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What is identified as a major nursing diagnosis related to nutritional status?

  • Impaired nutritional intake associated with decreased oral intake (correct)
  • Fear of social gatherings due to illness
  • Lack of knowledge about healthy eating habits
  • Social isolation due to loss of appetite
  • What can be a potential complication in patients with HIV according to the assessment?

  • Improvement in body image
  • Development of HAND (correct)
  • Temporary weight gain
  • Increased energy levels
  • Which goal is NOT included in the planning for patients with HIV?

  • Increased socialization
  • Promotion of dietary supplements only (correct)
  • Improved nutritional status
  • Absence of complications
  • Which of the following nursing interventions is aimed at managing grief in patients?

    <p>Encouraging expression of emotions and coping mechanisms (D)</p> Signup and view all the answers

    What is an expected patient outcome regarding knowledge for those managing HIV?

    <p>Reports increased understanding of HIV infection and self-management (A)</p> Signup and view all the answers

    What percentage of the global burden of HIV is accounted for by Sub-Saharan Africa?

    <p>70% (C)</p> Signup and view all the answers

    Which population is NOT identified as being at higher risk for HIV infection?

    <p>Individuals with high educational background (B)</p> Signup and view all the answers

    What is a primary method through which HIV is transmitted from mother to child?

    <p>During childbirth or breastfeeding (C)</p> Signup and view all the answers

    Which age group accounts for a significant number of new HIV infections?

    <p>Adolescents and young adults (ages 15-24) (A)</p> Signup and view all the answers

    Which factor is NOT contributing to the spread of HIV in vulnerable populations?

    <p>Access to quality healthcare (C)</p> Signup and view all the answers

    What has contributed to the decline in new infections and AIDS-related deaths since the peak of the epidemic?

    <p>Antiretroviral therapy (ART) and prevention efforts (A)</p> Signup and view all the answers

    In which region have some areas experienced rising numbers of new HIV infections?

    <p>Eastern Europe and Central Asia (A)</p> Signup and view all the answers

    What remains a key preventive measure against HIV transmission?

    <p>Consistent use of condoms (B)</p> Signup and view all the answers

    What is the main purpose of daily usage of Pre-exposure Prophylaxis (PrEP)?

    <p>To prevent HIV acquisition in high-risk individuals (D)</p> Signup and view all the answers

    Which factor significantly increases the risk of HIV transmission?

    <p>Presence of other STIs (A)</p> Signup and view all the answers

    In the HIV pathophysiology, which process occurs after viral entry into host cells?

    <p>Reverse transcription and integration (B)</p> Signup and view all the answers

    What defines the symptomatic stage of HIV infection?

    <p>Presence of flu-like symptoms and high viral load (A)</p> Signup and view all the answers

    What is a key consideration for women with HIV who are considering pregnancy?

    <p>Counseling about potential risks is essential (A)</p> Signup and view all the answers

    Which of the following describes the HIV risk in LGBTQ populations?

    <p>Increased risk alongside specific cultural challenges (D)</p> Signup and view all the answers

    Which protocol is important for healthcare workers to follow in case of a needle-stick injury?

    <p>Needle-stick Injury Protocol (PEP) (B)</p> Signup and view all the answers

    What role do public health campaigns play in HIV prevention?

    <p>They help address misconceptions and promote healthy behaviors (B)</p> Signup and view all the answers

    What is the male-to-female ratio of individuals diagnosed with primary immune deficiencies diseases?

    <p>5 to 1 (C)</p> Signup and view all the answers

    Which of the following is NOT a common clinical manifestation of primary immune deficiency diseases?

    <p>Frequent headaches (D)</p> Signup and view all the answers

    What type of testing should be avoided in individuals with primary immune deficiency diseases?

    <p>Live vaccines (D)</p> Signup and view all the answers

    Which of the following is a component of medical management for primary immune deficiency diseases?

    <p>Hematopoietic stem cell transplantation (C)</p> Signup and view all the answers

    Which class of drugs is typically utilized in the pharmacologic therapy of infections for immune-deficient patients?

    <p>Prophylactic drugs (C)</p> Signup and view all the answers

    What is a characteristic of acquired immune deficiency?

    <p>Develops at any age (D)</p> Signup and view all the answers

    When was HIV infection first identified?

    <p>1981 (C)</p> Signup and view all the answers

    Which of the following statements about highly active antiretroviral therapy (HAART) is true?

