Nursing Care of Patients With HIV Disease and AIDS PDF

4068_Ch20_362-386 15/11/14 1:26 PM Page 362 20 Nursing Care of Patients With HIV Disease and A...

4068_Ch20_362-386 15/11/14 1:26 PM Page 362 20 Nursing Care of Patients With HIV Disease and AIDS KEY TERMS PATRICE WADE acquired immunodeficiency syndrome (uh-KWHY- erd im-yoo-noh-dee-FISH-en-see SIN-drohm) cytomegalovirus (SY-tow-MEH-guh-low-vy-russ) LEARNING OUTCOMES human immunodeficiency virus (HYOO-man im-yoo- 1. Define human immunodeficiency virus (HIV) and noh-dee-FISH-en-see VY-rus) personal protective equipment (PUR-sun-al pra-TEK- acquired immunodeficiency syndrome (AIDS). tiv ee-KWIP-mant) 2. Explain how HIV is transmitted. Pneumocystis pneumonia (new-moh-SISS-tiss new- MOH-nee-ah) 3. List how HIV is diagnosed. 4. Describe the prognosis for HIV and acquired immunodefi- ciency syndrome (AIDS). 5. Develop a teaching plan for prevention of an HIV infection. 6. Identify prevention measures used to decrease infection and opportunistic diseases for patients with HIV. 7. Develop a teaching plan for a patient with HIV receiving antiretroviral therapy. 8. Plan nursing care for patients with HIV/AIDS related to medications, coinfection prevention, and maintaining nutritional status. 362 4068_Ch20_362-386 15/11/14 1:26 PM Page 363 Chapter 20 Nursing Care of Patients With HIV Disease and AIDS 363 Acquired immunodeficiency syndrome (AIDS) is the late Not all HIV-infected people develop AIDS, largely because phase of a chronic immune function disorder caused by infec- current treatments help to impro ve immune function and re- tion with the human immunodeficiency virus (HIV). AIDS duce the risk of opportunistic infections, which can be life can develop after a long period of HIV infection and can even- threatening in these patients. The first antiretroviral (ARV) tually be fatal, if left untreated. The Centers for Disease Control drug was introduced in 1987 and highly acti ve antiretroviral and Prevention (CDC) specifies the criteria for determining therapy (HAART) began in 1996; both greatly reduced the when HIV infection has developed into AIDS (Box 20-1). death rate from AIDS. As a result, the number of people living today with HIV/AIDS is at its highest level ever (Fig. 20.1). Box 20-1 CDC AIDS-Defining Conditions LEARNING TIP CD4+ T-lymphocyte count below 200/mm3, or a CD4+ HIV disease is no longer characterized as a life- T-lymphocyte percentage under 14 of total lymphocytes, ending illness. With ARV therapy, HIV disease is a or the presence of one of the following specified clinical chronic, sometimes progressive immune disorder. conditions: Candidiasis of bronchi, trachea, or lung Candidiasis, esophageal Cervical cancer, invasive Coccidioidomycosis, disseminated or extrapulmonary NURSING CARE TIP Cryptococcosis, extrapulmonary More than any other chronic disease in recent Cryptosporidiosis, chronic intestinal (greater than history, AIDS challenges nurses to call into play 1-month duration) all of their physical, emotional, social, and spiri- Cytomegalovirus (CMV) disease (not including liver, tual care skills. As you care for patients who are spleen, or nodes) HIV-positive or who have AIDS, it is important for CMV retinitis with loss of vision you to understand current information. Being in- Encephalopathy, HIV related formed helps you to provide caring, competent, Herpes simplex, chronic ulcers (>1 month’s duration) nonjudgmental care without fear (Table 20.1). or bronchitis, pneumonitis, or esophagitis (onset at Knowledge about HIV/AIDS and its treatment age >1 month) continues to evolve with new discoveries. Histoplasmosis, disseminated or extrapulmonary Isosporiasis, chronic intestinal (>1-month’s duration) Kaposi’s sarcoma Lymphoid interstitial pneumonia or pulmonary lymphoid hyperplasia complex For every 100 people living with HIV Lymphoma, Burkitt Lymphoma, immunoblastic Lymphoma of the brain, primary 80 are aware of their infection Mycobacterium avium intracellulare complex or My- cobacterium kansasii, disseminated or extrapulmonary Mycobacterium tuberculosis, any site (pulmonary or 62 are linked to HIV care extrapulmonary) Mycobacterium, other species or unidentified species, 41 stay in HIV care disseminated or extrapulmonary Pneumocystis jiroveci pneumonia Pneumonia, recurrent 36 get antiretroviral Progressive multifocal leukoencephalopathy therapy Salmonella septicemia, recurrent Toxoplasmosis of brain Wasting syndrome 28 have a very low amount of virus Note. Modified from CDC. (2008). Revised Surveillance Case Definitions for in their HIV Infection Among Adults, Adolescents, and Children Aged