ENGLISH PAPERS

“HIV AND AIDS”

SUPERVISOR:
Nurmayanti,S.Pd,MA

ARRANGED BY:
Group 6
 Erna Rosalina
 Nirmala
 Putri
 Sariatin
 Asrianti

MINISTRY OF HEALTH OF THE REPUBLIC OF INDONESIA

KENDARI HEALTH POLYTECHNIC
NURSING MAJOR
2020/2021
 FOREWORD

Praise be to Allah SWT who has given His grace and guidance so that we can
complete this thesis on time.
The purpose of this paper is to fulfill the task of Mrs. Nurmayanti, S.Pd, MA in
the English language course. In addition, this assignment also aims to add insight for
readers and also for writers.
We would like to thank Nurmayanti, S.Pd, MA, as an English lecturer who has
given this assignment so that it can add knowledge and insight according to the field of
study.
We realize that the paper we are writing is still far from perfect. Therefore, I look
forward to criticism and suggestions for the perfection of this task.

Kendari, 06 August 2021

Group 6
 TABLE OF CONTENTS

FOREWORD.....................................................................................................................
TABLE OF CONTENTS..................................................................................................
CHAPTER I INTRODUCTION......................................................................................
a. background..............................................................................................................
b. formulation of the problem......................................................................................
c. aim...........................................................................................................................

CHAPTER II DISCUSSION............................................................................................
a. Definition of hiv and aids........................................................................................
b. What is the etiology of hiv and aids........................................................................
c. What is the pathophysiology of hiv and aids?......................................................................
d. What are the signs and symptoms of hiv and
aids?....................................................................
e. How to prevent hiv and aids....................................................................................
f. How to treat hiv and aids
g. How is HIV and AIDS nursing care?......................................................................
CHAPTER III CLOSING.................................................................................................
a. conclusion................................................................................................................
b. suggestion................................................................................................................

REFERENCES..................................................................................................................
 CHAPTER I
INTRODUCTION

A. background

HIV is the number one killer infectious disease in the world. According to data
from the World Health Organization (WHO) in 2017, 940,000 people died of HIV. There
were approximately 36.9 million people living with HIV at the end of 2017 with 1.8
million people becoming newly infected in 2017 globally. More than 30% of all new HIV
infections globally are estimated to occur among adolescents aged 15 to 25 years.
Followed by children who were infected at birth growing up to be teenagers who had to
deal with their HIV positive status. Combining the two, there are 5 million adolescents
living with HIV (WHO, 2017). In 2017, the incidence of new HIV and AIDS infections
in adolescents in ASIA and the Pacific showed that there were 250,000 adolescents living
with HIV and AIDS. New HIV infections have decreased by 14% since 2010. There has
been a 39% decrease in people dying from HIV & AIDS (UNAIDS, 2017).

According to data from the Directorate General of Disease Control and

Prevention, the Indonesian Ministry of Health stated that the number of HIV cases from
2005 to 2017 has increased every year. HIV cases in Indonesia in 2016 recorded 41,250
cases and the latest data until December 2017 recorded 48,300 cases. Meanwhile, AIDS
cases in Indonesia in 2016 there were 10,146 cases and the latest data until December
2017 recorded 9,280 cases. The highest percentage of HIV infection was reported in the
age group 25-49 years (69.2%), followed by the age group 20-24 years (16.7%), the age
group 50 years (7.6%), the age group 15-19 years by 4%, and age <15 years by 2.5%.
The incidence of HIV has increased, while the incidence of AIDS has decreased. The
decline does not mean that HIV and AIDS are no longer dangerous diseases. Given that
in this case the Ice Berg Theory or often called the Iceberg Theory is applied, it means
that the figures presented from the source are 25% of the facts and the other 75% is
hidden due to various factors (Directorate General of P2P, Ministry of Health RI, 2017).

B. formulation of the problem

1. Definition of hiv and aids

2. What is the etiology of hiv and aids
3. What is the pathophysiology of HIV and AIDS?
4. What are the signs and symptoms of HIV and AIDS?
5. How to prevent hiv and aids
 6. How to treat hiv and aids
7. How is HIV and AIDS nursing care?

C. Aim

1. To know the definition of hiv and aids

2. To find out what is the etiology of hiv and aids
3. To find out how the pathophysiology of HIV and AIDS
4. To find out what are the signs and symptoms of HIV and AIDS
5. To know how to prevent hiv and aids
6. To know how to treat hiv and aids
7. To find out how HIV and AIDS nursing care
 CHAPTER II
DISCUSSION

A. Definition of hiv and aids

HIV (Human Immunodeficiency Virus) is a virus that attacks the immune

system which further weakens the body's ability to fight infection and disease. Drugs
or methods of treating HIV have not been found. By undergoing certain medications,
people with HIV can slow the progression of the disease, so people with HIV can
live a normal life. AIDS (Acquired Immune Deficiency Syndrome) is a condition in
which HIV is in the final stage of infection. When a person has AIDS, the body no
longer has the ability to fight off the infection it causes.

