4801 Adaptive Quizzing Review (HIV)
Which statement indicates that a client understands the ways HIV is transmitted?
"I can contract HIV by participating in oral sex." "HIV is contracted by using contaminated needles." "Babies can contract HIV because of contact with maternal blood during birth." HIV is transmitted sexually through oral sex. HIV is transmitted through the use of contaminated needles. HIV is transmitted by contact with maternal blood during the birthing process. HIV cannot be transmitted by sharing eating utensils or using the bathroom of a person who is HIV positive.
The nurse is counseling a client infected with human immunodeficiency virus (HIV) regarding prevention of HIV transmission. Which statement by the client indicates the nurse needs to follow up?
"I can safely have anal sex without any barriers." The client with HIV should use barrier protection when engaging in insertive sexual activity such as anal, oral, and vaginal. Therefore the nurse should follow up to provide the client with the correct information. All the other statements are correct and need no follow up. Abstaining from all sexual activity is a safe way to eliminate the risk of exposure to HIV in semen and vaginal secretions. The client should undergo HIV counseling and routinely offer access to voluntary HIV-antibody testing when planning for pregnancy. The most commonly used barrier is a condom, which allows for protected intercourse.
The nurse instructs a human immunodeficiency (HIV)-positive client about ways to prevent infections. During a follow-up visit, which statement made by the client indicates a need for more education?
"I wash my hands with tap water after gardening." An HIV-positive client should refrain from digging in soil and performing gardening activities. Soil contains several infectious microorganisms. In unavoidable circumstances, the client should wear gloves and wash hands thoroughly with antimicrobial soap after gardening. The client should refrain from reusing cups without washing them. Weekly rinsing of a toothbrush in liquid laundry bleach helps prevent infectious pathogens from accumulating on the brush. The armpits, groin, and genitals tend to house higher amounts of microorganisms and should be cleaned twice a day with antimicrobial soap.
The nurse is counseling an HIV positive woman on precautions to be followed. Which statement by the client indicates the need for further counseling?
"I will go for pelvic examination every 12 months." The routine gynecological care for HIV positive clients includes pelvic examination every 6 months. General prevention strategies such as smoking cessation and sound nutrition are an important part of care in HIV positive clients. HIV positive clients are at increased risk for opportunistic infections. Therefore they should be regularly screened for syphilis, gonorrhea, and other vaginal infections. Women should use female condoms or prefer abstinence if the partner is not willing to use condoms in order to prevent the transmission of HIV to the partner.
A nurse is educating a client with human immunodeficiency virus (HIV) about self-management. Which suggestion by the nurse benefits the client?
"Rinse your mouth with normal saline after every meal." A client infected with HIV should maintain proper oral care to improve his or her appetite. The client should rinse his or her mouth with sterile water or normal saline several times a day, especially after meals, to maintain proper oral hygiene. The client should drink plenty of fluids to maintain proper body fluid balance. Roughage should be limited in a client's diet because it is not easily digestible and may lead to severe diarrhea and contains microorganisms that can lead to infection. The client should consume small, frequent meals to maintain adequate caloric intake.
A nurse is caring for a client who is a victim of trauma and is to receive a blood transfusion. How should the nurse respond when the client expresses fear that acquired immunodeficiency syndrome (AIDS) may be acquired as a result of the blood transfusion?
"Screening for the human immunodeficiency virus (HIV) antibodies has minimized this risk." Although blood is screened for the antibodies, there is a period between the time a potential donor is infected and the time when antibodies are detectable; there is still a risk, but it is minimal. There is no current method of destroying the virus in a blood transfusion. The screening tests involve identification of the antibody, not the virus itself; the virus can be identified by the polymerase chain reaction test but is not part of routine screening. Although many people consider autotransfusion for elective procedures, a trauma victim does not have this option.
A nurse is planning to provide discharge teaching to the family of a client with acquired immunodeficiency syndrome (AIDS). Which statement should the nurse include in the teaching plan?
