Chapter 17: Concepts of Care for Patients with HIV Disease

A client with HIV-III asks the nurse why gabapentin is part of the drug regimen when the client does not have a history of seizures. What response by the nurse is best?

"This drug helps treat the pain from nerve irritation."

The nurse is teaching a client about medications for HIV-II treatment. What drugs are paired with the correct information? (Select all that apply.)

- Abacavir: avoid fatty and fried foods. - Efavirenz: take 1 hour before or 2 hours after antacids. - All drugs: you must adhere to the drug schedule at least 90% of the time for effectiveness.

A client with HIV-III is hospitalized with P. jiroveci pneumonia and is started on the drug of choice for this infection. What laboratory values would be most important for the nurse report to the primary health care provider? (Select all that apply.)

- Aspartate transaminase, alanine transaminase: elevated - Platelet count: 80,000/mm3 (80 × 109/L) - Serum sodium: 120 mEq/L (120 mmol/L)

A client with HIV-III has oral thrush and difficulty eating. What actions does the nurse delegate to the assistive personnel (AP)? (Select all that apply.)

- Assist the client with oral care every 2 hours. - Offer the client frequent sips of cool drinks. - Remind the client to use only a soft toothbrush. - Offer the client soft foods like gelatin or pudding.

A client has just been informed of a positive HIV test. The client is distraught and does not know what to do. What intervention by the nurse is best?

Assess the client for support systems.

A client with HIV-III is in the hospital with severe diarrhea. What actions does the nurse delegate to assistive personnel (AP)? (Select all that apply.)

- Assisting the client to get out of bed to prevent falls - Obtaining a bedside commode if the client is weak - Providing gentle perianal cleansing after stools - Reporting any perianal abnormalities

Which findings are AIDS-defining characteristics? (Select all that apply.)

- CD4+ cell count less than 200/mm3 (0.2 × 109/L) or less than 14% - Infection with P. jiroveci - Presence of HIV wasting syndrome - Confusion, dementia, or memory loss

A nurse is learning about human immune deficiency virus (HIV) infection. Which statements about HIV infection are correct? (Select all that apply.)

- CD4+ cells begin to create new HIV virus particles. - Antibodies produced are incomplete and do not function well. - Macrophages stop functioning properly. - Opportunistic infections and cancer are leading causes of death.

A nurse is providing education about HIV risks at a health fair. What groups would the nurse include as needing to be tested for HIV on an annual basis? (Select all that apply.)

- Couples planning on getting married - Those who are sexually active with multiple partners - Injection drugs users - Sex workers and their customers

The nurse is educating a client with HIV-II and the partner on self-care measures to prevent infection when blood counts are low. What information does the nurse provide? (Select all that apply.)

- Do not work in the garden or with houseplants. - Do not empty the kitty litter boxes. - Bathe daily using antimicrobial soap. - Avoid people who are sick and large crowds. - Make sure meat, fish, and eggs are cooked well.

A nurse begins a job at a Veterans Administration Hospital and asks why so much emphasis is on HIV testing for the veterans. What reasons is this nurse given? (Select all that apply.)

- Veterans have a high prevalence of substance abuse. - Many veterans may engage in high risk behaviors. - Many older veterans may not know their risks. - Everyone should know their HIV status. - Belief that the VA has tested them and would notify them if positive.

A client with HIV-III is hospitalized and has weeping Kaposi sarcoma lesions. The nurse dresses them with sterile gauze. When changing these dressings, which action is most important for the nurse's safety?

Adhering to Standard Precautions

The nurse is presenting information to a community group on safer sex practices. The nurse would teach that which sexual practice is the riskiest?

Anal intercourse

A client with HIV-II has had a sudden decline in status with a large increase in viral load. What action would the nurse take first?

Assess the client for adherence to the drug regimen.

A nurse is talking with a client about a negative enzyme-linked immunosorbent assay (ELISA) test for human immune deficiency virus (HIV). The test is negative and the client states "Whew! I was really worried about that result." What action by the nurse is most important?

Assess the client's sexual activity and patterns.

A client with HIV-III has been hospitalized with suspected cryptosporidiosis. What physical assessment would be most important with this condition?

Assessing mucous membranes

The nurse providing direct client care uses specific practices to reduce the chance of acquiring infection with human immune deficiency virus (HIV) from clients. Which practice is most effective?

Consistent use of Standard Precautions

A nurse is caring for a client with HIV-III who was admitted with HAND. What sign or symptom would be most important for the nurse to report to the primary health care provider?

Change in pupil size

A client with HIV-II is hospitalized for an unrelated condition, and several medications are prescribed in addition to the regimen already being used. What action by the nurse is most important?

Consult with the pharmacy about drug interactions.

A client has been hospitalized with an opportunistic infection secondary to HIV-III. The client's partner is listed as the emergency contact, but the client's mother insists that she should be listed instead. What action by the nurse is best?

Contact the social worker to assist the client with advance directives.

The nurse is caring for a client diagnosed with HIV-II. The client's CD4+ cell count is 399/mm3 (0.399 × 109/L). What action by the nurse is best?

Counsel the client on safer sex practices/abstinence.

An HIV-negative client who has an HIV-positive partner asks the nurse about receiving tenofovir/emtricitabine. What information is most important to teach the client about this drug?

Does not reduce the need for safe sex practices.

A client with HIV-III and wasting syndrome has inadequate nutrition. What assessment finding by the nurse best indicates that goals have been met for this client problem?

Has a weight gain of 2 lb (1 kg)/1 mo.

A client with HIV-III is admitted to the hospital with Toxoplasma gondii infection. Which action by the nurse is most appropriate?

Initiate Protective Precautions.

A client is hospitalized with Pneumocystis jiroveci pneumonia. The client reports shortness of breath with activity and extreme fatigue. What intervention is best to promote comfort?

Pace activities, allowing for adequate rest.

A client with known HIV-II is admitted to the hospital with fever, night sweats, and severe cough. Laboratory results include a CD4+ cell count of 180/mm3 and a negative tuberculosis (TB) skin test 4 days ago. What action would the nurse take first?

Place the client under Airborne Precautions.