A 31-year old woman is admitted to
the hospital with severe respiratory symptoms including wheezing, chest
pain, coughing and fever. She is known to be HIV positive and the
physician suspects that the woman has pneumocystis carinii pneumonia.
The patient's heart rate is 120, respirations are 30 and BP
is 130/84. She is extremely restless and needs to have the head of
the bed nearly completely elevated.
1. What nursing diagnosis would
you make that is related to the patient's respiratory status?
2. What are key interventions that would
facilitate the patient's breathing at this point?
3. The patient is started on intravenous
pentamidine. What special precautions should be taken?
4. What other assessments should be made
to identify other opportunistic infections?
5. Why is it important for the nurse to
inquire about the patient's last Pap smear?
6. Identify whether gloves are needed
or not needed for the following nursing care activities:
|
|
|
|
| Administering a bath (the patient has no skin lesions) | ||
| Emptying a bedpan | ||
| Removing her meal tray from the room | ||
| Providing mouth care | ||
| Administering oral medications | ||
| Changing an IV bag | ||
| Changing IV tubing | ||
| Starting an IV | ||
| Assisting her to walk to the bathroom | ||
| Taking vital signs |
7. What questions should be included in
the assessment in order to learn about the patient's knowledge of HIV and
willingness to decrease the risk of exposure to others?
8. The patient reports that she has lost
15 lbs. over the last two months and does not feel like eating. She
has sores in her mouth and often gets diarrhea.
9. What recommendations should be made
regarding mouth care?
10. What should be included in her diet
to help maintain her weight?
11. What strategies can be employed
to help prevent diarrhea?
12. The treatment for PCP has been
successful and the patient is being discharged to her home. She lives
with her two children, a male friend and two cats. What kind of preparation
is needed for her return to her home:
13. What should be done about food
utensils and dishes?
14. What should be done about animal
care and why?
15. How should body fluid spills
be handled?
16. What should be done about maintaining
a hygienic bathroom environment?
17. What should the patient be told about
sexual activity?
18. The patient will be continuing
her treatment with AZT and will add one of the new protease inhibitors,
Crixivan. The patient reports that she is just tired of taking all
the pills and that she will take them, but there are some days she really
does not want to be bothered. Why is important to take the medication as
it is ordered? How would you address these concerns with her?
Nursing
Care of the Patient with AIDs Quiz
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Copyright © 1998 Margarete Zalon