AIDS Case Study Essay Essays

AIDS Case Study Essay Essays AIDS Case Study Essay Essay AIDS Case Study Essay Essay Client Profile: Mr. Thomas is a 42 twelvemonth old adult male admitted to the infirmary with ailments of shortness of breath. febrility. weariness and unwritten thrush. The wellness attention supplier reviews the research lab and diagnostic trials with Mr. Thomas and informs him he has pneumonia and is HIV positive. Mr. Thomas believes that he contracted HIV while involved in an matter with another adult female three old ages ago. He is afraid to state his married woman. cognizing she will be angry and that she may go forth him. Case Study: The nurse assigned to care for Mr. Thomas reads in the medical record ( chart ) that he learned two yearss ago he was HIV positive. There is a note in the record that indicates that Mr. Thomas has non told his married woman the diagnosing. To finish a functional wellness form appraisal. the nurse asks Mr. Thomas if he may inquire him a few inquiries. Mr. Thomas is willing and in the class of their conversation portions with the nurse that he believes that he contracted the HIV during an matter with another adult female. He states. â€Å"How can I state my married woman about this? I am so ashamed. It is bad plenty that I had an matter. but to hold to state her in this manner – I merely don’t think I can. She is non ill at all. I will merely state I have pneumonia and take the medicine my wellness attention supplier gave me. I do non desire my married woman of anyone else to cognize. If she begins to demo marks of non experiencing good. so I will state her. I merely can’t tell anyone. What will people believe of me if they know I have AIDS? † 1. Briefly discuss how the HIV is transmitted and how it is non. How can Mr. Thomas prevent the transmittal of HIV to his married woman and others? In septic people. infective HIV is present merely in cells and in some bodily fluids. HIV can be isolated easy from blood. seeds and vaginal/cervical secernments ( including catamenial fluids ) . Blood and seeds are the cells that are most likely to transport HIV. HIV has besides been isolated from chest milk. With much greater trouble. the virus has on juncture. been isolated from spit. cryings. and urine. It is has non been isolated from sweat or fecal matters. The current scientific position is that organic structure fluids other than blood. seeds. vaginal/cervical secernments. and breast milk. contain so small. if any. HIV that they are non of major importance in HIV transmittal between persons. HIV is really delicate outside of the organic structure. so transmission requires direct contact of two substances. fluid incorporating the HIV from an septic individual and susceptible cells ( normally via the blood watercourse ) of another individual. Casual contact includes all types o f ordinary every twenty-four hours. non-sexual contact between and among people. Shaking custodies. caressing. caressing. sharing eating utensils. sharing towels or serviettes. utilizing the same phone and utilizing a lavatory place are all illustrations of insouciant contact. Because HIV is rapidly inactive outside the organic structure. it can non last in unfastened air or in H2O. ( 1 ) Methods that Mr. Thomas can convey HIV to his married woman and others would be any type of blood transmittal or adumbrate sexual contact. Epidemiological information points to three manners of HIV transmittal from individual to individual: from blood. from birth. and from sex. Since Mr. Thomas is male we can traverse out birth. Mr. Thomas can forestall transmittal of HIV to his married woman and others by merely prosecuting in sexual activity with a rubber. and even so there is a hazard of the rubber breakage and so being careful with any types of cuts. unfastened lesions. and contact with others and his ain blood. 2. Mr. Thomas stated. â€Å"What will people believe of me if they know I have AIDS? † How can the nurse explain the difference between being HIV positive and holding AIDS? The nurse can explicate n that Mr. Thomas does non hold AIDS. AIDs are a complication once the immune system can no longer manage contending the HIV infection. HIV is the existent infection itself. AIDS is what happens one time the immune system is compromised taking the manner to other infections that may non impact a normal healthy grownup or kid. but become life endangering to a individual with AID’s. This is caused by the diminished immune systems inability to contend off any infection. 