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What Is HIV?
H Human
I Immunodeficiency
V Virus
What is AIDS?
A Aquired
I Immune
D- Deficiency
S- Syndrome
For diagnosis must be:
HIV positive, and
CD4 (T-cell) count below 200, or
The presence of one or more opportunistic infections.
Global Epidemiology
39.5 million people living with HIV/AIDS in
2006
4.3 million newly infected with HIV (more
than half are younger than 25)
2.9 million people died from AIDS
Why?
OR
Protect Yourself!!!
Healthcare Workers Reported to have AIDS
Occupational Exposure
DOES occur.
HCPs reported to
have AIDS:
Physician 1792
Lab technician 3182
Dental worker 492
Surgeon 122
Nurses ???
Occupational Exposure to HIV
Exposure to HIVinfected blood via
percutaneous injury:
3/1000
Mucocutaneous exposure:
Less than 1/1000
Intact Skin:
No known risk
Post-Exposure Prophylaxis (PEP)
Administration of antiretroviral
medications (ARVs) after exposure to
HIV.
Given as soon as possible after exposure
Must be within 72 hours
4-week treatment with 2-3 different ARVs
Standard procedure since 1996.
Reduces transmission by 79%
PEP contd
Page 2145, Smeltzer
& Bare
Table 70-5
Recommended
Algorithm used to
determine PEP
Should a needlestick injury
occur
Administrative Efforts
Development/ Promotion of the use of safety
devices.
Sharp disposal containers
Disposable instrument use
Monitoring of the effectiveness of PEP.
Pre-Exposure Prophylaxis for HIV
Various studied have shown that antiretroviral
treatment given at or shortly after HIV exposure
can reduce likelihood of transmission
this lead to the hypothesis that transmission
may be decreased even further if treatment
were delivered before exposure to HIV
Paxton, 2007).
Tenofir
Safety/ effectiveness still unknown.
Ethics - Tenofir
Think about
Obligations of govt to provide pre-exposure
prophylaxis
Appropriate indications for prescribing Tenofir (
think high-risk populations)
Who should have priority for pre-exposure
prophylaxis?
Stigmatization:
- Stigma attached to engagement in risky behaviors
- Decision making clouded by underlying beliefs
Nursing Care of the HIV positive client:
THE NURSING PROCESS
ASSESSMENT
-identify risk factors
- unsafe sexual practices
- IV drug use
- Physical Assessment focus on Immune system
- Psychological status
- Nutritional status
- Skin integrity
- Respiratory status
- Neurological status
- Fluid and electrolyte balance
- Knowledge level
NSG DIAGNOSIS
Impaired skin integrity r/t percutaneous
manifestations of HIV infection.
Risk for fluid volume deficit r/t diarrhea
Risk for infection r/t immunodeficiency
Activity intolerance r/t weakness, fatigue.
Pain r/t impaired skin integrity
Anticipatory greiving r/t changes in lifetsyle 2
diagnosis of AIDS
Social isolation r/t stigma of the disease, fear of
infecting others
Ineffective A/W clearance r/t increased bronchial
secretions, decreased ability to cough.
PLANNING