Human Immunodeficiency Virus

Human Immunodeficiency Virus

Infections with the human immunodeficiency virus (HIV) results in a chronic life-threatening disease and over time may cause acquired immunodeficiency syndrome (AIDS). HIV is believed to have originated in Central Africa transmitted from chimpanzees to humans (CDC, 2017). As it spread globally from Africa, it is believed to have made its way into the United States (U.S.) in the mid 1970’s and was first reported to the CDC in 1981 (CDC, 2017). This paper will discuss the communicable disease, describe the determinants, discuss the factors, and explain the role of a Family Nurse Practitioner.

Description

HIV is a virus that when contracted inserts itself into the hosts DNA and over time results in destruction of the body’s immune system. HIV is a bloodbourne pathogen spread from one person to another, by transfers of blood, semen, or vaginal fluid, most commonly but not exclusively limited to sexual intercourse. Other modes of transfer include IV drug use or work-related exposure. It can also be spread through childbirth and infected breast milk (Wade, 2015). According to Wade (2015), one in six persons do not know they are infected with the virus. “Transmission of HIV first results in an acute infection, followed by an asymptomatic period that averages ten years” (Wade, 2015). It remains dormant in the lymph nodes, liver and spleen. As patients become symptomatic, the immune system weakens and opportunistic infections can occur (Wade, 2015). Although there are 2 strains, HIV1 and HIV2, they are transmitted the same way and both can lead to AIDS. HIV targets CD4 T-cells, which are needed to fight infections.

Individuals diagnosed with HIV usually exhibit signs and symptoms of weight loss, fever, night sweats, and fatigue. Advanced signs of HIV are swollen lymph nodes and Kaposi’s sarcoma lesions, which are purplish blotches located on the skin or inside the mucous membranes of the mouth (Wade, 2015).

HIV complications vary from person to person. With the highly active antiretroviral therapy (HAART), there are fewer complications noted. Some complications that can occur are AIDS wasting syndrome, HIV-associated neurocognitive disorder, cancer, and opportunistic infections such as candida albicans, tuberculosis, and pneumocystis pneumonia (Wade, 2015).

Treatment for people infected with HIV is antiretroviral therapy (ART). It is necessary to find the right “cocktail” or mixture of ART’s, which is determined based on the individuals specific viral resistance profile. “Since its initial observation in 1981, acute HIV disease treatment has transformed from a single drug to the current 30 medications, allowing patients an improved life expectancy” (Orsega, 2015).

Great strides have been made with HIV, but statistically, it still is a major problem in the U.S. and globally. According to the CDC (2017), there were an estimated 37,600 new HIV infections in 2014. “There are an estimated 1.1 million people in the U.S. living with HIV at the end of 2015” (CDC, 2017). In 2016, 39,782 people received an HIV diagnosis. In 2014, 6,721 people have died from HIV and AIDS in the U.S. Although these numbers are high, there has been a decline in new diagnosis by 5% from 2011-2015 (CDC, 2017).

Determinants

Social determinants such as poverty, IV drug use, lack of education, and income play a role in HIV infection and the people who are infected. The highest groups at risk are gay and bisexual men, accounting for 70% of all new diagnosis. When divided amongst ethnicity, African-Americans account for 44% of new diagnoses, Whites account for 26% and Hispanics/Latinos account for 25% (CDC, 2017). The highest average rates of HIV diagnoses were among whose who lived below the federal poverty level, who had less than a high school education, and who had an income less than $36,000 a year (CDC, 2017).

Factors

Host factors, agent factors, and environmental factors interact in ways that result in various states of health in an individual or a community. The host is defined as the organism that carries the disease and is affected by the agent. The agent is the microorganism that causes the disease and the environment includes outside factors that affect the spread of the disease (Engard, 2017). For HIV, the host is the human who is infected, the agent is the transmittable viral infection that targets a person’s immune system, and the environmental factors would be social norms, an individual’s average rate of sex partners, poverty, and discrimination to name a few (Engard, 2017).

