Nursing Assessment or Management or Intervention of HIV / AIDS

Nursing Assessment or Management or Intervention of HIV / AIDS According to Nursing Process:

The nursing care of patients with HITV/ADS is challenging because of the potential for any organ system to be the target of infections or cancer.

1. Nursing Assessment:

Nursing assessment includes identification of potential risk factors, including a history of risky sexual practices or IV/injection drug use.

• Nutritional status,
• Skin integrity,
• Respiratory status,
• Neurologic status,
• Fluid and electrolyte balance,
• Knowledge level.

2. Diagnosis:

The list of potential nursing diagnoses is extensive because of the complex nature of the disease:

• Impaired skin integrity related to cutaneous manifestations of HIV infection, excoriation, and diarrhea.
• Diarrhea related to enteric pathogens of HIV infection.
• Risk for infection related to immunodeficiency.
• Activity intolerance related weakness, fatigue, malnutrition, impaired F&E balance, and hypoxia associated with pulmonary infections.
• Disturbed thought processes related to shortened attention span, impaired memory, confusion, and disorientation associated with HIV encephalopathy.
• Ineffective airway clearance related to PCP, increased bronchial secretions, and decreased ability to cough related to weakness and fatigue.
• Pain related to impaired perianal skin integrity secondary to diarrhea, KS, and peripheral neuropathy.
• Imbalanced nutrition, less than body requirements related to decreased oral intake.

3. Planning & Goals:

Goals for a patient with HIVIAIDS may include:

• Achievement and maintenance of skin integrity,
• Resumption of usual bowel pattern,
• Absence of infection,
• Improve activity intolerance,
• Improve thought processes,
• Improve airway clearance,
• Increase comfort,
• Improve nutritional status,
• Increase socialization,
• Absence of complications,
• Prevent/minimize development of new infections,
• Maintain homeostasis,
• Promote comfort,
• Support psychosocial adjustment,
• Provide information about disease process/prognosis and treatment needs.

4. Nursing Interventions:

The plan of care for a patient with AIDS is individualized to meet the needs of the patient.

• Promote skin integrity: Patients are encouraged to avoid scratching; to use nonabrasive, nondrying soaps and apply non perfumed moisturizers; to perform regular oral care, and to clean the perianal area after each bowel movement with nonabrasive soap and water.
• Promote usual bowel patterns: The nurse should monitor for frequency and consistency of stools and the patient’s reports of abdominal pain or cramping.
• Prevent infection: The patient and the caregivers should monitor for signs of infection and laboratory test results that indicate infection.
• Improve activity intolerance: Assist the patient in planning daily routines that maintain a balance between activity and rest.
• Maintain thought processes: Family and support network members are instructed to speak to the patient in simple, clear language and give the patient sufficient time to respond to questions.
• Improve airway clearance: Coughing, deep breathing, postural drainage, percussion and vibration is provided for as often as every 2 hours to prevent stasis of secretions and to promote airway clearance.
• Relieve pain and discomfort: Use of soft cushions and foam pads may increase comfort as well as administration of NSAIDS and opioids.
• Improve nutritional status: The patient is encouraged to eat foods that are easy to swallow and to avoid rough, spicy, and sticky food items.

5. Evaluation:

Expected patient outcomes may include:

• Achieved and maintained of skin integrity,
• Resumption of usual bowel pattern,
• Absence of infection,
• Improved activity intolerance,
• Improved thought processes,
• Improved airway clearance,
• Increased comfort,
• Improved nutritional status,
• Increased socialization,
• Absence of complications.

6. Discharge an d Home Care Guidelines:

Before discharge, the nurse should educate the patient and the family about precautions and the transmission of HIV/AIDS.

• Patients and their families or caregivers should receive instructions about how to prevent disease transmission, including hand-washing techniques and methods for safely handling and disposing of items soiled with body fluids.
• Patients are advised to avoid exposure to others who are sick or who have been recently vaccinated.
• Medication administration. Caregivers in the home are taught how to administer medications, including IV preparations.
• The patient’s adherence to the therapeutic regimen is assessed and strategies are suggested to assist with adherence.
• Infection prevented/resolved.
• Complications prevented/minimized.
• Pain/discomfort alleviated or controlled.
• Patient dealing with current situation realistically.
• Diagnosis, prognosis, and therapeutic regimen understood.
• Plan in place to meet needs after discharge.

Maria Mona

Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”