Foundations of Nursing Study Set 1

Nursing

Quiz 27 :

Hiv Infection, Hepatitis, Tuberculosis, and Sexually Transmitted Diseases

Quiz 27 :

Hiv Infection, Hepatitis, Tuberculosis, and Sexually Transmitted Diseases

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Describe the scope of the problem with HIV, STDs, hepatitis, and tuberculosis (TB) and identify groups that are at greatest risk.
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HIV or human immunodeficiency virus is a lentivirus. It causes the infection of HIV and after certain period of time, it turns to become AIDS (acquired immunodeficiency virus). It is found in the fluids of a person that has been infected with this virus. The fluids include vaginal fluids, breast milk, blood and semen.
The scope of the problem of HIV that has been observed by the CDC (centers for disease control and prevention) is that it had grown rapidly since years. It is the issue of mortality and morbidity. It is one of the greatest health challenges in the public of the US (United States). It had financial, social and political impacts on the people.
The infections related to the AIDS are opportunistic and are caused by the microorganisms that are present commonly in the individual's that are healthy. These microorganisms do possess threat and increases in number in the infected people. The infections could be caused by fungi, protozoan, virus or bacteria. Most common diseases are oral candidiasis, pneumonia, cervical cancer and TB (tuberculosis).
STDs or sexually transmitted diseases or VDs (venereal diseases) are transferred from one individual to another through the sexual contact or oral sex and so, causes infections. There are no, as such, symptoms that could be seen by these infections. The STDs that are caused by the viruses have no cure.
It is the major health problem in the US. The cases of the chlamydia and herpes simplex in the US are increasing. Chlamydia is the common infectious disease and so, is the gonorrhea in the second position. They could be either viral or bacterial.
Hepatitis virus refers to a group of infections, which affects the liver that is cirrhosis of the liver. These viruses have different characteristics and causes, but, possess similar presentations clinically. The common types of hepatitis are A, B, C, D and E. The autoimmune diseases, certain drugs and alcohol consumption could cause hepatitis.
The global epidemic, in case of hepatitis, occurs by the hepatitis C and B is a severe health problem globally. The WHO (World Health Organization) has estimated that the HCV (Hepatitis C virus) had prevailed from Italy, US, Japan and France. In US and Europe, Hepatitis C is common rather than B.
Tuberculosis (TB) is a disease that is caused by the Mycobacterium tuberculosis. The transmission occurs through the airborne droplets of tubercle bacilli from the people those who talk and have pulmonary tuberculosis. By the estimation of the WHO, it is analyzed that approximately 1/3 rd of the population of the world is affected with TB.
The Asia, worldwide accounts for about 60% of the TB cases and Africa accounts for about 31% cases. In the US, the rate of TB has declined over the years. The CDC had worked with the health agencies of the public for preventing the TB and improving the reporting and screening of the cases.

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Discuss the clinical signs of HIV, hepatitis, and sexually transmitted diseases (STDs).
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The HIV (human immunodeficiency virus) is a situation that affects human. It leads to progression of failure of the human immune system. Symptoms range from myalgia, sore throat, fever, rash, lethargy, and lymphadenopathy. Antibodies are detectable in the blood after 6 weeks to 3 months.
Hepatitis B is a viral blood borne disease. It is spread primarily by contact with blood and body fluids of an affected person. Hepatitis B virus is very resistant and is known to survive in dried blood and surfaces for over a week.
Symptoms for acute condition include flulike mild signs to more severe jaundice, lethargy, joint ache, fever, and nausea. In acute conditions the virus is successfully eliminated from the body, although in severe cases it may necessitate hospitalization.
Sexually transmitted diseases (STD) include gonorrhea, chlamydia, herpes simplex, and syphilis. Typical primary symptoms include dysuria, urethral/vaginal discharge, epididymitis, diffused abdominal pain, fever, chills, and lesions near vagina/anus/penis.

