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admin | Get Rid Of Bacterial Infection | 22.10.2015
Dr Phillip Silberberg, Children's Hospital Omaha, Radiologist, Omaha Childrens, Creighton University and UNMC, Nebraska, USA.
The main treatment concepts of HIV therapy are to use medications specifically designed to combat a part of the retroviral replication cycle of HIV.
NRTIs replace part of HIV’s genetic material with alternate enzymes, which means that the virus does not have access to normal developmental life cycle growth.
NNRTIs attach themselves to reverse transcriptase and prevent the enzyme from converting RNA to DNA.
Entry inhibitors work by preventing HIV from entering healthy CD4 cells by blocking specific proteins on CDC4 cells.
Research is suggesting that an HIV-infected person can benefit from therapies that combat the virus by using one’s own immune system. With strong suppression of the virus via multiple drug therapies, the immune system may be able to rebuild. The CDC and the global medical community make continual revisions to definitions of HIV and AIDS.
Key Concept Early detection of HIV OIs, and AIDS allows for more options in treatment of infections and preventative healthcare. FIGURE 85-3 · Lesions called Kaposi’s sarcoma, an acquired immunodeficiency syndrome (AIDS)-related malignancy common in later stages of the disease.
A variety of other fungal, viral, and bacterial infections may also occur, causing constitutional disease (weight loss, diarrhea, fever) and neurologic disorders (dementia, muscle, nerve) (Figs. The ideal approach to the management of AIDS involves the prevention of opportunistic infections when possible (prophylaxis) and the early treatment of such infections when they occur. Since the institution of the use of powerful combinations of antiretroviral medications, the mortality rate from HIV has declined in the United States. Plan together with the client, family, and other members of the healthcare team for effective individualized care to meet the client’s needs. In addition to the physical effects of HIV infection, many persons with this diagnosis have experienced stigma, loss of job and insurance, depression, anxiety, and adjustment problems. Although many HIV-infected persons can function fully and do not require specialized care beyond that provided by their primary care providers, nursing care can be very helpful in many instances. Key Concept HIV cannot invade the body through intact skin, therefore, skin is an excellent barrierto HIV. The psychosocial aspects of being infected with HIV may be significant; persons are stigmatized, may lose the support of friends and family, and may find the restraints on sexual activity difficult.
Individuals in later stages of the disease are more likely to require special nursing care.
Opportunistic infections require special medications, and clients may need assistance in taking these properly or in contacting the healthcare provider when problems develop.
Risk for caregiver role strain related to prolonged disease progression and increasing care responsibilities in conjunction with parental age and physical condition as evidenced by client’s statements about current status and parents.
Identify role of client in family and how illness has changed the family roles, noting how the client feels about these changes. Note factors, other than illness, that may be affecting family’s ability to provide effective care. This basic information will enable the nurse to provide appropriate referral and to encourage the family to seek the help they need. Client and family met with Social Services; identified several areas in which it would be beneficial for them to seek help. It is important that the client and family understand how the human immunodeficiency virus (HIV) is transmitted.

