A patient has Human Immunodeficiency Virus infection and the viral load is reported as undetectable. What patient teaching should be provided by the nurse related to this laboratory study results?
The patient has the virus but the infection is well controlled and not currently transmissible
The syndrome has gone from Stage 3 back to stage 2
The patient can discontinue with antiretroviral therapy until the viral load rises again
The patient will be prescribed lower doses of antiretroviral medications for 2 months
The Correct Answer is A
A) "The patient has the virus but the infection is well controlled and not currently transmissible."
An undetectable viral load means that the amount of HIV in the blood is so low that it cannot be detected by standard laboratory tests, typically due to effective antiretroviral therapy. However, the patient still has the HIV virus in their body, and it is essential to continue treatment. An undetectable viral load reduces the risk of transmission, particularly to partners, but it does not eliminate the virus entirely. Hence, the infection is well controlled, but ongoing medication is still necessary to maintain viral suppression.
B) "The syndrome has gone from Stage 3 back to stage 2."
An undetectable viral load does not change the HIV stage. HIV is classified into three stages, with Stage 3 representing AIDS. While effective antiretroviral therapy can prevent the progression to AIDS and help control the viral load, it does not "reverse" the stage of HIV infection. Once a person progresses to Stage 3 (AIDS), they remain in this category even if their viral load becomes undetectable.
C) "The patient can discontinue with antiretroviral therapy until the viral load rises again."
An undetectable viral load indicates successful treatment, but it is crucial for the patient to continue taking antiretroviral medications to maintain viral suppression. Discontinuing therapy increases the risk of viral rebound and drug resistance. Long-term adherence to antiretroviral therapy is essential for keeping the virus under control.
D) "The patient will be prescribed lower doses of antiretroviral medications for 2 months.". The goal of antiretroviral therapy is to maintain viral suppression indefinitely, not to reduce the dose or discontinue it temporarily. Lowering the dose of antiretroviral medications could result in viral rebound and loss of viral suppression. Therefore, consistent, full-dose therapy is required for optimal HIV management.
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Related Questions
Correct Answer is B
Explanation
A. The blockage is most likely in the right parietal region:
While a facial droop and weakness can be indicative of a stroke, the specific location of the blockage cannot be definitively determined based on the symptoms alone. A right-sided facial droop suggests that the lesion or event likely involves the left side of the brain, particularly the frontal or temporal regions, as these areas are typically associated with facial motor control. A parietal lesion would more commonly result in sensory deficits or spatial issues, not primarily facial droop. Therefore, this statement is not correct in this case.
B. This type of event can be one of the primary warning signs of a future stroke:
The client’s presentation of unilateral facial droop and weakness that resolves spontaneously within an hour is highly consistent with a transient ischemic attack (TIA). A TIA, often referred to as a "mini-stroke," is characterized by temporary neurological deficits that resolve without permanent damage. TIAs are considered warning signs of a potential future stroke, and the client should be evaluated promptly to address risk factors and prevent a more serious, permanent stroke.
C. The signs and symptoms are most consistent with an acute hemorrhagic stroke:
An acute hemorrhagic stroke typically presents with sudden and severe neurological deficits, such as a severe headache, vomiting, and loss of consciousness. Hemorrhagic strokes do not typically resolve spontaneously within an hour. The client's symptoms (unilateral facial droop and weakness that resolve within an hour) are more indicative of a TIA, not a hemorrhagic stroke. A hemorrhagic stroke would likely result in sustained deficits and a more urgent clinical presentation.
D. The signs and symptoms are most consistent with a focal awareness seizure:
Focal awareness seizures (previously known as simple partial seizures) generally involve abnormal electrical activity in a specific area of the brain, leading to symptoms such as motor twitches or sensory disturbances, but not typically a full facial droop or weakness. These seizures do not cause symptoms that resolve in such a short time, nor do they present with unilateral weakness in the manner described here. Therefore, this scenario is not consistent with a seizure disorder.
Correct Answer is D
Explanation
A. "You probably have a gastrointestinal infection":
This statement is incorrect. A positive result on the enzyme-linked immunosorbent assay (ELISA) indicates the presence of antibodies to HIV, which suggests exposure to the virus. It does not point to a gastrointestinal infection. HIV is a viral infection that primarily affects the immune system, not the gastrointestinal system. Misleading the client in this way would delay proper care and understanding of their health status.
B. "You are confirmed to be infected with the HIV virus.":
A positive ELISA test result does not automatically confirm an HIV diagnosis. ELISA is a screening test that detects HIV antibodies, but it can sometimes produce false-positive results. A positive ELISA result must be confirmed with a more specific confirmatory test, such as the Western blot test. Therefore, it would be premature to tell the client that they are "confirmed" to be infected with HIV without further confirmatory testing.
C. "This is a good result, which means you do not have HIV.":
This statement is also incorrect. A positive ELISA test result does not mean that the client does not have HIV. In fact, it indicates potential exposure to the virus. However, because the result is a screening test, it must be followed up with confirmatory testing. Telling the client that this is a "good result" would be misleading and could cause confusion or delay in appropriate care.
D. "Your result will need to be confirmed with a Western blot test.":
This is the correct response. The Western blot test is the confirmatory test used to verify a positive result from the ELISA. If the ELISA result is positive, the client should be informed that further testing, such as the Western blot, is needed to confirm the diagnosis of HIV infection. It is important to explain that the ELISA is a screening tool, and a positive result does not mean a definitive diagnosis without confirmation. This helps to set realistic expectations and ensures the client receives the appropriate follow-up care.
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