"Wash used dishes in hot, soapy water." A person cannot contract human immunodeficiency virus (HIV) by eating from dishes previously used by an individual with AIDS; routine care is adequate. Washing used dishes in hot, soapy water is sufficient care for dishes used by the AIDS client. Dishes do not need to soak for 24 hours before being washed. The client's dishes do not need to be boiled for 30 minutes after use. Paper plates are fine to use but are not indicated to prevent the spread of AIDS.
A client asks the nurse, "Should I tell my partner that I just found out I'm human immunodeficiency virus (HIV) positive?" What is the nurse's most appropriate response?
"You are having difficulty deciding what to say." The correct response promotes an exploration of the client's dilemma; it encourages further communication. Although the decision is for the client to make, this response is not supportive and abandons the client. It is inappropriate for the nurse to give advice.
The nurse is reviewing blood screening tests of the immune system of a client with acquired immunodeficiency syndrome (AIDS). What does the nurse expect to find?
A decrease in CD4 T-cells. The human immunodeficiency virus (HIV) infects helper T-cell lymphocytes; therefore 300 or fewer CD4 T cells per cubic millimeter of blood or CD4 cells accounting for less than 20% of lymphocytes is suggestive of AIDS. The thymic hormones necessary for T-cell growth are decreased. An increase in immunoglobulin E is associated with allergies and parasitic infections. A decrease in the serum level of glucose-6-phosphate dehydrogenase is associated with drug-induced hemolytic anemia and hemolytic disease of the newborn.
Which client has the highest risk for human immunodeficiency virus (HIV) infection?
A client who shares equipment to snort or smoke drugs. Clients who use equipment to snort (straws) and smoke (pipes) drugs are at the highest risk for becoming infected with HIV as their judgment may be impaired regarding the high-risk behaviors. Safe activities that prevent the risk of contracting HIV include mutual masturbation, masturbation, and other activities that meet the "no contact" requirements. A client who undergoes perinatal HIV voluntary testing may reduce the chances of getting infected. Insertive sex between partners who are not infected with HIV are not at risk of becoming infected with HIV.
The nurse is taking care of four clients with human immunodeficiency virus (HIV) infections. Which client's condition should the nurse report to the primary healthcare provider within 24 hours after observation? A. Burning, itching, d/c from eyes B. Blood in urine C. Yellow discoloration D. N/V and abd. pain
A. Burning, itching, d/c from eyes A client with an HIV infection is at risk for multiple diseases. Burning, itching and discharge from the eyes are not life-threatening and can be reported within 24 hours. Therefore client A's condition can be reported within 24 hours. All the other clients' conditions should be reported immediately.
The nurse is reviewing the laboratory reports of four clients. Which client is in the third stage of human immune virus (HIV) disease? A. CD4T count = 180 B. CD4T count = 250 C. CD4T count = 380 D. CD4T count = 600
A. CD4T count = 180. According to HIV disease classification, a client with HIV disease is in the third stage of the disease if the CD4+ T-cell count is less than 200 cells/mm 3. Therefore, client A is in third stage of HIV disease. A client is in second stage of HIV disease if the CD4+ T-cell count is between 200 and 499 cells/mm 3. Therefore, client B and client C are in the second stage of HIV disease. A client is in the first stage of HIV disease if the CD4+ T-cell count is greater than 500 cells/mm 3. Therefore, client D is in first stage of HIV disease.
The nurse manager enlists 10 direct care nurses for a project addressing the needs of the human immunodeficiency virus (HIV). The project successfully completes within the timeline. What would be the most essential factor for the success of the nursing manager?
Allowing the direct care nurse to share ideas. The most important element of success for the nursing manager is to allow the direct care nurses to share their ideas about the project and participate in decision making. This approach will increase their organizational commitment and increase the feeling of self-worth. The nurses will then be more likely to invest extra effort for successful completion of the project. The other factors necessary for successful completion of the project include providing ideas, training the nurses, and promoting discipline.
