Nursing Responsibilities for HIV/AIDS Patients

Nursing Responsibilities for HIV/AIDS Patients

• Patient Education: Importance of adhering to ART (Antiretroviral Therapy) to prevent drug resistance. Safe practices to prevent HIV transmission (e.g., condom use). Recognizing signs of opportunistic infections.

• Monitoring: Assess for treatment side effects (e.g., hepatotoxicity, nephrotoxicity). Regularly check CD4 count and viral load.

Psychosocial Support

• Address stigma and fear related to HIV diagnosis.
• Provide resources for financial assistance or support groups.

Prophylactic Measures

• Vaccinations (e.g., hepatitis B, pneumococcal).
• Preventive medications for opportunistic infections.

Nursing Diagnoses

• Imbalanced Nutrition: Less than Body Requirements: Related to chronic diarrhea, poor appetite, or malabsorption. Interventions include providing high-calorie meals and supplements.

• Risk for Infection: Related to immunosuppression. Interventions involve implementing strict infection control measures and educating patients about safe practices.

• Ineffective Coping: Related to psychological distress due to HIV diagnosis. Interventions involve providing emotional support and referring patients to counseling.

• Fatigue: Related to chronic illness and infections. Encourage energy conservation and adequate rest.

Prophylaxis and Treatment for Opportunistic Infections

• Trimethoprim-sulfamethoxazole (TMP-SMX): Prevents PCP (Pneumocystis pneumonia) and toxoplasmosis.

• Fluconazole: Treats fungal infections.

• Antitubercular drugs: Treats latent or active TB.

• Supportive Medications: Include anti-emetics, antidiarrheals, and nutritional supplements for symptom management.

Drug Classes

• Nucleoside Reverse Transcriptase Inhibitors (NRTIs): e.g., tenofovir, zidovudine.
• Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): e.g., efavirenz.
• Protease Inhibitors (PIs): e.g., lopinavir, ritonavir.
• Integrase Strand Transfer Inhibitors (INSTIs): e.g., dolutegravir.
• Entry Inhibitors: e.g., maraviroc.

Antiretroviral Therapy (ART)

• Combination therapy reduces viral load to undetectable levels and restores immune function.

Diagnostic Tests and Evaluations

• HIV Testing: Antibody/Antigen Tests (4th generation) detect HIV-1/2 antibodies and p24 antigen. Nucleic Acid Test (NAT) detects viral RNA in blood, useful for early detection and confirming diagnosis.

• CD4 Count: Measures CD4+ T cell levels to determine immune status and disease progression.

• Viral Load Test: Quantifies HIV RNA in the blood to assess treatment efficacy and disease progression.

• Resistance Testing: Identifies drug-resistant HIV strains to guide ART selection.

• Opportunistic Infection Screening: Tests for TB, toxoplasmosis, and hepatitis. Opportunistic infections frequently accompany advanced HIV.

Affected Body Systems

• Immune System: Progressive depletion of CD4+ T cells leads to immunodeficiency and increased susceptibility to opportunistic infections and cancers.
• Nervous System: HIV-associated neurocognitive disorders (HAND) due to direct viral effects or opportunistic infections.

HIV/AIDS Overview

• HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, specifically CD4+ T lymphocytes, weakening the body's ability to fight infections.
• Without treatment, HIV can progress to AIDS (Acquired Immunodeficiency Syndrome), the most severe phase. AIDS is characterized by severe immune deficiency and opportunistic infections.

Other Affected Systems

• Integumentary System: Skin rashes, Kaposi sarcoma, and fungal infections like candidiasis.
• Respiratory System: Opportunistic infections such as Pneumocystis jirovecii pneumonia (PCP) and tuberculosis.
• Gastrointestinal System: Chronic diarrhea, weight loss, and malabsorption due to infections like Cryptosporidium or cytomegalovirus (CMV).