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Week 8: Infections

Prior to the H1N1 influenza pandemic in 2009, it had been more than 40 years since an infectious virus had resulted in such substantial illness, hospitalizations, and deaths on a global scale (CDC, 2010). This can be attributed to improved prevention such as proper hygiene, as well as vaccinations and other drug therapies. However, as the H1N1 pandemic illustrates, infections are sometimes unavoidable even when appropriate prevention methods are implemented. In clinical settings, patients present with various infections including common disorders such as flus and colds, as well as disorders that require more extensive treatment and care such as the human immunodeficiency virus (HIV) or tuberculosis (TB). As an advanced practice nurse, you must evaluate patients presenting with symptoms of infections and recommend appropriate drug treatments.
This week you begin to explore infections by considering issues surrounding the prevalence, management, and education about HIV/AIDS. You also examine viral and bacterial infections, as well as the appropriate use of antimicrobial agents.
Learning Objectives
By the end of this week, students will:
Analyze reasons for the prevalence of HIV/AIDS
Analyze ways health care professionals can change society?s perceptions of HIV/AIDS
Analyze strategies to educate HIV positive patients on treatment and management
Analyze categories of antimicrobial agents
Differentiate between viral and bacterial infections
Analyze the relationship between infections and antimicrobial agents
Understand and apply key terms, concepts, and principles related to prescribing drugs to treat infections and infestations
Photo Credit: E.M. Pasieka/ Science Photo Library/Getty Images

Learning Resources
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media player below.
Required Readings
Note:?To access this week’s required library resources, please click on the link to the Course Readings List, found in the?Course Materials?section of your Syllabus.
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 8, ?Principles of Antimicrobial Therapy? (pp. 96?117)?
This chapter covers factors that impact the selection of an antimicrobial treatment regimen. It also examines the clinical uses, adverse events, and drug interactions of various antimicrobial agents such as penicillin.
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Chapter 12, ?Fungal Infections of the Skin? (pp. 141?149)?
This chapter explores the pathophysiology of several fungal infections of the skin as well as related drug treatments and examines the importance of patient education when managing these infections.
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Chapter 14, ?Bacterial Infections of the Skin? (pp. 158?172)?
This chapter begins by examining causes of bacterial infections. It then explores the importance of selecting an appropriate agent for treating bacterial infections.
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Chapter 32, ?Urinary Tract Infection? (pp. 474?480)?
This chapter covers drugs used to treat urinary tract infections and identifies special considerations when treating geriatric patients, pediatric patients, and women.
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Chapter 35, ?Sexually Transmitted Infections? (pp. 512?535)?
This chapter outlines the causes, pathophysiology, and drug treatment of six sexually transmitted infections, including gonorrhea, syphilis, and human papilloma virus infection (HPV). It also examines the importance of selecting the proper agent and monitoring patient response to treatment.
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Chapter 48, ?Human Immunodeficiency Virus? (pp. 748?762)?
This chapter presents the causes, pathophysiology, diagnostic criteria, and prevention methods for HIV. It also covers various methods of drug treatment and patient factors to consider when selecting, administering, and managing drug treatments.
Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. AIDS Care, 23(5), 550?561.
Note: Retrieved from the Walden Library databases.
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This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.

Drugs.com. (2012). Retrieved from http://www.drugs.com/
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This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001?1011.
Note: Retrieved from the Walden Library databases.
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This article examines current therapies and strategies for treating HIV patients. It also examines factors that impact selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.
Required Media

Laureate Education, Inc. (Executive Producer). (2012). Antimicrobials. Baltimore, MD: Author.
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This media presentation outlines principles of antimicrobial therapy
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Note: The approximate length of this media piece is 7 minutes.

Optional Resources
Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine, 156(4), 312?314.
Note: Retrieved from the Walden Library databases.
In addition, refer to the Optional Resources listed in Week 1.

Discussion: Drug Treatments for HIV/AIDS
While HIV/AIDS is still currently incurable, the prognosis for patients with this infectious disease has improved due to advancements in drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in 1992 and was told she would survive, at most, 10 more years. Despite unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis, she has witnessed tremendous improvements in HIV/AIDS treatments which have helped patients live longer with fewer side effects. While she acknowledges that these drug treatments have kept her alive, she fears that improvements in drug therapy have led to more people becoming complacent about the disease (Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in the United States is higher than it has ever been (CDC, 2012). This poses the question: Is there a relationship between drug advancements, societal complacency, and infection?
To prepare:
Review Chapter 48 of the Arcangelo and Peterson text, as well as the Krummenacher et al. and Scourfield articles in the Learning Resources.
Reflect on whether or not the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options for HIV/AIDS.
Consider how health care professionals can help to change perceptions and make people more aware of the realities of the disease.
Think about strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.
With these thoughts in mind:
By Day 3
Post?an explanation of whether or not you think the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options.Then, explain how health care professionals can help to change perceptions and increase awareness of the realities of the disease. Finally, describe strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.