A client who is human immunodeficiency virus (HIV) positive is admitted to a surgical unit after an orthopedic procedure. The nurse should institute appropriate precautions with the awareness that HIV is highly transmissible through what means?
Blood; Semen. HIV, which is the virus that causes acquired immunodeficiency syndrome (AIDS), is transmitted through infected blood, semen, and bloody bodily fluids. HIV is not spread casually. Although HIV may be found in other bodily secretions, including feces, urine, sweat, tears, saliva, sputum, and emesis, the amount of virus is likely not sufficient enough to be transmitted.
A nurse is reviewing the laboratory reports of four clients. Which client's laboratory report indicates acquired immunodeficiency syndrome (AIDS)? A. CD4T 750 B. CD4T 550 C. CD4T 175 D. CD4T 450
C. CD4T 175 The diagnosis of AIDS requires that the person should be HIV positive and have either a CD4+ T-cell count of less than 200 cells/mm 3 (200 cells/uL) or less than 14% or an opportunistic infection. Therefore client 3, with a CD4+ T-cell count of less than 200 cells/mm 3 (200 cells/uL) and who is HIV positive, is having AIDS-defining illness. A healthy client usually has at least 800 to 1000 CD4+ T-cells per cubic millimeter (mm 3) of blood. This number is reduced in the client with HIV disease. Client 1, with a CD4+ T-cell count of 750 cells/mm 3 and HIV positive, does not have AIDS. Client 2, with a CD4+ T-cell count of 550 cells/mm 3 and HIV positive, does not have AIDS. Client 4, having a CD4+ T-cell count of 450 cells/mm 3 and HIV positive does not have AIDS.
Which finding in the client's laboratory report enables the nurse to conclude that the client has a stage 3 human immunodeficiency (HIV) infection according to the Centers for Disease Control and Prevention (CDC) classification?
CD4T 100; CD4T 150. The CDC has classified four stages of HIV infection. Stage 3 is characterized by a CD4+ T-cell count less than 200 cells/mm 3 or a percentage less than 14%. A T-cell count of greater than 500 cells/mm 3 or a percentage of 29% or greater is regarded as stage 1 HIV. A client whose HIV infection is confirmed with no information on the CD4+ T-cell count but who has an acquired immunodeficiency syndrome-defining illness such as Kaposi's sarcoma or Burkitt's lymphoma is considered to be in stage 4 HIV.
A client is diagnosed with acquired immunodeficiency syndrome (AIDS). When examining the client's oral cavity, the nurse assesses white patchy plaques on the mucosa. The nurse recognizes that this finding most likely represents what opportunistic infection?
Candida albicans. White patchy plaques on the oral mucosa would most likely be a result of C. albicans, a yeastlike fungal infection. This condition is also known as "thrush." Cytomegalovirus may cause a serious viral infection in persons with human immunodeficiency virus (HIV), resulting in retinal, gastrointestinal, and pulmonary manifestations. Histoplasmosis is an infection caused by inhalation of spores of the fungus Histoplasma capsulatum and is characterized by fever, malaise, cough, and lymphadenopathy. Human papillomavirus typically manifests as warts on the hands and feet, as well as mucous membrane lesions of the oral, anal, and genital cavities. It may be transmitted without the presence of warts through body fluids, with some forms associated with cancerous and precancerous conditions.
Which nursing interventions require a nurse to wear gloves?
Cleaning a newborn immediately after delivery. Emptying a portable wound drainage system. Personal protective equipment (PPE) should be used because the newborn is covered with amniotic fluid and maternal blood. PPE should be used because the nurse may be exposed to blood and fluid that are contained in the portable wound drainage system. PPE is not required for a back rub; there is no indication that the nurse is in contact with bodily secretions. PPE is not necessary when conducting an interview because it is unlikely that the nurse will come into contact with the client's body fluids. PPE is not necessary when obtaining the blood pressure of a client, even if the client is HIV positive.
