Lewis: Infection and HIV Infection Flashcards
A patient who has vague symptoms of fatigue, headaches, and a positive test for human immunodeficiency
virus (HIV) antibodies using an enzyme immunoassay (EIA) test. What instructions should the nurse give to
this patient?
The EIA test will need to be repeated to verify the results.
After an initial positive EIA test, the EIA is repeated before more specific testing such as the Western blot is
done.
A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is admitted to the
hospital with Pneumocystis jiroveci pneumonia (PCP) and a CD4+ T-cell count of less than 200 cells/mL.
Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), which
statement by the nurse is correct?
The patient has developed acquired immunodeficiency syndrome (AIDS).
Development of PCP meets the diagnostic criterion for AIDS.
A patient with a positive rapid antibody test result for human immunodeficiency virus (HIV) is anxious and
does not appear to hear what the nurse is saying. What action by the nurse is most important at this time?
Remind the patient about the need to return for retesting to verify the results.
After an initial positive antibody test, the next step is retesting to confirm the results.
A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the nurse, I feel obsessed with thoughts about dying. Do you think I am just being morbid? Which response by the nurse is best?
Can you tell me more about the kind of thoughts that you are having?
More assessment of the patients psychosocial status is needed before taking any other action.
A pregnant woman with a history of asymptomatic chronic human immunodeficiency virus (HIV) infection is seen at the clinic. The patient states, I am very nervous about making my baby sick. Which information will the nurse include when teaching the patient?
Most infants born to HIV-positive mothers are not infected with the virus.
Only 25% of infants born to HIV-positive mothers develop HIV infection, even when the mother does not use ART during pregnancy
Which patient exposure by the nurse is most likely to require postexposure prophylaxis when the patients human immunodeficiency virus (HIV) status is unknown?
Needle stick with a needle and syringe used to draw blood
Puncture wounds are the most common means for workplace transmission of blood-borne diseases, and a needle with a hollow bore that had been contaminated with the patients blood would be a high-risk situation
A young adult female patient who is human immunodeficiency virus (HIV)-positive has a new prescription for efavirenz (Sustiva). Which information is most important to include in the medication teaching plan?
Continue to use contraception while on this medications
Efavirenz can cause fetal anomalies and should not be used in patients who may be pregnant. The drug should not be used during pregnancy because large doses could cause fetal anomalies. Once
A patient who is human immunodeficiency virus (HIV)-infected has a CD4+ cell count of 400/L. Which
factor is most important for the nurse to determine before the initiation of antiretroviral therapy (ART) for this patient?
Patients ability to comply with ART schedule
Drug resistance develops quickly unless the patient takes ART medications on a strict, regular schedule. In addition, drug resistance endangers both the patient and the community.
The nurse will most likely prepare a medication teaching plan about antiretroviral therapy (ART) for which
patient?
Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV) retinitis
CMV retinitis is an acquired immunodeficiency syndrome (AIDS)-defining illness and indicates that the patient is appropriate for ART even though the HIV infection period is relatively short.
The nurse palpates enlarged cervical lymph nodes on a patient diagnosed with acute human immunodeficiency virus (HIV) infection. Which action would be most appropriate for the nurse to take?
Explain to the patient that this is an expected finding
Persistent generalized lymphadenopathy is common in the early stages of HIV infection. No antibiotic is needed because the enlarged nodes are probably not caused by bacteria.
Which information would be most important to help the nurse determine if the patient needs human immunodeficiency virus (HIV) testing?
Patient age
The current Center for Disease Control (CDC) policy is to offer routine testing for HIV to all individuals age
13 to 64.
A patient who uses injectable illegal drugs asks the nurse about preventing acquired immunodeficiency
syndrome (AIDS). Which response by the nurse is best?
It is important to participate in a needle-exchange program
Participation in needle-exchange programs has been shown to decrease and control the rate of HIV infection.
Which nursing action will be most useful in assisting a college student to adhere to a newly prescribed antiretroviral therapy (ART) regimen?
