Chapter 37 Patients w/ HIV & AIDs

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 12 weeks 18 weeks 24 weeks

6 weeks

Which assessment finding(s) are likely to cause noncompliance with antiretroviral treatment? Select all that apply. Active substance abuse Depression Past substance abuse Lack of social support

Active substance abuse

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: Anorexia. Chronic diarrhea. Nausea and vomiting. Oral candida.

Chronic diarrhea.

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 B-cell lymphoma Kaposi's syndrome Wasting syndrome

HIV encephalopathy

The nurse teaches the client that reducing the viral load will have what effect? Shorter time to AIDS diagnosis Longer survival Shorter survival Longer immunity

Longer survival

A client with severe combined immunodeficiency is to receive a hematopoietic stem cell transplant. What would the nurse expect to be started? Antibiotic therapy Immunosuppressive agents Chest physiotherapy Anticoagulation

Immunosuppressive agents For a client undergoing a hematopoietic stem cell transplant, immunosuppression is started to ensure engraftment of depleted bone marrow. Antibiotic therapy may or may not be indicated. Chest physiotherapy would be appropriate for clients with ataxia-telangiectasis who have chronic lung disease. Anticoagulation would not be used.

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? Molluscum contagiosum Tuberculosis of the skin Kaposi's sarcoma Seborrheic dermatitis

Kaposi's sarcoma Kaposi's sarcoma, the most common HIV-related malignancy, is a disease that involves the endothelial layer of blood and lymphatic vessels. Cutaneous signs may be the first manifestation of HIV; they can appear anywhere on the body and are usually brownish pink to deep purple. They may be flat or raised and surrounded by ecchymoses (hemorrhagic patches) and edema (Fig. 37-3).

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? Mycobacterium avium complex (MAC) Pneumocystis pneumonia Tuberculosis Community-acquired pneumonia

Pneumocystis pneumonia

A client is prescribed didanosine as part of a highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client? "You should take the drug with an antacid." "It doesn't matter if you take this drug with or without food." "Be sure to take this drug about 1/2 hour before or 2 hours after you eat." "When you take this drug, eat a high-fat meal immediately afterwards."

"Be sure to take this drug about 1/2 hour before or 2 hours after you eat Didanosine (Videx) should be taken 30 to 60 minutes before or 2 hours after meals. Other antiretroviral agents, such as abacavir, emtricitabine, or lamivudine can be taken without regard to meals. High-fat meals should be avoided when taking amprenavir. Atazanavir should be taken with food and not with antacids.

The nurse is instructing a male client about safer sexual behaviors. Which client statement indicates a need for additional instruction? "I will apply baby oil to lubricate the condom." "I should use a new condom each time I have sex." "My partner and I should avoid manual-anal intercourse." "After having sex, I should hold onto the condom when pulling out."

"I will apply baby oil to lubricate the condom."

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 wash my hands whenever I get home from work." "I will make sure to have my own toothbrush and tube of toothpaste at home." "I will avoid contact with people who are sick or who have recently been vaccinated." "I will be sure to eat lots of fresh fruits and vegetables every day."

"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.

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

Standard Precautions should be applied to patients regardless of diagnosis or presumed infectious status

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? Urine specimen for culture and sensitivity Blood specimen for electrolyte studies Stool specimen for ova and parasites Sputum specimen for acid fast bacillus

Stool specimen for ova and parasites

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 funding for the medications will cease if the client is not taking the meds correctly. The client is risking the development of drug resistance and drug failure. The client will have to take the drugs intravenously to ensure compliance. The client will have to take higher doses of the antiviral medications.

The client is risking the development of drug resistance and drug failure.

The nursing instructor is going over laboratory results for patients with HIV/AIDS. The instructor tells the students that, upon interpretation of a patient's laboratory results, the nurse should recognize that a patient with HIV is considered to have AIDS when the CD4 T-lymphocyte cell count drops below what level? 200 cells/mm3 of blood 300 cells/mm3 of blood 400 cells/mm3 of blood 500 cells/mm3 of blood

200 cells/mm3 of blood

Based on the nurse's base knowledge of primary immunodeficiencies, how would the nurse complete this statement? Primary immunodeficiencies develop early in life after protection from maternal antibodies decreases. occur most commonly in the aged population. develop as a result of treatment with antineoplastic agents. disappear with age.

develop early in life after protection from maternal antibodies decreases.

A client is taking a corticosteroid for the treatment of systemic lupus erythematosus. When the nurse is providing instructions about the medication to the client, what priority information should be included? If the client experiences nausea, omit the dose. The client should be alert for joint aches. This medication is commonly used for many inflammatory reactions and is relatively safe. Be alert for signs and symptoms of infection and report them immediately to the physician.

Be alert for signs and symptoms of infection and report them immediately to the physician.

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? Anorexia Chronic diarrhea Nausea and vomiting Oral candida

Chronic diarrhea

The nurse is performing an admission assessment on a patient with AIDS. When assessing the patient's gastrointestinal (GI) system what is most likely to be the priority nursing diagnosis? Imbalanced nutrition: more than body requirements Diarrhea Bowel incontinence Constipation

Diarrhea

Which blood test confirms the presence of antibodies to HIV? Erythrocyte sedimentation rate (ESR) p24 antigen Reverse transcriptase Enzyme-linked immunosorbent assay (ELISA)

Enzyme-linked immunosorbent assay (ELISA)