B. What is the etiology of hiv and aids

The cause of immune disorders in AIDS is a viral agent called HIV from a
group of viruses known as retroviruses called Lympadenopathy Associated Virus
(LAV) or Human T-Cell Leukemia Virus (HTL-III) which is also called Human T-
Cell Lympanotropic Virus (retrovirus). . Retroviruses convert their rebonucleic acid
(RNA) into deoxyribunocleic acid (DNA) after entering the host cell (Nurrarif &
Hardhi, 2015).
The cause is a group of retro viruses called Human Immunodeficiency Virus
(HIV). Transmission of HIV infection and AIDS consists of five phases, namely:
a. Window period: duration 4 weeks to 6 months after infection. No symptoms.
b. Acute primary HIV infection phase: 1-2 weeks duration with flu-like
symptoms.
c. Asymptomatic infection: the duration of 1-15 or more years with no symptoms.
d. Symptomatic immune suppression: over 3 years with symptoms of fever, night
sweats, weight loss, diarrhea, neuropathy, weakness, rash, lymphadenopathy,
oral lesions.
e. AIDS: the duration varies between 1 – 5 years from the first AIDS condition
was established. There are severe opportunistic infections and tumors in
various body systems, and neurological manifestations

C. What is the pathophysiology of HIV and AIDS

In adults, the window for HIV infection is about 3 months. As viral
replication increases and the disease progresses, the number of CD4+ lymphocytes
will continue to decrease. Generally, the distance between HIV infection and the
onset of clinical symptoms in AIDS ranges from 5 – 10 years. Primary HIV infection
can trigger specific acute infection symptoms, such as fever, headache, pharyngitis
and sore throat, lymphadenopathy, and skin rash. The acute phase is followed by an
asymptomatic latent period, but in this phase there is a decrease in the number of
 CD4+ lymphocytes for years until clinical manifestations of AIDS occur due to
immune deficiency (in the form of opportunistic infections). Various other clinical
manifestations can arise due to autoimmune reactions, hypersensitivity reactions, and
the potential for malignancy (Kapita Selekta, 2014).
T cells and macrophages and dendritic/langerhans cells (immune cells) are
cells infected with Human Immunodeficiency Virus (HIV) and are concentrated in
the lymph nodes, spleen and bone marrow. With a decrease in the number of T4
cells, the cellular immune system becomes progressively weaker. Followed by
http://repository.unimus.ac.id 14 reduced function of B cells and macrophages and
decreased function of helper T cells (Susanto & Made Ari, 2013).
A person infected with the Human Immunodeficiency Virus (HIV) can
remain asymptomatic for years. During this time, the T4 cell count may decrease
from about 1000 cells per ml of blood before infection to about 200-300 per ml of
blood, 2-3 years after infection. When T4 cells reach this level, the symptoms of
infection (herpes zoster and opportunistic fungi) (Susanto & Made Ari, 2013).

D. What are the signs and symptoms of HIV and AIDS

a) First stage:
1) Patients will experience pain similar to the flu, a few weeks after infection,
for one to two months.
2) May not cause any symptoms for several years.
3) Fever, sore throat, rash, swollen lymph nodes, diarrhea, fatigue, muscle and
joint pain may occur.

b) Second stage:
1) Generally, do not cause further symptoms for years.
2) The virus continues to spread and damage the immune system.
3) The transmission of infection can already be done by the sufferer to other
people.
4) Lasts up to 10 years or more.

c) Third stage
1) The patient's resistance is vulnerable, so it is easy to get sick, and will
continue to become AIDS.
2) Fever persists for more than ten days.
3) Feel tired all the time.
4) Difficulty breathing
5) Diarrhea that is severe and in the long term.
6) There is a yeast infection in the throat, mouth, and vagina.
7) Purple spots appear on the skin that will not go away.
8) Loss of appetite, resulting in drastic weight loss.
E. How to prevent hiv and aids
There are various efforts that can be done to prevent the transmission of HIV
and AIDS, including:
1) Use a new condom every time you have sex, both vaginal and anal
intercourse.
2) Avoid having sex with more than one partner.
3) Be honest with your partner if you are HIV positive, so that your partner also
undergoes an HIV test.
4) Discussion with the doctor if diagnosed HIV positive during pregnancy,
regarding further treatment, and planning for delivery, to prevent transmission
from mother to fetus.
5) Circumcision to reduce the risk of HIV infection.
6) If you suspect that you have recently been infected or have contracted the
HIV virus, such as after having sex with someone with HIV, you should
immediately see a doctor.

