Question

Joe Dean, a 38-year-old male client, is admitted to the medical–surgical unit with newly diagnosed acquired immunodeficiency syndrome (AIDS) and pneumocystic pneumonia (PCP). He states that he shares needles with other IV drug users. He has had unprotected sexual intercourse with several partners. The client has a nonproductive cough, chills, shortness of breath with exertion, and, at times, chest pain. The vital signs: T, 101°F; BP, 110/70 mm Hg; HR, 100 beats/minute; RR, 28 breaths/minute. The prescriber started the client on Atripla once daily dosing. The medication is a combination drug containing efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI); emtricitabine, a nucleoside reverse transcriptase inhibitor (NRTI); and tenofovir disoproxil fumarate, a NRTI. The client is also taking Bactrim DS (trimethoprim–sulfamethoxazole) for the PCP. The client refuses to enter a drug rehabilitation program. The client asks the LPN/LVN about a needle exchange program, so he can help protect the other IV drug abusers.

a. Explain the nursing management needed for Mr. Dean.

b. What client teaching should the nurse provide?

Answer 1

a,

Altered immune system functioning leads to infection. As the name indicate person may suffer from severe infections such as pneumonia and also fever. So need to avoid the chances of getting infections and treat the presented inections properly. Use antibiotics and use strict aspecptic techniques.

Due to the presence of pneumonia person may suffer from impaired gas exchange or altered respiratory function. As there is non productive cough ineffective airway clearance also present. So as nursing care provide chest physiotherapy, to loosen the thick secretions treat the pneumonia, administer oxygen therapy to maintain normal oxygen saturation.

Patient may have impaired or imbalanced nurtitional status less than body requirement, so provide atractive diet to patient and encourage the patient to take food.

Social withdrawal or impaired social intraction due to the disease condition so provide adequate psychological support to the patient and the family members. Maintain the confidentiality of the patient details.

b,

Teaching include avdice the patient to avoid sexual contact with multiple partners or use condom to avoid the spread of HIV. Instruct the patient to take appropriate treatment for the health problems.

Introduce the patient into the rehabilitation group. Provide adequate teaching about the need and importance of maintaining sexual and personal hygiene.

Instructed to avoid blood donations because of HIV can spread through body fluids.