NURSING CARE IN HIV-AIDS

 HIV AIDS

DEFENITION

A (Acquired)  is spread from person to person.

I (Immune)  Deplete the human immune system. Immunity is part of the body to defend itself against infection with such bacteria or viruses.

D (Deficiency) Creating a loss or reduced immune system.

S (Syndrome)  People with AIDS have bbg opportunistic infections & other diseases.

Etiology

• H: Human 
• I: Immunodeficiency 
• V: Virus 
HIV is the virus that causes AIDS & who belong to a group of retroviruses (the enzyme reverse transcriptase)

Modes of transmission

• Through sexual contact 
• Blood transfusion 
• Syringes
• Of the HIV + mothers to their babies during pregnancy, childbirth, through ation.

Signs and symptoms of major 

• Weight loss in 1 month more than 10% 
• Chronic diarrhea is more than a month. 
• prolonged fever for more than 1 month. 
• Decrease in consciousness and neurologic disorders. 
• dementia

Signs and symptoms of minor    
  
• persistent cough for more than 1 month 
• Dermatitis 
• Presence of recurrent herpes zoster 
• Oropharyngeal candidiasis 
• Herpes simplex chronic progressive 
• Generalized lymphadenopathy 
• recurrent yeast infections in the genitals

Clinical Manifestations 
Course of HIV disease is divided into stages based on clinical circumstances and the number of CD4

a. Acute retroviral infection 
• Fever• Enlarged lymph 
• Hepatoslenomegali 
• throat pain 
• myalgia 
• Rast like morbili

b. Asymptomatic period 
• At this time the patient showed no symptoms, but interchangeable occur lymphadenopathy. 
• Decrease in CD4 cell counts occur in stages called the window period.

c. The period of early symptomsDuring this fourth CD ranged from 100-300, this phenomenon arises due to pneumonia infection, vaginal candidiasis, canker sores herpes zoster, pulmonary tuberculosis.

d. The period of continued symptomsCD4 counts below 200, lower resistance to further this cause a high risk of opportunistic infections

The correlation of complications with CD4> 500 
• Acute retroviral syndrome 
• Vaginitis candid 
• Lymphadenopathy 
• Syndrome gullain barree 
• Myopathy• Meningitis

200-500 
• Pneumonia 
• TBC 
• Herpes zoster 
• Candidiasis oroparing 
• cervical neoplasms 
• ITP

<200 
• Pneumonia 
• dementia 
• peripheral neuropathy 
• miliary TB and extra pulmonary 
• Cardiomiopati 
• Poliradikulopati

<100 
• Herpes simplex 
• Toxoplasma gondii 
• Candida oesophagitis

<50 
• Cytomegali virus 
• Lymphoma of the ssp

The principle of treatment 
1. Supportive treatment 
• Treatment aims to improve the patient's general condition, by providing appropriate nutrition, systemic medications, vitamins, psychosocial support.

Nutritional needs in patients with HIV-AIDS 
• High energy is 45-50 kcal / kg• Protein from 1.1 to 1.5 g / kg / mm at a normal weight at the BB-2 ,1,5 actual kaheksia. 
• 17-20% fat of total calories.

2. Treatment of opportunistic infections 

3. Antiretroviral treatmentPrinciples of ARV: 

• Indications according to the guidelines WH 
• Overcome first opportunistic infection. 
• Be careful disruption fungsihati 

Nursing assessment 

1. History of present illness 
• Losing weight 
• Fever 
• Diarrhea 

2. Accompanying diseases 
• Candidiasis 
• Herpes simplex 
• lymphoma 

3. Past history of disease 
• History of receiving blood transfusion 
• History of sexual diseases 

4. Social History 
• Use of illicit drugs drugs 
• Jobs 
• Travel 
• Support system

Physical examination 
• General appearance looks sick moderate, severe 
• Vital signs 
• The skin there is a rush, Stevens-Johnson
• Red eyes, icterik, impaired vision 
• Neck: enlargement of the KGB 
• Ears and noses; sinusitis buzzing 
• Oral cavity: candidiasis 
• Lungs: shortness, pleural effusion, muscle aids 
• Cardiac: cardiac enlargement 
• Abdomen: ascites, abdominal distension, enlarged liver 
• genetalia and rectum: herpes 
• Neurology: seizures, memory impairment, neuropathy.

Investigations 

• Calculate lymphocytes
 CD4 
• Mantouk test 
• Test elisa

NURSING DIAGNOSIS 

High risk of infection b.d. immunodeficiency 
• Reduce and limit the number of patient visits 
• Describe personal hygiene techniques 
• Keep an eye on further signs of infection

Ineffective airway b.d. accumulation of mucus 
• Teach effective cough 
• Give bed semi-Fowler position 
• Maintain cleanliness of the airway 
• Assess the pattern of breathing, rhythm

Resti / actual lack of fluid volume b.d. Excessive fluid loss 
• Give fluid intake adequat reply 
• Avoid foods that stimulate diarrhea 
• Monitor vital signs 
• Assess the elasticity turgor and mucous membranes humidity 
• Monitor intake and output• Weigh the BB every day

DK who else ... 
• Impaired skin integrity b.d. immobilization 
• Social isolation b.d. stigma, fear 
• Disturbance in sleep patterns b.d. worry 
• Intolerance activities b.d. physical weakness 
• Disturbance role b.d. Chronic diseases