Chapter 35: Caring for Clients with HIV/AIDS

A client with AIDS has become forgetful with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? -candidiasis -AIDS dementia complex (ADC) -distal sensory polyneuropathy (DSP) -cytomegalovirus (CMV)

AIDS dementia complex (ADC) Explanation: ADC, a neurologic condition, causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking. DSP is characterized by abnormal sensations, such as burning and numbness in the feet and later in the hands. Candidiasis is a yeast infection that may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in the folds of the skin. CMV infects the choroid and retinal layers of the eye, leading to blindness, and can also cause ulcers in the esophagus, colitis, diarrhea, pneumonia, and encephalitis.

A home care nurse is visiting a client with acquired immune deficiency syndrome (AIDS) at home. During the visit, the nurse observes the caregiver providing care. What action by the caregiver would alert the nurse to the need for additional teaching? Caregiver uses a dilute bleach solution to clean up a urine spill. Caregiver cleans the client's anal area without wearing gloves Caregiver washes hands before and after providing care to the client. Caregiver disposes of syringe and needle in a metal coffee can with lid.

Caregiver cleans the client's anal area without wearing gloves Explanation: To prevent the risk of HIV transmission, standard precautions should be used. Cleaning the client's anal area without wearing gloves indicates that the nurse needs to reinstruct the caregiver in measures related to standard precautions. Handwashing before and after client care, disposing of sharps in a puncture-resistant container, and cleaning up spills with a dilute bleach solution are appropriate measures.

A client has a diagnosis of AIDS complicated by chronic diarrhea. What nursing intervention would be appropriate? -Obtain a stool culture to identify possible pathogens. -Temporarily eliminate animal protein from the client's diet. -Position the client in the high Fowler position whenever possible. -Make sure the client eats at least two servings of raw fruit each day.

Obtain a stool culture to identify possible pathogens. Explanation: A stool culture should be obtained to determine the possible presence of microorganisms that cause diarrhea. Clients should generally avoid raw fruit when having diarrhea. There is no need to avoid animal protein or increase the height of the bed.

A nurse is assessing the skin integrity of a client who has AIDS. When performing this inspection, the nurse should prioritize assessment of what skin surfaces? -Sacral region and lower abdomen -Axillae and upper thorax -Scalp and skin over the scapulae -Perianal region and oral mucosa

Perianal region and oral mucosa Explanation: The nurse should inspect all the client's skin surfaces and mucous membranes, but the oral mucosa and perianal region are particularly vulnerable to skin breakdown and fungal infection and thus should be prioritized.

A hospital educator is reiterating the importance of Standard Precautions to a group of nursing students who will soon begin a clinical rotation on the unit. Which of the following statements best describes the application of Standard Precautions? Standard Precautions should be used when providing care for any patient who has a white blood cell (WBC) count of 10.8 × 109/L or greater. Standard Precautions should be applied to patients regardless of diagnosis or presumed infectious status. Standard Precautions should be used in the care of any patient whose diagnosis is attributable to an infectious process. Standard Precautions should be applied in the care of any patient who has an actual or suspected primary or secondary immunodeficiency.

Standard Precautions should be applied to patients regardless of diagnosis or presumed infectious status. Explanation: Standard Precautions incorporate the major features of Universal Precautions (designed to reduce the risk of transmission of bloodborne pathogens) and Body Substance Isolation (designed to reduce the risk of transmission of pathogens from moist body substances); they are applied to all patients in health care facilities regardless of their diagnosis or presumed infectious status.