Chapter 37: Management of Patients With HIV Infection and AIDS

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 who is HIV positive is receiving highly active antiretroviral therapy (HAART) that includes a protease inhibitor (PI). The client comes to the clinic for a follow-up visit. Assessment reveals lipoatrophy of the face and arms. The client states, "I'm thinking the side effects of the drug are worse than the disease. Look what's happening to me." The nurse would most likely identify which nursing diagnosis as the priority?

Disturbed body image related to loss of fat in the face and arms

A nurse is implementing appropriate infection control precautions for a client who is positive for human immunodeficiency virus (HIV). The nurse demonstrates a need for a review of transmission routes by identifying which body fluid as a means of transmission?

Urine

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 client is prescribed didanosine (Videx) as part of his 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.

Which category of HIV disease correlates with "full-blown" AIDS?

C

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 with AIDS is brought to the clinic by their 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?

HIV encephalopathy

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 containing the genetic viral material?

Ribonucleic acid (RNA)

You are caring for a client who has a diagnosis of HIV. Part of this client's teaching plan is educating the client about his or her medications. What is essential for the nurse to include in the teaching of this client regarding medications?

Side effects of drug therapy

A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when he schedules a return visit for viral load testing at which time?

6 weeks

When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following?

Antibodies to HIV are not present in his blood.

The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client's plan of care?

Assist with chest physiotherapy every 2 to 4 hours.

A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enters the host cell. Which of the following would the nurse describe as the first step?

Attachment

A client taking abacavir (ABC) has developed fever and rash. What is the priority nursing action?

Call the health care provider to report.

A patient with AIDS informs the nurse of difficulty eating and swallowing, and shows the nurse white patches in the mouth. What problem related to AIDS does the nurse understand the patient has developed?

Candidiasis

Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS?

Cytomegalovirus

During assessment of a patient with Kaposi's sarcoma, the nurse knows to look for the initial sign of:

Deep purple cutaneous lesions.

A client suspected of having HIV has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive?

ELISA

Which blood test confirms the presence of antibodies to HIV?

Enzyme-linked immunosorbent assay (ELISA)

Which of the following 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 is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find?

Hypokalemia

Which assessment finding is not likely to cause noncompliance with antiretroviral treatment?

Past substance abuse

The nurse completes a history and physical assessment on a patient with AIDS who was admitted to the hospital with respiratory complications. The nurse knows to assess for the most common infection in persons with AIDS (80% occurrence). This is:

Pneumocystis pneumonia.

A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in?

Primary infection

A 16-year-old client suspected of having HIV/AIDS asks the nurse what causes AIDS. What should the nurse say?

The human immunodeficiency virus

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 patient taking amprenavir (APV, Agenerase) complains of "getting fat." What is the nurse's best action?

Teach the patient about medication side effects.

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)

The lower the patient's viral load,

the longer the survival time.

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

Diagnosis of Kaposi's sarcoma (KS) is made by which of the following?

Biopsy

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.

Blood Semen Vaginal secretions Breast milk

Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy?

CD4 counts

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:

Chronic diarrhea.

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 patient with 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 patient?

Pneumocystis pneumonia

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

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

A client who is HIV positive has been prescribed antiretroviral drugs. The nurse explains the action of each antiretroviral drug and develops a schedule for the client's self-administration, including strong emphasis about rigidly adhering to the dosage, time and frequency of the administration of the drugs. Why is it important to adhere to the schedule of drug dosing developed for this client?

To avoid resistance to the drugs

A client with suspected HIV has had two positive enzyme-linked immunosorbent assay tests. What diagnostic test would be run next?

Western Blot