AIDS Case Study (45 min)
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Mr. Hernandez is a 33 year old male with a history of IV Drug Use, Hepatitis C, and HIV. He has previously been managed on HAART therapy, but has been having recurrent bouts of pneumonia in the last 6 months. He presents to the Free Clinic today complaining of weakness and fatigue, shortness of breath, and a
persistent cough. He reports a 10 lb weight loss over the last 3 weeks. He says “I think I have pneumonia again”.
Upon further questioning, the patient reports fever, chills, and night sweats for the last few days. His coughing has been nonproductive. He has diffuse rhonchi through his right lung and scattered rhonchi on the left. A Chest x-ray shows a nodular consolidation on the right side and diffuse infiltrates. The provider orders a CBC with Diff and a CD4 cell count. Vital signs show the following: HR 100 RR 20 BP 108/67 SpO2 90% Temp 101.6°F The Complete Blood Count with Differential shows the following abnormal values: RBC 3.9 H/H 8.1/24.3 WBC 7,000 Plt 104,000 CD4 <10 / mm3 Mr. Hernandez is sent straight to the hospital to be admitted. He is started on high-dose IV antibiotics and his HAART therapy dosages are increased. He receives 2 units of Packed Red Blood Cells when his Hgb drops to 7.6 mg/dL. He continues to be weak and has fevers and night sweats, treated with PO Acetaminophen. He is flushed and his skin is warm. His vital signs in the morning are: HR 110 RR 22 BP 88/47 SpO2 92% on 4 lpm nasal cannula Temp 101.8°F Reference: Diagnostic Criteria for AIDS – https://www.ucsfhealth.org/conditions/aids/diagnosis.html 200% NCLEX Pass Guarantee. What further history questions and assessment data would you obtain at this time?
What laboratory or diagnostic tests do you anticipate the provider ordering?
What respiratory disease has Mr. Hernandez contracted?
What should your first nursing action be?
What is going on physiologically with Mr. Hernandez? How do you know?
What condition is Mr. Hernandez developing because of his infection?
What medications or treatments might he require to maintain his hemodynamics?
Could anything have been done differently for Mr. Hernandez?
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Concepts Covered:
- Documentation and Communication
- Legal and Ethical Issues
- Perioperative Nursing Roles
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Intraoperative Nursing
- Microbiology
- Communication
- Fundamentals of Emergency Nursing
- Preoperative Nursing
- Basics of NCLEX
- Medication Administration
- Vascular Disorders
- Upper GI Disorders
- Urinary Disorders
- Renal Disorders
- Central Nervous System Disorders – Brain
- Studying
- Emergency Care of the Neurological Patient
- Postpartum Complications
- Liver & Gallbladder Disorders
- Factors Influencing Community Health
- Community Health Overview
- Immunological Disorders
- Integumentary Disorders
- Male Reproductive Disorders
- Pregnancy Risks
- Prioritization
- Childhood Growth and Development
- Musculoskeletal Trauma
- Terminology
- Respiratory Disorders
- Cognitive Disorders
- Adulthood Growth and Development
- EENT Disorders
- Concepts of Population Health
- Basic
- Disorders of the Adrenal Gland
- Disorders of the Thyroid & Parathyroid Glands
- Tissues and Glands
- Emergency Care of the Trauma Patient
- Cardiovascular
- Lower GI Disorders
- Circulatory System