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A client with human immune deficiency virus infection is hospitalized for an unrelated condition, and several medications are prescribed in addition to the regimen already being used. What action by the nurse is most important?
- A. Consult with the pharmacy about drug interactions.
- B. Ensure the client understands the new medications.
- C. Give the new drugs without considering the old ones.
- D. Schedule all medications at standard times.
Correct Answer: A
Rationale: The drug regimen for someone with HIV/AIDS is complex and consists of many medications that must be given at specific times and that have many interactions with other drugs. The nurse should consult with a pharmacist about possible interactions. Client teaching is important but does not take priority over ensuring the medications do not interfere with each other, which could lead to drug resistance or a resurgence of disease.
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A client with human immune deficiency virus (HIV) has had a sudden decline in status with a large increase in viral load. What action should the nurse take first?
- A. Ask the client about travel to any foreign countries.
- B. Assess the client about adherence to the drug regimen.
- C. Determine if the client has any new sexual partners.
- D. Gather more information about new living quarters or pets.
Correct Answer: B
Rationale: Adherence to the complex drug regimen needed for HIV treatment can be daunting. Clients must take their medications on time and correctly at a minimum of 90% of the time. Since this client's viral load has increased dramatically, the nurse should first assess this factor. After this, the other assessments may or may not be needed.
A client with acquired immune deficiency syndrome is in the hospital with severe diarrhea. What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)
- A. Assessing the client's fluid and electrolyte status.
- B. Assisting the client to use a soft toothbrush.
- C. Obtaining a bedside commode if the client is weak.
- D. Providing gentle perineal cleansing after stools.
- E. Reporting any abnormal patient status.
Correct Answer: B,C,D,E
Rationale: The UAP can assist the client with getting out of bed, obtain a bedside commode for the client's use, cleanse the client's perineal area after bowel movements, and report any abnormal observations such as redness or open areas. The nurse assesses fluid and electrolyte status.
A client with HIV/AIDS asks the nurse why gabapentin (Neurontin) is part of the drug regimen when the client does not have a history of seizures. What response by the nurse is best?
- A. Gabapentin can be used as an antidepressant too.
- B. I have no idea why you should be taking this drug.
- C. This drug helps treat the pain from nerve irritation.
- D. You are at risk for seizures due to fungal infections.
Correct Answer: C
Rationale: Many classes of medications are used for neuropathic pain, including gabapentin. It is not being used as an antidepressant or to prevent seizures from fungal infections. If the nurse does not know the answer, he or she should find out for the client, not admit ignorance.
A client with HIV wasting syndrome has inadequate nutrition. What assessment finding by the nurse best indicates that the goals for this client problem have been met?
- A. Chooses high-protein food.
- B. Has decreased oral discomfort.
- C. Eats 90% of meals and snacks.
- D. Has a weight gain of 2 pounds in 1 month.
Correct Answer: D
Rationale: The weight gain is the best indicator that goals for this client problem have been met because it demonstrates that the client not only is eating well but also is able to absorb the nutrients.
A client with acquired immune deficiency syndrome is hospitalized and has weeping Kaposi sarcoma lesions. The nurse dresses them with sterile gauze. When changing these dressings, which action is most important?
- A. Adhering to Standard Precautions.
- B. Assessing tolerance to dressing changes.
- C. Performing hand hygiene before and after care.
- D. Ensuring proper disposal of soiled dressings.
Correct Answer: D
Rationale: All of the actions are important, but due to the infectious nature of this illness, ensuring proper disposal of soiled dressings is vital to prevent the spread of infection.