    <p>It has helped in treating opportunistic infections as well (B)</p> Signup and view all the answers

    Which of the following is a significant factor in managing patients with primary immune deficiencies?

    <p>Health teaching and continual monitoring (C)</p> Signup and view all the answers

    Which of the following correctly states the global prevalence of individuals living with HIV?

    <p>Approximately 38 million (D)</p> Signup and view all the answers

    Which of the following is a common respiratory manifestation associated with HIV/AIDS?

    <p>Pneumocystis Pneumonia (C)</p> Signup and view all the answers

    What is a primary goal of nutrition therapy in individuals with HIV?

    <p>Maintaining a balanced diet (C)</p> Signup and view all the answers

    Which neurologic manifestation is characterized by prolonged cognitive decline in HIV patients?

    <p>Progressive Multifocal Leukoencephalopathy (B)</p> Signup and view all the answers

    Which of the following would most likely be included in assessing a patient for HIV-related nursing care?

    <p>History of risky sexual practices or injection drug use (A)</p> Signup and view all the answers

    What is an important aspect of hydration in the management of HIV patients?

    <p>Ensuring adequate fluid intake to prevent dehydration (B)</p> Signup and view all the answers

    Which type of oncologic manifestation is specifically linked to HIV/AIDS?

    <p>Sarcoma (C)</p> Signup and view all the answers

    What role do registered dietitians play in the nutritional therapy of HIV patients?

    <p>They develop nutritional plans in collaboration with healthcare providers. (C)</p> Signup and view all the answers

    What is a key aspect of the nursing process for patients living with HIV/AIDS?

    <p>Evaluating care with a focus on symptom management (A)</p> Signup and view all the answers

    What is the primary goal of antiretroviral therapy (ART) for HIV treatment?

    <p>To suppress the HIV viral load and restore immune function (D)</p> Signup and view all the answers

    Which CD4+ T cell count category defines an individual as having Stage 3: AIDS?

    <p>200-499 cells/mm3 (A)</p> Signup and view all the answers

    Which of the following statements about the HIV life cycle is true?

    <p>Stage 1 can be attacked by Fusion Inhibitors. (B)</p> Signup and view all the answers

    What characterizes the Immune Reconstitution Inflammatory Syndrome (IRIS)?

    <p>Rapid reactivation of immune responses leading to exacerbation of infections (C)</p> Signup and view all the answers

    Which class of antiretroviral drugs primarily targets the process of viral replication at an early stage?

    <p>Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (D)</p> Signup and view all the answers

    What does effective antiretroviral therapy (ART) aim to prevent in individuals with HIV?

    <p>Subsequent opportunistic infections and virus transmission (D)</p> Signup and view all the answers

    Which factor contributes to drug resistance in HIV treatment?

    <p>Presence of drug-resistant HIV at initial infection (D)</p> Signup and view all the answers

    What are the common goals of ART in the context of HIV treatment?

    <p>Maximally suppress viral load and restore immune function (A)</p> Signup and view all the answers

    Flashcards

    Pre-exposure Prophylaxis (PrEP)

    Daily use of PrEP by high-risk individuals is effective in preventing HIV acquisition.

    HIV Transmission Modes

    HIV spreads through sexual contact, blood/blood products, and mother-to-child transmission.

    Factors Increasing HIV Risk

    High viral load, other STIs, unprotected sex practices, and sexual types increase HIV transmission risk.

    HIV Pathophysiology

    HIV targets and destroys the immune system, mainly CD4+ T cells, leading to chronic inflammation.

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    HIV Stages

    HIV infection progresses through stages: initial flu-like symptoms, symptomatic decline in immunity, and eventually AIDS.

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    HIV Prevention Education

    Public health campaigns, community engagement, and comprehensive sex ed are essential.

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    Healthcare Worker Precautions

    Standard precautions and needle-stick injury protocols protect healthcare workers from HIV.

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    LGBTQ and HIV Risk

    LGBTQ+ individuals face increased HIV risks due to social challenges and stigma.

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    HIV Infections in 2021

    In 2021, approximately 1.5 million new HIV infections and 650,000 deaths related to AIDS were reported globally.

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    High-burden HIV regions

    Sub-Saharan Africa accounts for about 70% of the global HIV burden.

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    HIV Transmission Routes

    HIV is transmitted through unprotected sexual contact, contaminated needles, blood transfusions, and mother-to-child transmission.

