Nokea
The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluid(s) does the nurse inform them will transmit the virus? Select all that apply.
- A. Semen
- B. Urine
- C. Breast milk
- D. Blood
- E. Vaginal secretions
Correct Answer: A,C,D,E
Rationale: There are only four known body fluids through which HIV is transmitted: blood, semen, vaginal secretions, and breast milk. HIV may be present in saliva, tears, and conjunctival secretions, but transmission of HIV through these fluids has not been implicated. HIV is not found in urine, stool, vomit, or sweat.
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A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?
- A. Sign a refusal of blood transfusion form so the client will not receive the transfusion.
- B. Bank autologous blood.
- C. Ask people to donate blood.
- D. Use volume expanders in case blood is needed.
Correct Answer: B
Rationale: Banking autologous blood that is self-donated is the safest option for the client. Signing the refusal form does not give the client any information about the options that are available and places the client at risk. Directed donor blood may be no safer than blood collected from public donors. Those who support this belief say that directed donors may not reveal their high-risk behaviors that put the potential recipient at risk for blood-borne pathogens such as HIV.
A client tells the nurse, 'You know I have AIDS. I still cannot afford to tell my employer because they will probably cancel my health insurance, then what would I do?' What is the best response by the nurse?
- A. An employer cannot cancel your currently active health insurance on the basis of AIDS.'
- B. I just wouldn't tell them. It is none of their business.'
- C. You have to tell them, it is not your right to allow them exposure to you. What if you give it to someone?'
- D. I understand your dilemma, but I think you should tell them. I would want to know.'
Correct Answer: A
Rationale: Despite HIV-specific confidentially laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. An employer cannot cancel a client's currently active health insurance policy on the basis of AIDS. However, employers are more apt to dismiss a worker with a known HIV-positive status from employment to reduce future insurance premiums and death payments. The other answers are nontherapeutic and not based in fact.
A client who is HIV/AIDS positive has a prescription for laboratory tests to be performed. What precautions should the nurse observe whenever there is a risk of exposure to the blood and body fluids of an infected client?
- A. Avoid any physical contact with the client.
- B. Avoid cleaning up spilled urine and feces.
- C. Wear barrier garments for as long as possible after leaving a client's room.
- D. Transport the specimens of body fluids in leak-proof containers.
Correct Answer: D
Rationale: Whenever there is a risk of exposure to the blood and body fluids of an infected client, the nurse should transport these specimens in leak-proof containers. The nurse need not avoid physical contact with the client or cleaning the client's urine or stools. Barrier garments, such as face shields and glasses, should be removed soon after leaving a client's room.
A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining the progression of the disease as well as guiding drug therapy?
- A. The client will be required to stop the medication for 2 weeks and then have laboratory studies drawn to determine if the antiretroviral therapy has cured the disease.
- B. Viral load and T4-cell counts will be performed every 2 to 3 months.
- C. More antiretroviral medication will be added every 2 to 3 months.
- D. The Western blot test will be monitored every 6 months to see if the virus is still present.
Correct Answer: B
Rationale: Viral load testing is used to guide drug therapy and follow the progression of the disease. Viral load tests and T4-cell counts may be performed every 2 to 3 months once it is determined that a person is HIV positive. The medication should be adhered to and not discontinued. There is no cure for the disease at this time. Antiretroviral therapy is not generally changed or added to without reason or lack of response. The Western blot is used for confirmation of the presence of the HIV virus.
The nurse is preparing to start an IV for a client who is combative. What precautionary measure should the nurse take in order to avoid a needlestick?
- A. Have the client placed in restraints.
- B. Ask for assistance.
- C. Refuse to start the IV.
- D. Give the client a sedative prior to starting the IV.
Correct Answer: B
Rationale: If a client is uncooperative, the nurse should request assistance when starting IV therapy. Restraints can cause the client to become more agitated and less cooperative. Sedation can be considered chemical restraint and can have side effects that are undesirable. Refusing to start the IV will not allow the client to receive the care required.