Medical-Surgical Nursing

A 32 year old man is admitted to the isolation unit with acquired immune deficiency syndrome.

He is married and has one child. His wife is a depressed because of his diagnosis. Which of the following nursing problems requires immediate planning?

  1. A Risk of infection due to autoimmune cell destruction Correct answer
  2. B Nutrition deficit due to due body cell mass wastage
  3. C Risk of ineffective ineffective psychosocial and family support
  4. D Knowledge deficit about prognosis and treatment

Explanation

Core Concept: In patients with AIDS, the immediate life-threatening priority is the risk of opportunistic infections due to severe immunodeficiency (destruction of CD4+ T-cells by HIV). According to Maslow's hierarchy and ABCs, physiological survival and preventing life-threatening infections take precedence over psychosocial or knowledge deficits.

Clinical Presentation:

  • Susceptibility to opportunistic infections (e.g., Pneumocystis jirovecii pneumonia, esophageal candidiasis, toxoplasmosis, CMV)
  • Unexplained weight loss, chronic diarrhea, persistent fever, and generalized lymphadenopathy

Diagnosis:

  • HIV screening (Ag/Ab combination assay) confirmed by viral load and CD4 count (<200 cells/mm3 defines AIDS)

Management:

  • First-line/Acute: Initiation of prophylactic antibiotics (e.g., TMP-SMX for PCP prophylaxis based on CD4 count) and strict infection control precautions
  • Long-term/Definitive: Antiretroviral therapy (ART) to suppress viral load and restore immune function; psychosocial support and counseling for the patient and family

40 free questions with an account

The questions published here are a fixed sample. Create a free account to practise on the full bank, with performance analytics by specialty and a page for reviewing your mistakes.

Create a free account

No payment card