Chapter 35: Caring for Clients with HIV/ AIDS
A client tells the nurse, "You know I have AIDS. I still cannot afford to tell my employer because they will probably cancel my health insurance, then what would I do?" What is the best response by the nurse?
"An employer cannot cancel your currently active health insurance on the basis of AIDS."
A public health nurse is giving an informational presentation on HIV/AIDS at a nearby college. How would the nurse best define AIDS?
Acquired immunodeficiency syndrome is a fatal infection that profoundly weakens the immune system.
A client requires a blood transfusion for anemia and informs the nurse that he refuses because he doesn't want to contract acquired immune deficiency syndrome (AIDS). What is the best response by the nurse?
"The blood is screened very carefully; the risk is 1 in 2,000,000."
A female client informs the nurse that she is considering beginning sexual relations and wants to know the best way to protect herself from a sexually transmitted infection and HIV. What is the best response by the nurse?
"Using a condom (latex) and spermicidal jelly is one of the most effective ways to Page 4 decrease the risk of transmission of an STI and HIV."
The nurse has four clients that come to the clinic for healthcare. Which one of these clients has the highest risk factor for HIV infection?
A 26-year-old inmate who receives tattoos in prison
A client who had sexual contact with a partner who is HIV+ recently develops flulike symptoms such as a low grade fever, headache, and muscle pain. What does the nurse suspect this client is experiencing?
Acute retroviral syndrome
A 17-year-old client with a diagnosis of HIV presents at the public health clinic complaining of pharyngitis, rash on the palms and soles of his feet, and diarrhea. What would the nurse suspect the client is suffering from?
Acute retroviral syndrome (ARS)
A client who is HIV positive is taking zidovudine. Which adverse effects should the nurse closely monitor for in this client?
Anemia and granulocytopenia
The nurse is collecting objective data for a client with AIDS at the clinic. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does the nurse understand this finding indicates?
Candidiasis
A client with cytomegalovirus infection tells the nurse at the clinic that he is starting to have difficulty seeing and his glasses don't seem to be working as they used to. The physician determines that the client is developing CMV retinitis. What medication does the nurse anticipate the client will receive for this?
Foscarnet (Foscavir)
A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?
Gynecologic problems
A client is informed that he will have to start on antiretroviral therapy, and the client is concerned that he will not be able to afford the therapy. What can the nurse inform the client is the largest source of public funding for HIV/AIDS care?
Medicaid
The nurse is administering an injection to a client with AIDS and, when finished, attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse?
Report the incident to the supervisor
A client with HIV will be started on a medication regimen of three medications. Which medication will be given that will interfere with the virus's ability to make a genetic blueprint. What drug will the nurse instruct the client about?
Reverse transcriptase inhibitors
The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply.
Semen Breast milk Blood Vaginal secretions
A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often." What should the nurse consult with the physician regarding?
Testing the client for the presence of HIV
The nurse is gathering data from laboratory studies for a client who has HIV. The clients T4-cell count is 200/mm3 , and the client has been diagnosed with Pneumocystis pneumonia. What does this indicate to the nurse?
The client has converted from HIV infection to AIDS.
A client on antiretroviral drug therapy is discussing with the nurse that sometimes he "forgets to take his meds for a few days." What should the nurse inform the client can occur when the medications are not taken as prescribed?
The client is risking the development of drug resistance and drug failure.
The client comes to the clinic to obtain the results from the test to determine if he is infected with HIV. The physician informs the client that he has a CD4 cell count of 300 cells/mm3 and a high viral load. What does the nurse anticipate the physician will discuss with the client?
The initiation of antiretroviral therapy
A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?
Trimethoprim-sulfamethoxazole (Bactrim, Septra)
Which tests tell the physician what the viral load is in a client with HIV/AIDS? Select all that apply.
polymerase chain reaction p24 antigen test
A client has discussed therapy for his HIV-positive status. What does the nurse understand is the goal of antiretroviral therapy?
Keep the CD4 cell count above 350/mm3 and viral load undetectable.
The nurse is preparing to start an IV for a patient who is combative. What precautionary measure should the nurse take in order to avoid a needlestick?
Ask for assistance.
A client visits the nurse complaining of diarrhea every time he eats. The client has AIDS and wants to know what he can do to stop having diarrhea. What should the nurse advise?
Avoid fibrous foods, lactose, fat, and caffeine.
A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?
AIDS dementia complex (ADC)
A client with AIDS has been tested for cytomegalovirus (CMV) with positive titers. What severe complication should the nurse be alert for with cytomegalovirus?
Blindness
A healthcare worker has been exposed to the blood of an HIV-positive client and is awaiting the results of an HIV test. In the meantime, what precautions must the healthcare worker take to prevent the spread of infection?
Follow the same sexual precautions as someone who has been diagnosed with AIDS.
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____.
HIV-1 is more prevalent than HIV-2 subtypes
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay with positive results twice. What is the next step for the nurse to explain to the patient for confirmation of the diagnosis?
Perform a Western blot test for confirmation of diagnosis
A male client is having sexual relations with another male as well as using methamphetamine and has contracted HIV. What concern does the nurse have for this client?
The client may develop AIDS in a shorter period of time.
A client will be having a hysterectomy and wants her daughter to donate the blood for directed donor donation. What factor would eliminate her daughter from donating the blood?
The daughter is 15 years of age
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 client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining the progression of the disease as well as guiding drug therapy?
Viral load and T4-cell counts will be performed every 2 to 3 months.
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?
Stool specimen for ova and parasites
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
