AIDS Case Study (45 min)
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Outline
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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Adult 2 Final
Concepts Covered:
- Immunological Disorders
- Liver & Gallbladder Disorders
- Upper GI Disorders
- Neurological Emergencies
- Emergency Care of the Neurological Patient
- Central Nervous System Disorders – Brain
- Peripheral Nervous System Disorders
- Central Nervous System Disorders – Spinal Cord
- Infectious Respiratory Disorder
- Respiratory Disorders
- Noninfectious Respiratory Disorder
- Oncology Disorders
- Hematologic Disorders
- Oncologic Disorders
- Cardiac Disorders
- Acute & Chronic Renal Disorders
- Renal Disorders
- Urinary Disorders
- Vascular Disorders
- Emergency Care of the Cardiac Patient
- Pregnancy Risks