The nurse is caring for a 55-year-old patient who has been HIV-infected for 15 years. The nurse understands that this patient
a. has an increased risk of
... [Show More] transmitting the HIV infection.
b. is less likely to develop AIDS than younger persons with HIV infection.
c. is less likely to respond to antiretroviral agents.
d. may have comorbid illnesses that can complicate HIV.
A patient who is newly diagnosed with HIV infection after a recent exposure calls to report fever, sore throat, myalgia, and night sweats. The nurse will notify the provider that this patient is most likely experiencing
a. acute retroviral syndrome.
b. AIDS.
c. an increased viral load.
d. an opportunistic infection.
A patient with HIV infection has been receiving antiretroviral therapy for 2 months. At the initiation of treatment, the patient had a viral load (VL) of 60 copies/mL and a CD4 count of 450 cells/mm3. Todays lab results reveal a VL of 20 copies/mL and a CD4 cell count of 800 cells/mm3. How will the nurse interpret the patient's results?
a. A drug-resistant strain is likely.
b. The patient is progressing as expected.
c. The patient's treatment goals have been met.
d. Treatment failure has occurred.
A pregnant patient is HIV-positive. Which antiretroviral agent will the nurse expect the patient's provider to order?
a. Abacavir/lamivudine/zidovudine (Trizivir)
b. Efavirenz/emtricitabine/tenofovir (Atripla)
c. Lamivudine/zidovudine (Combivir)
d. Rilpivirine/emtricitabine/tenofovir (Complera)
A patient who is HIV-positive begins therapy with the fixed-dose combination nucleoside reverse transcriptase inhibitor (NRTI) Combivir (lamivudine/zidovudine) twice daily. The patient is in the clinic for follow-up 1 week after initiation of therapy and reports having nausea. The patient's creatinine clearance is 40 mL/minute. Based on these findings, the nurse will perform which action?
a. Instruct the patient to take the medication 60 minutes prior to meals.
b. Notify the provider to discuss single-dose NRTI products.
c. Request an order for once-daily dosing of this medication.
d. Suggest that the patient increase fluid intake.
A patient who has HIV infection will begin treatment with efavirenz. The nurse expects this agent to be given in the combination product Atripla in order to
a. avoid development of psychiatric comorbidities.
b. prevent dizziness, sedation, and nightmares.
c. reduce viral resistance.
d. prevent severe rash and hepatotoxicity.
A patient who is HIV-infected takes 800 mg of indinavir (Crixivan), a protease inhibitor medication. The provider has ordered adding ritonavir (Norvir) to the regimen. The nurse will teach the patient that the addition of ritonavir
a. allows decreasing the dosing from 3 times daily to twice daily.
b. can lead to increased cholesterol and triglycerides.
c. may worsen insulin resistance.
d. will require increased dietary restrictions.
A patient will begin taking the protease inhibitor combination Kaletra (lopinavir/ritonavir). What information will the nurse include when teaching the patient about dietary changes?
a. Consume a low-cholesterol diet.
b. Consume more acidic foods.
c. Take the pill on an empty stomach.
d. Take the pill with fatty foods.
A patient who has recently begun antiretroviral therapy with a combination drug develops immune reconstitution inflammatory syndrome (IRIS) with mild symptoms. What does the nurse expect that the provider will order?
a. Administration of a high dose of corticosteroids
b. Changing the regimen to a single antiretroviral drug
c. Temporarily discontinuing the antiretroviral therapy
d. Treating an underlying opportunistic infection
A patient who will begin antiretroviral therapy reports having trouble sticking with drug regimens in the past. Which action will the nurse take?
a. Ask the patient's family members to administer the medications.
b. Avoid discussing adverse effects to prevent focus on negative aspects of ART.
c. Give a detailed list of medications and stress the need to adhere to the schedule.
d. Offer written and verbal information about each drugs purpose.
