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A client visits the nurse complaining of diarrhea after every meal. The client has AIDS and wants to know what to do to stop having diarrhea. What should the nurse advise?
- A. Avoid fibrous foods, lactose, fat, and caffeine.
- B. Encourage large, high-fat meals.
- C. Reduce food intake.
- D. Increase the intake of iron and zinc.
Correct Answer: A
Rationale: Diarrhea may subside when the client avoids residue, lactose, fat, and caffeine. Although eating may seem to cause diarrhea, the client must understand that limiting the intake of food to control diarrhea only exacerbates wasting. The client will tolerate a low-fat, high-carbohydrate, and soft or liquid diet better than large, high-fat meals. The client should be advised to avoid large doses of iron and zinc because they can impair the functioning of the immune system.
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A teenaged client with a diagnosis of HIV presents at the public health clinic complaining of pharyngitis, rash on the palms and soles of the feet, and diarrhea. What would the nurse suspect the client is suffering from?
- A. AIDS dementia complex (ADC)
- B. Acute retroviral syndrome (ARS)
- C. Distal sensory polyneuropathy (DSP)
- D. AIDS-related complex (ARC)
Correct Answer: B
Rationale: Some manifestations of ARS include: fever; swollen and tender lymph nodes; pharyngitis; rash about the face, trunk, palms, and soles; muscle and joint pain; headache; nausea and vomiting; and diarrhea. In addition, there may be enlargement of the liver and spleen, weight loss, and neurologic symptoms such as visual changes or cognitive and motor involvement. The scenario does not describe symptoms of ARC, DSP, or ADC.
A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?
- A. Trimethoprim-sulfamethoxazole
- B. Nystatin
- C. Amphotericin B
- D. Fluconazole
Correct Answer: A
Rationale: To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed. The other medications are antifungals and used to treat candidiasis.
A client is informed of needing to start on antiretroviral therapy, and the client is concerned about the possibility of not being able to afford the therapy. What can the nurse inform the client is the largest source of public funding for HIV/AIDS care?
- A. Medicaid
- B. Medicare
- C. Blue Cross/Blue Shield
- D. AIDS Drug Assistance Program
Correct Answer: A
Rationale: Medicaid, a state-based medical assistance program for low-income clients, is the largest source of public funding for HIV/AIDS care. Medicare is for clients who are over age 65 years or disabled. Blue Cross/Blue Shield is a private insurance with a cap on coverage. AIDS Drug Assistance Program is the third largest source of funding for HIV in the United States for individuals who do not have health insurance that pays for drug therapy.
The nurse conducts an educational in-service training on infection protection and control for staff members who will provide care to clients who are positive for human immunodeficiency virus (HIV). Which subtype of HIV does the nurse inform staff members is the most prevalent in the United States?
- A. HIV-1, Group M, subtype A
- B. HIV-1, Group M, subtype B
- C. HIV-1, Group M, subtype C
- D. HIV-1, Group M, subtype D
Correct Answer: B
Rationale: Two HIV subtypes have been identified: HIV-1 and HIV-2. HIV-1 is composed of four groups identified as M, N, O, and P. Group M mutates easily and frequently, producing multiple substrains that are identified by letters from A through K, and circulating recombinant form (CRF), a hybrid virus formed by genetic material from various combined subtypes. HIV-2 is the primary type of infection in Western Africa. It is less transmittable, and the interval between initial infection with HIV-2 and the development of AIDS is longer. HIV-1, Group M, subtype B is more prevalent in the United States and in the rest of the world, but the distribution of subtypes changes from time to time because of the diverse merging of populations.
A client on antiretroviral drug therapy informs the nurse about sometimes forgetting to take the medication for a few days. What should the nurse inform the client can occur when the medications are not taken as prescribed?
- A. The funding for the medications will cease if the client is not taking the meds correctly.
- B. The client is risking the development of drug resistance and drug failure.
- C. The client will have to take the drugs intravenously to ensure compliance.
- D. The client will have to take higher doses of the antiviral medications.
Correct Answer: B
Rationale: Clients who neglect to take antiretroviral drugs as prescribed risk development of drug resistance. When drug levels are not adequately maintained, viral replication and mutations increase. Funding will not cease for noncompliance. The medications are not all available in IV form. Taking a higher dose of the medication if missed does not resolve drug resistance.