Nursing care of the client hiv and aids

2,024 views

Published on

Published in: Education
0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,024
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
168
Comments
0
Likes
3
Embeds 0
No embeds

No notes for slide

Nursing care of the client hiv and aids

  1. 1. Dr. Jayesh V. Patidar www.drjayeshpatidar.blogspot.com NURSING CARE OF THE CLIENT: HIV AND AIDS
  2. 2. HIV and AIDS  The human immunodeficiency virus (HIV), first reported in the U.S. in 1981, is a retrovirus that causes acquired immunodeficiency syndrome (AIDS), a progressively fatal disease that destroys the immune system and the body’s ability to fight infection. 7/14/2014 2www.drjayeshpatidar.blogspot.in
  3. 3. HIV/AIDS Statistics  By the end of 1998, an estimated 33.4 million people in the world were living with HIV/AIDS.  In the U.S., 688,200 cases of AIDS reported by the end of 1998, with as many as 900,000 infected with HIV. 7/14/2014 3www.drjayeshpatidar.blogspot.in
  4. 4. Continuum of HIV Disease Advanced HIV disease (AIDS) Early HIV disease (Symptomatic infection) Persistent, unexplained fever, night sweats, diarrhea, weight loss, fatigue, and lymphadenopathy; signs and symptoms may not occur until 10 years or more after initial exposure Asymptomatic HIV Infection (HIV Seropositivity) Infectious but no evidence of illness except positive HIV antibody test Primary HIV infection (acute infection) Flu-like s ymptoms; develop antibodies to HIV in 1 to 6 months Initial Exposure 7/14/2014 4www.drjayeshpatidar.blogspot.in
  5. 5. AIDS-Defining Conditions  Most AIDS-defining conditions are opportunistic infections (infections in persons with a defective immune system that rarely cause harm in healthy individuals).  Pneumocytis carinii pneumonia is the most frequent AIDS-defining condition in the U.S. and Europe. 7/14/2014 5www.drjayeshpatidar.blogspot.in
  6. 6. AIDS Testing  The enzyme-linked immunosorbent assay (ELISA) is the basic screening test to detect antibodies of HIV.  A confirmatory test, the Western blot, is always employed when the ELISA is positive.  The two taken together have an extremely high accuracy rate.  Obtaining a signed informed consent for testing is often a nursing responsibility.7/14/2014 6www.drjayeshpatidar.blogspot.in
  7. 7. Demographics of AIDS in the United States  Age (AIDS affects mainly people during the most productive years of their life).  Gender (More men from women, though women’s rates are increasing).  Race (The HIV/AIDS epidemic is growing most rapidly among some minority populations and is a leading cause of death of African American males). 7/14/2014 7www.drjayeshpatidar.blogspot.in
  8. 8. Modes of Transmission  The virus may be found in blood, semen, vaginal secretions, and breast milk of infected individuals.  No evidence that HIV is spread through sweat, tears, urine, or feces. Risk of infection from “deep kissing” or oral sex is unknown. 7/14/2014 8www.drjayeshpatidar.blogspot.in
  9. 9. Medical-Surgical Management MEDICAL  Goal is to keep disease from progressing as long as possible.  Patient monitored by viral load test. PHARMACOLOGICAL  Goal of anti-HIV treatment is to keep viral load as low as possible for as long as possible.  Use of protease inhibitors. 7/14/2014 9www.drjayeshpatidar.blogspot.in
  10. 10. Common Diagnostic Tests for HIV and AIDS  CD4-T-cells  ELISA  Polymerase chain reaction (PCR)  Western blot 7/14/2014 10www.drjayeshpatidar.blogspot.in
  11. 11. Pulmonary Opportunistic Infections  Pneumocystis Carinii Pneumonia.  Histoplasmosis.  Tuberculosis. 7/14/2014 11www.drjayeshpatidar.blogspot.in
  12. 12. Pneumocystis Carinii Pneumonia  The most common opportunistic infection associated with advanced HIV disease.  Found primarily in the lungs, but also reported in the adrenal glands, bone marrow, skin, thyroid, kidneys, and spleen.  Clinical signs include fever, shortness of breath, nonproductive cough, and crackles.  Initial diagnosis made by chest x-ray.7/14/2014 12www.drjayeshpatidar.blogspot.in
  13. 13. Histoplasmosis  An infection caused by the fungus Histoplasma capsulatum. The fungus has been isolated in bird droppings, dirt from chicken coops, and caves.  Histoplasmosis should be suspected if the person presents with fever of uncertain origin, cough, and malaise. 7/14/2014 13www.drjayeshpatidar.blogspot.in