Role of the Community Health FNP

All aspects of the healthcare community play a collaborative and multidisciplinary role in caring for HIV patients. As a nurse practitioner, a comprehensive health assessment including a physical examination should be conducted initially to determine the proper screening and testing. Serology diagnostic screening includes HIV antibody testing. If positive, CD4-T cell count, and viral load by PCR are then collected (Orsega, 2015). Although there is no cure, HIV can be well controlled with ART and patients who receive early and consistent treatment are able to live full and productive lives. The role of a family nurse practitioner (FNP) is to provide educational support, management, and guidance for patients living with HIV as well as to provide preventative measures to those individuals at risk for the disease. According to the CDC, patients who receive treatment and achieve an undetectable viral load have little to no risk of spreading the infection to other individuals (CDC, 2017). As such, it is the role of a FNP to appropriately screen patients at risk for the disease, make early diagnoses, and connect patient to treatment early in the disease process to help curb the HIV public health crisis. Furthermore, it is the role of the FNP, as a primary care provider, to educate at-risk patients of prevention measures including but not limited to safe sex practices, drug rehabilitation, and options for pre-exposure prophylaxis (PreEP) (CDC, 2017).

Conclusion

HIV can affect any sex, ethnicity, and age group. With proper medical management and individualized care, HIV can be controlled. With appropriate patient education, patients can make healthy choices and prevent disease. Additionally, once disease is identified, appropriate treatment is essential for the prevention of spread throughout the population. People with HIV can live full and high quality lives, but it takes a collaborative team approach to provide compassionate and effective care.

Reference

Centers for Disease Control and Prevention. (2017). HIV basics. Retrieved  from https://www.cdc.gov/hiv/basics/

Engard, B. (2017). What is the epidemiologic triangle?. Retrieved from  http://online.river.edu/epidemiologic-triangle/

Orsega, S. (2015). Adult HIV infection treatment update 2014: An approach to HIV infection  management and antiretroviral treatment. Journal For Nurse Practitioners11(1), 95.  doi:10.1016/j.nurpra.2014.10.034

Wade, P. (2015). Chapter 20: Nursing care of patients with HIV disease and AIDS.  Understanding Medical Surgical Nursing, 5th ed (pp. 362-385). Philadelphia,  Pennsylvania: F.A. Davis Company.

Week 5: Infectious Disease Short Paper

Assignment Rubric

 

Purpose

Infectious disease occurs worldwide and must be addressed just as chronic disease is approached. This assignment will offer the opportunity to explore the various communicable diseases, the epidemiological background data as well as the implications of these infections.

Course Outcomes

Through this assessment, the student will meet the following Course Outcomes.

CO 3: Identify appropriate outcome measures and study designs applicable to epidemiological subfields such as infectious disease, chronic disease, environmental exposures, reproductive health, and genetics.

CO 6: Identify important sources of epidemiological data.

Total Points Possible

This assessments is worth 100 points.

Due Date

Submit your file(s) by Sunday, 11:59 p.m. MT of Week 5.

Requirements

Criteria for Content

Apply the concepts of epidemiology to a communicable disease.

Choose one communicable disease from the following list:

· Zeka

· Salmonella

· MRSA

· Clostridioides difficile infection

· Meningitis

· Lyme Disease

· Borellia Burgdorferi

· Rocky Mountain Spotted Fever

· Hantavirus

· Giardia

· Chickenpox

· Tuberculosis

· Influenza

· Mononucleosis

· Hepatitis B

· HIV

· Chlamydia

· Gonorrhea

· Syphillis

· Measles

· Pertussis

Include the following in your assignment:

· Description of the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence).

· Synthesize the determinants of health as related to the development of this disease.

· Identify and describe the host factors, agent factors (presence or absence), and environmental factors.

· Synthesize the role of the primary care FNP to the management of infectious diseases (case finding, reporting, data collecting, data analysis, and follow-up).

· A minimum of three scholarly references, research articles, is required. Web sites may be utilized but do not count towards the three scholarly references. Your course text may be utilized but does not count towards the three scholarly references.

Preparing the paper

Submission Requirements

1. Application: Use Microsoft Word 2013™ to create the written assessment.

2. Length: The paper (excluding the title page and reference page) is a maximum three (3) pages.

3. A minimum of three (3) scholarly research/literature references must be used. CDC or other web sources may be utilized but are not counted towards the three minimum references required. Your course text may be used as an additional resource but is not included in the three minimum scholarly references.

4. APA format 6th edition.

5. Include scholarly in-text references and a reference list.

6. Papers not adhering to the page length may be subject to the either (but not both) of the following at the discretion of the course faculty; 1. Your paper may be returned to you for editing to meet the length guidelines, or, 2. Your faculty may deduct up to five (5) points from the final grade.

