Nokea
The nurse is preparing a plan of care for a client who is to receive antiviral therapy. Which nursing diagnoses would the nurse most likely include related to drug therapy? Select all that apply
- A. Acute Pain
- B. Risk for Impaired Skin Integrity
- C. Risk for Injury
- D. Risk for Imbalanced Nutrition
- E. Body Image Disturbances
Correct Answer: A,C,D,E
Rationale: Drug-specific diagnoses for antiviral drugs include Risk for Imbalanced Nutrition, Risk for Impaired Skin Integrity, Risk for Injury, Body Image Disturbance, and Acute Pain.
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A nursing instructor is describing the different categories of antiretroviral agents used in treatment for HIV infection. The instructor determines that the teaching was successful when the students identify which category as affecting an enzyme so that new viral particles cannot mature?
- A. Protease inhibitors
- B. Reverse transcriptase inhibitors
- C. Nonnucleoside reverse transcriptase inhibitors
- D. Integrase inhibitors
- E. Entry inhibitors
Correct Answer: A
Rationale: Protease inhibitors block the protease enzyme so the new viral particles cannot mature. Reverse transcriptase inhibitors block the reverse transcriptase enzyme so the HIV material cannot change into DNA in the new cell, preventing new HIV copies from being created. Nonnucleoside reverse transcriptase inhibitors latch on to the reverse transcriptase molecule to block the ability to make viral DNA. Integrase inhibitors prevent enzymes from inserting HIV genetic material into the cell's DNA. Entry inhibitors block HIV from entering the cell.
A patient is being discharged from a health care facility but is required to continue antiviral therapy at home. Which of the following points should the nurse include in the teaching plan to educate the patient?
- A. A slight elevation in temperature is normal and needn't be reported.
- B. Double the dosage of the drug if you miss a dose.
- C. Stop taking the drug as soon as the symptoms of the infection disappear.
- D. Make sure to notify your primary health care provider if you develop any adverse reactions.
- E. Take the drug with food to reduce stomach upset
Correct Answer: D
Rationale: The nurse should instruct the patient to report adverse reactions to the primary health care provider. The nurse should also tell the patient to report any increase in temperature, even if it is a slight increase. If the patient misses a dose, the next dose should be taken as soon as remembered, but it should not be doubled. The nurse should also instruct the patient to take the drug exactly as directed for the full course of therapy, even if the symptoms of the infection disappear. Taking the drug with food is not a general requirement for all antivirals but may apply to specific drugs.
An HIV-positive patient on antiretroviral therapy informs the nurse that he is considering taking sildenafil. The nurse informs the patient that he may experience which of the following when taking sildenafil with antiretroviral therapy?
- A. Feching of dizziness
- B. Tching of skin
- C. Risk of hypotension
- D. Depression
- E. Nausea
Correct Answer: C
Rationale: The nurse should educate the patient regarding the associated risks, such as hypotension, visual disturbances, and prolonged penile erection. Feeling of dizziness, itching of skin, depression, and nausea are not conditions that are specifically associated with sildenafil and antiretroviral drugs.
A client is ordered to receive an antiretroviral agent that is categorized as a nonnucleoside reverse transcriptase inhibitor. Which of the following would the nurse expect to administer?
- A. Indinavir
- B. Nevirapine
- C. Saquinavir
- D. Ritonavir
- E. Zidovudine
Correct Answer: B
Rationale: Nevirapine is classified as a nonnucleoside reverse transcriptase inhibitor. Indinavir, saquinavir, and ritonavir are classified as protease inhibitors. Zidovudine is a nucleoside reverse transcriptase inhibitor.
A patient is being treated with saquinavir. The nurse would assess the patient for which of the following?
- A. Increase in patient's weight
- B. Evidence of liver dysfunction
- C. Photosensitivity
- D. Allergic skin reaction
- E. Diarrhea
Correct Answer: A
Rationale: Patients taking saquinavir experience redistribution of body fat, with the movement to the center of the body. The nurse should spend time with these patients, encouraging them to verbalize their feelings regarding this change in appearance. Taking saquinavir does not cause liver dysfunction, photosensitivity, allergic skin reactions, or diarrhea.