  14. 14. Gastrointestinal Opportunistic Infections  Mycobacterium avium complex.  Cytomegalovirus.  Cryptosporidiosis.  Hepatitis.  HIV-wasting syndrome. 7/14/2014 14www.drjayeshpatidar.blogspot.in
  15. 15. Mycobacterium avium complex  In persons with AIDS, involvement of the bowel is usually extensive. The microorganism can fill the bone marrow and lymph nodes.  Most common symptoms are chronic fever, malaise, anemia, weight loss, diarrhea, and abdominal pain. 7/14/2014 15www.drjayeshpatidar.blogspot.in
  16. 16. Cytomegalovirus (CMV)  Belongs to the herpes virus group.  Causes disease by destroying the brain, lung, retina, and liver.  Signs and symptoms include weight loss, fever, diarrhea, and malaise. 7/14/2014 16www.drjayeshpatidar.blogspot.in
  17. 17. Cryptosporidosis  Caused by a protozoan that usually infects the epithelial cells that line the digestive tract.  Clinical signs include profuse water diarrhea, up to 20 liters a day. Abdominal pain, serious weight loss, abdominal cramping, anorexia, low-grade fever, dehydration, electrolyte imbalance and malaise may also be present. 7/14/2014 17www.drjayeshpatidar.blogspot.in
  18. 18. Hepatitis  Hepatitis B virus, C virus, and D virus are commonly seen with HIV infection.  Signs and symptoms include malaise, weakness, anorexia, nausea, vomiting, and right upper quadrant pain. 7/14/2014 18www.drjayeshpatidar.blogspot.in
  19. 19. HIV-Wasting Syndrome  Defined as unexplained weight loss of more than 10% of body weight accompanied by weakness, chronic diarrhea, and fever in those affected with HIV.  Signs and symptoms include anorexia, diarrhea, nausea, vomiting, changes in taste and smell, aphthous ulcers of mouth and esophagus, and abdominal pain. 7/14/2014 19www.drjayeshpatidar.blogspot.in
  20. 20. Oral Opportunistic Infections  Oral candidiasis (thrush), a fungal infection, is seen in more than 90% of AIDS clients. Symptoms include unpleasant taste, mouth dryness, and creamy, white oral plaques.  Oral Hairy Leukoplakia (OHL) usually appears as a white patch on the lateral borders of the tongue. OHL is not usually bothersome to the client and may regress spontaneously. 7/14/2014 20www.drjayeshpatidar.blogspot.in
  21. 21. Gynecological Opportunistic Infections  Vaginal Candidiasis is the most common initial infection occurring in HIV-infected women.  Cervical Intraepithelial Neoplasia (CIN) is of a much higher incidence in women affected with HIV. 7/14/2014 21www.drjayeshpatidar.blogspot.in
  22. 22. Central Nervous System Opportunistic Infections  AIDS dementia complex.  Toxoplasmosis.  Cryptococcosis. 7/14/2014 22www.drjayeshpatidar.blogspot.in
  23. 23. AIDS Dementia Complex  The most common central nervous system complication in persons with AIDS.  This disorder is chronic and progressive with cognitive, motor, and behavioral dysfunction. 7/14/2014 23www.drjayeshpatidar.blogspot.in
  24. 24. Toxoplasmosis  Caused by the protozoan Toxoplasma gondii, found in cats and other animals.  Clinical signs may be vague and nonspecific, ranging from mild headache, fever, and lethargy to poor coordination, seizures, and coma. 7/14/2014 24www.drjayeshpatidar.blogspot.in
  25. 25. Cryptococcosis  A fungal infection caused by Cryptococcus neoformans.  The most life-threatening fungal infection associated with AIDS.  Clinical symptoms include fever, headache, nausea, vomiting, dizziness, photophobia, mental status changes, seizures, and stiff neck. 7/14/2014 25www.drjayeshpatidar.blogspot.in
  26. 26. Opportunistic Malignancies: Kaposi’s Sarcoma  A vascular malignancy that can occur any place in the body, including the internal organs.  First lesions often appear subtly on the face or in the oral cavity. 7/14/2014 26www.drjayeshpatidar.blogspot.in
  27. 27. Opportunistic Malignancies: Non-Hodgkin’s Lymphoma  Clinical manifestations include fever, night sweats, and weight loss.  Treatment of NHL in clients with advanced HIV disease is often withheld, because it is not tolerated well and may even lead to earlier death. 7/14/2014 27www.drjayeshpatidar.blogspot.in
  28. 28. Thank you 7/14/2014 www.drjayeshpatidar.blogspot.in 28

×