Bài giảng Medical Assisting - Chapter 21: HIV, Hepatitis, and Other Blood-Borne Pathogens

Objectives: 21-1 Describe ways in which blood-borne pathogens can be transmitted. 21-2 Explain why strict adherence to Universal Precautions is essential in preventing the spread of infection. 21-3 Describe the symptoms of hepatitis and AIDS. 21-4 List and describe the blood tests used to diagnose HIV infections.

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ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical Assisting Chapter 211Objectives:21-1 Describe ways in which blood-borne pathogens can be transmitted.21-2 Explain why strict adherence to Universal Precautions is essential in preventing the spread of infection.21-3 Describe the symptoms of hepatitis and AIDS.21-4 List and describe the blood tests used to diagnose HIV infections.HIV, Hepatitis, and Other Blood-borne Pathogens 2Objectives (cont.)21-5 Identify chronic disorders often found in patients who have AIDS.21-6 Compare and contrast drugs used to treat AIDS/HIV infection.21-7 Describe the symptoms of infection by other common blood-borne pathogens.HIV, Hepatitis, and Other Blood-borne Pathogens3Objectives (cont.)21-8 Explain how to educate patients about minimizing the risks of transmitting blood-borne infections to others.21-9 Describe special issues you may encounter when dealing with patients who have terminal illnesses.HIV, Hepatitis, and Other Blood-borne Pathogens4Introduction What you will learn:HIV, hepatitis, and other blood-borne infections Expansion on OSHA blood-borne pathogen standards and how to reduce your risk of exposure to blood-borne pathogens.Issues associated with terminal illnesses such as AIDS5Transmission of Blood-borne Pathogens Blood-borne pathogens are disease-causing microorganisms carried in the host’s blood.Transmission from one host to another through contact with infected blood, tissue, body fluids, or mucous membranes.6Transmission AgentsBloodBlood productsHuman tissueSemenVaginal secretionsSaliva from dental procedures.Cerebrospinal fluidSynovial fluidPleural fluidPeritoneal fluidPericardial fluidAmniotic fluid The Centers for Disease Control and Preventions has identified specific substances that can serve as transmission agents for blood-borne diseases.7People at Increased RiskPeople who come in contact with substances that may harbor the pathogens.Health-care professionalsLaw enforcement officersMortuary or morgue attendantsFirefightersMedical equipment service techniciansBarbersCosmetologists8Universal PrecautionsThe most effective means of preventing the spread of HIV, hepatitis and other blood-borne pathogens is avoid contaminations.Universal Precautions is required by OSHA.9Disease ProfilesKeep up-to-date on developments to perform your job effectively.Knowledge needed:Of symptoms that may indicate the patient has the disease.To provide education to patients to limit risks of contracting disease.To identify habits of your patients that increase risk of spreading the disease.10HepatitisViral infection of the liver that can lead to cirrhosis and deathHepatitis A – spread by fecal-oral routeHepatitis B – blood borne that spreads with contact with contaminated blood or body fluids or sexual contact11Hepatitis (cont.)Hepatitis C (non A, non B)- spread through contact with contaminated blood or body fluids and sexual contact. No cure Many people are carriersCauses immediate symptoms like fluDamages liver, causing liver failure and death12Hepatitis cont.Hepatitis D (delta agent hepatitis) – occurs when people are infected with HBV.May make symptoms of hepatitis B but more severeAssociated with liver cancerHepatitis E – caused by hepatitis E virus (HEV)Transmitted by fecal – oral route13Risk FactorsRisk of contracting HIV from a single needle stick is approximately 0.5% Risk for contracting Hepatitis B from single needle stick is 6% to 33%. The primary risk factor for HBV and HCV infection is occupational exposure to the virus.14Infection ProgressionProdromal -general malaise, maybe nausea or vomiting, or no symptoms Icteric or jaundice – yellowing of the skin, eyes, mucous membranes –Appears 5-10 days after initial infectionConvalescent – can last 2 to 3 weeks15Preventive MeasuresAvoiding contact with contaminated substancesA vaccine is available to prevent HBV infectionsWill not protect you from other strains of hepatitisRecommended for high risk medical personnel, dialysis patients, homosexual men, and IV drug users.16Apply Your KnowledgeA patient is diagnosed with Hepatitis E. What caused it, and what was the most likely route of transmission? 17Apply Your Knowledge -AnswerHepatitis E is caused by hepatitis E virus (HEV) and is transmitted by fecal – oral route.A patient is diagnosed with Hepatitis E. What caused it, and what was the most likely route of transmission? 