Included In This Lesson
Study Tools
Outline
Overview
Pathophysiology
A sexually transmitted disease of the immune system in which HIV (human immunodeficiency virus) destroys specific immune cells (CD4) leaving the body vulnerable and unable to fight off organisms that cause disease. Infections to someone without AIDS can be worrisome, but the same infection in a person with AIDS can be life threatening. To be fully diagnosed with AIDS, a person with HIV must have a CD4 count of <200 cells/mm3. There is no cure, but some treatments can help slow the progression of the disease.
Etiology
AIDS develops from the HIV virus that destroys CD4 cells. These are white blood cells that help the body fight disease. It may take years for the virus to progress to AIDS. It is spread through contact with bodily secretions from having sex, sharing needles, blood transfusions, pregnancy, delivery or breastfeeding.
Desired Outcome
Optimal immune response and minimize risk of infections
Acquired Immune Deficiency Syndrome (AIDS) Nursing Care Plan
Subjective Data:
- Headache
- Muscle aches
- Joint pain
- Sore throat
- Fatigue
Objective Data:
- Fever
- Rash
- Mouth sores (painful)
- Swollen lymph glands (mainly on the neck)
- Diarrhea
- Weight loss
- Oral yeast infections (thrush)
- Shingles (herpes zoster)
Nursing Interventions and Rationales
- Assess and manage pain
- Assess respiratory system, auscultate lungs and provide supplemental oxygen as necessary
- Assess and maintain fluid balance to avoid dehydration; assess skin turgor, mucous membranes and thirst
- Encourage self-care and schedule activity to provide for periods of rest
- Encourage and educate patients and caregivers regarding need to reduce risk of infection.
- Assess buccal mucosa and ability to chew, taste and swallow; observe secretion precautions
- Administer medications as appropriate:
- Sucralfate
- Ondansetron
- Anti-HIV medications (HAART therapy)
- Lifestyle and nutrition education
- Avoid illicit drug use
- No sharing of needles
- Inform sexual partners of disease
- Avoid raw eggs and meats
- Eat a healthy diet to increase immune system function
- Provide patient education regarding disease, precautions and modes of transmission
References
Transcript
Hey guys, in this lesson, we’re going to take a look at the care plan for acquired immune deficiency syndrome also known as AIDS. So in this lesson, we’ll briefly take a look at the pathophysiology and etiology of AIDS, also subjective and objective data, as well as nursing interventions and rationales.
Okay. Let’s take a closer look at aids. So this is a sexually transmitted disease of the immune system in which HIV or human immunodeficiency virus destroy specific CD four cells leaving the body vulnerable and unable to fight off organisms that cause disease. So, infections to someone without aids can be worrisome, but to someone with aids can be extremely life-threatening. So, to be fully diagnosed with AIDS, a person with HIV must have a CD four count of less than 200.
There is no cure, but some treatments can help slow. The progression of the disease, AIDS develops from the HIV virus that destroys CD four cells, like I mentioned, which are basically white blood cells that help fight disease. So it may take several years for the virus to progress to AIDS. If it does at all, it is spread through contact with bodily secretions, from having sex, sharing needles, blood transfusions, pregnancy, um, possibly delivery or breastfeeding.
So, the desired outcome is optimal immune response in the patient and to minimize the risk of infections. So, let’s take a look at some of the subjective as well as objective data that your patient with AIDS may present with.
Now, remember subjective data. These are going to be things that are based on your patient’s opinions or feelings. So for aids, they might complain of a headache, muscle aches, joint pain, sore throat, and fatigue, objective, or measurable data might include fever, rash, painful mouth sores, swollen lymph glands, which are mainly on the neck, diarrhea, weight loss, thrush, which is oral yeast infection and maybe shingles, or herpes zoster.
So, let’s take a look at some of the nursing interventions when caring for a patient with AIDS: assess and manage pain as tissue inflammation and autonomic responses may cause significant pain in aids patients. So, manage this with analgesics, positioning, non-pharmacological interventions, such as guided imagery, deep breathing and meditation. Assess the patient’s respiratory status as anemia and hypoxemia are common side effects of anorexia, which can lead to decreased amount of oxygen available for cellular uptake. So, provide supplemental oxygen to your patient if necessary.
Assess and maintain the patient’s fluid balance to avoid dehydration and electrolyte light imbalances. Be sure to assess skin turgor, mucus membranes and thirst in your patient. Severe vomiting, diarrhea, fever, or sweating can all contribute to fluid loss. Also fatigue is a common problem with patients with aids. So, encourage patients to provide as much self-care as possible to promote their independence, allow for rest periods to conserve energy for important functions like eating.
So, simple infections can be detrimental for an AIDS patient. It is super important that patients and caregivers understand the need to reduce infection. Encourage good hand hygiene as well as clean nails. Health care staff must remember to use PPE when caring for patients, including gown, gloves, and a mask if needed. Assess your patient’s buccal mucosa and their ability to chew, as well as to swallow. Painful oral lesions make eating difficult, and patients often have poor nutrition for this reason.
So, encourage and provide regular oral care to increase their appetite and reduce oral discomfort. As far as medications are concerned, most are given to treat the symptoms; things maybe, like ondansetron or soclofate, anti-HIV medications are available and help to prevent the replication of the virus in the body.
Lifestyle and nutrition education is critical for a patient with AIDS, encourage patients to correct any lifestyle habits that lead to worsening of symptoms or spread of the disease. Avoid drug use sharing of needles and encourage patients to inform sexual partners of the disease.
Some foods, if undercooked, can lead to food borne illnesses, which may be severe for these patients. So, avoid raw eggs and meats, encourage the patient to eat a healthy diet to increase immune function. Finally, provide patient education regarding the disease, meaning correct any myths or misconceptions and impress the importance of infection prevention to help reduce the risk of infection.
Okay, guys, here is a look at the completed care plan for AIDS. That’s it. We love you guys. Go out and be your best self today and as always happy nursing.
Marie Clark, MSN, RN, CMSRN
Paige Canarr, MSN, RN, MHA
Kara Tarr, BSN, RN
Miriam Wahrman, MSN/Ed, RNC-MNN
Chance Reaves, MSN-Ed, RN
Nichole Weaver, MSN/Ed, RN, CCRN
Ashley Powell, MSN, RN, PCN