F. To know how to treat hiv and aids

Although until now there is no cure for HIV, but there are types of drugs
that can slow the progression of the virus. This type of drug is called an antiretroviral
(ARV). ARVs work by removing elements needed by the HIV virus to multiply and
preventing the HIV virus from destroying CD4 cells. There are various types of ARV
drugs, including Etravirine, Efavirenz, Lamivudine, Zidovudine, and also
Nevirapine.
While taking antiretroviral drugs, the doctor will monitor the number of
viruses and CD4 cells to assess the patient's response to treatment. CD4 cell count
will be done every 3-6 months. Meanwhile, HIV RNA examination was carried out
since the beginning of treatment, then continued every 3-4 months during the
treatment period.
In order for the development of the virus to be controlled, people with HIV
must immediately take ARVs as soon as they are diagnosed with HIV. The risk of
people living with HIV to develop AIDS will be even greater if treatment is delayed,
because the virus will further damage the immune system. In addition, it is important
for people with ARVs to take ARVs according to the doctor's instructions.
Consumption of drugs that are missed will only make the HIV virus grow faster and
worsen the condition of the sufferer.
Take medication immediately if you are taking medication for the sufferer
and keep following the next schedule. However, if the missed dose is quite large, talk
to your doctor immediately. The patient's condition also affects the appropriate
 prescription or dosage. Doctors can also replace it according to the patient's
condition. In addition, sufferers are also allowed to take more than 1 ARV drug in a
day.

G. How is HIV and AIDS nursing care

1. Assessment
a. Identity
Includes name, age, occupation, education, address, medical record
number, medical diagnosis, height, weight, upper arm
circumference.
b. Chief complaint
The most felt complaints by the patient, look weak and pale, cough
for more than 2 weeks, decreased appetite and there is stomatitis in
the mouth. Usually, HIV/AIDS patients will feel fever and diarrhea
continuously (Katiandagho, 2015).
c. History of current illness
The history of the disease experienced by the patient from the onset
of symptoms at home to treatment efforts at home until the patient is
taken to the hospital and explained the patient's complaints while in
the hospital. Usually patients complain of hypoxia, shortness of
breath, clubbing fingers, lymphadenopathy (Jauhar & Bararah,
2013).
d. Past medical history
In HIV/AIDS patients, the history of having been hospitalized with
different or the same disease was studied before. Previously, 48
patients complained of experiencing a weight loss of more than 10%,
fever, and cough for a long time. (Jauhar & Bararah, 2013). Review
treatment history of ARV drugs consisting of several groups such as
nucleoside reverse transcriptase inhibitors, nucleotide reverse
transcriptase inhibitors, non-nucleoside reverse transcriptase
inhibitors, and protease inhibitors (Yulrina & Lusiana, 2015).
e. Family history of illness
In HIV/AIDS patients, it is necessary to study whether the family
has the same HIV disease as the patient. It is also necessary to study
TB disease which can be transmitted to the patient and cause the
patient to be exposed to TB. Also review the history of hepatitis and
DM. Usually, HIV is transmitted from mother to child (Jauhar &
Bararah, 2013).
f. Psychosocial history
 Fear of revealing it to others, fear of rejection/loss of opinion.
Isolation and loneliness change in the interaction of family or close
people. Unorganized activities, changes in goal setting (Desmawati,
2013). Patients' perceptions of the conditions experienced are
different, some HIV/AIDS patients have knowledge about their
condition and carry out activities that support increasing endurance
by sleeping regularly, eating balanced and routine ARV consumption
which is influenced by coping strategies to the psychological
response of each patient (Nursalam & Ninuk, 2013).
g. Daily health pattern
1) Nutrition
In HIV patients, there is no appetite, changes in the ability to
recognize food, dysphagia, retrosternal pain when swallowing,
nausea or vomiting, and rapid weight loss.
2) Elimination
In HIV patients there is persistent diarrhea, often with or without
abdominal cramps. Pain in the pelvis when urinating feels like
burning. Watery stools with or without mucus or blood, thick
diarrhea, changes in the amount, color and characteristics of
urine.
3) Personal hygiene
Unable to complete activities of daily living.
4) Activity/rest
At rest there is a change in sleep patterns. Experiencing easy
fatigue, fatigue / malaise and reduced tolerance for activities in
daily life.
h. Physical examination
Physical examination in HIV/AIDS patients according to Desmawati
(2013) as follows :50
1) General condition
Covering the general condition of the client, the patient was
found to be weak, cooperative composmentis consciousness
until there was a decrease in consciousness, apathy,
somnolence, stupor to coma. TTV examination, normal blood
pressure, tachycardia pulse, increased respiratory rate, and
increased temperature.
2) Eye
There is a change in visual acuity. Anemic conjunctiva.
3) Nose
Nostril breathing occurs.
4) Ear
 The auditory is less clean due to the spread of disease.
5) Mouth
There are lesions in the oral cavity, a white membrane and
discoloration, the lips look pale/cyanotic. Poor dental or gum
health.
6) Neck
The jugular venous pressure is not elevated, the thyroid gland
is usually enlarged and nodules appear, and the lymph nodes
are enlarged.
7) Thorax: Lungs
Symmetrical chest movements, progressive shortness of breath,
tachypnea, and changes in adventitious breath sounds.
Abdomen Abdominal distension occurs, intestinal peristalsis
increases >25x/minute due to viruses that attack the intestines.
Pain in the abdomen.
8) Extremities
There is muscle weakness, decreased muscle mass and tremors,
numbness, tingling in the extremities and swelling of the joints.
9) Skin integrity
The skin color looks pale and there are itchy spots. Decreased
skin turgor, warm akral, if cold, alert, shock occurs. CRT
(Capilary Refil Time) > 2 seconds. Changes in skin integrity
(rash, discoloration, easy bruising that cannot be explained).
10) Genetalia
Presence of rectal or perianal lesions or abscesses. There is also
herpes, genital warts and an itchy inflammation in the anus and
there are spots or spots.