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    Vulnerable HIV Populations

    Men who have sex with men, sex workers, people who inject drugs, and transgender people are at higher risk of HIV.

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    HIV & Gender Inequality

    Women and young girls are disproportionately affected in certain regions, particularly in Sub-Saharan Africa, due to gender-based violence and limited access to healthcare.

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    HIV incidence trend

    New infections have decreased since the peak of the epidemic due to antiretroviral therapy (ART) and prevention efforts.

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    HIV geographical variation

    Some regions have significantly declined in new infections, while others (Eastern Europe and Central Asia) have rising numbers due to factors like limited ART coverage and increased intravenous drug use.

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    HIV Prevention Strategies

    Condom use remains a key preventive measure against HIV.

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    CD4+ T Cell Count

    A measurement of the number of CD4+ T cells in a person's blood. It's a key indicator of immune health, especially crucial in HIV cases, as a low count indicates reduced immunity.

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    HIV Infection Stage 3 (AIDS)

    Severe immune suppression marked by opportunistic infections, life-threatening complications, and low CD4+ counts.

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    Antiretroviral Therapy (ART)

    The primary treatment for HIV, aiming to suppress the virus, restore immunity, and prevent complications. It usually involves combining multiple drugs.

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    Goals of ART

    To reduce illness, improve health, restore immune function, suppress HIV in the blood, and prevent spreading the virus to others.

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    ART Drug Resistance

    The ability of HIV to change in response to ART, making it harder to suppress or cure.

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    Immune Reconstitution Inflammatory Syndrome (IRIS)

    A reaction where the immune system, strengthened by ART, overreacts to a past or new infection, potentially causing symptoms.

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    Viral Load

    The amount of HIV virus in the blood.

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    Combination Therapy

    Using multiple antiviral drugs to combat HIV, improving treatment effectiveness and reducing drug resistance.

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    Primary Immune Deficiencies (PIDDs)

    Rare inherited disorders that impair the immune system, often diagnosed in infancy, with a high male-to-female ratio.

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    PIDD Pathophysiology

    Over 200 forms, affecting over 270 genes, resulting in the body's failure to develop normal immune responses.

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    PIDD Clinical Manifestations

    Recurring infections despite treatment, unusual or opportunistic infections, poor growth, and a strong family history.

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    PIDD Assessment and Diagnosis

    Laboratory tests focus on cellular (T-cell) defects, neutrophil disorders and complement deficiencies.

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    PIDD Prevention

    Avoid live vaccines, practice family planning, and consider prenatal in-utero testing.

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    PIDD Medical Management

    Treatments include hematopoietic stem cell transplantation (HSCT) and gene therapy

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    HIV Infection (acquired)

    An acquired immune deficiency caused by a virus, first identified in 1981.

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    HIV Infection Stages

    Early treatment focused on opportunistic infections; later, HAART (highly active antiretroviral therapy) improved treatment; now focuses on prevention, adherence, and new drug development

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    HIV Global Prevalence

    Approximately 38 million people worldwide are living with HIV.

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    Nursing Management: HIV

    Focuses on hand hygiene, infection prevention, patient monitoring, and health education.

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    Nutritional Status Assessment

    Assessing nutritional status involves gathering dietary history and identifying factors impacting oral intake.

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    Nursing Diagnoses (HIV)

    Nursing diagnoses for HIV patients might include impaired intake, social isolation, grief, and lack of knowledge.

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    Collaborative Problems (HIV)

    Potential complications for HIV patients include medication side effects, HIV-associated neurocognitive disorders (HAND), and body image changes.

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    Goals for HIV Patients

    Patient goals include improved nutrition, reduced social isolation, healthy grief management, disease knowledge increase, and prevention of complications.

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    Expected Patient Outcomes (HIV)

    Expected outcomes include maintaining nutritional status, decreasing social isolation, progressing through grief, increased HIV knowledge, and absence of complications.

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    HIV Respiratory Manifestations

    Conditions like Pneumocystis pneumonia, Mycobacterium Avium Complex, and Tuberculosis, that affect the respiratory system in people with HIV.

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    Nutrition Therapy in HIV

    A focused strategy to maintain balanced diet, treat symptoms, support immune function, and tackle related illnesses.

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    Nursing Assessment (HIV)

    Identifying potential risk factors like sexual practices or drug use and evaluating the patient's physical and mental well-being in the context of HIV.

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    Gastrointestinal HIV Manifestations

    Conditions like Candidiasis (yeast infection) and HIV Wasting Syndrome affecting the digestive system in people with HIV.

