HIV/AIDS Prep U Collection
How does vertical transmission of HIV occur?
Mother to fetus during breastfeeding. Mother to fetus during pregnancy. Mother to fetus during delivery.
The patient is concerned that he may be infected with HIV. Which sign or symptom is most commonly associated with an HIV infection?
Night sweats
A nurse is addressing the incidence and prevalence of HIV infection among older adults. What principle should guide the nurses choice of educational interventions?
Many older adults do not see themselves as being at risk for HIV infection.
During the admission assessment of an HIV-positive patient whose CD4+ count has recently fallen, the nurse carefully assesses for signs and symptoms related to opportunistic infections. What is the most common life-threatening infection?
Pneumocystis pneumonia. There are a number of opportunistic infections that can infect individuals with AIDS. The most common life-threatening infection in those living with AIDS is Pneumocystis pneumonia, caused by P. jiroveci. Other opportunistic infections may involve. Salmonella, Mycobacterium tuberculosis, and Clostridium difficile.
A nurse is providing discharge teaching to a client who is immunosuppressed. Which statement by the client indicates the need for additional teaching?
"I can eat whatever I want as long as it's low in fat."
What education point will the registered nurse (RN) provide to the client diagnosed with schizophrenia who receives a new prescription for risperidone?
"This drug can result in weight gain so it is important to maintain a healthy diet."
What statement made by the client diagnosed with schizophrenia alerts the registered nurse (RN) the occurrence of a flight of ideas?
"it is hot in here, so I need to get my blanket, so that I can go to the cafeteria, and take a nap".
The nurse plays a vital role in screening patients for a possible HIV infection. What questions below could the nurse ask to help identify a patient who is at risk for HIV? Select all that apply:
1. "How often do you use alcohol or drugs?" 2. "If you are sexually active, do you or your partner use protection?" 3. "Have you ever been treated for a sexually transmitted infection?"
A patient is on highly active antiretroviral therapy (HAART) for the treatment of HIV. What does the nurse know would be an adequate CD4 count to determine the effectiveness of treatment for a patient per year?
50 to 150. An adequate CD4 response for most patients on HAART is an increase in CD4 count in the range of 50 to 150 per year, generally with an accelerated response in the first 3 months.
What is a normal CD4 count?
500-1500 cells/mm3
29. Which statement below is true about Antiretroviral Treatment?
A. "The patient starts out taking 3 medications from at least 2 drug classes." B. "ART decreases the amount of virus in the blood within about 6 months." C. "ART helps decrease the risk of developing an opportunistic infection."
An adolescent client tells the nurse during a clinic visit that they are sexually active and concerned about prevention of HIV. Which would be the best response by the nurse?
Abstinence is the most effective method of preventing sexual transmission of HIV. After abstinence, consistent and correct use of condoms is the only effective method to decrease the risk of transmission. Both female and male condoms confer significant protection.
A client being treated for HIV/AIDS has a decreased appetite, almost to the point of anorexia. What is the best action by the nurse?
Administer megestrol acetate.
While providing care for the client diagnosed with schizophrenia and admitted to the hospital, which assessment will the registered nurse (RN) monitor after the administration of ziprasidone hydrochloride?
After administering ziprasidone hydrochloride the RN will monitor for hypotension and widened QT interval.
Which client is at highest risk for contracting HIV?
An individual struggling with I.V. drug use.
A hospital patient is immunocompromised because of stage 3 HIV infection and the physician has ordered a chest radiograph. How should the nurse most safely facilitate the test?
Arrange for a portable x-ray machine to be used. A patient who is immunocompromised is at an increased risk of contracting nosocomial infections due to suppressed immunity.
The nurse is caring for a client who has a diagnosis of human immunodeficiency virus (HIV). Part of this client's teaching plan is educating the client about their medications. What is essential for the nurse to include in the teaching of this client regarding medications?
Describing the side effects of drug therapy is essential, with the admonition to refrain from discontinuing any of the prescribed drugs without first consulting the prescribing physician.
Enzyme immunoassay (EIA)
Enzyme immunoassay (EIA) is a blood test that can determine the presence of antibodies to HIV in the blood or saliva; it is also referred to as an enzyme-linked immunosorbent assay (ELISA).
A 30-year-old patient is in the Acute Stage of HIV. What findings below correlate with this stage of HIV?
First stage. Tends to occur a couple of weeks to a month after becoming infected. Viral load is very HIGH during this time. CD4 count should be greater than 500 cells/mm3. NO opportunistic infections are present during this time because CD4 count is high enough to fight off infections/diseases. Flu-like symptoms such as aches, joint pain, headache, fever, fatigue, sore throat, swollen lymph nodes, GI upset, and rash.
The nurse is preparing a teaching plan for a client with an immunodeficiency. What aspect would the nurse emphasize as most important?
Frequent and thorough handwashing.
What step in the ""Lifecycle of HIV" does the Human Immunodeficiency Virus (HIV) become united with the targeted cell and dumps its contents into that cell?
Fusion
A patient, who is in the Chronic Stage of HIV, has a CD4 count ordered. What does this test measure?
Helper T cells
A patient who has AIDS has been admitted for the treatment of Kaposis sarcoma. What nursing diagnosis should the nurse associate with this complication of AIDS?
Impaired Skin Integrity Related to Kaposis Sarcoma. Kaposis sarcoma (KS) is a disease that involves the endothelial layer of blood and lymphatic vessels.
A patient with AIDS has dark purplish brown lesions on the mucus membranes of the mouth. As the nurse you know these lesions correlate with what type of opportunistic disease?
Kaposi's Sarcoma
The nurse care plan for a patient with AIDS includes the diagnosis of Risk for Impaired Skin Integrity. What nursing intervention should be included in the plan of care?
Keep the patients bed linens free of wrinkles. Skin surfaces are protected from friction and rubbing by keeping bed linens free of wrinkles and avoiding tight or restrictive clothing.
What enzyme is responsible for cutting long chains of virus to help prep the HIV for maturity?
Protease
A patient with Stage 2 HIV aka Chronic Stage is prescribed to take Raltegravir. The nurse knows that this medication is part of what class of ART?
Raltegravir is an Integrase Inhibitors. Remember from the lecture: "tegra" in Integrase....the meds in this class have "tegra" in the middle...like RalTEGRAvir.
A client is diagnosed with pneumocystis pneumonia (PCP). What medication does the nurse anticipate educating the client about for treatment?
