CamaristaCM - HIV and AIDS (Questions and Answers)

ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING

West Avenue Timawa, Molo, Iloilo City
NCM 112 (RLE)

CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND
ELECTROLYTES, INFECTIOUS, INFLAMMATORY AND IMMUNOLOGIC
RESPONSE, CELLULAR ABERRATIONS, ACUTE AND CHRONIC
QUESTION AND ANSWER:
HIV-AIDS
A Case Study Presented to the Department of Nursing of Iloilo Doctor’s College
PRESENTED TO: MRS.

Arvi Tenderly V. Melliza, RN, M.A.N.
(NCM 112 RLE & SKILLS CLINICAL INSTRUCTOR)
PRESENTED BY:
Camarista, Coleen Mae C.
(BSN III-G GROUP 1)
OCTOBER 27, 2021

Questions:
1. What are the role of nurses in HOLISTIC care for HIV-AIDS patients?
The American Nurses Association (ANA) clearly stipulates that nurses have an obligation to
“provide fair and equal treatment to all patients” and also stipulates in its Code of Ethics that
nurses must provide fair and equitable treatment to all individuals regardless of gender,
socioeconomic status, religious, culture, or sexual orientation (ANA, 2015). Nurses are apt to
establish these holistic approach such as the following:
DECREASING THE SENSE OF ISOLATION - Nurses are in a key position to provide an atmosphere
of acceptance and understanding for people with AIDS and their social networks.
COPING WITH GRIEF - The nurse can help the patient verbalize feelings and explore and identify
resources for support and mechanisms for coping, especially when the patient is grieving
anticipated losses.
MAINTAINING COHERENT THOUGHT PROCESSES - The nurse encourages the social support
network to remain calm and not to argue with the patient while protecting the patient from
injury.
IMPROVING NUTRITIONAL STATUS - Based on the results of assessment, the nurse can
implement specific measures to facilitate oral intake.
RELIEVING PAIN AND DISCOMFORT - The nurse must assessed for the quality and severity of
pain associated with impaired perianal skin integrity, the lesions of KS, and peripheral
neuropathy.
PROMOTING, HOME, COMMUNITY-BASED, AND TRANSITIONAL CARE - The nurse discusses

precautions the patient can use to avoid transmitting HIV sexually or through sharing of body
fluids, especially blood.
2. What are the ethical consideration for nurses in the treatment for patients with HIV-AIDS?
Nurses in all settings are called on to provide care for patients with HIV infection. In doing so,
they encounter not only the physical challenges of this epidemic but also emotional and ethical
concerns. The concerns raised by health care professionals involve issues such as fear of
infection, responsibility for giving care, values clarification, and confidentiality, developmental
stages of patients and caregivers, and poor prognostic outcomes. Despite those challenges
nurse must do the following:
 Nurses are encouraged to examine their personal beliefs and to use the process of
values clarification to approach controversial issues.
 Nurses are responsible for protecting the patient’s right to privacy by safeguarding
confidential information.
 Health care team members need accurate patient information to conduct assessment,
planning, implementation, and evaluation of patient care.
 Education and provision of up-to-date information help to alleviate apprehension and
prepare nurses to deliver safe, high-quality patient care.
 Interdisciplinary meetings allow participants to support one another and provide
comprehensive patient care.
3. Discuss the difference between HIV disease and AIDS

ACQUIRED IMMUNE DEFICIENCY
- Acquired immunodeficiency syndrome (AIDS) is a term that applies to the most advanced
stages of HIV infection. It is defined by the occurrence of any of the more than 20 life-
threatening cancers or “opportunistic infections”, so named because they take advantage of
a weakened immune system. AIDS was a defining feature of the earlier years of the HIV
epidemic, before antiretroviral therapy (ART) became available. Now, as more and more
people access ART, most people living with HIV do not progress to AIDS. However, it is more
likely to occur in people with HIV who have not been tested, in people who are diagnosed at
a late stage of infection, and in people who are not taking ART.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)

- Is an infection that attacks the body’s immune system, specifically the white blood cells
called CD4 cells. HIV destroys these CD4 cells, weakening a person’s immunity against
opportunistic infections, such as tuberculosis and fungal infections, severe bacterial
infections and some cancers.
- WHO recommends that every person who may be at risk of HIV should access testing. HIV
infection can be diagnosed using simple and affordable rapid diagnostic tests, as well as self-
tests. It is important that HIV testing services follow the 5Cs: consent, confidentiality,
counselling, correct results and connection with treatment and other services.
4. What are the precautionary measure to avoid HIV-AIDS transmissions?