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    Oncologic Manifestations (HIV)

    Cancer-related conditions, such as Kaposi sarcoma and Lymphomas, associated with HIV.

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    Neurological HIV Manifestations

    Conditions affecting the nervous system from subcortical disease to peripheral neuropathy and encephalopathy.

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    Nutrition Therapy Goals (HIV)

    Enhance well-being and treatment outcomes through balanced diet and symptom management in HIV.

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    Nursing Process (HIV/AIDS)

    Assessing, diagnosing, planning, implementing, and evaluating care for patients, focusing on immunity/symptoms/infection prevention.

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    Study Notes

    NCM 105 Infectious, Inflammatory, and Immunologic Problems

    • Course covers infectious, inflammatory, and immunologic problems.

    Primary Immune Deficiencies Diseases

    • Rare inherited disorders impairing the immune system.
    • Commonly diagnosed in infancy.
    • Male-to-female ratio is 5:1.

    Pathophysiology

    • More than 200 forms of PIDDs.
    • More than 270 different genes associated with PIDDs.
    • Prevent the body from developing normal immune responses.

    Clinical Manifestations

    • Multiple infections despite aggressive treatment.
    • Infections with unusual or opportunistic organisms.
    • Failure to thrive or poor growth.
    • Significant family history.

    Assessment and Diagnostic Findings

    • Laboratory tests reveal cellular (T-cell) defects, neutrophil disorders, and complement deficiencies.

    Prevention

    • Avoid live vaccines.
    • Family planning is crucial.
    • Prenatal in-utero testing is recommended.

    Medical Management

    • Hematopoietic stem cell transplantation (HSCT).
    • Gene therapy, leveraging emerging technologies for precise DNA targeting.

    Pharmacologic Therapy

    • Treatment depends on the type and severity of infection.
    • Prophylactic drug treatment.
    • Empiric therapy.
    • Immunoglobulin (Ig) replacement therapy.

    Nursing Management

    • Essential: appropriate hand hygiene and infection prevention precautions.
    • Adherence to institutional policies and procedures related to infection prevention.
    • Continual monitoring of the patient's condition.
    • Education and health teaching.

    Acquired Immune Deficiency

    • Acquired from chemotherapy and pathogens like HIV.

    HIV Infection and AIDS

    • First identified in 1981.
    • First decade focused on recognition and treatment of opportunistic infections.
    • Second decade focused on highly active antiretroviral therapies (HAART).
    • Third decade focused on preventing new infections, adhering to antiretroviral therapy (ART), developing second-generation combination medications, and the need for an effective vaccine.

    Epidemiology

    • Global prevalence: approximately 38 million people worldwide living with HIV.
    • Approximately 1.5 million new infections and 650,000 AIDS-related deaths reported in 2021.
    • Sub-Saharan Africa accounts for about 70% of the global burden of HIV.

    Modes of Transmission

    • Primary routes: unprotected sexual contact, sharing contaminated needles, blood transfusions, mother-to-child transmission (during childbirth or breastfeeding).
    • Vulnerable populations: men who have sex with men (MSM), sex workers, people who inject drugs (PWID), and transgender people.

    Demographic and Social Determinants

    • Gender: Women and young girls disproportionately affected in some regions due to gender-based violence, limited access to healthcare, and economic dependence.
    • Age: Adolescents and young adults (15-24) account for a significant number of new infections, necessitating youth-targeted interventions.
    • Socioeconomic Factors: Poverty, lack of education, stigma, and discrimination limit access to prevention, testing, and treatment services.
    • Decline in new infections and AIDS-related deaths since the peak of the epidemic, due to antiretroviral therapy (ART) and prevention efforts.
    • Geographical variation: some regions experience significant declines, while others, like Eastern Europe and Central Asia, face rising numbers due to limited ART coverage and increased intravenous drug use.

    Prevention Strategies

    • Condom Use: Consistent condom use remains a crucial preventive measure.
    • Pre-exposure Prophylaxis (PrEP): Daily PrEP use by high-risk individuals exhibits significant efficacy in preventing HIV acquisition.
    • Education and Awareness: Public health campaigns, community engagement, and comprehensive sex education are important to address misconceptions and promote healthy behaviors.

    Modes of HIV Transmission

    • Sexual transmission.
    • Blood and blood products.
    • Mother-to-child transmission (MTCT).

