Prep you Chapter 10
An HIV-positive patient comes to the clinic and asks the nurse if the patient should receive a flu vaccine. The patient states, "I never get the flu, so why should I take it?" What is the best response by the nurse?
"All HIV-positive patients should receive the flu vaccine as prophylaxis."
What statement made by the patient indicates to the nurse that the patient does not understand the transmission of HIV?
"As long as I am taking the HAART therapy, I cannot transmit the virus to anyone else."
An adult client is being treated for genital herpes with acyclovir. Which client statement indicates a need for further health education?
"It's a relief to know that this drug will stop me from spreading the infection."
A client is receiving tenofovir as part of a therapy regimen for HIV infection. The nurse should provide what teaching related to what the client may experience?
"It's possible you might have changes in body fat distribution."
A client, who began antiretroviral therapy several weeks ago, states to the nurse, "I've been pretty good about taking all my pills on time, though it was a bit hit and miss over the holiday weekend." How should the nurse best respond to this client's statement? Select all that apply.
"Remember that your antiretroviral drugs will only be effective if you take them very consistently." "If you're not consistent with taking your medications, you're likely to develop more side effects."
The nurse is reviewing the medication instruction for the client taking acyclovir. Which statement by the client would indicate the need for additional teaching?
"This medication will maintain the symptoms and cure my disease."
A college student is given valacyclovir for HSV-2 infection. He states that he is glad that the medicine will get rid of the infection so he doesn't have to worry about giving it to anyone else. What would be the nurse's appropriate response to that statement?
"Valacyclovir does not cure HSV-2. It helps to alleviate the frequency and severity of outbreaks. You could still spread the disease to others through contact. You should use barrier methods (such as condoms) to decrease the chance of spreading the disease."
A 23-year-old client is prescribed zidovudine for treatment of human immunodeficiency virus (HIV). Which statement indicates that the client has understood the client teaching regarding the action of this medication?
"Zidovudine slows the progression of the disease but does not cure it."
For which clients would treatment with acyclovir be most clearly indicated?
A 77-year-old whose recent debilitating pain has been attributed to a herpes zoster infection
Which statement regarding antiviral medications is true?
Antivirals do not eliminate existing viruses from tissues.
The nurse is caring for a client receiving antiviral medications to treat HIV. What laboratory study should the nurse monitor most closely to determine the effectiveness of the medications?
CD4 count
A client with a diagnosis of AIDS has been prescribed valganciclovir. The nurse should expect that this client has developed what AIDS-related complication?
CMV retinitis
A patient diagnosed with acute primary HIV infection is in the clinic. What treatment should be initiated for this patient?
Combination antiretroviral therapy
Which microorganism is known to cause retinitis in people with HIV/AIDS?
Cytomegalovirus
The nurse is caring for a client who has been on ritonavir. The nurse identifies an adverse reaction in relation to body fat. What does the nurse see when assessing this client?
Fat has moved to the center of the body and the client appears to have thinner arms and legs.
Antiretroviral drugs are used to treat which of the following viral infections? (Select all that apply.)
Human immunodeficiency virus (HIV) Hepatitis B virus (HBV)
A nurse is preparing to administer famciclovir to a client with a herpes virus infection. The nurse should expect to administer this drug by which route?
Oral
In which of the following patients is the use of cidofovir contraindicated?
Patients with renal impairment
A HIV-positive patient is being treated with didanosine as part of the antiretroviral therapy. Which of the following symptoms should the nurse monitor for and immediately report to the care provider?
Peripheral neuropathy
A 70-year-old man is being treated for herpes zoster virus. He has been prescribed acyclovir (Zovirax). The clinic nurse should prioritize assessments of which of the following?
Renal function
The nurse knows that pregnant caregivers should not inhale which medication while administering the medication to clients?
Ribavirin
An immigrant and his wife are both HIV positive. The physician prescribes antiretroviral medications. However, the client, tell the nurse he is concerned about his ability to afford the treatment. What advice can the nurse provide to the client to help begin the treatment?
The client can approach social agencies and pharmaceutical companies that provide antiretroviral drugs on compassionate grounds
A 45-year-old client is prescribed acyclovir for the treatment of genital herpes. Which is an expected outcome for this client?
The client will experience fewer recurrences.
The nurse is providing health education to a client who has recently been diagnosed with HIV and will soon begin antiretroviral therapy. What teaching point should the nurse prioritize?
The need to adhere rigidly to the prescribed drug schedule
The nurse is caring for a patient who has HIV and is taking saquinavir therapy. What should the nurse include in the dietary education for this patient?
The patient should not take this medication with grapefruit or pomegranate juice.
A female HIV-positive patient with a high CD4 count has been taking nevirapin (Viramune) for 9 weeks. What clinical manifestations indicate to the nurse that the patient is having complications from this medication?
Yellow sclera and hepatomegaly
A nurse is providing care to a client who is receiving a protease inhibitor with a nursing diagnosis of Disturbed Body Image related to a redistribution of fat to the abdomen. Which intervention would the nurse include in the client's plan of care?
encouraging the client to verbalize feelings about body changes
A nurse, reviewing a newly admitted client's previous health records, notes that the client is currently prescribed acyclovir. The nurse should assess the client for signs and symptoms associated with what medical diagnosis?
herpes simplex virus
A nursing student is reading a journal article about highly active antiretroviral therapy (HAART). The nurse would expect to find which condition as being treated with this therapy?
human immunodeficiency virus (HIV)
A nurse is caring for a client diagnosed with HIV. The client wants to know when they will be started on medication for their disease. What would be the nurse's best response?
if the client has a CD4 T-cell count less than 350 cells/mm3
A nurse is administering a drug that blocks the protease enzyme so new viral particles cannot mature. Which category of drugs is the nurse most likely administering?
protease inhibitors
A 42-year-old client, diagnosed with human immunodeficiency virus (HIV), has been receiving antiretroviral therapy for several years. Recently, raltegravir was added to the drug regimen. When appraising the success of this addition to the treatment, the nurse should prioritize which laboratory value?
the client's CD4 count
The nurse is caring for a client with AIDS who has developed cytomegalovirus (CMV). The nurse anticipates the health care provider will order which drug to treat this client?
