Hallucinations
cirrhosis may result from Hematologic
disorders such as • Bleeding
hemochromatosis. • Anemia
● Cardiac cirrhosis- Cardiac Endocrine
cirrhosis refers to cirrhosis • Testicular Atrophies
caused by right-sided heart • Menstrual Irregularities
failure. • Gynecomastia
● Idiopathic cirrhosis- Idiopathic • Loss of chest and axillary hair
cirrhosis has no known cause. Skin
history. • Severe pruritus
• Extreme dryness
SIGNS AND SYMPTOMS* • Poor tissue turgor
• Hepatic • Abnormal Pigmentation
• Jaundice • Spider angiomas
• Ascites • Palmar erythema
• Hepatomegaly • Jaundice
• Bipedal edema
• Hepatic renal syndrome

COMPLICATIONS
Portal hypertension
● Elevation of pressure in
the portal vein that occurs
when blood flow meets
increased resistance.
Esophageal varices
● Dilated tortuous veins in
submucosa of the lower
esophagus.
Hepatic encephalopathy
● May manifest as
deteriorating mental status
and dementia or as
physical signs such as
abnormal involuntary and
voluntary movements.
Fluid volume excess
● Increased cardiac output
and decreased peripheral
vascular resistance.
INTERVENTIONS*
Diet
● high-calorie and a medium to
high protein diet, as
developing hepatic encephalopathy
mandates restricted
protein intake.
Sodium restriction.
● is usually restricted to 2g/day.
Fluid restriction.
● restricted to 1 to 1.5 liters/day.
Activity.
● Rest and moderate exercise is
essential.
Paracentesis.
● Paracentesis may help
alleviate ascites.
Sengstaken-Blakemore or Minnesota
tube.
● control hemorrhage by
applying pressure on the
bleeding site.
Pharmacological
• Octreotide
● Octapeptide mimics natural
somatostatin
● Prescribed for esophageal
varices
Diuretics
● Promotes diuresis
● For edema
Lactulose
● Non-absorbable, synthetic
disaccharide
● Used to treat Encephalopathy
Antibiotics
● Antibiotics are used to decrease
intestinal bacteria and reduce
ammonia production, one of the
causes of encephalopathy
NURSING MANAGEMENT
● Promoting rest
● Improving nutritional status
● Providing skin care
● Reducing risk of injury
● Monitoring and managing
complications
● Provide information about
disease process, prognosis, and
treatment needs.