3. Discourse the ethical quandary inherent in this instance. HIV revelation is defined as a ‘complex and multifaceted procedure of doing a voluntary or nonvoluntary determination about whom to inform about one’s position. why. when. where and how’ . This is peculiarly disputing when it comes to informing patients’ sexual spouses. besides referred to as spouse presentment. The three attacks to spouse presentment include: I ) beginning referral. whereby the wellness attention supplier encourages the patients to alarm their spouses themselves ; twos ) provider referral. whereby the wellness attention supplier notifies the spouses with the consent of the patients while esteeming the patients’ confidentiality ; and iii ) conditional referral. whereby the patients in understanding with the wellness attention supplier are supposed to inform their spouses within a given clip frame otherwise the wellness attention supplier will make so ( but without uncovering the patients’ individuality ) ( 2 ) 4. Does the wellness attention supplier have a legal duty to state anyone other than Mr. Thomas that he is HIV positive? If so. discuss. Legally. the nurse can’t tell anyone. â€Å"In tribunal advising an HIV-positive patient’s spouse can be argued in footings of transgressing professional moralss because ethically it is incorrect to unwrap your patient’s consequence or diagnosing to 3rd parties without that individual’s consent. † 5. Any loss. such as loss of one’s wellness. consequences in a grief response. Describe the phases of heartache harmonizing to Kubler-Ross. Denial: â€Å"This can non go on to me! †Anger: â€Å"Why did this happen to me? Who’s to fault for this? † Bargaining: â€Å"Just allow me populate. and I’ll do anything†Depression: â€Å"I am excessively sad to make anything†Credence: â€Å"I’m at peace with what is coming† . 6. Discuss which phase of grief Mr. Thomas is most likely experiencing. Provide examples of Mr. Thomas’s behavior that back up your determination. I believe that Mr. Thomas is sing both denial and choler. In denial. he recognizes that this is so go oning to him but he does non desire his married woman to cognize and that is his refusal to accept what is traveling on. The choler part comes from him faulting his matter for it go oning in which sense he blames both himself and the adult female he had the matter with. 7. What research lab trials are used to corroborate the diagnosing of HIV infection in an grownup? HIV is most normally diagnosed by proving your blood or spit for the presence of antibodies to the virus. A newer type of trial cheques for HIV antigen. a protein produced by the virus instantly after infection. 8. Discourse the map of CD4 T cells and supply an illustration of how the CD4 T cell count guides the direction of HIV. CD4 cells are a type of white blood cell that’s specifically targeted and destroyed by HIV. A healthy person’s CD4 count can change from 500 to more than 1. 000. Even if a individual has no symptoms. HIV infection progresses to Help when his or her CD4 count becomes less than 200. ( 3 ) 9. Briefly explain the intent of viral burden blood trials in supervising the patterned advance of HIV. The viral burden trial measures the sum of virus in your blood. Surveies have shown that people with higher viral tonss by and large fare more ill than do those with a lower viral burden. ( 3 ) 10. Mr. Thomas expresses a preparedness to larn more about HIV. Discuss the nurse’s initial intercession when get downing client instruction and so discourse the patterned advance of the HIV disease. including an account of primary infection. A. B. and C and four chief types of timeserving infections. There are different phases of HIV infection. Primary HIV infection can demo symptoms that can be confused as the grippe. These symptoms can last for a couple yearss to a few hebdomads and so vanish. Phase 2 is an symptomless phase significance that the patient likely shows small to no symptoms. â€Å"This phase stopping points for an norm of 10 old ages and. as its name suggests. is free from major symptoms. although there may be swollen secretory organs. The degree of HIV in the peripheral blood beads to really low degrees but people remain infective and HIV antibodies are noticeable in the blood. so antibody trials will demo a positive consequence. Research has shown that HIV is non hibernating during this phase. but is really active in the lymph nodes. A trial is available to mensurate the little sum of HIV that escapes the lymph nodes. This trial which measures HIV RNA ( HIV familial stuff ) is referred to as the viral burden trial. and it has an of import function in the intervention of HIV infection. † ( 4 ) Phase 3 is diagnostic HIV characterized by lymph nodes and tissues going for good damaged and the virus get downing to mutate to AIDs due to the inability of the organic structure maintaining up with helper T cell reconstructing as the HIV virus putting to deaths off the assistant