A client with acquired immunodeficiency syndrome (AIDS) is receiving zidovudine. Which laboratory values are most important for the nurse to monitor in this client?
Complete blood counts (CBCs). Zidovudine can cause anemia, leukopenia, and granulocytopenia; these blood dyscrasias can be life threatening and therefore the CBC should be monitored. Cardiac enzymes are not affected directly by zidovudine. Serum electrolytes are not affected directly by zidovudine. Once infected, the client will continue to test positive for the antibody.
Which reasons should the nurse suggest that a client be tested for HIV?
Diagnosed with tuberculosis in 1985. Received blood transfusions in 1980 during total hip replacement surgery. Engaged in sexual relations with a someone of the same gender for several years. Reasons for a client to be tested for HIV include diagnosis with a communicable disease such as tuberculosis, receiving blood transfusions before blood was routinely tested for HIV contamination, and engaging in sexual relations with a member of the same gender. Travel to Italy and Greece and spending several nights in jail waiting for bond due to a DUI would not require testing for HIV.
A circulating nurse in the operating room learns of being HIV positive. What should this nurse do regarding participation in exposure-prone procedures?
Discuss procedures that can be performed with a review panel. Workers who are infected with HIV should seek advice from an expert review panel before performing exposure-prone procedures to determine under what circumstances they may continue to practice these procedures. All healthcare workers should adhere to standard precautions at all times and not just those who are HIV positive. Workers with exudative lesions or weeping dermatitis should not perform direct client care or handle client care equipment and devices used in invasive procedures. Workers must follow guidelines for disinfection and sterilization of reusable equipment utilized in invasive procedures.
A client comes to the clinic for a physical and asks to be tested for acquired immune deficiency syndrome (AIDS). Which test should the nurse explain will be used for the initial screening for human immunodeficiency virus (HIV)?
Enzyme-linked immunosorbent assay (ELISA) -The ELISA is the first screening test done to detect serum antibodies that bind to HIV antigens on test plates. The CD4 T cell count is not a screening test; it is done to monitor the progression of HIV infection and response to treatment. The Western blot test is not done first; the Western blot is done to validate repeatedly reactive ELISA results. The polymerase chain reaction test is not an initial screening test; it is done when there are consistently inconclusive test results with previous screening tests
A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. What does the nurse explain to the client regarding the diagnostic criterion for acquired immunodeficiency syndrome (AIDS)?
Has a CD4+ T lymphocyte level of less than 200 cells/µL. AIDS is diagnosed when an individual with HIV develops one of the following: a CD4+ T lymphocyte level of less than 200 cells/µL, wasting syndrome, dementia, one of the listed opportunistic cancers (e.g., Kaposi sarcoma [KS], Burkitt lymphoma), or one of the listed opportunistic infections (e.g., Pneumocystis jiroveci pneumonia, Mycobacterium tuberculosis). The development of HIV-specific antibodies (seroconversion), accompanied by acute retroviral syndrome (flu-like syndrome with fever, swollen lymph glands, headache, malaise, nausea, diarrhea, diffuse rash, joint and muscle pain), one to three weeks after exposure to HIV reflects acquisition of the virus, not the development of AIDS. A client who is HIV positive is capable of transmitting the virus with or without the diagnosis of AIDS.
A nurse is counseling the family of an infant who is HIV positive. Where is the best place for this infant to receive long-term care?
Home environment Unless there is an episode of acute illness, home is the best place for the infant; this prevents hospital-acquired infection and promotes family interaction.
A client has a history of a persistent cough, hemoptysis, unexplained weight loss, fatigue, night sweats, and fever. Which risk should be assessed?