Check the patients class schedule to help decide when the drugs should be taken
The best approach to improve adherence is to learn about important activities in the patients life and adjust the ART around those activities.
A patient with human immunodeficiency virus (HIV) infection has developed Mycobacterium avium
complex infection. Which outcome would be appropriate for the nurse to include in the plan of care?
The patient will maintain intact perineal skin (Manage skin integrity)
The major manifestation of M. avium infection is loose, watery stools, which would increase the risk for perineal skin breakdown.
A patient treated for human immunodeficiency virus (HIV) infection for 6 years has developed fat
redistribution to the trunk, with wasting of the arms, legs, and face. What instructions will the nurse give to the
patient?
Discuss a change in antiretroviral therapy.
A frequent first intervention for metabolic disorders is a change in antiretroviral therapy (ART).
The nurse prepares to administer the following medications to a hospitalized patient with human immunodeficiency (HIV). Which medication is most important to administer at the right time?
Oral saquinavir (Invirase)
It is important that antiretrovirals be taken at the prescribed time every day to avoid developing drug-resistant HIV.
To evaluate the effectiveness of antiretroviral therapy (ART), which laboratory test result will the nurse
review?
Viral load testing
The effectiveness of ART is measured by the decrease in the amount of virus detectable in the blood
The nurse cares for a patient who is human immunodeficiency virus (HIV) positive and taking antiretroviral therapy (ART). Which information is most important for the nurse to address when planning care?
The patient states, Sometimes I miss a dose of zidovudine (AZT).
Because missing doses of ART can lead to drug resistance, this patient statement indicates the need for interventions such as teaching or changes in the drug scheduling
Eight years after seroconversion, a human immunodeficiency virus (HIV)-infected patient has a CD4+ cell count of 800/L and an undetectable viral load. What is the priority nursing intervention at this time?
Encourage adequate nutrition, exercise, and sleep.
The CD4+ level for this patient is in the normal range, indicating that the patient is the stage of asymptomatic chronic infection, when the body is able to produce enough CD4+ cells to maintain a normal CD4+ count
Which of these patients being seen at the human immunodeficiency virus (HIV) clinic should the nurse assess first?
Patient who has had 10 liquid stools in the last 24 hours
The nurse should assess the patient for dehydration and hypovolemia
An older adult who takes medications for coronary artery disease has just been diagnosed with
asymptomatic chronic human immunodeficiency virus (HIV) infection. Which information will the nurse include in patient teaching?
Many medications have interactions with antiretroviral drugs
The nurse will teach the patient about potential interactions between antiretrovirals and the medications that
the patient is using for chronic health problems.
The registered nurse (RN) caring for an HIV-positive patient admitted with tuberculosis can delegate
which action to unlicensed assistive personnel (UAP)?
Stock the patients room with all the necessary personal protective equipment.
A patient diagnosed with tuberculosis would be placed on airborne precautions. Because all health care workers are taught about the various types of infection precautions used in the hospital, the UAP can safely
stock the room with personal protective equipment.
The nurse designs a program to decrease the incidence of human immunodeficiency virus (HIV) infection in the adolescent and young adult populations. Which information should the nurse assign as the highest priority?
Prevention of HIV transmission between sexual partners
The nurse cares for a patient infected with human immunodeficiency virus (HIV) who has just been diagnosed with asymptomatic chronic HIV infection. Which prophylactic measures will the nurse include in the plan of care (Multiple Response)?
HIP
Hepatitis B vaccine
Pneumococcal vaccine
Influenza virus vaccine
According to the Center for Disease Control (CDC) guidelines, which personal protective equipment will the nurse put on when assessing a patient who is on contact precautions for diarrhea caused by Clostridium difficile (Multiple Response)?
Gown
Gloves
The nurse plans a presentation for community members about how to decrease the risk for antibioticresistant
infections. Which information will the nurse include in the teaching plan (Multiple Response)?
Continue taking antibiotics until all the medication is gone.
Antibiotics may sometimes be prescribed to prevent infection.
Hand washing is effective in preventing many viral and bacterial infections
