How to write a nursing HIV Case Study and Plan of Care
HIV Causes
Despite the recent advances in treatment and technology, the human immunodeficiency virus (HIV) remains a complex healthcare problem. HIV is caused by a virus and is spread through sexual contact, sharing needles, close contact with infected blood, or mother to child during pregnancy, birth, or breastfeeding (Saag, 2021). HIV belongs to a group of viruses called lentiviruses that cause infection in both humans and animals. HIV is an enveloped retrovirus that is observed to contain two copies of a single-stranded RNA genome. The virus attacks the CD4 cells making the body’s immune system weak and unable to provide defense against other infections (Saag, 2021). Acquired immunodeficiency syndrome (AIDS) is an advanced stage of HIV characterized by a low amount of CD4 cells below 200 cells/mm in the body (Centers for Disease Control and Prevention (CDC), 2021). Without treatment, progression from acute HIV infection to AIDS is very fast and one can only last for a few years.
HIV Risk Factors
Certain behaviors and conditions put individuals at risk of getting HIV. Individuals that have unprotected anal or vaginal sex are among the groups with the greatest risk of getting the virus (World Health Organization (WHO), 2021). Those with another sexually transmitted infection like syphilis or chlamydia are at risk of getting the infection. Behaviors like sharing contaminated needles, syringes, or other injecting equipment predispose one to get the virus (WHO, 2021). Receiving unsafe injections, organ transplants, or blood transfusions can make one get the disease. In some cases, experiencing accidental needle injuries, especially among healthcare workers is a risk factor for getting HIV.
Education
Educational strategies for patients with HIV take into account individual values, knowledge, and preferences. The first aspect of education that should be emphasized is treatment adherence. The healthcare provider should assess understanding of treatment adherence and create a follow-up plan for medication adherence. The patient should be educated about opportunistic infections that can result from low immunity or other causes. An example is pneumonia and tuberculosis which commonly affect these individuals. The patient should be informed about vaccination against Hepatitis A and B, pneumonia, and influenza. For women, reproductive health education should focus on pap smears done during diagnosis and then yearly.
Lab Monitoring
The main laboratory investigations that should be monitored for individuals with HIV are CD4 cell count and viral load. The CD4 test measures the number of CD4 cells in the body. These cells are a type of white blood cell called T-cells and move throughout the body to fight against bacteria, viruses, and other pathogens. The normal CD4 count in the body is between 500 to 1400 cells/mm and at levels below 200 cells/mm individuals may develop AIDS (Saag, 2021). The viral load is a test used to measure the number of HIV particles in a milliliter of blood. This test is used to assess the progression of HIV and see how well an individual is progressing with treatment.
Confidentiality
Everyone is entitled to legal protection for confidential information including HIV status. The Health Insurance Portability and Accountability Act (HIPAA) warns against disclosing the patient’s medical records without permission. For this patient, no medical information will be disclosed without permission from the patient.
Prevention and Referral
The prevention of HIV for the patient’s close contacts like spouses should involve the use of protection during sexual intercourse (WHO, 2021). In addition to this strategy, all patients should take antiretrovirals to keep them healthier for longer and reduce the risk of passing the virus to their partners (Saag, 2021). Regarding the referral of infected patients, I would recommend seeing an infectious disease specialist. These patients are at risk of developing opportunistic infections that may require special attention.
References
Centers for Disease Control and Prevention. (2021). HIV: HIV Basics. https://www.cdc.gov/hiv/basics/whatishiv.html
Saag M. S. (2021). HIV Infection – Screening, Diagnosis, and Treatment. The New England journal of medicine, 384(22), 2131–2143. https://doi.org/10.1056/NEJMcp1915826
World health Organization. (2021). HIV/AID. https://www.who.int/news-room/fact-sheets/detail/hiv-aids
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