Human immunodeficiency virus (HIV) infection. A client with a history of persistent cough, hemoptysis, unexplained weight loss, fatigue, night sweats, or fever may have a human immunodeficiency virus (HIV) infection or tuberculosis. Lung cancer and cerebrovascular disease are risks to be assessed in the client with a history of tobacco or marijuana use. Cardiopulmonary alterations may be present in a client with a persistent cough (productive or nonproductive), sputum streaked with blood, or voice changes.
While performing a neck assessment, the nurse finds the client has enlarged lymph nodes. The client also had a history of intravenous drug use and bisexual activity. What would be the possible diagnosis?
Human immunodeficiency virus (HIV) infection. The presence of enlarged lymph nodes may indicate infection. Further findings of intravenous drug use and bisexual activity may indicate an HIV infection. Cancer may be detected by enlarged lymph nodes; however the history of drug use and bisexual activity would not necessarily point to a cancer diagnosis. Neck swelling and changes in hair texture, skin texture, or nails coupled with a change in emotional stability may indicate thyroid disease. A history of a bronchial tumor or pneumothorax may lead to tracheal displacement.
A client is undergoing highly active antiretroviral therapy (HAART). From what viral disease could the client possibly be suffering?
Human immunodeficiency virus (HIV). Highly active antiretroviral therapy (HAART) is a combination of antiretroviral drugs used to treat human immunodeficiency virus (HIV). Because hepatitis, herpes simplex virus (HSV), and human papillomavirus (HPV) are not retroviral, HAART is ineffective for these disorders.
A client with human immunodeficiency virus (HIV)-associated Pneumocystis jiroveci pneumonia is to receive pentamidine isethionate intravenously (IV) once daily. The nurse should monitor the client for what adverse effect?
Hypoglycemia. Pentamidine isethionate can cause either hypoglycemia or hyperglycemia even after therapy is discontinued, and therefore blood glucose levels should be monitored. Hypotension, not hypertension, occurs with pentamidine isethionate. Hyperkalemia, not hypokalemia, occurs with pentamidine isethionate. Hypocalcemia, not hypercalcemia, occurs with pentamidine isethionate.
A 16-year-old client has a steady boyfriend with whom she is having sexual relations. She asks the nurse how she can protect herself from contracting human immunodeficiency virus (HIV). Which guidance is most appropriate for the nurse to provide?
Insist that her partner use a condom when having sex. A condom covers the penis and contains the semen when it is ejaculated; semen contains a high percentage of HIV in infected individuals. Preejaculatory fluid carries HIV in an infected individual, so withdrawing before ejaculation is not effective. Although a monogamous relationship is less risky than having multiple sexual partners, if one partner is HIV positive, the other person is at risk for acquiring HIV. The client is not asking about various contraceptive methods. Most contraceptives do not provide protection from HIV.
A client at term is admitted in active labor. She has tested positive for human immunodeficiency virus (HIV). Which intervention in the standard prescriptions should the nurse question?
Internal fetal scalp electrode. The electrode used for internal fetal monitoring pierces the fetal scalp; fetal exposure to maternal blood increases the risk of the fetus contracting HIV. Sonograms and nonstress tests are noninvasive tests that pose no risk to the fetus. Sterile vaginal examination is necessary to determine progression of labor; although invasive, it poses no risk to the fetus if standard precautions are used.
The family of a client infected with human immunodeficiency virus (HIV) wants to see the results of the client's blood tests, unaware that the client is infected. A nurse obliges the family's request without waiting for the client's consent. What legal charge may be brought against the nurse?
Invasion of privacy. Invasion of privacy is unwanted intrusion into the private affairs of a client. In this situation, the nurse has divulged the client's confidential medical information to family members without consent. Slander is when one person speaks falsely about another. In this situation, the nurse has not given false information about the client. Negligence is conduct that falls below the established standard of care. The nurse in this situation has not engaged in any negligent acts. Defamation of character is the publication of false statements that could damage a person's reputation. The nurse has not damaged the reputation of the client with false statements.
