Chapter 37: Management of Patients With HIV Infection and AIDS

2 May 2024
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question
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?
answer
Side effects of drug therapy
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A client with suspected HIV has had two positive enzyme-linked immunosorbent assay tests. What diagnostic test would be run next?
answer
Western Blot
question
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?
answer
Avoid fibrous foods, lactose, fat, and caffeine
question
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?
answer
Follow the same sexual precautions as someone who has been diagnosed with AIDS.
question
Diagnosis of Kaposi's sarcoma (KS) is made by which of the following?
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Biopsy
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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?
answer
HIV encephalopathy
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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?
answer
To avoid resistance to the drugs
question
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?
answer
Primary infection
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During assessment of a patient with Kaposi's sarcoma, the nurse knows to look for the initial sign of:
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Deep purple cutaneous lesions.
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A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?
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Risk for injury
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Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy?
answer
CD4 counts
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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?
answer
Urine
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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?
answer
Ribonucleic acid (RNA)
question
Which category of HIV disease correlates with "full-blown" AIDS?
answer
C
question
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.
answer
Blood Semen Vaginal secretions Breast milk
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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?
answer
Bank autologous blood.
question
A client taking abacavir (ABC) has developed fever and rash. What is the priority nursing action?
answer
Call the health care provider to report.
question
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?
answer
Candidiasis
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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:
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Pneumocystis pneumonia.
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The lower the patient's viral load,
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the longer the survival time.
question
A client is prescribed didanosine (Videx) as part of his highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client?
answer
Be sure to take this drug about 1/2 hour before or 2 hours after you eat.
question
A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find?
answer
Hypokalemia
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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?
answer
ELISA
question
Which of the following indicates that a client with HIV has developed AIDS?
answer
Herpes simplex ulcer persisting for 2 months
question
Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS?
answer
Cytomegalovirus
question
Which blood test confirms the presence of antibodies to HIV?
answer
Enzyme-linked immunosorbent assay (ELISA)
question
A patient with HIV develops a nonproductive cough, shortness of breath, a fever of 101ยฐF and an O2 saturation of 92%. What infection caused by Pneumocystis jiroveci does the nurse know could occur with this patient?
answer
Pneumocystis pneumonia
question
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?
answer
Attachment
question
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?
answer
6 weeks
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A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?
answer
Gynecologic problems
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When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following?
answer
Antibodies to HIV are not present in his blood.
question
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?
answer
AIDS dementia complex (ADC)
question
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?
answer
Testing the client for the presence of HIV
question
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?
answer
Reverse transcriptase inhibitors
question
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?
answer
Trimethoprim-sulfamethoxazole (Bactrim, Septra)
question
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:
answer
Chronic diarrhea.
question
Which of the following is an early manifestation of HIV encephalopathy?
answer
Headache
question
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?
answer
Disturbed body image related to loss of fat in the face and arms
question
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?
answer
Assist with chest physiotherapy every 2 to 4 hours.
question
A 16-year-old client suspected of having HIV/AIDS asks the nurse what causes AIDS. What should the nurse say?
answer
The human immunodeficiency virus
question
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____.
answer
HIV-1 is more prevalent than HIV-2 subtypes
question
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?
answer
The initiation of antiretroviral therapy
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Which assessment finding is not likely to cause noncompliance with antiretroviral treatment?
answer
Past substance abuse
question
A patient taking amprenavir (APV, Agenerase) complains of "getting fat." What is the nurse's best action?
answer
Teach the patient about medication side effects.