Nursing Management: Patients With Immunodeficiency, HIV Infection, and AIDS
When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following?
Antibodies to HIV are not present in his blood.
A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?
Bank autologous blood.
There are major differences between primary and secondary immunodeficiencies. Select the most accurate statement the nurse would use to explain the cause of a secondary immunodeficiency.
"Your immune system was most likely affected by an underlying disease process."
The nurse is preparing to infuse gamma-globulin intravenously (IV). When administering this drug, the nurse knows the speed of the infusion should not exceed what rate?
3 mL/min
A nurse is collecting objective data for a client with AIDS. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does this finding indicate?
candidiasis
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
A nurse is monitoring the client's progression of human immunodeficiency virus (HIV). What debilitating gastrointestinal condition found in up to 90% of all AIDS clients should the nurse be aware of?
Chronic diarrhea
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.
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
A nurse is teaching a health education class to a group of young adults and perceives that misinformation exists about the signs, symptoms, and trajectory of HIV infection. The nurse should inform participants that the first symptoms of HIV exposure include:
Fever, headache, and malaise
Which of the following would a nurse be least likely to identify as a cause of secondary immunodeficiency?
Genetics
Which condition is an early manifestation of HIV encephalopathy?
Headache
Which of the following is a lack of one or more of the five immunoglobulins?
Hypogammaglobulinemia
Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS?
Liquids
The nurse teaches the client that reducing the viral load will have what effect?
Longer survival
A nurse knows that more than 50% of clients with CVID develop the following disorder.
Pernicious anemia
A client is diagnosed with common variable immunodeficiency (CVID). When assessing the client for possible infection, what would the nurse identify as a least likely cause?
Pneumocystis jiroveci pneumonia
A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?
Risk for injury
Thirty minutes after the nurse begins an intravenous immunoglobulin (IVIG) infusion, the client reports itching at the site and a lump in the throat. Which action should the nurse take first?
Stop the infusion.
A nursing educator is discussing primary immunodeficiency diseases with a group of recent graduates. What would the educator tell the nurses about primary immunodeficiency diseases?
Their origin is genetic.
Which is a major manifestation of Wiskott-Aldrich syndrome?
Thrombocytopenia
The balance between the amount of HIV in the body and the immune response is the:
Viral set point
The majority of patient with primary immunodeficiency are in which age group?
Younger than 20
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."
What intervention is a priority when treating a client with HIV/AIDS?
Assessing fluid and electrolyte balance
A nurse on a medical unit is caring for a patient who has experienced a recent exacerbation of HIV. The nurse is being vigilant in assessments and preventative measures related to the common complications of HIV infection. What assessment addresses the most common opportunistic infection related to HIV?
Auscultating the patient's lungs and monitoring oxygen saturation and respiratory rate
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 clinic nurse is caring for a patient who has a longstanding diagnosis of HIV. 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?
HIV encephalopathy
A client with severe combined immunodeficiency is to receive a hematopoietic stem cell transplant. What would the nurse expect to be started?
Immunosuppressive agents
What test will the nurse assess to determine the client's response to antiretroviral therapy?
Viral load
A client with AIDS has been tested for cytomegalovirus (CMV) with positive titers. What severe complication should the nurse be alert for with cytomegalovirus?
blindness
The term used to define the amount of virus in the body after the initial immune response subsides is
viral set point.
When do most perinatal HIV infections occur?
After exposure during delivery
The nursing instructor is discussing allergic reactions with her clinical group. What allergic reactions would the nursing instructor talk about? Select all that apply.
Cytotoxic Atopic Immune complex
While caring for a patient with pneumocystis pneumonia, the nurse assesses flat, purplish lesions on the back and trunk. What does the nurse suspect these lesions indicate?
Kaposi's sarcoma
A client taking abacavir has developed fever and rash. What is the priority nursing action?
Report to the health care provider.
Which nursing action is essential before an EIA test is performed?
Obtaining a general consent for medical care from the client
An experienced medical nurse has provided care for patients who have immunodeficiencies that are primary, as well as for patients who have secondary immunodeficiencies. Which of the following individuals is most clearly exhibiting secondary immunodeficiency?
A woman whose diagnosis of sepsis is attributable to her recent chemotherapy
A nurse is preparing an in-service presentation about primary immunodeficiencies. When describing these conditions, what would the nurse need to integrate into the presentation?
Most cases are typically diagnosed in infancy.
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)
A client taking fosamprenavir reports "getting fat." What is the nurse's best action?
Teach the client about medication side effects.