TMP-SMZ; Bactrim, Cotrim, Septra is the treatment of choice for PCP
A patient who has AIDS is being treated in the hospital and admits to having periods of extreme anxiety. What would be the most appropriate nursing intervention?
Teach the patient guided imagery. Measures such as relaxation and guided imagery may be beneficial because they decrease anxiety, which contributes to weakness and fatigue.
Which clinical manifestation alerts the registered nurse (RN) of the presence of catatonic schizophrenia?
The RN will be alert to specific clinical manifestations that indicate the presence of catatonic schizophrenia. These clinical manifestations include: staring off into space and negativism.
Which clinical manifestation will the registered nurse (RN) identify as a presentation of negative symptoms in a client diagnosed with schizophrenia?
The clinical manifestations that present negative symptoms include: lack of excitement about receiving a birthday cake, lack of motivation to cut the birthday cake to eat, and lack of interest in the person that brought the birthday cake.
Which statement below is true regarding the role of the helper t cell?
The helper T cell releases cytokines to help activate other immune system cells. The helper T cell is part of the adaptive immune system. The helper T cell has CD4 receptors found on its surface.
The term used to define the amount of virus in the body after the initial immune response subsides is
Viral Set Point.
Which term defines the balance between the amount of HIV in the body and the immune response?
Viral Set Point.
Which diagnostic test measures HIV RNA in the plasma?
Viral load. A viral load test measures the quantity of HIV RNA in the blood.
Which statement best explains the goal of HAART (highly active antiretroviral therapy) when used for HIV/AIDS?
When a virus replicates, it increases the viral load. HAART attempts to cease the virus from replicating by using several classes of drugs that help to inhibit replication. As a result, CD4 cell count is restored to help immune function.
What sign and symptoms in your patient with HIV indicates the disease is worsening and the immune system is severely compromised?
White hair like spots on the side of the tongue. This is known as oral hairy leukoplakia. It occurs when the immune system is extremely compromised like with HIV and the Epstein-Barr virus. It is a signal the HIV is getting worse.
Western blotting assay
a blood test that identifies antibodies to HIV and is used to confirm the results of an EIA (ELISA) test.
Which action by the client diagnosed with schizophrenia will the registered nurse (RN) recognize as a presentation of a negative symptom of schizophrenia?
walking out of a room if anyone else enters the room, becoming anxious if anyone tries to sit in the room with them, and refusing to eat meals in the common room with others.
The first step in the "Lifecycle of HIV" is the attachment step. During this step what co-receptors are also targeted so entry can be gained inside the cell?
CCR5 or CXCR4. Attachment occurs when the glycoproteins aka GP120 projections make contact and bind with a CD4 receptor. In addition, there is also binding with certain co-receptors called CCR5 or CXCR4 to gain entry into the cell.
Fill-in-the-blank: Chemokine Receptor Antagonists block the co-receptor __________ on the cell so HIV cannot engage the receptor and enter the cell.
CCR5.
Select the criteria below that is used to help diagnosed a patient with Acquired Immunodeficiency Syndrome (AIDS):
CD4 count <200 cells. Presence of opportunistic infection.
A nurse works in an employee health department of a hospital. She was asked to treat a staff nurse who was exposed to blood from a patient with an HIV infection. The nurse practitioner instituted a PEP protocol that includes which of the following actions?
Continue HIV medications for 4 weeks postexposure. Initiate postexposure testing after 4 weeks. Finish postexposure testing at 6 months.
Which microorganism is known to cause retinitis in people with HIV/AIDS?
Cytomegalovirus is a species-specific herpes virus.
While providing care for a client diagnosed with schizophrenia, which statement made by the client will alert the registered nurse (RN) to the presence of delusions?
"I can only drink bottled water because the state is trying to poison me", "I don't turn on the television because that is how the government sees what I am doing", and "I must get cleaned up soon as I am having dinner with the President tonight".
A patient with HIV is prescribed to start antiretroviral therapy. The nurse is providing education about these medications. Which statement below by the patient indicates they need re-education on these medications?
"I currently take a medication called St. John's Wort to treat depression." Patients who take ART should be educated about how medications can interact with over-the-counter medications, especially herbal supplements like St. John's Wort which is used to treat depression.
A schizophrenic client is pacing around the hallways of the unit. The nurse asked the client why he was pacing. The client stated, "Those people behind me are trying to catch me to stab me. Don't you see them with their knives?" What is the nurse's best response?
"I know you must be frightened. I do not see anyone behind you". Acknowledge that the client is frightened and the nurse does not see anybody behind client. The nurse should gather more information about the client's thoughts and feelings.
The nurse is teaching the client who has an immunodeficiency disorder how to avoid infection at home. Which statement indicates that additional teaching is needed?
"I will be sure to eat lots of fresh fruits and vegetables every day." The client should avoid eating raw fruits and vegetables. All foods should be cooked thoroughly and all leftover food should be refrigerated immediately to prevent infection.
The nurse is caring for a schizophrenic client. The client states, "Do you see those cameras? The government is watching me." What is the nurse's best response?
"The cameras are scaring you. We use those cameras to keep the clients and staff safe" The nurse should restate the client's concerns and explain what the cameras are used for.
The registered nurse (RN) provides which response to the client diagnosed with schizophrenia who was prescribed clozapine one week ago and is experiencing increased drowsiness?
"the drowsiness will stop once your body begins to tolerate the drug" and "avoid driving or operating machinery when you are drowsy from this drug".
When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following?
A negative test result indicates that antibodies to HIV are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies which take from 3 weeks to 6 months or longer.
What intervention is a priority when treating a client with HIV/AIDS?
Assessing fluid and electrolyte balance.
A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses, including the steps in the process of HIV entering the host cell. What would the nurse describe as the first step?
Attachment. Once HIV enters the host cell, attachment occurs in which the glycoproteins of HIV bind with the host's uninfected CD4+ receptor and chemokine coreceptors. This is followed by uncoating, in which HIV's viral core is emptied into the CD4+ T cell. Cleavage and budding occur as the last steps.
A nurse is caring for a client with HIV who inquires about a CD4 level. The best response from the nurse would be:
CD4 are white blood cells that fight infection. Therapeutic range for CD4 level is between 500-1200 cells. When the CD4 level drops below 200 cells, this means that the virus has progressed into Acquired Immunodeficiency Syndrome AIDS.