T cells. Phase 4 is patterned advance of HIV to AIDS. AIDS is diagnosed when any status listed in clinical phase 4 is diagnosed and/or the CD4 count is less than 200 cells/mm3 or a CD4 per centum less than 15. ( 4 ) The ABC’s of HIV are: Abstinence for young person. including the hold of sexual introduction and abstention until matrimony Being tested for HIV and being faithful in matrimony and monogamous relationships Correct and consistent usage of rubbers for those who pattern high-risk behavior ( 4 ) The CDC has listed 24 types of timeserving infections sing HIV. As his nurse I would do certain Mr. Thomas had the information sing all 24. but I would clear up on the 4 chief 1s since he is already exhibiting symptoms of those. Four chief types of timeserving infections in respects to HIV are: â€Å"Thrush: fungous infection of the oral cavity. pharynx. or vagina. Herpes simplex virus: can do unwritten herpes ( cold sores ) or venereal herpes. This is a reasonably common infection but if you have HIV. the eruptions can be much more frequent and more terrible. Mycobacterium avium composite ( MAC or MAI ) – a bacterial infection that can do repeating febrilities. general ill feelings. jobs with digestion. and s erious weight loss Pneumocystis pneumonia ( PCP ) – a fungous infection that can do a fatal pneumonia. † ( 6 ) 11. Following the nurse’s instruction. Mr. Thomas states. â€Å"How stupid I was to hold that matter. Not merely could it destroy my matrimony. but it gave me a decease sentence. † Share with Mr. Thomas what you know about long-run subsisters. long-run non-progressors. and extremely active antiretroviral therapy ( HAART ) . HIV bearers can transport the virus for a decennary demoing small to no symptoms.There are many different types of care drug therapies to relieve symptoms. and cut down the rate of patterned advance. Antiretroviral therapy can assist procrastinate the patterned advance of the disease. nevertheless. discontinuance of antiretroviral therapy may ensue in viral recoil. immune decomposition. and clinical patterned advance of HIV. Break of HAART is non recommended ( 7 ) . With HAART. patients who have had a positive HIV trial have gone every bit long as 30 old ages with small to no symptoms and no patterned advance of AIDS ( 6 ) . HAART is defined as a drug regimen to accomplish sustained viral suppression. Simplified intervention regimens and diminishing the figure of medicines that patients have to take each twenty-four hours has proven effectual in patient’s attachment to their intervention. Drug companies are invariably happening new ways to unite the inhibitors into 2-3 medicin es versus the extended intervention regimens originally used. Overall attachment rates are still merely 30-50 % in the US. so I would urge extended follow up with Mr. Thomas and his wellness attention suppliers to increase his attachment. 12. Discourse how the nurse should react if Mr. Thomas’s married woman approaches him in the hall and asks. â€Å"Did the trial consequences come back yet? Do you cognize what is incorrect with my hubby? † The nurse must state Mr. Thomas’s married woman that she can non discourse Mr. Thomas’s medical status with her and that she must inquire Mr. Thomas himself. Legally and ethically. the nurse can non give Mr. Thomas’s married woman any information sing his status and diagnosing if Mr. Thomas has specifically asked for no information to be disclosed. which he has. 13. List five possible nursing diagnosings appropriate to see for Mr. Thomas. I chose these 5 for where Mr. Thomas is related to his disease at this clip. 1. Deficient cognition related to HIV infection. agencies of forestalling HIV transmittal. and self-care 2. Hazard for infection related to immunodeficiency.3. Activity intolerance related to failing. weariness. malnutrition. impairedfluid and electrolyte balance and hypoxia associated with pneumonic infections. 4. Social isolation related to stigma of disease. backdown of support systems. isolation processs. and fright of infecting others. 5. Anticipatory sorrowing related t alterations in life style and functions and unfavourable forecast Mentions1 ) Conner. Ross F. . A ; Fan. Hung Y. . A ; Vilarreal. Luis P. Aids. Science and Society. Sixth Edition. 2011. Jones and Bartlett Publishers. LLC 2 ) hypertext transfer protocol: //www. biomedcentral. com/1472-698X/11/63 ) World Wide Web. mayoclinic. com4 ) World Wide Web. avert. org5 ) World Wide Web. Center for Disease Control and Prevention. org6 ) World Wide Web. AIDSs. org7 ) Smeltzer. Suzanne C. . A ; Hinkle. Janice L. . A ; Bare. Brenda G. . A ; Cheever. Kerry H. Brunner A ; Suddarth’s Textbook of Medical-Surgical Nursing. ( 2010 ) . Wolters Kluwer Health/Lippincott Williams A ; Wilkins