The nurse is caring for a patient who is HIV-positive and has been receiving antiretroviral therapy for several months. The nurse experiences a needlestick injury resulting in exposure to the patient's blood. The nurse asks the Occupational Health nurse if treatment is necessary. How will the Occupational Health nurse respond?
a. No treatment is necessary since the patient is receiving antiretroviral therapy.
b. We will treat you if the patients VL is > 20 copies/mL.
c. You will require 4 weeks of antiretroviral therapy.
d. You will undergo HIV testing and will be treated if you are positive.
A client with clinical AIDS is treated with a protease inhibitor. The highest priority nursing intervention based on this medication is to monitor for incidence of:
a. hepatic steatosis.
b. hyperglycemia.
c. urinary retention.
d. coma.
A client with HIV is treated with the nonnucleoside reverse transcriptase inhibitor (NNRTI) efavirenz (Sustiva). The nurse is aware that other agents may be used because of which significant problem with NNRTIs?
a. Alopecia
b. Resistance
c. Coma
d. Hepatic dysfunction
A client with a very low T4 count is placed on several medications to prevent infections. The nurse instructs the client to expect to be placed on which medication as a prophylactic agent to prevent herpes simplex?
a. Ciprofloxacin (Cipro)
b. Fluconazole (Diflucan)
c. Acyclovir (Zovirax)
d. Pentamidine (Nebupent)
Which is important to consider when developing a plan with the client receiving antiretroviral therapy to ensure adherence to the therapeutic regimen?
a. Make no association between taking medications with daily routine.
b. Avoid discussing management of anticipated side effects.
c. Ensure client has understanding of the purpose for each drug.
d. Avoid confusing clients by telling them about drug actions.
A child with AIDS is placed on antiretroviral therapy. The nurses instructions to the child and family are based on the premise that the goals of antiretroviral therapy include:
a. increasing viral load to detectable levels.
b. slowing the decline in the number of CD4 cells.
c. increasing resistance to opportunistic infections.
d. decreasing the severity of opportunistic infections.
In teaching the client about Enfuvirtide (Fuzeon), the nurse would instruct the patient to watch for and report:
a. chronic diarrhea.
b. injection site irritation.
c. persistent arthralgia.
d. heart block.
A client questions a nurse about taking antiretrovirals with other medications, which may cause drug interactions. What is the most accurate statement that the nurse can give in response?
a. Make sure you don't take your antiviral medications with any other medications.
b. Bring all your medications into the office as soon as possible and we will ensure that they are safe to take together.
c. Next time you go to your doctor, let the doctor know all the medications you are taking.
d. If you have any questions about your medications, ask your pharmacist.
A nurse sustains a needlestick injury and is exposed to an HIV-positive patient's blood. What is the highest priority action for the nurse?
a. Wait for appearance of symptoms to receive treatment.
b. Begin triple antibiotic therapy to prevent symptoms.
c. Start 4 weeks of antiretroviral therapy.
d. Start 10 days to 2 weeks of antibiotic therapy.
A pregnant woman who is HIV positive may transfer the HIV virus to the fetus. The nurse caring for the client anticipates that the client will receive which medication to treat potential vertical transmission of HIV?
a. Acyclovir (Zovirax)
b. Zidovudine (AZT)
c. Isoniazid (INH)
d. Ethambutol (Myambutol)
The client has been ordered to be treated with Kaletra. The nurse anticipates that the medication will be administered:
a. on an empty stomach.
b. with food.
c. at bedtime.
d. upon rising.
The nurse anticipates the client's laboratory values will result in increased ______ due to treatment with Kaletra?
a. cholesterol
b. magnesium
c. potassium
d. calcium
The client has been started on treatment with Sustiva. To achieve maximum absorption of the drug, the client should choose a breakfast of:
a. whole-wheat toast with jam.
b. egg-white omelet with spinach.
c. sausage patties with an English muffin.
d. sliced fruit with nonfat yogurt. [Show Less]