A nurse is caring for a client who is newly diagnosed with HIV. Prior to discharge, the nurse would anticipate the client verbalizing which of the following statements?
"If I develop a fever, I will tell my doctor at the next scheduled office appointment."
I will avoid hugging my family, so that I don't give them the virus."
"I can still have my favorite sushi occasionally as long as I wear a mask to the restaurant."
I will need to take the medications even when the virus is well-controlled."
The Correct Answer is D
A) "If I develop a fever, I will tell my doctor at the next scheduled office appointment."
. Clients with HIV should not wait for their next scheduled appointment to report any signs of infection or complications. Fever, as well as other symptoms such as cough, fatigue, or skin rashes, may indicate a potential infection or opportunistic infection that requires immediate medical attention. Early intervention can prevent complications. Therefore, the nurse should emphasize the importance of reporting any symptoms of illness immediately to the healthcare provider.
B) "I will avoid hugging my family, so that I don't give them the virus."
. HIV is not transmitted through casual contact such as hugging, shaking hands, or sharing meals. HIV is transmitted through blood, semen, vaginal fluids, breast milk, and through needle sharing or sexual contact. It is important for patients with HIV to understand that they can continue to engage in normal daily activities and maintain close relationships with family members and friends without the fear of spreading HIV through non-bodily fluid contact.
C) "I can still have my favorite sushi occasionally as long as I wear a mask to the restaurant."
. The need to wear a mask to prevent HIV transmission is a misconception. HIV is not transmitted through food, air, or casual social interactions. The concern regarding eating sushi comes from the risk of foodborne illness, particularly for individuals with compromised immune systems, such as those with HIV. Raw or undercooked food (like sushi) can expose individuals to bacterial, viral, or parasitic infections, which are more harmful to immunocompromised clients. Safe food handling practices and avoiding raw or undercooked foods are more important than wearing a mask.
D) "I will need to take the medications even when the virus is well-controlled."
. Adherence to antiretroviral therapy (ART) is essential for people living with HIV, even when the virus is well-controlled and their viral load is undetectable. Stopping or interrupting ART can lead to drug resistance and a return of the virus. Consistent medication use is the key to preventing the progression of HIV, reducing viral transmission, and maintaining long-term health. The patient should be educated about the importance of taking ART as prescribed for life, even when feeling well, to keep the virus suppressed and prevent complications
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Respiratory acidosis:
Respiratory acidosis is characterized by an increased CO2 level (above 45 mmHg) due to hypoventilation or impaired gas exchange, leading to a decrease in pH (below 7.35). In this case, the CO2 level is 25 mmHg, which is lower than normal and suggests a loss of CO2, not an accumulation. Therefore, respiratory acidosis is not the correct interpretation of these ABG results.
B. Metabolic acidosis:
Metabolic acidosis occurs when the pH drops below 7.35 due to conditions like kidney failure, diarrhea, or diabetic ketoacidosis. This would typically be accompanied by a low bicarbonate (HCO3-) level (less than 22 mEq/L). However, in this case, the pH is 7.52 (alkalotic), and the HCO3- level is 24 mEq/L, which is within the normal range. Thus, metabolic acidosis is not the correct interpretation.
C. Respiratory alkalosis:
Respiratory alkalosis is characterized by a decrease in CO2 (less than 35 mmHg) due to hyperventilation, which causes an increase in pH (above 7.45). In this case, the pH is 7.52 (alkalotic), and the CO2 is 25 mmHg, which is lower than the normal range (35–45 mmHg). The bicarbonate (HCO3-) level is 24 mEq/L, which is normal and compensatory. This matches the pattern of respiratory alkalosis, where the body compensates with a normal bicarbonate level as CO2 decreases.
D. Metabolic alkalosis:
Metabolic alkalosis occurs when the pH rises above 7.45, often due to excessive vomiting, diuretic use, or antacid overuse, leading to an increase in bicarbonate (HCO3-) levels. While the pH is 7.52, indicating alkalosis, the bicarbonate (HCO3-) level is 24 mEq/L, which is within the normal range for bicarbonate. In metabolic alkalosis, you would typically see an elevated HCO3- level, which is not the case here. Therefore, metabolic alkalosis is not the correct interpretation of these ABG results.
Correct Answer is C
Explanation
A. The client should report to an urgent care for potential hypokalemia:
While ACE inhibitors like Captopril can increase potassium levels (hyperkalemia) due to their effects on the renin-angiotensin-aldosterone system, they are not typically associated with hypokalemia. The client's complaint of a dry cough is a well-known side effect of ACE inhibitors, not an indication of low potassium levels. Therefore, the recommendation to seek urgent care for hypokalemia is not appropriate in this case.
B. The client should immediately use an epinephrine auto-injector (Epi-Pen) and call 9-1-1:
The use of an epinephrine auto-injector is specifically indicated for severe allergic reactions (anaphylaxis), which typically present with symptoms such as difficulty breathing, swelling of the throat, or anaphylactic shock. A chronic dry cough associated with the use of Captopril is not indicative of an allergic reaction, but rather a known adverse effect of ACE inhibitors. Therefore, this response is inappropriate for the situation described.
C. The client should contact their provider, who may switch them to a different medication:
A chronic dry cough is a common side effect of ACE inhibitors like Captopril, occurring in some individuals due to the accumulation of bradykinin. If the cough is bothersome, the best course of action is for the client to contact their healthcare provider. The provider may consider switching the patient to an angiotensin II receptor blocker (ARB), which does not typically cause this side effect. This is the most appropriate and safe action.
D. The client should stop taking the Lisinopril immediately:
Lisinopril is an ACE inhibitor, similar to Captopril, and shares the same potential side effects, including a chronic dry cough. However, the client should not stop taking their medication without consulting their healthcare provider. Discontinuing the medication abruptly can result in uncontrolled hypertension and other risks. The correct course of action is to contact the provider to discuss possible alternatives, not to stop the medication independently.
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