Ganciclovir
A nurse is caring for a client who is taking acyclovir. What is likely to be a priority nursing diagnoses for this client?
Imbalanced Nutrition: Less than body requirements related to drug adverse effects
A 58-year-old with HIV is starting treatment with Combivir. He currently has a CD4+ cell count of less than 200 cells/mL and a viral load greater than 45,000 copies/mL. The nurse treating the client knows that what is a sign of effective drug therapy?
Increased CD4+ cell counts
Which was the first class of drugs developed to treat HIV infections?
Nucleoside reverse transcriptase inhibitors
A 3-month-old infant has been diagnosed with respiratory syncytial virus (RSV) and will begin treatment with inhaled ribavirin. Which of the following measures should be taken in the care of this patient and administration of ribavirin?
Nurses who are pregnant or who may be pregnant should not administer the drug.
When describing the action of an integrase inhibitor, the nurse understands that this class of drug acts by which mechanism?
Inhibiting the activity of a virus specific encoded enzyme needed for viral replication
A nurse is caring for a client who has been diagnosed with HIV. The client tells the nurse that he is considering supplementing his antiretroviral drug therapy with an herbal regimen that he read about recently. What should the nurse say in response?
"Some herbal supplements could interfere with your medication, so talk with your physician first."
A nurse is teaching a client with herpes zoster to apply acyclovir ointment. What guidance should the nurse include in the instructions?
"Wear gloves when applying the ointment."
The hospital nurse is caring for a diverse group of clients and is reviewing each client's medication regimen. Which client is most likely to benefit from combination therapy?
A client being treated for acquired immunodeficiency syndrome (AIDS)
A patient with AIDS is being prepared for discharge. The nurse caring for the patient with AIDS knows the patient receives Agenerase. What dietary counseling will the nurse provide based upon the patient's medication regimen?
Avoid high-fat meals while taking this medication
A patient with chronic hepatitis B (HBV) infection is scheduled to begin a new treatment regimen that will include adefovir dipivoxil (Hepsera). What assessments should be prioritized before the initiation of this drug treatment?
Liver function testing and HIV testing
Which would be most important to stress with a client who is receiving adefovir for treatment of chronic hepatitis B?
Maintenance of a continuous adequate supply of drug
A client for whom antiretroviral therapy has been prescribed informs the nurse that the client is taking oral contraceptives. What should the nurse inform the client is one of the effects of combining birth control pills with antiretroviral therapy?
Decreases effectiveness of birth control pills
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
A client has been treated with abacavir for the past 6 weeks. The client contacts the physician's office with reports of diarrhea, abdominal pain, sore throat, cough, and shortness of breath. Which is the appropriate action to take for this situation?
Discontinue the therapy.
A patient is being discharged from a health care facility. The patient is, however, required to continue with antiviral therapy at home. Which point should the nurse include in the teaching plan to educate the patient?
Report adverse reactions to the primary health care provider.
The student nurse has learned that HIV is a retrovirus. Reverse transcriptase is the enzyme it contains. The student understands this enzyme when making which statement?
Reverse transcriptase is used to turn the RNA of the virus into DNA.
What laboratory studies would be important for the nurse to especially monitor to check for lactic acidosis in the pregnant client on zidovudine therapy, especially during the last trimester?
Serum electrolytes and liver function tests
When focusing on the lifestyle of the patient with HIV, what are important teaching considerations? (Select all that apply.)
Take drug therapy as prescribed. Transmission can occur while on medication. Advise the patient about the adverse effect of granulocytopenia.
An asymptomatic patient infected with HIV asks the nurse, "When will I have to start taking antiviral therapy?" What is the recommendation for initiating treatment in this patient? Select all that apply.
The patient has a CD4 count of 250 cell/mm. The patient has HIV nephropathy. The patient has active hepatitis B virus(HBV) with the intent to treat the HBV.
An HIV-positive patient is taking etavirenz and tells the nurse that she now has fat on the upper back and neck but is losing fat in the extremities and face. What does the nurse determine is causing this patient's symptoms?
The patient has lipodystrophy from the etavirenz.
A nurse is explaining the rationale for the use of combination therapy in the treatment of HIV infections. Which would the nurse include as the primary reason?
The use of multiple drugs allows attack on the virus at different points in its life cycle.
The health care provider prescribes zanamivir to a client. When developing the teaching plan, the nurse should include what important instructions?
Using the special inhaler included with the drug to administer it.
The nursing instructor is giving memory aids to the students to help them to better remember the different drug classifications. When learning about antivirals the nurse instructs the students to look for which syllables?
VIR
The nursing student asks the instructor why it is more difficult to develop antiviral drugs than anti-infectives. The nursing instructor's best reply would be which?
Viruses are tiny and replicate inside cells.
A young adult, diagnosed with hepatitis B virus (HBV), has been prescribed treatment with lamivudine. Shortly after beginning treatment, the client reports experiencing intense abdominal pain. The nurse should recognize the possibility of what medication-associated adverse effect?
pancreatitis
A client, undergoing treatment for cytomegalovirus, received an initial dose of IV ganciclovir 3 days ago. When reviewing this client's most recent blood work, what abnormality should the nurse recognize as a possible adverse effect of this drug?
platelet count 118,000/mm3 (low)