18AIDS/HIV InfectionVirus that infects and destroys components of the immune system.HIV infection develops into AIDS.Pathogen destroys helper T cells (white blood cells component of immune system).19Risk Factors for AIDS/HIVPeople who have unprotected sexual activityIV drug users who share needles Mother to fetus during pregnancyHealth care workers exposed to blood-borne pathogens because of a needle stick (percutaneous exposure)20Progress of the InfectionThree main stagesInitial infection –can occur years after exposureVirus enters cell and makes copies-helper T cells die.Body immune system responds, cleaning the blood supply of the virus, and the virus enters an inactive phase.21Progress of the Infection (cont.) Incubation periodVirus incorporates its genetic material into the genetic material of the helper T cellsIncubation period can be 8 to 15 yearsFull blown AIDSDuring the incubation period HIV becomes active again and continues to attack and kill helper T cells200 or fewer helper T cells/mL blood indicates full blown AIDS22Diagnosis of HIV/AIDSEnzyme-linked immunosorbent assay (ELISA)Confirms presence of antibodies in response to HIVWestern Blot Test or immunofluorescent antibody (IFA) 23Symptoms of HIV/AIDSSystemic Respiratory Oral Gastrointestinal Peripheral nervous systemSkin- relatedKaposi’s sarcoma 24Preventive MeasuresPrevention and sexual contractUse protection during sexual contractAvoid multiple sexual partnersAvoid concurrent sexual transmitted infections Prevention and IV drug usersAvoid sharing or reusing needlesPrevention and medical proceduresUniversal PrecautionsWash hands 25 AIDS PatientsNo one is immune to AIDSDecember 1966, 22.6 million men, women and children were HIV infected worldwide.In 2000 there were 200 millionHomosexual menIV drug usersWomen26Chronic Disorders of the AIDS PatientImpaired immune system permits opportunistic infectionsPneumocystis carinii pneumoniaKaposi’s SarcomaNon-Hodgkin’s lymphomaTuberculosisKaposi’s Sarcoma27Chronic Disorders of the AIDS Patient (cont.)Mycobacterium Avium Complex (MAC) infectionsMeningitisOral candidiasisVaginal candidiasisHerpes SimplexHerpes Zoster28Opportunistic Infections of AIDSHerpes simplexPneumocystis cariniiKaposi’s sarcomaTuberculosisMeningitisMycobacterium avium complex (MAC)Non-Hodgkin’s lymphomaOral candidiasisHerpes zosterTuberculosisIdentify where these opportunistic infections affect the body.29Opportunistic Infections of AIDS (cont.)Herpes simplex – mouth, lips, genitaliaPneumocystis carinii – lungsKaposi’s sarcoma – arms, legs, chest, neck, face, conjunctiva, palateTuberculosis – lungsMeningitis – brainMycobacterium avium complex (MAC) – systemicNon-Hodgkin’s lymphoma – neck, armpits, groinOral candidiasis – mouth, tongue, mucous membranesHerpes zoster – skin over ribs, neck, arms; nervesTuberculosis – lungs30Treating Opportunistic InfectionsDrug side effects pose major problems for the AIDS patient.Repeated episodes of infection can leave patient allergic to treatment or intolerance to medications.31Testing RegulationsCDC does not require mandatory HIV testing for health care workers.Health care workers chances of being infected by a patient are greater than a patient being infected by a health care worker.32Treatment for AIDSDrugsMore than 20 drugs available See table 21-2 in textTreatment GuidelinesDeveloped by Panel of Clinical Practices for Treatment of HIV InfectionsInitialing TherapyMust be made by patient and physicianDelayed TreatmentPostponement of drug related adverse affectsEarly TreatmentSuppresses viral replication Reduces risk of transmitting to others33Other Blood-Borne InfectionsCytomegalovirusExtremely common infectionPregnant women can pass to newborns.Erythema InfectiosumParvovirus B19Fifth diseaseHuman T-Cell Lymphotropic VirusHTLV-1Appears in IV drug usersListeriosisCaused by listeria monocytogenesFever, shock, rash, and aches34Other Blood-Borne Infections (cont.)MalariaEnters bloodstream through mosquito’s biteSyphilisCaused by treponema pallidumThree stages ToxoplasmosisCaused by toxoplasma gondii in cat feces35Reporting GuidelinesEach state formulates requirements for reporting HIV infections and AIDSVerify the specific guidelines in the state you are employed.36Patient EducationPatient education is one of the most effective means of preventing disease transmission.You can assess the patient’s understanding of their risk for infection and provide information about preventions and treatments.37Patients with Special ConcernsTeenagersEducate them about dangers of HIV and AIDSPatients about to be dischargedMake sure that the patient comes for follow-up, reports any adverse reactions, and knows signs and symptoms to watch for.38Apply Your KnowledgeWhat guidance could you give a patient with AIDS or Hepatitis that would like more information about the disease?39Apply Your Knowledge -AnswerWhat guidance could you give a patient with AIDS or Hepatitis that would like more information about the disease?Suggest the patient contact government agencies such as the CDC or the Consumer Information Center by mail or by the Internet. In addition local support groups and resource organizations may be available in your area.40Summary Medical Assistant Use Universal Precautions, watch for signs of infectious disease and education patient about risk factors associated with blood-borne diseases. You are to help prevent the spread of infectious diseases.41End of ChapterEnd of Chapter 42
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