HIV: Diagnosis, Management, and Patient Care

• Focuses on coordinating care for patients with HIV.
• Considers presentations of HIV across the disease spectrum.
• Includes pharmacological management, diet and lifestyle.
• Describes diagnostic results and findings for diagnosis and monitoring.
• Utilizes communication skills to provide education and counseling.
• Outlines self-management.

HIV

• Constantly changing viral structure leads to AIDS.
• Represents a chronic condition.
• Weakens the immune system.
• Males are four times more likely to contract HIV than females.
• The most commonly infected are African American men.
• Main risk factor is male-male sexual behavior.
• Other risk factors entail, unprotected sex and IV drug use.
• Prevention includes safe sex and avoiding IV drug use, including dirty needles.

HIV Diagnosis & Staging

• CD4+ cells are infection-fighting cells targeted by HIV.
• Diagnosis and staging are based on CD4+ lymphocyte count, percentage of total lymphocytes, and presence of AIDS-defining conditions.
• A patient with a CD4+ count greater than 500 may not show symptoms.
• A patient with CD4+ count between 500-350 may experience increased respiratory infections and dermatological illnesses.
• A patient with CD4+ count between 350-200 may experience increased infections with immune responses, such as fever and fatigue, or severe bacterial infections.
• A patient with a CD4+ count of less than 200 is diagnosed with AIDS.
• AIDS-defining conditions encompass lymphomas, and Kaposi's sarcomas.
• Rare transmission occurs via blood transfusions, pregnancies, and occupational hazards.

Clinical Manifestations of HIV

• Fever
• Cough
• Nausea/weakness/vomiting
• Diarrhea
• Dysphagia/difficulty swallowing
• Forgetfulness
• Skin lesions
• Shortness of breath/ dyspnea on exertion
• Headache
• Vision changes
• Night sweats
• Lymphadenopathy.

Deteriorating Status Manifestations

• New cough
• Increased fatigue
• Fever less than 97°F or greater than 102°F
• Night sweats
• New skin lesions or Kaposi Sarcoma
• New onset of headache
• New onset of visual blurring
• Recent change in mental status
• New onset of diarrhea
• Weight loss greater than 10% of previously recorded weight.

Complications of HIV

• Respiratory infections
• Dermatological manifestations
• Fever
• Fatigue
• Severe bacterial infections
• Pneumocystis pneumonia, cryptococcal meningitis, and cytomegalovirus.
• Immune reconstruction inflammatory syndrome or IRIS
• AIDS.

Medical Management

• Diagnostic testing includes screening, HIV virus antibodies, CD4+ count, and viral load.
• Medications, prophylaxis, antiretroviral therapy or ART, and immunizations.

Nursing Assessment

• Fever
• Cough
• Weakness
• Nausea/vomiting
• Diarrhea
• Dysphagia
• Viral load
• Adherence to ART
• TB Status
• Forgetfulness
• Skin lesions
• Shortness of breath/dyspnea on exertion
• Headache
• Vision changes
• Pain
• Weight trends
• CD4+ count.

Nursing Interventions

• Utilizing universal precautions.
• Administering ART as prescribed and on time.
• Providing nutritionally dense foods and small, frequent meals.
• Providing emotional support.
• Teach about avoiding high-risk behaviors
• Promote adherence to treatment regimen
• Implementing infection-control precautions at home
• Communicate signs and symptoms to report urgently
• Explain that Undetectable = Untransmittable, or U=U

Nursing Goal

• Individuals with HIV can live a normal life span when they are adherent to treatment therapy.