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On Friday afternoon, Jane Brown, the nurse epidemiologist at the Bertrand County Health Department had just finished her last influenza vaccine clinic for the season. She sat down at her desk to respond to telephone and email messages. She found a voicemail message that Dr. Smith, a local physician, left earlier in the day to report two cases of acute hepatitis B infection. Dr. Smith said both of these patients were elderly and live in an assisted living facility. He stated that he would fax a copy of the reportable disease form and the laboratory results to the health department that day. He said that he was calling not only to report the infections but to seek direction on what to advise the facility. Ms) Brown read the form Dr. Smith had faxed and confirmed that both patients are in their 80s, live at the same address, and have laboratory evidence of acute hepatitis B infection. She is puzzled by the report because she has never seen an acute case of hepatitis B in an elderly person in the past. In fact, she has only had three reported cases of acute hepatitis B infection in the 5 years she has been at the health department: one in an infant, another in a health care worker who had a needlestick injury, and the other in a 40-year-old man with a history of intravenous drug use. Ms) Brown called the physician to discuss the report and gather additional information about the cases. She learned that the physician had left for the day, but she spoke with his nurse, Sally Johnson. Ms. Johnson said that both patients were seen the prior week for complaints of nausea, lethargy, and weight loss, and one had yellowing of the skin. Based on their presenting symptoms Dr. Smith decided to perform a hepatitis B and C panel and draw blood to evaluate their liver enzymes. The hepatitis C antibody results were negative, but the liver enzymes were elevated and the hepatitis B surface antigen was positive, along with the hepatitis B core immunoglobulin M. The remaining markers were negative. The patients have no known history of exposure to hepatitis B, drug abuse, or multiple sex partners, and both have lived in the facility for over 5 years. Ms. Brown explains to the nurse that this is an unusual event and that she will launch an investigation to try to identify the source of transmission and help the assisted living facility to effectively manage their residents. She called the facility immediately to set up a meeting with the administrator that evening. In analyzing the data, Ms. Brown identifies commonalities among the two patients. She learns that both patients live in the same unit, eat in the same dining hall, are diabetic, and receive blood glucose monitoring. Ms. Brown knows that the hepatitis B virus can be transmitted by blood, so she decides to observe the nurse performing glucose monitoring. She sees that the nurse used a penlet device to secure the lancets that are used on the residents and that all residents have their own glucometer. The nurse uses a separate lancet for each patient, but the same penlet is used on each resident. Ms. Brown also observes dried blood on the lancet. Based on this observation, she decides to test all of the diabetic residents for hepatitis B infection. Ms) Brown reviews the hepatitis B testing results and learns that one patient has chronic hepatitis B infection and three other patients have had the infection in the past but are no longer infected. She recommends hepatitis B vaccine for all of the residents and staff who are susceptible to the infection. Immunizations represent what level of prevention
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Communicable diseases are those which can be transmitted from person to person or from animals via air, direct contact, exposure to body fluids etc. Such diseases may be controlled effectively at the personal or social level by various approaches typically requiring the interaction of multiple systems.
Prevention is done primarily at three levels - primary (preventing the disease from occurring), s econdary (preventing the disease from spreading) and tertiary (providing palliative care once the disease has surfaced) - control of communicable diseases require host of factors.
Secondary level aims at preventing the spread of disease once it has affected an individual. This includes identifying and isolating contacts exposed to the affected individuals. Such contacts may be treated as affected or as possibly exposed but yet not affected. Under such circumstances they are provided with proper prophylaxis.
Tertiary prevention care mainly aims for alleviating morbidity and pain and reduce disabilities. It includes helping the individual restore to original or altered health status. This also inculcates the essence of primary and secondary level and helps in arresting the spread of disease. The nurse was not sitting idle rather she was actively taking part in detecting the source and preventing further spread.
Hence, the options B, C and D are incorrect.
The nurse epidemiologist noticed the use of same penlet for glucose monitoring of all diabetic patients in the assisted living facility. The penlet had dried blood on it. Now, two of the inmates had already been confirmed to have an acute Hepatitis B infection which is a virus infection and spread by contact with blood and body fluids.
Moreover, this virus is known to survive for over a week in dried blood samples and environmental surfaces. With this in mind, the nurse suspected the disease being spread from the penlet and started surveillance with the goal of detecting and arresting further spread of the disease in the facility. For this she identified all those inmates with diabetes and ordered their screening for Hepatitis B infection
Hence, the correct answer is option
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Describe nursing actions to prevent these diseases and care for people who experience these diseases.
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On Friday afternoon, Jane Brown, the nurse epidemiologist at the Bertrand County Health Department had just finished her last influenza vaccine clinic for the season. She sat down at her desk to respond to telephone and email messages. She found a voicemail message that Dr. Smith, a local physician, left earlier in the day to report two cases of acute hepatitis B infection. Dr. Smith said both of these patients were elderly and live in an assisted living facility. He stated that he would fax a copy of the reportable disease form and the laboratory results to the health department that day. He said that he was calling not only to report the infections but to seek direction on what to advise the facility. Ms) Brown read the form Dr. Smith had faxed and confirmed that both patients are in their 80s, live at the same address, and have laboratory evidence of acute hepatitis B infection. She is puzzled by the report because she has never seen an acute case of hepatitis B in an elderly person in the past. In fact, she has only had three reported cases of acute hepatitis B infection in the 5 years she has been at the health department: one in an infant, another in a health care worker who had a needlestick injury, and the other in a 40-year-old man with a history of intravenous drug use. Ms) Brown called the physician to discuss the report and gather additional information about the cases. She learned that the physician had left for the day, but she spoke with his nurse, Sally Johnson. Ms. Johnson said that both patients were seen the prior week for complaints of nausea, lethargy, and weight loss, and one had yellowing of the skin. Based on their presenting symptoms Dr. Smith decided to perform a hepatitis B and C panel and draw blood to evaluate their liver enzymes. The hepatitis C antibody results were negative, but the liver enzymes were elevated and the hepatitis B surface antigen was positive, along with the hepatitis B core immunoglobulin M. The remaining markers were negative. The patients have no known history of exposure to hepatitis B, drug abuse, or multiple sex partners, and both have lived in the facility for over 5 years. Ms. Brown explains to the nurse that this is an unusual event and that she will launch an investigation to try to identify the source of transmission and help the assisted living facility to effectively manage their residents. She called the facility immediately to set up a meeting with the administrator that evening. What data source would not be useful to the nurse epidemiologist in this situation