    Factors Increasing Transmission Risk

    • Viral load.
    • Presence of other STIs.
    • Unprotected sexual practices.
    • Type of sexual contact.

    Special Considerations for Healthcare Workers

    • Standard precautions.
    • Needle-stick injury protocol (PEP).
    • Family planning considerations for women with HIV.
    • Risks for discordant couples (one partner HIV-positive).
    • Counseling for women considering pregnancy.
    • Findings from the ECHO Trial on contraception and HIV risk.
    • Breastfeeding recommendations for HIV-infected women.

    HIV Prevention in LGBTQ Populations

    • Increased HIV risk among LGBTQ individuals.
    • Social challenges faced by LGBTQ communities.
    • Cultural competence in healthcare.

    Pathophysiology of HIV

    • The Human Immunodeficiency Virus (HIV) targets and destroys the immune system, specifically CD4+ T cells, which have a crucial role in immune defense.

    HIV Life Cycle

    • Seven key drug classes interfere with different stages of the HIV life cycle: binding/attachment, fusion, reverse transcription, replication, assembly, budding, and protease.

    Stages of HIV Infection

    • Primary infection: flu-like symptoms, high viral load.
    • Symptomatic stage: immune system weakens, CD4 count is between 200-499 cells/mm3.
    • AIDS: severe immune suppression, opportunistic infections, and life-threatening complications.

    Assessment Findings

    • Health history.
    • Physical examination.
    • Psychosocial assessment

    HIV Diagnostic Findings

    • HIV testing.
    • CD4+ T cell count.
    • Viral load testing.
    • Other laboratory tests.
    • Genotypic and phenotypic resistance testing.

    Treatment of HIV Infection

    • Antiretroviral therapy (ART) is the cornerstone, focusing on viral suppression, immune system recovery, and prevention of complications.
    • Aims to prolong survival, quality of life, and prevent transmission.

    Antiretroviral Therapy (ART)

    • Over 30 FDA-approved antiretroviral (ARV) drugs, organized into seven classes, are available for HIV treatment.
    • Combination therapy.
    • Goals: reduce HIV-associated morbidity, prolong survival, restore immune function, suppress plasma HIV viral load, and prevent HIV transmission.

    ART Drug Resistance

    • Transmission of drug-resistant HIV during initial infection.
    • Selective drug resistance in patients on nonsuppressive regimens.

    Immune Reconstitution Inflammatory Syndrome (IRIS)

    • Rapid restoration of organism-specific immune responses to infections.
    • Can result in deterioration of a treated infection or new presentation of a subclinical infection.

    Clinical Manifestations

    • Respiratory: Pneumocystis pneumonia, Mycobacterium Avium Complex (MAC), Tuberculosis.
    • Gastrointestinal: Candidiasis, HIV wasting syndrome.
    • Oncologic: Kaposi sarcoma, AIDS-related lymphomas.
    • Neurological: Subcortical neurodegenerative disease, peripheral neuropathy, HIV encephalopathy, Cryptococcus Neoformans, Progressive Multifocal Leukoencephalopathy, other neurological disorders.

    Nutrition Therapy

    • Maintaining a balanced diet, managing symptoms and side effects of medications, supporting immune function, and addressing comorbidities.
    • Crucial for optimizing health outcomes and quality of life.
    • Important for adherence and optimizing treatment responses.

    Goals of Nutrition Therapy

    • Optimization for health outcomes and quality of life.
    • Addresses common nutritional needs, symptoms, comorbidities, and side effects.
    • Nutritional needs are often assessed and managed in collaboration with a dietitian.

    Nursing Process

    • Systematic approach to assessing, diagnosing, planning, implementing, and evaluating care for HIV/AIDS patients.
    • Focus on supporting immune function, managing symptoms, preventing infection, and promoting overall well-being.

    Nursing Assessment

    • Identifying potential risk factors (risky sexual practices and injection drug use).
    • Assessing overall physical and psychological status.
    • Evaluating nutritional status (dietary history, factors interfering with oral intake).

    Nursing Diagnoses

    • Impaired nutritional intake.
    • Social isolation.
    • Grief.
    • Lack of knowledge.

    Collaborative Problems/Potential Complications

    • Adverse effects of medications.
    • Development of HAND (HIV-associated neurocognitive disorder).
    • Body image changes.

    Planning and Goals

    • Patient goals include improved nutritional status, increased socialization, grief expression, increased knowledge of disease prevention, self-care, and absence of complications.

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