1: MR Axial STIR shows enlarged right kidney with abnormal cortical medullary differentiation.
2: Coronal fat suppressed T2, enlarged right kidney with abnormal corticomedullary differentiation most marked in the upper pole. 5: Axial T1 post contrast, note enhancement of the right upper pole peripherally with a more normal signal centrally.
Phillip Silberberg, Omaha Children?s Hospital, Omaha, NEBrandi Reeve, Medical Student, University of Nebraska Medical Center, Omaha, NEReferences: Aronoff SC, Egland TK, McCoy AC. As a consequence, HIV’s genetic material cannot be incorporated into the normal genetic material of the invaded cell.
This classification may be especially beneficial to HIV-positive individuals who have become resistant to some other classifications. Important proteins called cytokines, such as interleukin-2 (IL-2), can affect immune cells. It is highly recommended that individuals seek treatment for HIV from people who are knowledgeable and experienced professionals. You may be asked to identify rationales for Standard Precautions, educational topics for caregivers, or nutritional concerns. Initial infections of the skin and mucous membranes, such as oral thrush, shingles, and severe athlete’s foot, may develop.
In the later stages of AIDS, the client loses weight and is susceptible to many opportunistic infections. The use of antiretroviral medications has resulted in the decline (or perhaps delay) in the number of individuals who progress from HIV to AIDS. However, in developing countries without adequate healthcare, educational programs, or medications, and in impoverished populations in the United States, the mortality rate continues to be high. The client may require assistance in meeting all basic and healthcare needs, as well as in dealing with the chronic or terminal nature of the disorder.
For example, it is essential to take prescribed antiretroviral agents as directed, and persons with HIV often require assistance with medication adherence.
Healthcare for the older population typically includes heart disease, hypertension, diabetes, cancer; and respiratory problems, which may need pharmaceutical or surgical therapies.
Support from healthcare professionals can assist HIV-positive clients to adjust to the diagnosis. Intravenous medications may be used and, with such medications, comes the associated care of venous access lines. Rationale: Having the client talk with her parents opens the channels of communication for future action. Rationale: Past relationships, time schedules, available space, and finances are some factors that may affect the family’s effectiveness. Rationale: Social Services has a wide knowledge base to provide assistance in numerous areas. HIV is the virus responsible for causing AIDS, but the person who is HIV positive does not automatically have AIDS. As the virus progressively destroys the immune system, a variety of infections and cancers can develop.
Keep in mind and prior-tize the needs for basic nursing care that would be appropriate for any client.
As immunity diminishes further, more life-threatening infections are likely to occur (see Box 85-1). When a person is in the terminal stages of AIDS, the focus is on providing the client with comfort.

Determine if medication regimens and requirements for taking anti-HIV medications are being followed.
The nurse plays a key role in client and family teaching about all aspects of the disease and care (see In Practice: Educating the Client 85-1).
Some HIV-infected individuals choose to return to school and work and may benefit from referral to retraining programs or educational counselors. Emotional support, combined with technical skills, will help clients and families cope with the illness.
Rationale: Hospice personnel are skilled in assisting families and clients to adjust to death and dying as part of the continuum, and to recognize those comfort measures that will contribute to this process. Postexposure prophylaxis (PEP) should begin immediately with thorough washing of the exposed area.
Because each classification is designed to attack a different developmental cycle of the virus, the use of different drugs simultaneously is more effective in controlling the amount of the virus in the individual. Illnesses, such as diabetes, and increased cholesterol or triglyceride levels, can become life threatening. Observe for evidence of depression, anxiety, or other symptoms, which may indicate psychological dysfunction or lack of coping mechanisms. A nursing care plan is developed to meet identified needs (see In Practice: Nursing Care Plan 85-1). In addition, it is important that those who are infected know how to prevent transmission of HIV to family, friends, and sexual partners. Client repeatedly talking about the fact that she seems to be getting progressively sicker and that her weight loss, fatigue, and pain were also increasing in severity She cried about the fact that her family is becoming exhausted as time goes on.
Some individuals seem to maintain a healthy immune system for many years despite HIV infection, without the use of medications. When a person has AIDS, specific signs and symptoms may be difficult to identify because this disorder can affect many body systems.
All healthcare agencies will have specific protocols to follow if an individual has had possible exposure to HIV.
Development of amphotericin B-resistant Candida tropicalis in a patient with defective leukocyte function. Refer to Table 85-1 and In Practice: Important Medications 85-1 for a listing of current classifications and some examples of each. Establish a baseline for future comparison and determine the presence of suspected complications.
Data collection generally includes specific legal concerns, such as consents to obtain HIV infection status.
More information can also be found at the National Institute of Health’s Nonoccupational Exposure Considerations or Health-Care Worker Exposure Guidelines on the internet. Planning for further nursing and healthcare considers the client’s prognosis and responses to care. They’re not rich either” When questioned, parents report being tired, stating, "But we want to do everything that we can for her” Client has a younger sister and brother living nearby who come by to help occasionally.

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