NCLEX RN Practice Question # 485

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 Immunodeficiency Syndromes (NCLEX Review)    

Acquired immunodeficiency syndrome (AIDS)

  • AIDS is a viral disease caused by human immunodeficiency virus (HIV), which destroys T cells, thereby increasing susceptibility to infection and malignancy.
  • The syndrome is manifested clinically by opportunistic infection and unusual neoplasms.
  • AIDS is considered a chronic illness.
  • The disease has a long incubation period, sometimes 10 years or longer.
  • Manifestations may not appear until late in the infection.

Diagnosis and monitoring the client with AIDS

  • See Chapter 11 for diagnostic tests.
  • Refer to Box 70-4 for tests used to evaluate the progression of HIV infection.

High-risk groups

  • Heterosexual or homosexual contact with highrisk individuals
  • Intravenous drug abusers
  • Persons receiving blood products
  • Health care workers
  • Babies born to infected mothers

Assessment

  • Malaise, fever, anorexia, weight loss, influenzalike symptoms
  • Lymphadenopathy for at least 3 months
  • Leukopenia
  • Diarrhea
  • Fatigue
  • Night sweats
  • Presence of opportunistic infections
  • Protozoal infections (Pneumocystis jiroveci pneumonia, major source of mortality)
  • Neoplasms (Kaposi’s sarcoma, purplish-red lesions of internal organs and skin, B-cell non-Hodgkin’s lymphoma, cervical cancer)
  • Fungal infections (candidiasis, histoplasmosis)
  • Viral infections (cytomegalovirus, herpes simplex)
  • Bacterial infections

Interventions

  • Provide respiratory support.
  • Administer oxygen and respiratory treatments as prescribed.
  • Provide psychosocial support as needed.
  • Maintain fluid and electrolyte balance.
  • Monitor for signs of infection.
  • Prevent the spread of infection.
  • Initiate standard and other necessary precautions.
  • Provide comfort as necessary.
  • Provide meticulous skin care.
  • Provide adequate nutritional support as prescribed.
  • See Chapters 25 and 47 for additional information on AIDS.
  • Kaposi’s sarcoma
  • Description: Skin lesions that occur primarily in individuals with a compromised immune system
  • Assessment
    • Kaposi’s sarcoma is a slow-growing tumor that appears as raised, oblong, purplish, reddish-brown lesions; may be tender or nontender.
    • Organ involvement includes the lymph nodes, airways or lungs, or any part of the gastrointestinal tract from the mouth to anus.

 Interventions

  • Maintain standard precautions.
  • Provide protective isolation if the immune system is depressed.
  • Prepare the client for radiation therapy or chemotherapy as prescribed.
  • Administer immunotherapy, as prescribed, to stabilize the immune system.

 

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