A client who has recently been found to be infected with human immunodeficiency virus (HIV) comments to the nurse, "There are so many terrible people around. Why couldn't one of them get HIV instead of me?" What is the best response by the nurse?
It seems unfair that you should have this disease. The client is in the anger or "why me" stage of grieving; encouraging the client to express feelings will help the client resolve them while moving toward acceptance.
The registered nurse instructs the nursing student about caring for a hospitalized client with a human immunodeficiency (HIV) infection. Which action made by the nursing student indicates effective learning?
Keeping a dedicated disposable glove box in the client's room. A client with an HIV infection is at a high risk of contracting infections. Therefore the nurse should keep a dedicated disposable glove box in the client's room and avoid using supplies from a common area. The nurse should refrain from keeping potted plants and flowers in the client's room because they act as source of potentially infectious bacteria and fungi. A client with an HIV infection should be discouraged from consuming raw fruits and vegetables and should be given well-cooked food to reduce risk of food borne pathogens. In order to reduce the risk of infections, the nurse should change gauze-containing wound dressings every day.
A client comes to the emergency department reporting symptoms of the flu. When the health history reveals intravenous drug use and multiple sexual partners, acute retroviral syndrome is suspected, and a test for the human immunodeficiency virus (HIV) is performed. Which clinical responses are associated most commonly with this syndrome? (Select all that apply.) 1 Malaise 2 Confusion 3 Constipation 4 Swollen lymph glands 5 Oropharyngeal candidiasis
Malaise Swollen lymph glands Development of HIV-specific antibodies (seroconversion) is accompanied by a flulike syndrome called acute retroviral syndrome. This syndrome includes malaise, swollen lymph glands, fever, sore throat, headache, nausea, diarrhea, muscle/joint pain, or a diffuse rash. It occurs one to three weeks after infection and may continue for several months. Acute retroviral syndrome over time is followed by the early-chronic, intermediate-chronic, and late-chronic stages of HIV infection. Development of HIV-specific antibodies, accompanied by flulike syndrome, includes swollen lymph glands. Confusion is associated with the intermediate-chronic and late-chronic stages of HIV infection when the individual develops AIDS-dementia complex or opportunistic infection that affects the neurological system. Diarrhea, not constipation, is associated with this syndrome. Oropharyngeal candidiasis occurs during the intermediate-chronic stage of HIV infection.
Which medications will prevent the binding of human immunodeficiency virus (HIV) to a client's cells?
Maraviroc; Enfuvirtide. Maraviroc and enfuvirtide are entry inhibitors that prevent the binding of HIV. Rilpivirine is one of the nonnucleoside reverse transcriptase inhibitors that inhibit the action of reverse transcriptase. Saquinavir is one of the protease inhibitors that prevent the protease enzyme from cutting HIV proteins into proper lengths. Raltegravir is one of the integrase inhibitors; it binds with integrase enzymes and prevents HIV from incorporating its genetic material into the host cell.
A client with a diagnosis of anemia is receiving packed red blood cells. What is the most important action by the nurse when administering the transfusion?
Monitoring the client's response, particularly within the first 10 minutes. Transfusion reactions usually occur early during the administration of a blood transfusion (first 30 mL of blood); early detection of a transfusion reaction will permit a quick termination of the infusion. The risk of fluid overload is unlikely, and this information can be frightening. The donor's, not the recipient's, blood is tested for HIV. The flow rate should be slower during the first 10 to 15 minutes of the infusion to limit the amount of blood infused; this allows time to assess the client's response for signs and symptoms of a transfusion reaction before too much of the blood is infused.
Which is the most common opportunistic infection in a client infected with human immunodeficiency virus (HIV)?
Oropharyngeal candidiasis. Oropharyngeal candidiasis is the most common infection associated with HIV because the immune system can no longer control Candida fungal growth. Pneumocystis jiroveci pneumonia (PCP) is the more common in a client infected with AIDs. It causes tachypnea and persistent dry cough. Cryptosporidiosis, an intestinal infection caused by Cryptosporidium organisms, presents in clients with AIDS as does toxoplasmosis encephalitis, which is caused by Toxoplasma gondii and is acquired through contact with contaminated cat feces or by ingesting infected undercooked meat. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.
