Pathophysiology
A sexually transmitted disease of the immune system in which HIV (human immunodeficiency virus) destroys specific immune cells (CD4) leaving the body vulnerable and unable to fight off organisms that cause disease. Infections to someone without AIDS can be worrisome, but the same infection in a person with AIDS can be life threatening. To be fully diagnosed with AIDS, a person with HIV must have a CD4 count of <200 cells/mm3. There is no cure, but some treatments can help slow the progression of the disease.
Etiology
AIDS develops from the HIV virus that destroys CD4 cells. These are white blood cells that help the body fight disease. It may take years for the virus to progress to AIDS. It is spread through contact with bodily secretions from having sex, sharing needles, blood transfusions, pregnancy, delivery or breastfeeding.
Desired Outcome
Optimal immune response and minimize risk of infections
Acquired Immune Deficiency Syndrome (AIDS) Nursing Care Plan
Subjective Data:
- Headache
- Muscle aches
- Joint pain
- Sore throat
- Fatigue
Objective Data:
- Fever
- Rash
- Mouth sores (painful)
- Swollen lymph glands (mainly on the neck)
- Diarrhea
- Weight loss
- Oral yeast infections (thrush)
- Shingles (herpes zoster)
Nursing Interventions and Rationales
Tissue inflammation and autonomic responses may cause significant pain. Manage with analgesics, positioning and non-pharmacological interventions such as guided imagery, deep-breathing and meditation.
- Assess respiratory system, auscultate lungs and provide supplemental oxygen as necessary
Anemia and hypoxemia are common side effects of anorexia and can lead to decreased amount of oxygen available for cellular uptake. These factors contribute to fatigue.
- Assess and maintain fluid balance to avoid dehydration; assess skin turgor, mucous membranes and thirst
Severe vomiting, diarrhea, fever and sweating contribute to fluid loss. Monitor for signs and symptoms of dehydration and electrolyte imbalances.
- Encourage self-care and schedule activity to provide for periods of rest
Fatigue is a common problem for patients with AIDS. Encourage patients to provide as much self-care as possible to promote independence. Allow for rest periods to conserve energy for important functions such as eating.
- Encourage and educate patients and caregivers regarding need to reduce risk of infection.
Simple infections can be detrimental for the patient. Encourage good hand hygiene and clean nails. Healthcare staff must remember to use appropriate PPE when caring for patients (gown and gloves, mask as needed)
- Assess buccal mucosa and ability to chew, taste and swallow; observe secretion precautions
Painful oral lesions make eating difficult and patients often have poor nutrition for this reason. Encourage and provide regular oral care to increase appetite and reduce oral discomfort.
- Administer medications as appropriate:
- Sucralfate
- Ondansetron
- Anti-HIV medications (HAART therapy)
Most medications are given to treat the symptoms. Anti-HIV drugs are available and help to prevent the replication of the virus in the body.
- Lifestyle and nutrition education
- Avoid illicit drug use
- No sharing of needles
- Inform sexual partners of disease
- Avoid raw eggs and meats
- Eat a healthy diet to increase immune system function
Encourage patients to correct lifestyle habits that lead to worsening of symptoms or spread of disease. Some foods, if undercooked, can lead to foodborne illnesses which may be severe.
- Provide patient education regarding disease, precautions and modes of transmission
Correct any myths and misconceptions, impress importance of infection prevention. Help reduce risk of transmission.
References
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell
