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1. Question
A client with acquired immunodeficiency syndrome (AIDS) has histoplasmosis. The nurse should assess the client for which expected finding?
Correct
Answer: Option 1 is the correct answer.
Rationale: Histoplasmosis is an opportunistic fungal infection that can occur in the client with AIDS. The infection begins as a respiratory infection and can progress to disseminated infection. Typical signs and symptoms include fever, dyspnea, cough, and weight loss. Enlargement of the client’s lymph nodes, liver, and spleen may occur as well. Test-Taking Strategy: Focus on the subject, manifestations of histoplasmosis. Recalling that histoplasmosis is an infectious process will help you to eliminate option 4. Because the client has AIDS and another infection, weight gain is an unlikely symptom and can be eliminated next. Knowing that histoplasmosis begins as a respiratory infection helps you to choose dyspnea over headache as the correct option.
Incorrect
Answer: Option 1 is the correct answer.
Rationale: Histoplasmosis is an opportunistic fungal infection that can occur in the client with AIDS. The infection begins as a respiratory infection and can progress to disseminated infection. Typical signs and symptoms include fever, dyspnea, cough, and weight loss. Enlargement of the client’s lymph nodes, liver, and spleen may occur as well. Test-Taking Strategy: Focus on the subject, manifestations of histoplasmosis. Recalling that histoplasmosis is an infectious process will help you to eliminate option 4. Because the client has AIDS and another infection, weight gain is an unlikely symptom and can be eliminated next. Knowing that histoplasmosis begins as a respiratory infection helps you to choose dyspnea over headache as the correct option.
Acquired immunodeficiency syndrome (AIDS)
AIDS is a viral disease caused by HIV, which destroys T cells, thereby increasing susceptibility to infection and malignancy.The syndrome is manifested clinically by opportunistic infections and unusual neoplasms. AIDS is considered a chronic illness. The disease has a long incubation period, sometimes 10 years or longer.
Histoplasmosis
Description
Pulmonary fungal infection caused by spores of Histoplasma
capsulatum
Transmission occurs by the inhalation of spores,
which commonly are found in contaminated soil.
Spores also are usually found in bird droppings.
Nursing Assessment
Similar to pneumonia
Positive skin test for histoplasmosis
Positive agglutination test
Splenomegaly, hepatomegaly
Interventions
Administer oxygen as prescribed.
Monitor breath sounds.
Administer antiemetics, antihistamines,
antipyretics, nd corticosteroids as prescribed.
Administer fungicidalmedications as prescribed.
Encourage coughing and deep breathing.
Place the client in a semi-Fowler’s position.
Monitor vital signs.
Monitor for nephrotoxicity from fungicidal medications.
Instruct the client to wear a mask and spray the
floor with water before sweeping barn and chicken coops.