What does the nurse explain to a client that a positive diagnosis for human immunodeficiency virus (HIV) infection is based on?
Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests. Positive ELISA and Western blot tests confirm the presence of HIV antibodies that occur in response to the presence of the HIV. Performance of high-risk sexual behaviors places someone at risk but does not constitute a positive diagnosis. Evidence of extreme weight loss and high fever do not confirm the presence of HIV; these adaptations are related to many disorders, not just HIV infection. The diagnosis of just an opportunistic infection is not sufficient to confirm the diagnosis of HIV. An opportunistic infection (included in the Centers for Disease Control and Prevention surveillance case definition for acquired immunodeficiency syndrome [AIDS]) in the presence of HIV antibodies indicates that the individual has AIDS.
The nurse is caring for a client on antiretroviral therapy who has Pneumocystis jiroveci pneumonia. Which action is priority?
Providing adequate oxygenation for the client. Pneumocystis jiroveci pneumonia may cause difficulty in breathing; therefore the client should be provided adequate oxygenation. A client with human immunodeficiency virus and mouth lesions may need assistance in eating and drinking. An important nursing concern in a client with dehydration is maintaining fluid balance. Encouraging regular breathing exercises may be incorporated when the client is stable and is not the priority.
Which medications act by binding with integrase enzyme and prevent human immunodeficiency virus (HIV) from incorporating its genetic material into the client's cell?
Raltegravir; Elvitegravir. Raltegravir and elvitegravir are integrase inhibitors. They act by binding with integrase enzyme and prevent HIV from incorporating its genetic material into the client's cell. Ritonavir and nelfinavir are protease inhibitors. They act by preventing the protease enzyme from cutting HIV proteins into the proper lengths needed to allow viable virions to assemble and bud out from the cell membrane. Tenofovir is a nucleotide reverse transcriptase inhibitor. It acts by combining with reverse transcriptase enzyme to block the process needed to convert HIV ribose nucleic acid into HIV deoxyribose nucleic acid.
A nurse is teaching a client about human immunodeficiency virus (HIV). What are the various ways HIV is transmitted?
Sharing needles; anal; breastfeeding. Fluids such as blood and semen are highly concentrated with human immunodeficiency virus (HIV). HIV may be transmitted parenterally by sharing needles and postnatally through breast milk. HIV may also be transmitted through anal intercourse. HIV is not transmitted by mosquito bites or dry kissing.
A client's laboratory report reveals a CD4+ T-cell count of 520 cells/mm 3. According to the Centers for Disease Control and Prevention (CDC), which stage of human immunodeficiency virus (HIV) disease is present in the client?
Stage 1. According to the CDC, HIV disease is divided into four stages. A client with a CD4+ T-cell count of greater than 500 cells/mm 3 is in the first stage of HIV disease. A client with a CD4+ T-cell count between 200 and 499 cells/mm 3 is in the second stage of HIV disease. A client with a CD4+ T-cell count of less than 200 cells/mm 3 is in the third stage of HIV disease. The fourth stage of HIV disease indicates a confirmed HIV infection with no information regarding the CD4+ T-cell counts.
Which stage of HIV would a client with a CD4+ T-cell count of 325 cells/mm 3 be classified?
Stage 2 describes a client with a CD4+ T-cell count between 200 and 499 cells/mm3. Stage 1 describes a client with a CD4+ T-cell count of greater than 500 cells/mm3. Stage 3 describes a client with a CD4+ T-cell count of less than 200 cells/mm3. Stage 4 describes a client with a confirmed HIV infection but no information regarding CD4+ T-cell counts is available.
What determines if a client will develop AIDS from an HIV infection?