2. Diagnosa
Nursing diagnoses that appear in HIV/AIDS patients according to T.
Heather & Shigemi in NANDA (North Nursing Diagnosis Association NIC-
NOC, 2018) include:
a) Ineffective airway clearance related to pneumocystis carinii pneumonia
(PCP) increased bronchial secretions and decreased ability to cough
accompanying weakness and fatigue.
b) Activity intolerance related to fatigue, weakness, malnutrition, fluid
and electrolyte balance disorders.
c) Imbalanced nutrition less than body requirements related to inability to
eat.
d) Risk of infection b.d immunodeficiency.
 e) Knowledge deficiency b.d Lack of knowledge sources, lack of
information

3. Intervention
a) Nutrition management
1. Identify the patient's food allergies or intolerances
2. Instruct the patient regarding dietary needs for sick conditions
3. Determine the nutritional status of the patient and the patient's
ability to meet nutritional needs
b) Teaching:
Diet prescription
1. Assess the patient's current and previous eating patterns,
including preferred foods and current eating patterns
2. Instruct the patient to avoid forbidden foods and consume
permitted foods
3. Explain to the patient about the goals of adherence to the
recommended diet related to general health
4. Help the patient to choose his favorite food according to the
recommended diet
5. Involve patients and families

4. Implementation
Implementation is the processing and realization of a nursing plan that
has been prepared at the intervention/planning stage. Focus on nursing
interventions, among others, maintaining endurance, establishing client
relationships with the environment, implementing doctor's messages (Sri
Wahyuni, 2016). From the 3 journals that have been selected, it is found that
the implementation given to HIV/AIDS patients to overcome the problem of
knowledge deficiency about nutrition fulfillment is through education and
explanation.

5. Evaluation
Evaluation is an action used to find out or evaluate the extent to which
the success of care has been achieved and provide feedback on nursing care
that has been provided by nurses (Zaidin Ali, 2009). SOAP writing technique
 S (Subjective): information or response in the form of an expression
obtained from the client after getting the action.
 O (Objective): Information obtained based on the results of
observations, assessments, measurements made by nurses after the
action.
 A (Analysis): Comparing between subjective & objective information
with the objectives & results criteria which can then be concluded that
the problem is resolved, the problem is partially resolved, or the
problem is not resolved.
 P (Planning): Follow-up nursing plan that will be given based on the
results of the analysis.
 CHAPTER III
CLOSING

A. Conclusion
HIV is a virus that attacks the immune system which
further weakens the body's ability to fight infection and disease.
While AIDS is a condition where HIV is in the final stage of
infection. When a person has AIDS, the body no longer has the
ability to fight off the infection it causes.

B. Suggestion
The completion of this paper is inseparable from the many
shortcomings of its discussion due to various factors such as
limited time, thoughts and our limited knowledge, therefore for the
perfection of this paper we really need suggestions and
constructive input to all readers.