Human Immunodeficiency Virus (HIV) mainly attacks what type of cells in the human body?
CD4 positive cells
Your patient is in the last stage of HIV. The patient CD4 count is 100 cells. Which of the following FUNGAL infections if your patient at risk for?
Candidiasis, Coccidioidomycosis, Histoplasmosis are all FUNGAL infections.
A client receiving atazanavir for HIV treatment requires what priority intervention?
Cardiac assessment. This medication may cause prolongation of the PR interval and first-degree AV block. Clients with underlying conduction deficits may develop problems. A cardiac assessment will assist in determining whether the client has underlying problems that could be exacerbated by this drug therapy.
A 48-year-old patient is HIV positive. The patient has no signs and symptoms and has a CD4 count of 400 cells/mm3. In addition, no opportunistic infections or diseases are present. These findings correlate with what stage of HIV?
Chronic. Findings correlate with the Chronic Stage aka Asymptomatic Stage of HIV. Signs and symptoms may not be experienced, viral load is lower than Acute Stage, but the virus is still replicating and destroying the cells. Patient can still transmit the virus to others. CD4 count should be more than 200 cells to about 500 cells.
While providing care for a client diagnosed with schizophrenia, the registered nurse (RN) notices involuntary facial muscle movement and attributes this assessment to what drug in the client's daily drug plan?
Client presents with symptoms of dystonia. The drug the RN anticipates to be in the client's drug plan is haloperidol.
While assessing a client diagnosed with schizophrenia, what action by the client will the registered nurse (RN) identify as a presentation of preservation?
Client responds with the same answer for each question asked by the RN.
While providing care for a client diagnosed with schizophrenia, which clinical manifestation will the registered nurse (RN) expect to assess as a negative symptom of this disorder? Select all that apply.
Clinical manifestations the RN assesses of negative symptoms includes: one word responses, poor eye contact, and lack of expression.
What indicates that a client with HIV has developed AIDS?
Diagnosis of AIDS cannot be made until person with HIV meets criteria established by Centers for Disease Control and Prevention. The immune system becomes compromised. The CD4 T-cell count drops below 200 and develops one of the opportunistic diseases, Pneumocystis carinii pneumonia, candidiasis, cytomegalovirus, or herpes simplex.
The nurse is reviewing the medical record of a client who is positive for human immunodeficiency virus (HIV). The nurse notes that the client is classified as HIV asymptomatic based on which CD4+ T lymphocyte count?
Greater than 500. A client is classified as HIV asymptomatic when the CD4+ T lymphocyte count is greater than 500. A person is considered HIV symptomatic when the CD4+ count is 200 to 499.
A client infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?
Gynecologic problems. In clients with HIV, gynecologic problems, such as abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis may be the focus of a majority of complaints.
Identify the correct statements about the anatomy of the Human Immunodeficiency Virus (HIV).
HIV is a retrovirus. The protein projections found on the virus' surface play a key role in attaching to the receptors on the helper t-cell.
A nurse is preparing a presentation about human immunodeficiency virus (HIV) for a local community group. What would the nurse include in the presentation about HIV transmission?
HIV-1 is transmitted in body fluids that contain free virions and infected CD+4 T cells. These fluids include blood, seminal fluid, vaginal secretions, amniotic fluid, and breast milk. The amount of HIV and infected cells in the body fluid is associated with the probability that the exposure will result in infection. Blood and blood products can transmit HIV to recipients; however, the risk associated with transfusions have been virtually eliminated as the result of intensive donor screening. Most perinatal infections are thought to occur during delivery. Sharing infected equipment during drug injections increases a person's risk for acquiring HIV.
A nurse is planning the care of a patient with AIDS who is admitted to the unit with Pneumocystis pneumonia (PCP). Which nursing diagnosis has the highest priority for this patient?
Ineffective Airway Clearance. Although all these nursing diagnoses are appropriate for a patient with AIDS, Ineffective Airway Clearance is the priority nursing diagnosis for the patient with Pneumocystis pneumonia (PCP). Airway and breathing take top priority over the other listed concerns.
Fill in the blank: Once inside the nucleus of the cell, the Human Immunodeficiency Virus (HIV) needs to become part of the cell's DNA. To do this, the virus releases an enzyme called __________________.
Integrase
Patient arrives to clinic and requests HIV test. Patient had unprotected sexual intercourse 2 days ago with a person who may have HIV. As the nurse you know there is a window period for detecting infection of HIV. What statements should you provide to patient about this window period and testing?
No test is available at this time to show immediate infection. The window period is the time when you become infected with HIV to when a test can deliver positive results.
Which antiretroviral medication treatment stops the enzyme reverse transcriptase from working by binding to it?
Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Which HIV test can give the earliest test results?
Nucleic Acid Test (NAT). Can detect HIV the earliest of all the test types. Can detect around 10 days after exposure for some patients. It assesses for the virus' genetic material and measures the amount of virus present in the blood.
A nurse is performing the admission assessment of a patient who has AIDS. What components should the nurse include in this comprehensive assessment?
Nursing assessment includes numerous focuses, including identification of medication use, support system, immune function and sexual history.
A patient has been diagnosed with AIDS complicated by chronic diarrhea. What nursing intervention would be appropriate for this patient?
Obtain a stool culture to identify possible pathogens. A stool culture should be obtained to determine the possible presence of microorganisms that cause diarrhea. Patients should generally avoid raw fruit when having diarrhea.
Which class of antiretroviral medications bind with the CD4 receptors and inhibit the HIV's glycoprotein from being able to activate and engage the co-receptors?
Post-attachment Inhibitors. Trogarzo aka ibalizumab is a type of post-attachment inhibitor. It is given IV every 2 weeks.
In regards to HIV education, which is the most important objective for the nurse?
Prevention of HIV.
The period from infection with HIV to the development of antibodies to HIV is known as which of the following?
Primary infection is the period from the infection with HIV to the development of antibodies to HIV.
What group of ART for the treatment of HIV stop an enzyme from cutting the long chains of virus so the immature virus can't be assembled and mature?
Protease Inhibitors
A 25-year-old patient reports that they engage in high risk activities that could lead to an HIV infection. The patient's test results show the patient is HIV-negative. The nurse should provide the patient with education about?
Provide the patient with education about PrEP; Pre-Exposure Prophylaxis. These medications are taken BEFORE a possible encounter with HIV, which helps prevent a possible HIV infection. Patient must be HIV-negative before taking these medications.