7. Adhere to the Chamberlain College of Nursing academic policy on integrity as it pertains to the submission of original work for assignments.

8. Avoid writing in the first person (such as “me” “I”).

Best Practices in Preparing the Project

The following are best practices in preparing this project.

1. Review directions thoroughly.

2. Follow submission requirements.

3. Make sure all elements on the grading rubric are included.

4. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.

5. Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.

6. Ideas and information that come from scholarly literature must be cited and referenced correctly.

7. A minimum of three (3) scholarly literature references must be used. **See above section on “Preparing the Paper”.

8. Abide by CCN academic integrity policy.

Grading Criteria

CategoryPointsDescription
Introduction of Communicable Disease20Description of the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence).
Determinants of Health20Synthesize the determinants of health as related to the development of this disease.
Host Factors20Define and discuss the host factors, agent factors (presence or absence), and environmental factors.
Role of FNP20Synthesize the role of the primary care FNP to the management of infectious diseases (case finding, reporting, data collecting, data analysis, and follow-up).
APA Format / Writing Mechanics20Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section or topic of the paper (one deduction for each type of APA style error). Ideas and information that come from scholarly sources must be cited and referenced correctly. A minimum of three (3) scholarly references are used.**Refer to “Preparing the Paper” section. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal written work as found in the 6th edition of the APA manual. Avoid use of first person when writing this scholarly paper. The paper (excluding the title page and reference page) is a maximum three (3) pages.
Total100A quality assessment will meet or exceed all the above requirements.

NR503

NR503 11/182

Grading Rubric

Assignment CriteriaExceptionalOutstanding or highest level of performanceExceedsVery good or high level of performanceMeetsCompetent or satisfactory level of performanceNeeds ImprovementPoor or failing level of performanceDevelopingUnsatisfactory level of performance
Introduction of Communicable Disease20 Points18 Points16 Points8 Points0 Points
 Comprehensively describes the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence).Adequately identifies the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence).Limited description of the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence).Unclear description of the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence).Description of the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence) is absent
Determinants of Health20 Points18 Points16 Points8 Points0 Points
 Describe the determinants of health and explain how those factors contribute to the development of this disease. Evidence supports background.Determinants is complete, presents risk factors, disease impact and at least one set of incidence and prevalence statistics are presented and supported by evidence.Description of determinants is missing one or more key points. Limited presentation of the contributing factors. Lack of evidence to support.Determinants missing more than one key point and lack of contributing factors. There is no supported evidence.Determinants and contributing factors of the disease is not provided.
Host Factors20 Points18 Points16 Points8 Points0 Points
 Comprehensive review of the host factors, agent factors (presence or absence), and environmental factors.Adequate review of the host factors, agent factors (presence or absence), and environmental factors.Limited review of the host factors, agent factors (presence or absence), and environmental factors.Minimal or unclear review of the host factors, agent factors (presence or absence), and environmental factors.Review of the host factors, agent factors (presence or absence), and environmental factors not provided.
Role of FNP20 Points18 Points16 Points8 Points0 Points
 A comprehensive review of the role of the primary care FNP (case finding, reporting, data collecting, data analysis, and follow-up).An adequate, but not fully comprehensive, review of the role of the community health FNP (case finding, reporting, data collecting, data analysis, and follow-up).A limited review of the role of the community health FNP (case finding, reporting, data collecting, data analysis, and follow-up). The role is presented with limited or little evidence.The FNP role (case finding, reporting, data collecting, data analysis, and follow-up) is minimal or unclear and is not supported directly by evidence.FNP role (case finding, reporting, data collecting, data analysis, and follow-up) not provided.
APA Format / Writing Mechanics20 Points18 Points16 Points8 Points0 Points
 APA format, grammar, spelling, and/or punctuation are accurate, or with zero to one errors.Two to four errors in APA format, grammar, spelling, and syntax noted.Five to seven errors in APA format, grammar, spelling, and syntax noted.Eight to nine errors in APA format, grammar, spelling, and syntax noted or the paper exceeds maximum of two (2) pages.Post contains greater than ten errors in APA format, grammar, spelling, and/or punctuation or repeatedly makes the same errors after faculty feedback.
  Total Points Possible = 100 points

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