Test 5 HIV/Aids

Question 1

1. List opportunistic infections and their manifestations (pp slide 10)

Answer 1

(Can be cancerous, viral, bacterial, fungal, or protozoal)
Cancerous: Kaposi’s sarcoma – dark purple lesions
Viral: cytomegalovirus- multiple problems/blindness
Bacterial: mycobacterium TB
Fungal: candidiasis/ pneumocystis pneumonia (help w/ADLS like bathing & hygiene) due to coughing (early sx),SOB, difficulty breathing: preserve energy for more important tasks

Question 2

2. Manifestations of HIV (PP slide 6)

Answer 2

Chronic Stage:
 May not have signs & sx but if they do they will be flu like sx that last for a few wks (aches, joint pain, headache, fever, sore throat, swollen lymph nodes GI upset & rash); woman: chronic vaginal infections, abnormal pap smears
 Can last up to a decade or more for people who AREN’T taking medications to treat & some who are taking ART may stay in this stage & may never progess to the last stage (AIDS)
 Lower viral load but virus is still replicating & destroying the cells
 Can still transmit HIV to others (ART can help lower this chance)

Question 3

3. Risk factors to contracting HIV (pp slide 3)

Answer 3

 Exposure to body fluids: blood, semen, vaginal secretions, breast milk

Question 4

4. Type of precaution used with HIV positive clients (pp slide 12)

Answer 4

 Standard precautions

Question 5

5. HIV client education (PP slide12)

Answer 5

 Maintain weight w/supplemental vitamins (B12 & thymineto help w/neuropathy caused by antiretroviral meds )
 Adhere to medication regimen
 Avoid people w/infections
 Rest
 Take temperature daily (if developing fever, sign of infection, can be provided w/antibiotics immediately)

Question 6

6. Antiretroviral adverse effects and client education (Pharm ATI pg.344)

Answer 6

AE: bone marrow suppression, causing anemia, agranulocytosis & thrombocytopenia, peripheral neuropathy, N/V
 Take on a regular schedule, don’t miss doses (missed medication doses can cause drug resistance),
 Take w/food to reduce gastric irritation.
 Educate to monitor for bleeding, easy bruising, sore throat & fatigue.

Question 7

7. ADC manifestations (PP slide 10)

Answer 7

AIDS dementia complex: degeneration of brain: affects mood, cognition & motor functions (Prevent falls with rails & bed alarms)

Question 8

8. End of life nursing actions for clients with AIDS (PP slide 12)

Answer 8

 Provide analgesia

Question 9

9. Nursing actions for diarrhea (PG.603)

Answer 9

Diarrhea:
 Avoid: fiber, dairy, fat, caffeine, alcohol
Limit intake of clear liquids for 1 or 2 meals, gradually advance to regular diet.
 Antidiarrheal agents
 Replace Fluid & electrolytes IV
 Increase potassium rich foods (hypokalmemia)

Question 10

9. Nursing actions for constipation (PG.603)

Answer 10

 High fiber foods & Increase fluids
 Encourage mobility
 Establish regular time for bowel movement (w/in 30 mins of meal)
 Stool softener

Question 11

10. Zidovudine K,H,K (Pharm ATI pg.344)

Answer 11

 Reverse transcriptase (prevents new HIV copies from being created)
Monitor for severe N/V & abdominal pain
 Monitor for pancreatitis & liver disfunction
 Used in prevention of maternal-fetal HIV transmission
 Monitor CBC, platelets & liver enzymes.

Question 12

11. AIDS nursing interventions (PP slide 12)

Answer 12

 Standard precautions
 Antiretroviral drug: drug teaching & side teaching
 Reduce occupational risks
 At end of life: provide analgesia
 Support group & resource referrals

Question 13

12. Criteria for confirming a diagnosis of AIDS (pp slide 7)

Answer 13

 Acquired Immunodeficiency Syndrome (LAST STAGE)
 Immune system will be destroyed by the virus: viral load very high & person can easily spread to others and w/out medications survival time is only a few years
Dx w/AIDS if:
 CD4 count drops to <200 cells per millimeter.
 Opportunistic disease is present

Question 14

13. Priorities for pregnant clients with AIDS (Maternity ATI pg.43)

Answer 14

 Early identification & treatment (to significantly decrease the incidence of perinatal transmission)
 Administer Zidovudine to infant at delivery & for 6 weeks after birth

Question 15

14. HIV testing protocol (pp slide 8)

Answer 15

 Western Blot (confirmation test)must be repeated: in 2 weeks then 1 month, if negative after 6months then client is negative
 Elisa test(detects HIV antibodies)
 Total t-cell count: once a + HIV status is established , its necessary to monitor the CD4 count & viral load of the patients blood.

Question 16

15. AIDS manifestations (PP slide 9)

Answer 16

 Fever & night sweats (administer preventative antipyretics before bed, provide fluids)
 Nausea (room temp foods, no spicy foods, provide crackers)
 Weight loss (give supplements)
 Swollen lymph nodes(apply warm compress, rest, pain relievers)
 Pharyngitis & difficulty swallowing(increase fluids, gargle salt water, thickened fluids)
 Rash (cool compresses to suppress itching, moisturized skin)
 Muscle & joint pain (balance rest w/activity, ice packs to joints, analgesics)
 OI’s & their manifestations