A hospital nurse has experienced percutaneous exposure to an HIV-positive patients blood as a result of a needlestick injury. The nurse has informed the supervisor and identified the patient. What action should the nurse take next?
Report to the emergency department or employee health department. After initiating the emergency reporting system, the nurse should report as quickly as possible to the employee health services, the emergency department, or other designated treatment facility.
Which statement below best describes the role of reverse transcriptase?
Reverse transcriptase is an enzyme that turns viral RNA into viral DNA.
A patient with AIDS has developed CMV cytomegalovirus. The nurse makes it PRIORITY to educate the patient about which of the following regarding CMV?
Scheduling an eye appointment. Cytomegalovirus an opportunistic infection that can develop in patients with AIDS. Virus can cause damage to retina, hence retinitis, and lead to blindness. Educate the patient about scheduling an eye exam to monitor for this condition.
Negative Symptoms explained
Schizophrenia presents with scattered thinking for 6 or more months. Associated with dopamine imbalance in brain. Negative symptoms of schizophrenia present as loss of interest or decreased emotional response to situations. Individual with schizophrenia will have increased anxiety when around people. Individual prefers to be alone. Will avoid social interaction.
Which intervention will the registered nurse (RN) implement for the client who states "the people hiding in the ceiling are trying to kill me in my sleep"?
Statement by the client is an example of paranoid schizophrenia. Implement interventions with client that include: avoid arguing with the client about beliefs that they will be killed, reinforce client that they do have this thought that someone is trying to kill them, and reinforce to client that though these thoughts exist, the client is safe from harm .
The patient is prescribed to take Enfuvirtide (Fuzeon). The nurse prepares to administer this medication via?
Subcutaneous Route
What intervention will the registered nurse (RN) implement for the client diagnosed with schizophrenia to maintain proper nutrition?
The RN is aware that a specific intervention is needed to assist the client with schizophrenia to maintain proper nutrition. The intervention the RN will implement is to redirect the client to the need to finish their meal.
What action will the registered nurse (RN) implement while providing care to a client diagnosed with schizophrenia?
The RN will implement a specific intervention while providing care to a client diagnosed with schizophrenia. The action the RN will implement is to sit in the room with the client for short, frequent times during the day.
A client's antibody test for HIV showed no antibodies. For which reason would the client need to have a nucleic acid test completed before being told that testing for HIV is negative?
The client may be in stage 0 of the disease.
A nurse would identify that a colleague needs additional instruction on standard precautions when the colleague exhibits which of the following behaviors?
The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure. Gloves must be changed after contact with materials that may contain high concentration of microorganisms, even when working with the same patient.
A patient has come into the free clinic asking to be tested for HIV infection. The patient asks the nurse how the test works. The nurse responds that if the testing shows that antibodies to the AIDS virus are present in the blood, this indicates what?
The patient has been infected with HIV. Positive test results indicate that antibodies to the AIDS virus are present in the blood.
25-year-old female is about to deliver a baby. The patient is HIV-positive and has been taking antiretroviral therapy during the pregnancy. What steps can be taken to help prevent transmitting the virus to the baby after birth?
The patient should avoid breastfeeding and use formula instead.
The registered nurse (RN) identifies what psychotic presentation during a conversation with a client diagnosed with schizophrenia who frequently states that the flittlebots are hiding under the table?
The statement made by the client concerning flittlebots is a presentation of neologism.
The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus?
There are only four known body fluids through which HIV is transmitted: blood, semen, vaginal secretions, and breast milk.
Which type of opportunistic infection occurs from inhaling a parasitic organism that can be found in cat and bird feces?
Toxoplasmosis is a protozoal parasitic infection that is found in cat and bird feces along with undercook meat, such as pork and red meat.
TRUE OR FALSE: The Center for Disease Control and Prevention (CDC) recommends that all people between the ages of 13-64 be tested at least once for HIV during a routine health visit, regardless of risk factors.
True
Which intervention(s) will the registered nurse (RN) implement for the client diagnosed with schizophrenia that reports hearing voices at various times during the day?
acknowledge that the client believes he/she is hearing these voices, provide a distraction from the voices with music and earphones, and explain to the client that the RN does not hear these voices.
Which clinical manifestation will the registered nurse (RN) identify as a presentation of cognitive symptoms in a client diagnosed with schizophrenia?
cognitive symptoms of schizophrenia: The clinical manifestations that the RN identifies include: problems with abstract thinking, difficulty understanding others feelings, and difficulty with problem solving.
While providing care for a client diagnosed with catatonic schizophrenia, which intervention will the registered nurse (RN) implement?
offer easy to eat foods frequently, offer milk shakes frequently, and assist with daily body care.
The physician orders a combination HIV antigen/antibody test on a patient. The patient was potentially exposed to HIV 3 weeks ago. What HIV antigen does this test assess for?
p24
A nurse is working with a patient who was diagnosed with HIV several months earlier. The nurse should recognize that a patient with HIV is considered to have AIDS at the point when the CD4+ T-lymphocyte cell count drops below what threshold?
200 cells/mm3 of blood. When CD4+ T-cell levels drop below 200 cells/mm3 of blood, the person is said to have AIDS.
Which condition is an early manifestation of HIV encephalopathy?
Headache. Early manifestations of HIV encephalopathy include headache, memory deficits, difficulty concentrating, progressive confusion, psychomotor slowing, apathy, and ataxia. Later stages include hyperreflexia, a vacant stare, and hallucinations.
A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in?
Primary infection. The period from infection with HIV to the development of HIV-specific antibodies is known as primary infection, or stage 1.
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. The next step for the nurse to explain to the client for confirmation of the diagnosis is to perform a:
Western blot test for confirmation of diagnosis. Enzyme-linked immunosorbent assay ELISA test, initial HIV screening test, positive when sufficient HIV antibodies; it also is positive when there are antibodies from other infectious diseases. Test repeated if results are positive. If results of second ELISA test are positive, Western blot is performed.
A patient was tested for HIV using enzyme immunoassay (EIA) and results were positive. The nurse should expect the primary care provider to order what test to confirm the EIA test results?
Western blot test. The Western blot test detects antibodies to HIV and is used to confirm the EIA test results.
