drugs since receiving hiv diagnosisdenies recent travel H e a l t h M e d i c a l
– Answer the discussion questions based off the patient profile.
Ch. 14 Human Immunodeficiency Virus Infection
A.D. is a 37-year-old man who has been positive for human immunodeficiency virus (HIV) for 6 years. He went to the outpatient clinic today, stating that he has a cough that will not go away and increasing shortness of breath. He is being admitted as an inpatient on the medical unit of the hospital. He is taking:
- Efavirenz (Sustiva) 600 mg PO daily at bedtime
- Tenofovir DF and emtricitabine (Truvada) 1 tablet PO daily at bedtime
- Has had increasing fatigue and shortness of breath over the past week
- States, “I can’t even walk to the bathroom without stopping to catch my breath”
- Has had a nonproductive cough for two weeks and pain with coughing
- Has lost 13 lb over the past 2 months
- States he is taking his ART medications as prescribed
- Has had multiple sexual partners; is currently in a monogamous relationship
- Denies tobacco use
- Has history of IV drug use but has not used any drugs since receiving HIV diagnosis
- Denies recent travel out of the country
- Vital signs: blood pressure 115/70, pulse 112, temperature 102°F, respiration 20
- Crackles at bases of lungs, left side greater than right
- Heart rate and rhythm regular, no murmurs
- Nonproductive cough
- Pulse oximetry is 90% on room air
- One anterior cervical lymph node on left side is palpable
- CD4+ lymphocyte count 76 cells/µL
- Chest x-ray shows probable pneumonia in left lower lobe
- What is the likely medical diagnosis for A.D.? What assessment data leads you to this conclusion?
- What are the priority nursing diagnoses for A.D. currently?
- What are the priority nursing interventions in A.D.’s plan of care
- Is A.D. now considered to have AIDS?
- A.D. has been HIV positive for 6 years, yet he has not developed AIDS. What factors might have delayed A.D.’s transitioning to AIDS?
- A.D is continuing therapy with trimethoprim–sulfamethoxazole (TMP-SMX) after discharge. Why?
- What areas should you address in A.D.’s discharge teaching?