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:
- Gastrointestinal
- Upper GI Disorders
- Respiratory Emergencies
- Immunological Disorders
- Hematologic Disorders
- Intraoperative Nursing
- Medication Administration
- Newborn Complications
- Noninfectious Respiratory Disorder
- Peripheral Nervous System Disorders
- Studying
- Central Nervous System Disorders – Brain
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Disorders of Pancreas
- Liver & Gallbladder Disorders
- Disorders of Thermoregulation
- Musculoskeletal Trauma
- Disorders of the Posterior Pituitary Gland
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Emergency Care of the Trauma Patient
- Neurological Trauma
- Disorders of the Thyroid & Parathyroid Glands
- Male Reproductive Disorders
- Oncology Disorders
- Postoperative Nursing
- Renal Disorders
- Renal and Urinary Disorders
- Central Nervous System Disorders – Spinal Cord
- Integumentary Disorders
- Shock
- Acute & Chronic Renal Disorders
- Respiratory Disorders
- Vascular Disorders
- Lower GI Disorders
- Respiratory System
- Disorders of the Adrenal Gland
- Neurologic and Cognitive Disorders
- Infectious Disease Disorders
- Female Reproductive Disorders
- EENT Disorders
- Respiratory
- Emergency Care of the Respiratory Patient
- Neurological Emergencies
- Communication