A client who is HIV positive is receiving highly active antiretroviral therapy (HAART) that includes a protease inhibitor (PI). The client comes to the clinic for a follow-up visit. Assessment reveals lipoatrophy of the face and arms. The client states, "I'm thinking the side effects of the drug are worse than the disease. Look what's happening to me." The nurse would most likely identify which nursing diagnosis as the priority?
Disturbed body image related to loss of fat in the face and arms. Client experiencing lipoatrophy, which results in localized loss of subcutaneous fat in face, arms, legs, and buttocks manifested as sinking of cheeks, eyes, and temples. These changes as well as his statement about side effects of drug being worse than disease indicate he is concerned about how he appears.
A patient with a recent diagnosis of HIV infection expresses an interest in exploring alternative and complementary therapies. How should the nurse best respond?
Many patients with HIV use some type of alternative therapy and, as with most health treatments, there are benefits and risks. The nurse should approach the topic of alternative or complementary therapies from an open-ended, supportive approach, emphasizing the need to communicate with care providers.
What is the purpose of performing a viral load study once every 3 to 4 months in an HIV positive person?
To determine the effectiveness of the medication regimen
When do most perinatal HIV infections occur?
After exposure during delivery. Mother-to-child transmission of HIV-1 may occur in utero or through breastfeeding, but most perinatal infections are thought to occur after exposure during delivery.
An HIV-infected patient presents at the clinic for a scheduled CD4+ count. The results of the test are 45 cells/mL, and the nurse recognizes the patients increased risk for Mycobacterium avium complex (MAC disease). The nurse should anticipate the administration of what drug?
Azithromycin. HIV-infected adults and adolescents should receive chemoprophylaxis against disseminated Mycobacterium avium complex (MAC disease) if they have a CD4+count less than 50 cells/L. Azithromycin (Zithromax) or clarithromycin (Biaxin) are the preferred prophylactic agents.
A child has just been diagnosed with a primary immune deficiency. The parents state, "Oh, no. Our child has AIDS." Which response by the nurse would be most appropriate?
"Although AIDS is an immune deficiency, your child's condition is different from AIDS." Primary immune deficiencies should be not be confused with AIDS. They are not the same condition.
After teaching a client with immunodeficiency about ways to prevent infection, the nurse determines that teaching was successful when the client makes which statement?
"I should avoid being around other people who have an infection."
A patient receives a diagnosis of HIV disease. She visits the physician today for her prescriptions. What medications does the nurse expects the physician to order for the patient/
A combination of Truvada, Sustiva, and Kaletra
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?
AIDS dementia complex. 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.
A client with AIDS has developed cytomegalovirus (CMV) retinitis and is receiving treatment with foscarnet. The nurse would monitor for which possible adverse drug effects? Select all that apply.
Adverse reactions associated with foscarnet include nephrotoxicity, including acute renal failure, and electrolyte imbalances such as hypocalcemia, hyperphosphatemia, and hypomagnesemia, which can be life-threatening. Seizures also may occur.
A 34 year old patient comes to the clinic requesting HIV testing. He is a gay man with two significant others in his lifetime. His partner recently received a diagnosis of HIV infection. The patient asks the nurse how long it will take before the infection could show in him. What would be the nurse's best response?
Antibodies may be detected in the blood within 1 to 12 weeks of exposure.`
A hospital client is immunocompromised because of stage 3 HIV infection and the physician has ordered a chest radiograph. How should the nurse most safely facilitate the test?
Arrange for a portable x-ray machine to be used. A client who is immunocompromised is at an increased risk of contracting nosocomial infections due to suppressed immunity. The safest way the test can be facilitated is to have a portable x-ray machine in the client's room.
The nurse is caring for a client whose most recent laboratory values reveal a neutrophil level of 21,000 mm3. When preparing to assess the client, the nurse should prioritize what assessment?
Assessing the client for signs and symptoms of infection. Normal neutrophil levels range from 3,000 to 7,000 mm3. Levels rise in response to infection, so the nurse should monitor the client closely for signs and symptoms of infection.
The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client's plan of care?
Assisting with performing chest physiotherapy every 2 to 4 hours to prevent stasis of secretions, assist the client to attain semi- or high Fowler's position to facilitate breathing and airway clearance, allow for frequent rest periods to prevent excessive fatigue, and maintain a fluid intake of at least 3 liters per day unless contraindicated.
A client with acquired immune deficiency syndrome (AIDS) reports diarrhea after every meal. What is the nurse's best response?
Avoid residue, lactose, fat, and caffeine.
The mother of two young children has been diagnosed with HIV and expresses fear of dying. How should the nurse best respond to the patient?
Can you tell me what concerns you most about dying? The nurse can help the patient verbalize feelings and identify resources for support. The nurse should respond with an open-ended question to help the patient to identify fears about being diagnosed with a life-threatening chronic illness.
A client with acquired immune deficiency syndrome (AIDS) informs the nurse of difficulty eating and swallowing, and shows the nurse white patches in the mouth. What problem related to AIDS does the nurse understand the client has developed?
Candidiasis, a fungal infection, occurs in almost all clients with AIDS and immune depression. Oral candidiasis characterized by creamy-white patches in oral cavity and, if left untreated, progress to involve esophagus and stomach. Signs and symptoms include difficult and painful swallowing and retrosternal pain.
A client with paroxysmal hemoglobinuria, a deficiency of complement proteins, reports headache and weakness of the right arm and leg. Based on these symptoms, for which health complication should the nurse assess?
Cerebral venous thrombosis. Paroxysmal nocturnal hemoglobinuria is an acquired clonal stem cell disorder resulting from a somatic mutation in hematopoietic stem cells. Clinical manifestations may be indolent or life threatening. The disorder is characterized by hemoglobinuria that increases during sleep, as well as intravascular hemolysis, cytopenia, infections, bone marrow hyperplasia, and a high incidence of life-threatening venous thrombosis, which occurs most commonly in the abdominal and cerebral veins.
The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is:
Chronic diarrhea is believed related to the direct effect of HIV on cells lining the intestine. Although all gastrointestinal manifestations of AIDS can be debilitating, the most devastating is chronic diarrhea. It can cause profound weight loss and severe fluid and electrolyte imbalances.
A nurse is assessing a client with Kaposi's sarcoma. What initial sign does the nurse know to look for during assessment?
Deep purple cutaneous lesions. Localized cutaneous lesions may be the first manifestation of this HIV-related malignancy, which appears in 90% of clients as immune function deteriorates.