PRECAUTIONARY MEASURES DURING SEXUAL INTERCOURSE:
All patients should be advised to:
 Abstain from exchanging sexual fluids (semen and vaginal fluid).
 Reduce the number of sexual partners to one.
 Always use latex condoms. If the patient is allergic to latex, nonlatex condoms should be
used; however, they will not protect against HIV infection.
 Not reuse condoms.
 Avoid using cervical caps or diaphragms without using a condom as well.
 Always use dental dams for oral–genital or anal stimulation.
 Avoid anal intercourse, because this practice may injure tissues; if not possible, use
lubricant—there are water and silicone-based products designed for anal sex.
 Avoid manual–anal intercourse (“fisting”).
 Avoid sharing needles, razors, toothbrushes, sex toys, or blood contaminated articles.
 Consider PrEP if regularly engage in high-risk behaviors.

 Patients who are HIV seropositive should also be advised to:
 Take ART regularly to achieve viral suppression.
 Inform previous, present, and prospective sexual and drug-using partners of their HIV-
positive status. If the patient is concerned for their safety, advise the patient that many
states have established mechanisms through the public health department in which
professionals are available to notify exposed contacts.
 Avoid having unprotected sex with another HIV-seropositive person.
 Cross-infection with that person’s HIV can increase the severity of infection.
 Not donate blood, plasma, body organs, or sperm.
PRECAUTIONARY MEASURE USING NEEDLES/SYRINGE:

 Harm reduction interventions aim to reduce the harms associated with injecting drug
use, including HIV and viral hepatitis without necessarily stopping drug use.
 The provision of sterile needle/syringes and other injecting equipment through
needle/syringe programmes helps people who inject drugs to use a sterile
needle/syringe at each injection, reducing their risk of HIV.
 Opioid substitution therapy (OST) is an evidence-based treatment for opioid
dependence which reduces HIV risk and has other health benefits.
VERTICAL PRECAUTIONARY MEASURE:

 HIV can be transmitted from a mother to her child during pregnancy, labour, delivery or
breastfeeding. But such vertical transmission can be prevented with effective
interventions, including the use of ART by the mother and a short course of
antiretroviral drugs for the baby.
 Other effective interventions include measures to prevent HIV acquisition in pregnant
woman, prevent unintended pregnancies in women with HIV and appropriate
breastfeeding practices. HIV testing services should be integrated into maternal and
child health services, so that they women at risk can readily access testing.
 Pregnant women and mothers diagnosed with HIV should receive ART as soon as
possible, so that their children are born free from HIV.
5. Discuss important aspects of the TB/AIDS relationship.
The estimated annual risk of reactivation with TB among those with untreated HIV
infection and latent TB infection is 3% to 16% and approximates the lifetime risk for individuals
without HIV infection who have latent TB infection. TB disease can occur at any CD4+ T-
lymphocyte (CD4+ cell) count, although the risk increases with progressive immune deficiency.
Testing for latent TB at the time of HIV diagnosis should be routine, regardless of an individual’s
risk of TB exposure. Individuals with negative diagnostic tests for latent TB who have stage 3 HIV
infection should be retested once their CD4+ count increases due to ART. Screening for
symptoms (asking for cough of any duration) coupled with chest radiography is recommended
to exclude TB disease in a patient with a positive skin test or interferon-gamma release assays.
Latent TB in a person with HIV infection is treated with isoniazid (INH), supplemented with
pyridoxine (Aminoxin) to prevent peripheral neuropathy, for 9 months since it has proven
efficacy, good tolerability, and infrequent severe toxicity.

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ILOILO DOCTOR’S COLLEGE

BACHELOR OF SCIENCE IN NURSING

NCM 112 (RLE)

A Case Study Presented to the Department of Nursing of Iloilo Doctor’s College

PRESENTED TO: MRS.

(BSN III-G GROUP 1)

OCTOBER 27, 2021

PROMOTING, HOME, COMMUNITY-BASED, AND TRANSITIONAL CARE - The nurse discusses

3. Discuss the difference between HIV disease and AIDS

HUMAN IMMUNODEFICIENCY VIRUS (HIV)

4. What are the precautionary measure to avoid HIV-AIDS transmissions?

 Consider PrEP if regularly engage in high-risk behaviors.

PRECAUTIONARY MEASURE USING NEEDLES/SYRINGE:

VERTICAL PRECAUTIONARY MEASURE:

5. Discuss important aspects of the TB/AIDS relationship.

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