The number of CD4+ T-cells available. Whether HIV becomes AIDS depends upon the number of CD4+ T-cells. IgM and the presence of antigen-antibody complexes have no effect on HIV. The speed with which HIV invades the RNA has no impact on the future development of AIDS.
A nurse is caring for a 26-year-old client recently diagnosed with human immunodeficiency virus (HIV) and has a CD4 count of 150. The client needs an update on immunizations and asks which ones are needed. Which vaccines are required to comply with the recommended immunization schedule for a client with HIV?
Tetanus, hepatitis B, influenza, and pneumococcal vaccines According to recent recommendations, adults with HIV should receive tetanus, influenza, hepatitis B, and pneumococcal vaccines. Live pathogen vaccines (MMR, varicella) are contraindicated for individuals who are immunosuppressed. Currently there is no immunization for hepatitis C and the diphtheria vaccine is not recommended.
Which act protects a person who is HIV positive?
The Americans with Disabilities Act (ADA). The Americans with Disabilities Act (ADA) protects a person who is HIV positive. The National Organ Transplant Act protects the donor's estate from liability for injury or damage that results from the use of the organ. The Patient Self-Determination Act (PSDA) requires healthcare associations to provide written information to clients about their rights under state law to make decisions, including the right to refuse treatment and formulate advance directives. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects individuals from losing their health insurance when changing jobs by providing portability.
A client who is negative for human immunodeficiency virus (HIV) but who has a history of chronic obstructive pulmonary disease (COPD) requests the nurse to read the results of the client's Mantoux test for tuberculosis. The test site has a 10-mm area of induration with 5 mm of erythema. How should the nurse interpret the finding?
The client has been exposed to the pathogen that causes tuberculosis. The size of the induration determines the clinical significance of the reaction; an induration of 5 mm or more is considered positive in a client with HIV, indicating exposure to the tuberculosis bacillus or vaccination with bacillus Calmette-Guérin (BCG) vaccine, not the presence of active disease. The finding of an induration of 10 mm is a positive response. The size of the induration, not the amount of erythema, is used to determine the test result. Having COPD does not alter the reading; however, HIV does.
A pregnant client is concerned that she may have been infected with human immunodeficiency virus (HIV). Which information should a nurse include when counseling this client regarding HIV testing?
The risks of passing the virus to the fetus. What positive or negative test results indicate. The emotional, legal, and medical implications of test results. Understanding the risks of transmission, along with treatment options if the client is HIV positive, will help her make appropriate decisions regarding testing. Some women are confused about what positive or negative means in regard to test results. Explaining this in pretest counseling and again when results are given decreases unnecessary stress and misunderstanding. Because of the stigma of the disease and the possible effects on insurance and medical care, clients should receive adequate counseling regarding implications. Although it may be helpful for primary healthcare providers to know if a client is at risk for HIV, the client is not required to disclose this information. HIV testing of pregnant women is not required; however, it is highly recommended by most primary healthcare providers.
A client who is homeless is hospitalized for alcohol withdrawal. When considering the type of personal protective equipment that is needed for the client's care, what condition does the nurse recall that homeless persons are at risk for?
Tuberculosis Medically underserved clients such as the homeless, clients who are alcohol or drug dependent, and those who have human immunodeficiency virus (HIV) infections are at risk for developing tuberculosis. Being homeless does not increase a person's risk for developing prostatitis, osteoarthritis, or diverticulosis.
A client with a human immunodeficiency virus (HIV) infection reports genital discharge associated with irritation, pain, and itching. Which actions of the client might have lead to this condition?
Wearing tight jean pants. Using antibiotic medications. Discharge from the genital area is commonly observed in clients with sexually transmitted diseases such as human immunodeficiency virus (HIV). Genital discharge causes irritation, pain, and itching and may trigger when the client wears tight jean pants, fabric underwear, and when the client is using antibiotics. Diethylstilbestrol, iron supplements, and Kegel exercises do not cause genital discharge.