A nurse is implementing appropriate infection control precautions for a client who is positive for human immunodeficiency virus (HIV). The nurse knows which body fluid is not a means of transmission?
Urine
When developing a plan of care for a hospitalized client with HIV/AIDs who is at risk for impaired skin integrity and confined to bedrest, which interventions would the nurse most likely include? Select all that apply.
using an alternating-pressure mattress performing meticulous perianal skin care
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."
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?
6 weeks
A nurse practitioner who works in an inner-city health clinic would recommend HIV testing to the patient who is most likely to have a diagnosis of HIV. Which of the following is most likely to have this diagnosis?
African American gay man
An immunocompromised patient with a diagnosis of AIDS has just been admitted to the medical unit with abdominal pain. The patient's health care provider has ordered an abdominal radiograph. How should the nurse best facilitate the test?
Arrange for a portable X-ray machine to be used.
A male patient's symptomatic HIV has progressed to AIDS, and the patient is now unable to independently perform most of his activities of daily living. To prevent skin breakdown, what action should the nurse take?
Arrange for a pressure-reducing mattress.
Which microorganism is known to cause retinitis in people with HIV/AIDS?
Cytomegalovirus
A client received 2 units of packed red blood cells while in the hospital with rectal bleeding. Three days after discharge, the client experienced an allergic response and began to itch and break out with hives. What type of reaction does the nurse understand could be occurring?
Delayed hypersensitivity response
There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS?
Disclosure of the client's condition
When describing the effects of treatment for phagocytic cell disorders, which of the following would the nurse include as being the most successful?
Hematopoietic stem cell transplantation
Which of the following indicates that a client with HIV has developed AIDS?
Herpes simplex ulcer persisting for 2 months
During a third-trimester transabdominal ultrasound, cardiac anomaly and facial abnormalities are noted in the fetus. Further testing reveals that the thymus gland has failed to develop normally, and the fetus is diagnosed with thymic hypoplasia. Based on this diagnosis, the nurse anticipates careful monitoring for which common manifestation during the first 24 hours of life?
Hypocalcemia
Which term means a lack of one or more of the five immunoglobulins?
Hypogammaglobulinemia
A client with common variable immunodeficiency (CVID) comes to the ED reporting tingling and numbness in the hands and feet, muscle weakness, fatigue, and chronic diarrhea. An assessment reveals abdominal tenderness, weight loss, and loss of reflexes. A gastric biopsy shows lymphoid hyperplasia of the small intestine and spleen as well as gastric atrophy. Based on these findings, what common secondary problem has this client developed?
Pernicious anemia
The nurse completes a history and physical assessment on a client with acquired immune deficiency syndrome (AIDS) who was admitted to the hospital with respiratory complications. The nurse knows to assess for what common infection (80% occurrence) in persons with AIDS?
Pneumocystis pneumonia
A nursing student assists a registered nurse to admit a client with a primary immunodeficiency. The nurse explains to the student that primary immunodeficiencies predispose people to three conditions. Which of the following three are those conditions?
Severe infections Autoimmunity Cancer
The nurse is teaching the client with HIV about therapy. Which elements are essential for the nurse to include in the teaching plan? Select all that apply.
The CD4 count is the major indicator of immune function and guides therapy. Antiretroviral therapy targets different stages of the HIV life cycle.
Reproductive health education for women who are HIV-positive includes recommending which of the following contraceptives?
The female condom
A patient is being tested for HIV using enzyme immunoassay (EIA). The EIA shows antibodies. The nurse expects the health care provider to order what test to confirm the EIA test results?
Western blot test
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? Select all that apply.
semen breast milk blood vaginal secretions
The lower the client's viral load,
the longer the survival time.
A client who is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication will the client take for the treatment of this infection?
trimethoprim-sulfamethoxazole
A hospice nurse has been providing care for a man who has AIDS. Among the manifestations of the man's disease has been a profound weight loss over the past several weeks. Consequently, the nurse is adjusting the patient's plan of care to reprioritize this problem. When planning interventions for the patient's weight loss, the nurse should be aware that:
Nutritional interventions may not necessarily resolve the patient's weight loss.
A client diagnosed with AIDS develops pneumocystis pneumonia (PCP). When planning the care for the client, which medication would the nurse anticipate being prescribed?
trimethoprim-sulfamethoxazole (TMP-SMZ)
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.
A client comes in to get an EIA test done because the health care provider suspects HIV. Which nursing action is essential before an EIA test is performed?
Obtaining a general consent for medical care from the client
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
