Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide Nursing diagnosis for HIV/AIDS: • Ineffective airway clearance related to respiratory complications • Impaired gas exchange related to respiratory infections • Altered nutritional status related to gastrointestinal complications • Activity intolerance related to fatigue, secondary to respiratory status and infection • Altered thought processes related neurological complications • Risk for impaired skin integrity related to lowered nutrition, Candida, and lowered immunity • Knowledge deficit related to lack of knowledge of disease management and transmission • Risk for secondary infections related to lowered immunity Nursing interventions for HIV/AIDS: • Monitor respiratory status often • Treat fever, aches, chills, and pain with analgesics and antipyretics per MDorder • Provide diet education and offer small frequent meals with nutritionally dense foods • Teach proper dental care to prevent gum disease (periodontitis) • Encourage patient to pace activities and take frequent rest periods; monitor vital signs with activity; teach patient to conserve energy and stop if symptoms increase or vital signs change • Teach patient to make notes if forgetful and help them reorient to person, place, and time • Provide good skin care, frequent skin assessments, and teach good handwashing technique for patient and family • If infection is present, give antibiotics per MDorder: o Isoniazid and Rifampin: antibiotic medications used to treat tuberculosis; highly effective in treating or preventing resistant strains of infection found in HIV/AIDS patients; used in combination for a period of two months in HIV positive patients o Fluconazole, Nystatin, and Miconazole: antifungal medications used to treat chronic candida infections in HIV/AIDS patients o Bactrim (Trimethoprim sulfate): sulfa drug used to treat pneumocystis carinii; it is very common to start this drug for prophylaxis when CD4 count is below 200/mm3 • Give antineoplastics (interferon alpha-2a and 2b) per MD order for preventing HIV related malignancies; used very carefully due to interactions with antiviral medication • Give antiviral medications per MD order: o NNRTI’s (non-nucleoside reverse transcriptase inhibitors): etravirine, efavirenz, and nevirapine; prevent HIV from copying itself inside the CD4 cell proteins o NRTI’s (nucleoside reverse transcriptase inhibitors): abacavir, lamivudine, and zidovudine (AZT); slows down the virus during the replication phase’ most of these are used in combination therapy o PI’s (protease inhibitors): atazanavir, darunavir, and ritonavir; inhibit protease and render the virus unable to copy itself

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