A public health nurse is preparing an educational campaign to address a recent local increase in the incidence of HIV infection. The nurse should prioritize which of the following interventions?
Educational programs that focus on control and prevention. Until an effective vaccine is developed, preventing HIV by eliminating and reducing risk behaviors is essential. Educational interventions are the primary means by which behaviors can be influenced.
Which blood test confirms the presence of antibodies to HIV?
Enzyme-linked immunosorbent assay (ELISA). ELISA and Western blotting identify and confirm the presence of antibodies to HIV.
A client suspected of having human immunodeficiency virus (HIV) has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive?
Enzyme-linked immunosorbent assay (ELISA). The ELISA test, an initial HIV screening test, is positive when there are sufficient HIV antibodies; it also is positive when there are antibodies from other infectious diseases. If the ELISA is positive twice then the Western Blot test is run.
A client is suspected of having an immune system disorder. The health care provider wants to perform a diagnostic test to confirm the diagnosis. What test should the nurse prepare the client for?
Enzyme-linked immunosorbent assay. T-cell and B-cell assays (or counts) and the enzyme-linked immunosorbent assay may be performed.
A healthcare worker has been exposed to the blood of an HIV-positive client and is awaiting the results of an HIV test. In the meantime, what precautions must the healthcare worker take to prevent the spread of infection?
Follow the same sexual precautions as someone who has been diagnosed with AIDS. The healthcare worker will be tested for HIV at regular intervals and treated with antiretrovirals depending on the results of the tests or the potential for infection.
The patient asks the nurse, How does HIV cause AIDS? What is the nurse's best response?
HIV attacks the immune system, a system that protects the body from foreign invaders, and thus makes it unable to protect the body from organisms that cause diseases.
A clinic nurse is caring for a patient admitted with AIDS. The nurse has assessed that the patient is experiencing a progressive decline in cognitive, behavioral, and motor functions. The nurse recognizes that these symptoms are most likely related to the onset of what complication?
HIV encephalopathy is a clinical syndrome characterized by a progressive decline in cognitive, behavioral, and motor functions.
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic?
HIV-1 is more prevalent than HIV-2 . HIV-1 mutates easily and frequently, producing multiple sub-strains that are identified by letters from A through O. HIV-2 less transmittable, and interval between initial infection with HIV-2 and development of AIDS is longer. HIV-1 prevalent in United States and in rest of the world. Western Africa primary site of HIV-2.
The nurse is assessing a patient who has requested HIV testing. What would be considered to be the most risky behavior?
Having more than three sex partners in a year
What diet should the patient with HIV follow?
High calorie, high protein, low residue
The nurse is addressing condom use in the context of a health promotion workshop. When discussing the correct use of condoms, what should the nurse tell the attendees?
Hold the condom by the cuff upon withdrawal. The condom should be unrolled over the hard penis before any kind of sex. The condom should be held by the tip to squeeze out air. Skin lotions, baby oil, petroleum jelly, or cold cream should not be used with condoms because they cause latex deterioration/condom breakage.
What is responsible for causing the majority of HIV disease and AIDS?
Human immunodeficiency virus type 1
A client with ataxia-telangiectasia is admitted to the unit. The nurse caring for the client would expect to see what included in the treatment regimen?
IV gamma globulin administration. Treatment for ataxia-telangiectasia includes IV gamma globulin, antimicrobial therapy, and bone marrow transplantation.
A patient with HIV will be receiving care in the home setting. What aspect of selfcare should the nurse emphasize during discharge education?
Importance of personal hygiene. Infection control is of high importance in patients living with HIV, thus personal hygiene is paramount.
Phagocytic dysfunction is characterized by the following.
In phagocytic cell disorders, incidence of bacterial and fungal infections is increased, resulting from organisms that are normally nonpathogenic. Clients experience recurrent cutaneous abscesses, chronic eczema, bronchitis, pneumonia, chronic otitis media, and sinusitis.
An 18-year-old pregnant female has tested positive for HIV and asks the nurse if her baby is going to be born with HIV. What is the nurses best response?
Its possible that your baby could contract HIV, either before, during, or after delivery. Mother-to-child transmission of HIV-1 is possible and may occur in utero, at the time of delivery, or through breast-feeding.
Which of the following is the most common HIV-related malignancy?
Kaposi's sarcoma is the most common HIV-related malignancy and involves the endothelial layer of blood and lymphatic vessels. Kaposi's sarcoma, certain types of B-cell lymphomas, and invasive cervical carcinoma are included in the CDC classification of AIDS-related malignancies.
Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS?
Liquids. The nurse should encourage clients with AIDS to consume liquids in order to help replace fluid and electrolyte losses.
The nurse teaches the client that reducing the viral load will have what effect?
Longer survival. The lower the client's viral load, the longer the survival time and the longer the time to AIDS diagnosis.
A patient with AIDS is admitted to the hospital with AIDS-related wasting syndrome and AIDS-related anorexia. What drug has been found to promote significant weight gain in AIDS patients by increasing body fat stores?
Megestrol. Megestrol acetate (Megace), a synthetic oral progesterone preparation, promotes significant weight gain. In patients with HIV infection, it increases body weight primarily by increasing body fat stores.
A 16-year-old has come to the clinic and asks to talk to a nurse. The nurse asks the teen what she needs and the teen responds that she has become sexually active and is concerned about getting HIV. The teen asks the nurse what she can do keep from getting HIV. What would be the nurses best response?
Other than abstinence, only the consistent and correct use of condoms is effective in preventing HIV. Other than abstinence, consistent and correct use of condoms is the only effective method to decrease the risk of sexual transmission of HIV infection. Both female and male condoms confer significant protection.
Which characteristic has NOT been implicated as a factor for noncompliance with antiretroviral treatment?
Past substance abuse. Factors associated with nonadherence include active substance abuse, depression, and lack of social support, as well as neurocognitive impairment, low health literacy, stressful life events, high levels of alcohol consumption, homelessness, poverty, nondisclosure of HIV serostatus, denial, stigma, and inconsistent access to medications.
A nurse is assessing the skin integrity of a patient who has AIDS. When performing this inspection, the nurse should prioritize assessment of what skin surfaces?
Perianal region and oral mucosa. The nurse should inspect all the patients skin surfaces and mucous membranes, but the oral mucosa and perianal region are particularly vulnerable to skin breakdown and fungal infection.
