Chapter 35: Caring for Clients with HIV/AIDS

The nurse receives a phone call at the clinic from the family of a client with AIDS. They state that the client started "acting funny" and reported headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?

"The client may have cryptococcal meningitis and will need to be evaluated by the health care provider."

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

The nurse teaches the client that reducing the viral load will have what effect?

Longer survival

A client is prescribed didanosine as part of a highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client?

"Be sure to take this drug about 1/2 hour before or 2 hours after you eat."

Since the emergence of the human immunodeficiency virus (HIV), there have been significant changes in epidemiologic trends. At present, members of which group are most affected by new cases of HIV?

Male-to-male sexual contact

A nurse is working with a client who was diagnosed with HIV several months earlier. This client will be considered to have AIDS when the CD4+ T-lymphocyte cell count drops below what threshold?

200 cells/mm3 of blood

A client 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 prescribed.

Traditionally, HIV infection has been a danger for specific population groups who engaged in risky behaviors. Recently, incidence has spread to groups who are not typically thought to be in danger of contracting HIV. Which population group in the United States has HIV infection rates eight times higher than whites?

African-Americans

A client has come into the free clinic asking to be tested for human immunodeficiency virus (HIV) infection. The client asks the nurse how the test works. The nurse responds that if the testing shows that antibodies to the acquired immunodeficiency syndrome (AIDS) virus are present in the blood, this indicates that the client has which of the following?

An HIV infection

The nurse is preparing to start an IV for a client who is combative. What precautionary measure should the nurse take in order to avoid a needlestick?

Ask for assistance.

A client who has AIDS reports having diarrhea after every meal, and wants to know what can be done to stop this symptom. What should the nurse advise?

Avoid fibrous foods, lactose, fat, and caffeine.

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.

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

Which microorganism is known to cause retinitis in people with HIV/AIDS?

Cytomegalovirus

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

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 subtypes

Which condition is an early manifestation of HIV encephalopathy?

Headache

Which of the following indicates that a client with HIV has developed AIDS?

Herpes simplex ulcer persisting for 2 months

A client who has acquired immunodeficiency syndrome (AIDS) has been admitted for the treatment of Kaposi sarcoma. Which nursing diagnosis should the nurse associate with this complication of AIDS?

Impaired skin integrity related to Kaposi sarcoma

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.

A client is prescribed didanosine as part of a highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client?Which characteristic has NOT been implicated as a factor for noncompliance with antiretroviral treatment?

Past substance abuse

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?

Perianal region and oral mucosa

The period from infection with HIV to the development of antibodies to HIV is known as which of the following?

Primary infection

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 in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?

Risk for injury

A nurse is assessing a client with HIV who has been admitted with pneumonia. In assessing the client, which of the following observations takes immediate priority?

Tachypnea and restlessness

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 what behavior?

The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure.

A male 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 antibodies to the AIDS virus are present in the blood, this indicates what?

The patient has been infected with HIV.

A client who is HIV/AIDS positive has orders for laboratory tests to be performed. What precautions should the nurse observe whenever there is a risk of exposure to the blood and body fluids of an infected client?

Transport the specimens of body fluids in leak-proof containers.

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

A client comes to the clinic to obtain HIV test results. The physician states that the client has a CD4 cell count of 300 cells/mm3 and a high viral load. What will the physician discuss with the client?

initiation of antiretroviral therapy

Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS?

liquids