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Analyze behaviors that place people at risk for contracting selected communicable diseases.
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Describe the natural history of human immunodeficiency virus (HIV) infection and plan appropriate client education at each stage.
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On Friday afternoon, Jane Brown, the nurse epidemiologist at the Bertrand County Health Department had just finished her last influenza vaccine clinic for the season. She sat down at her desk to respond to telephone and email messages. She found a voicemail message that Dr. Smith, a local physician, left earlier in the day to report two cases of acute hepatitis B infection. Dr. Smith said both of these patients were elderly and live in an assisted living facility. He stated that he would fax a copy of the reportable disease form and the laboratory results to the health department that day. He said that he was calling not only to report the infections but to seek direction on what to advise the facility. Ms) Brown read the form Dr. Smith had faxed and confirmed that both patients are in their 80s, live at the same address, and have laboratory evidence of acute hepatitis B infection. She is puzzled by the report because she has never seen an acute case of hepatitis B in an elderly person in the past. In fact, she has only had three reported cases of acute hepatitis B infection in the 5 years she has been at the health department: one in an infant, another in a health care worker who had a needlestick injury, and the other in a 40-year-old man with a history of intravenous drug use. Ms) Brown called the physician to discuss the report and gather additional information about the cases. She learned that the physician had left for the day, but she spoke with his nurse, Sally Johnson. Ms. Johnson said that both patients were seen the prior week for complaints of nausea, lethargy, and weight loss, and one had yellowing of the skin. Based on their presenting symptoms Dr. Smith decided to perform a hepatitis B and C panel and draw blood to evaluate their liver enzymes. The hepatitis C antibody results were negative, but the liver enzymes were elevated and the hepatitis B surface antigen was positive, along with the hepatitis B core immunoglobulin M. The remaining markers were negative. The patients have no known history of exposure to hepatitis B, drug abuse, or multiple sex partners, and both have lived in the facility for over 5 years. Ms. Brown explains to the nurse that this is an unusual event and that she will launch an investigation to try to identify the source of transmission and help the assisted living facility to effectively manage their residents. She called the facility immediately to set up a meeting with the administrator that evening. In analyzing the data, Ms. Brown identifies commonalities among the two patients. She learns that both patients live in the same unit, eat in the same dining hall, are diabetic, and receive blood glucose monitoring. Ms. Brown knows that the hepatitis B virus can be transmitted by blood, so she decides to observe the nurse performing glucose monitoring. She sees that the nurse used a penlet device to secure the lancets that are used on the residents and that all residents have their own glucometer. The nurse uses a separate lancet for each patient, but the same penlet is used on each resident. Ms. Brown also observes dried blood on the lancet. Based on this observation, she decides to test all of the diabetic residents for hepatitis B infection. What level of prevention is the nurse exercising in this situation
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On Friday afternoon, Jane Brown, the nurse epidemiologist at the Bertrand County Health Department had just finished her last influenza vaccine clinic for the season. She sat down at her desk to respond to telephone and email messages. She found a voicemail message that Dr. Smith, a local physician, left earlier in the day to report two cases of acute hepatitis B infection. Dr. Smith said both of these patients were elderly and live in an assisted living facility. He stated that he would fax a copy of the reportable disease form and the laboratory results to the health department that day. He said that he was calling not only to report the infections but to seek direction on what to advise the facility. Ms. Brown read the form Dr. Smith had faxed and confirmed that both patients are in their 80s, live at the same address, and have laboratory evidence of acute hepatitis B infection. She is puzzled by the report because she has never seen an acute case of hepatitis B in an elderly person in the past. In fact, she has only had three reported cases of acute hepatitis B infection in the 5 years she has been at the health department: one in an infant, another in a health care worker who had a needlestick injury, and the other in a 40-year-old man with a history of intravenous drug use. Ms. Brown called the physician to discuss the report and gather additional information about the cases. She learned that the physician had left for the day, but she spoke with his nurse, Sally Johnson. Ms. Johnson said that both patients were seen the prior week for complaints of nausea, lethargy, and weight loss, and one had yellowing of the skin. Based on their presenting symptoms Dr. Smith decided to perform a hepatitis B and C panel and draw blood to evaluate their liver enzymes. The hepatitis C antibody results were negative, but the liver enzymes were elevated and the hepatitis B surface antigen was positive, along with the hepatitis B core immunoglobulin M. The remaining markers were negative. The patients have no known history of exposure to hepatitis B, drug abuse, or multiple sex partners, and both have lived in the facility for over 5 years. Ms. Brown explains to the nurse that this is an unusual event and that she will launch an investigation to try to identify the source of transmission and help the assisted living facility to effectively manage their residents. She called the facility immediately to set up a meeting with the administrator that evening. Which term describes the system the physician used to collect, organize, and report disease information A. Screening B. Surveillance C. Distribution D. Rate adjustment
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