The nurse is caring for a patient who has been admitted for the treatment of AIDS. In the morning, the patient tells the nurse that he experienced night sweats and recently coughed up some blood. What is the nurses most appropriate action?
Place the patient on respiratory isolation and inform the physician. These signs and symptoms are suggestive of tuberculosis, not Kaposis sarcoma; prompt assessment and treatment is necessary.
What are the most common opportunistic infection and malignant neoplasm in the patient with advanced HIV disease (AIDS)?
Pneumocystis jiroveci pneumonia, and Kaposi Sarcoma
A client with human immunodeficiency virus (HIV) develops a nonproductive cough, shortness of breath, a fever of 101°F and an O2 saturation of 92%. What infection caused by Pneumocystis jiroveci does the nurse know could occur with this client?
Pneumocystis pneumonia. The most common life-threatening infection in those living with acquired immune deficiency syndrome (AIDS) is Pneumocystis pneumonia (PCP), caused by P. jiroveci. Without prophylactic therapy, most people infected with HIV will develop PCP.
A client is diagnosed with severe combined immunodeficiency (SCID). What would the nurse expect to integrate into the client's plan of care?
Preparation for bone marrow transplantation.
The nurses plan of care for a patient with stage 3 HIV addresses the diagnosis of Risk for Impaired Skin Integrity Related to Candidiasis. What nursing intervention best addresses this risk?
Providing thorough oral care before and after meals. Thorough mouth care has the potential to prevent or limit the severity of this infection.
The nurse administers an injection to a client with AIDS. When finished, the nurse attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse?
Report the incident to the supervisor. Because post exposure protocols can reduce the risk of HIV infection if initiated promptly, nurses must immediately report any needlestick or sharp injury to a supervisor.
A client with HIV will be started on a medication regimen of three medications. What class of drugs will the nurse instruct the client about?
Reverse transcriptase inhibitors. Reverse transcriptase inhibitors are drugs that interfere with the virus' ability to make a genetic blueprint.
Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as the form of the genetic viral material?
Ribonucleic acid; RNA. HIV is a retrovirus that carries its genetic material in the form of RNA rather than DNA. HIV consists of a viral core containing the viral RNA, surrounded by an envelope consisting of protruding glycoproteins.
The student nurse is giving a presentation on the transmission of HIV to his class. The student is correct by sharing what information?
Risk for transmission of HIV higher with anal intercourse than other types of sex. People who use I.V. drugs and share needles represent second largest population worldwide who transfer HIV. Leading mode of transmission of HIV worldwide is sexual intercourse, despite sexual preference.
A patient with HIV is admitted to the hospital because of chronic severe diarrhea. The nurse caring for this patient should expect the physician to order what drug for the management of the patients diarrhea?
Sandostatin. Therapy with octreotide acetate (Sandostatin), a synthetic analogue of somatostatin, has been shown to be effective in managing chronic severe diarrhea.
For most people who are HIV positive, marker antibodies are usually present 10 to 12 weeks after exposure. What is the development of these antibodies called?
Seroconversion
The health care provider asks the nurse to talk with a patient about how HIV is transmitted. Which routes of transmission are most important for the nurse to discuss with the patient?
Sexual intercourse, sharing needles, mother to child transmission
A client who is has been HIV positive for 10 years has a CD4+T-lymphocyte count of 2600 cells/L. For which stage of the virus will the nurse provide care when the client is diagnosed with invasive cervical cancer?
Stage 3 because an opportunistic infection has occurred. There are five stages of HIV infection based on clinical history, physical examination, laboratory evidence, signs and symptoms, and associated infections and malignancies. If a stage 3-defining opportunistic illness has been diagnosed, the client is identified as being in stage 3 regardless of the CD4+ T-lymphocyte test.
A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?
Stool specimen for ova and parasites will give a definitive diagnosis. Organism is spread by fecal-oral route from contaminated water, food, or human or animal waste. Those infected can lose from 10 to 20 L of fluid per day. Losing this magnitude of fluid quickly leads to dehydration and electrolyte imbalances.
A nurse is assessing a 28-year-old man with HIV who has been admitted with pneumonia. In assessing the patient, which of the following observations takes immediate priority?
Tachypnea and restlessness. In prioritizing care, the pneumonia would be assessed first by the nurse. Tachypnea and restlessness are symptoms of altered respiratory status and need immediate priority.
A patients current antiretroviral regimen includes nucleoside reverse transcriptase inhibitors (NRTIs). What dietary counseling will the nurse provide based on the patients medication regimen?
Take this medication without regard to meals. Many NRTIs exist, but all of them may be safely taken without regard to meals.
A client with human immunodeficiency virus undergoes intradermal anergy testing using Candida and mumps antigen. During the 3 days following the tests, there is no induration or evidence of reaction at the intradermal injection sites. What accurate conclusion can the nurse make?
The client is immunodeficient and won't have a skin response. Anergy testing determines the level of immune response an individual has to common microbes. A normal response is a local skin reaction to all the antigens injected intradermally. Absence of a response within 3 days suggests the individual is immunodeficient and can't produce a normal immune response.
A client on antiretroviral drug therapy informs the nurse about sometimes forgetting to take the medication for a few days. What should the nurse inform the client can occur when the medications are not taken as prescribed?
The client is risking the development of drug resistance and drug failure. Clients who neglect to take antiretroviral drugs as prescribed risk development of drug resistance. When drug levels are not adequately maintained, viral replication and mutations increase.
A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?
Trimethoprim-sulfamethoxazole. To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed.
A patient with HIV has a nursing diagnosis of Risk for Impaired Skin Integrity. What nursing intervention best addresses this risk?
Utilize a pressure-reducing mattress. Devices such as alternating-pressure mattresses and low-air-loss beds are used to prevent skin breakdown.
The nurse is admitting a client to the unit with a diagnosis of ataxia-telangiectasia. The nurse would recognize that the client is exhibiting telangiectasia when assessing the presence of what?
Vascular lesions caused by dilated blood vessels. Telangiectasia is the term that refers to vascular lesions caused by dilated blood vessels. Ataxia refers to uncoordinated muscle movement and is a clinical manifestation of combined B-cell and T-cell deficiencies.
Which assessment finding would the nurse expect to document for a client with ataxia-telangiectasis?
Vascular lesions. Ataxia-telangiectasis is characterized by loss of muscle coordination and vascular lesions.
