NCLEX RN Practice Question # 404

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ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)

 Description

• AIDS is a disorder caused by human immunodeficiency virus (HIV) and characterized by generalized dysfunction of the immune system
• HIV infects CD4þ T cells; a gradual decrease in CD4þ T cell count occurs and this results in a progressive immunodeficiency; the risk for opportunistic infections is present.
• HIV is transmitted through blood, semen, vaginal secretions, and breast milk; the incubation period is months to years.
• Horizontal transmission occurs through intimate sexual contact or parenteral exposure to blood or body fluids that contain the virus.
• Vertical (perinatal) transmission occurs from an HIV-infected pregnant woman to her fetus
• The most common opportunistic infection that occurs in children infected with HIV is Pneumocystis jiroveci pneumonia (formerly known as Pneumocystis carinii pneumonia); P. jiroveci pneumonia most frequently occurs between the ages of 3 and 6 months, when HIV status may be indeterminate.

 Assessment

• Candidal esophagitis
• Cryptosporidiosis
• Cytomegalovirus disease
• Herpes simplex disease
• Human immunodeficiency virus encephalopathy
• Lymphoid interstitial pneumonitis
• Mycobacterium avium-intracellulare infection
• Pneumocystis jiroveci pneumonia
• Pulmonary candidiasis
• Recurrent bacterial infections
• Wasting syndrome

 Diagnostic tests:

• Before testing, counseling should be provided to parents; issues that should be addressed include the causes of HIV, reasons for testing, implications of positive test results, confidentiality issues, and beneficial effects of early intervention.