A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when scheduling a return visit for viral load testing at which time?
Viral load tests measured before initiating antiretroviral therapy and again in 2 to 8 weeks. Adherence to regimen of potent antiretroviral agents should result in large decrease in the viral load by 2 to 8 weeks. Therefore, return visit at 6 weeks would be in this time frame. By 16 to 20 weeks, viral load should continue to decline, dropping below detectable levels.
A patients primary infection with HIV has subsided and an equilibrium now exists between HIV levels and the patients immune response. This physiologic state is known as which of the following?
Viral set point. The remaining amount of virus in the body after primary infection is referred to as the viral set point, which results in a steady state of infection that lasts for years.
The lower the client's viral load,
the longer the survival time. The lower the client's viral load, the longer the time to AIDS diagnosis and the longer the survival time. The key goal of antiretroviral therapy is to achieve and maintain durable viral suppression.
A patient in the clinic states, "My boyfriend told me he went to the clinic and was treated for gonorrhea." While testing for the sexually transmitted infection (STI), what else should be done for this patient?
Inform the patient that it would be beneficial to test for HIV. HIV screening is recommended for all persons who seek evaluation and treatment for STIs. HIV testing must be voluntary and free of coercion.
The nurse's plan of care for a client with stage 3 HIV addresses the diagnosis of Risk for Impaired Skin Integrity Related to candidiasis. What nursing intervention best addresses this risk?
Providing thorough oral care before and after meals. Thorough mouth care has the potential to prevent or limit the severity of this infection.
What is the expanded definition of AIDS?
The patient is HIV positive with a CD4+ lymphocyte count lower than 200
A patient is in the primary infection stage of HIV. What is true of this patients current health status?
The patient is infected with HIV but lacks HIV-specific antibodies. The period from infection with HIV to the development of HIV-specific antibodies is known as primary infection. The virus is not being eradicated and infection is certain. Opportunistic infections emerge much later in the course of the disease.
What test will the nurse assess to determine the client's response to antiretroviral therapy?
Viral load. Viral load should be measured at baseline and on a regular basis thereafter because viral load is the most important indicator of response to ART.
A patient develops gastrointestinal bleeding from a gastric ulcer and requires blood transfusions. The patient states to the nurse, "I am not going to have a transfusion because I don't want to get AIDS." What is the best response by the nurse?
"I understand your concern. The blood is screened very carefully for different viruses as well as HIV." Blood and blood products can transmit HIV to recipients. However, the risk associated with transfusions has been virtually eliminated as a result of voluntary self-deferral, completion of a detailed health history, extensive testing, heat treatment of clotting factor concentrates, and more effective virus inactivation methods. Donated blood is tested for antibodies to HIV-1, human immunodeficiency virus type 2 (HIV-2), and p24 antigen
A nurse is working in a health clinic at a retirement community. What is the nurse's primary rationale for recommending HIV testing for older adults?
Age-related immune system changes increase the risks of infections for older adults. Normal aging decreases the immune system's response to infection and puts the older adult at greater risk for HIV. Since 2006, more than 10% of new HIV cases occurred in those older than 50.
A patient has come into contact with HIV. As a result, HIV glycoproteins have fused with the patients CD4+ T-cell membranes. This process characterizes what phase in the HIV life cycle?
Attachment. During the process of attachment, glycoproteins of HIV bind with the hosts uninfected CD4+ receptor and chemokine coreceptors, which results in fusion of HIV with the CD4+ T-cell membrane.
A client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wart-like lesions on my vagina. This is happening quite often." Which nursing action is the priority for this client?
In women, gynecologic problems may be the focus of the chief complaint for clients who are HIV positive but not yet diagnosed. Abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis may also correlate with HIV infection.
A nurse is caring for a patient hospitalized with AIDS. A friend comes to visit the patient and privately asks the nurse about the risk of contracting HIV when visiting the patient. What is the nurses best response?
AIDS isnt transmitted by casual contact. AIDS is commonly transmitted by contact with blood and body fluids. Patients, family, and friends must be reassured that HIV is not spread through casual contact.
A patient is beginning an antiretroviral drug regimen shortly after being diagnosed with HIV. What nursing action is most likely to increase the likelihood of successful therapy?
Addressing possible barriers to adherence. ART is highly dependent on adherence to treatment, and the nurse should proactively address this.
A patient with HIV infection has begun experiencing severe diarrhea. What is the most appropriate nursing intervention to help alleviate the diarrhea?
Administer antidiarrheal medications on a scheduled basis, as ordered. Administering antidiarrheal agents on a regular schedule may be more beneficial than administering them on an as-needed basis, provided the patients diarrhea is not caused by an infectious microorganism.
A nurse is performing an admission assessment on a patient with stage 3 HIV. After assessing the patients gastrointestinal system and analyzing the data, what is most likely to be the priority nursing diagnosis?
Diarrhea is a problem in 50% to 60% of all AIDS patients.
Since the emergence of HIV/AIDS, there have been significant changes in epidemiologic trends. Members of what group currently have the greatest risk of contracting HIV?
Gay, bisexual, and other men who have sex with men remain the population most affected by HIV and account for 2% of the population but 61% of the new infections.
An 8 year old boy receives a diagnosis of hemophilia. His mother is upset about his risk of acquiring HIV from blood products. What would be the nurse's best response?
Many blood products are treated with heat or chemicals to inactivate the HIV virus
The two types of inherited B-cell deficiencies result from lack of differentiation of B cells. These types result from which two of the following deficiencies? Choose the two that apply.
Mature B-cells & Plasma cells. Two types of inherited B-cell deficiencies exist. First type results from lack of differentiation of B-cell precursors into mature B cells. As a result, plasma cells are absent, and germinal centers from all lymphatic tissues disappear, leading to complete absence of antibody production against invading bacteria, viruses, and other pathogens.
A nurse is completing a nutritional status of a patient who has been admitted with AIDS-related complications. What components should the nurse include in this assessment?
Nutritional status is assessed by obtaining a dietary history and identifying factors that may interfere with oral intake, such as anorexia, nausea, vomiting, oral pain, or difficulty swallowing. In addition, the patients ability to purchase and prepare food is assessed. Weight history; changes over time, anthropometric measurements; and blood urea nitrogen BUN, serum protein, albumin, and transferrin levels provide objective measurements of nutritional status.
The balance between the amount of HIV in the body and the immune response is the:
Viral set point.
