CALAMBA DOCTORS' COLLEGE

Virborough Subdivision Brgy. Parian Calamba, Laguna

Bachelor of Science in Nursing

NAME: PATRICIA CALADO

YEAR/SECTION: BSN 4C

HIV/AIDS

According to Center for Disease Control and Prevention (CDC), HIV (human immunodeficiency virus) is
a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired
immunodeficiency syndrome). It is spread by contact with certain bodily fluids of a person with HIV, most
commonly during unprotected sex (sex without condom or HIV medicine to prevent or treat HIV) or through
sharing injection drug equipment.

The Incubation period of the disease is from HIV infection until development of AIDS. It is from a few
months to 10 years or even more.

STAGE 1 Acute HIV infection (symptomatic)

- Begins about a couple of weeks to a month after becoming infected

- Can spread to others
- Viral load is very high in the blood

STAGE 2 Chronic HIV infection (asymptomatic)

- Signs & symptoms may disappear

- Lower viral load but virus is still active
- People may not have any symptoms or get sick during this phase but can transmit HIV.
- People who take HIV treatment as prescribed may never move into Stage 3 (AIDS).
- Without HIV treatment, this stage may last a decade or longer, or may progress faster. At the end of
this stage, the amount of HIV in the blood (viral load) goes up and the person may move into Stage 3
(AIDS).

STAGE 3 Acquired Immunodeficiency Syndrome (AIDS)

- The most severe stage of HIV infection.

- People with AIDS can have a high viral load and may easily transmit HIV to others.
- People with AIDS have badly damaged immune systems. They can get an increasing number of
opportunistic infections or other serious illnesses.
- Without HIV treatment, people with AIDS typically survive about three years.

AIDS

• Fatal illness caused by a retrovirus HIV

• It breaks down the body’s immune system, leaving the patient vulnerable to a host of life threatening
opportunistic infections, neurological disorders or unusual malignancies.

Mode of Transmission

Fluids that can transmit HIV (these are listed from MOST infectious fluid to LEAST infectious fluid.

- Blood
- Sexual contact
- During pregnancy

Methods of Transmission

- Blood (virus must be present in the blood)

❖ Needle sharing -IV drug use
❖ Piercing
❖ Tattoo
❖ Transfusion
- Sexual
❖ Oral, vaginal, and anal
- Pregnancy
 CALAMBA DOCTORS' COLLEGE
Virborough Subdivision Brgy. Parian Calamba, Laguna
Bachelor of Science in Nursing

HIV/AIDS is NOT transmitted through

- Saliva, sweat, tears, or closed mouth kissing

- Sharing toilets, Food, or drinks
- Air or water
- Insect or pet bites

Clinical Manifestations

- Most people have flu-like symptoms within 2 to 4 weeks after infection. Symptoms may last for a few
days or several weeks.
- Having these symptoms alone doesn’t mean you have HIV. Other illnesses can cause similar symptoms.
- Some people have no symptoms at all. The only way to know if you have HIV is to get tested.

There are three types of human immunodeficiency virus (HIV) tests used to diagnose HIV infections, which are

Antibody tests: These tests check for HIV antibodies in the blood or oral fluid.

Antigen/antibody tests: These help to detect both HIV antibodies and antigens in the blood.

Nucleic acid tests: These look for HIV in the blood.

Pathognomonic Sign

According to National Institutes of Health, the pathognomonic feature of HIV is the progressive
reduction in the CD4+ T cells, leading to the destruction of both cell-mediated and antibody-mediated immune
mechanisms.

The World Health Organization (WHO) classifies human immunodeficiency virus (HIV) into 3 stages

Stage 1 (HIV infection): The CD4+ cell count is at least 500 cells per microliter.

Stage 2 (HIV infection): The CD4+ cell count is 350 to 499.

Stage 3 (Acquired immunodeficiency syndrome (AIDS): The CD4+ cell count is less than 200.

The normal CD4+ cell count should be between 500 and 1600 cells per microliter. The higher the CD4+ cell
count, the lower the chances of opportunistic diseases.
 CALAMBA DOCTORS' COLLEGE
Virborough Subdivision Brgy. Parian Calamba, Laguna
Bachelor of Science in Nursing

Pathophysiology

Human Immunodeficiency virus (HIV) attacks the cells of the immune system. The CD4+ cells help the
body to resist any infections. With a lack of these cells, the body is less resistant, which makes it vulnerable to
other infections and diseases. HIV spreads mainly via body fluids (blood and semen) from the infected person.

Diagnostic Procedures

Antiretroviral therapy (ART) - is a combination of medications used to treat HIV (human immunodeficiency
virus). It works by stopping HIV from reproducing. It can reduce your levels of HIV and keep your immune
system healthy.

Oral PrEP – PrEP(Pre-Exposure Prophylaxis) is for people who don't have HIV and are at risk of getting HIV
from sex or injection drug use.

Nursing Diagnosis: Disturbed Body Image related to altered self perception

Nursing intervention:

• Assess factors that contribute to perceptions of disturbed body image.

❖ Meticulous assessment of factors and psychological issues can help identify patients who are at
risk for developing disturbed body image due to a permanent condition.
• Observe the patient’s description of self.
❖ Listen to the patient talk about their body and self and observe for positive and negative
comments and how they believe others perceive them.
• Allow the patient to express emotions and feelings.
❖ Expression of feelings and emotions relieves anxiety and reduces depressive behavior. It also
helps nurses better understand what the patient is going through.
• Provide education and support.
❖ Patients with HIV infection often feel rejected or stigmatized by society. Provide support to the
patient about their disease and educate them that patients can live normal lives with treatment.
• Interact as you would with any other patient.
❖ Patients can sense if a healthcare provider is judgmental or stereotyping them. Patients with
HIV deserve the same care and interaction as all patients. Contact with a patient with HIV does
not require anything beyond standard precautions and the nurse must educate themselves if
they recognize feelings of assumption or prejudice.
• Encourage support groups.
❖ Social support is important in learning to live with HIV. Encourage the patient to interact with
others who are HIV positive by joining online groups and community programs to gain
confidence and recognize their diagnosis does not define them.
 CALAMBA DOCTORS' COLLEGE
Virborough Subdivision Brgy. Parian Calamba, Laguna
Bachelor of Science in Nursing

Nursing Diagnosis: Ineffective Protection related to HIV infection

The decreased number of CD4 cells depresses immune function, causing the patient to be at higher risk of
acquiring infection.

Nursing Intervention:

• Observe standard precautions.

❖ When starting IVs or performing invasive procedures, adhere to aseptic or sterile techniques to
prevent the transmission of pathogens.
• Provide meal planning with high-calorie and high-protein foods.
❖ HIV experience wasting syndrome, especially with the progression to AIDS. Once muscle and
fat are lost, it’s difficult to regain. Providing high-calorie and high-protein foods will help replace
lost fat, muscle, and nutrients.
• Administer antimicrobials and antifungals.
❖ Patients may require prophylactic antibiotics and antifungals against opportunistic infections
when CD4 counts become suboptimal.
• Referrals to community resources.
❖ HIV’s devastating effects on the socioeconomic status of the patient can be addressed by
linking them to social services, free health clinics, financial services, food banks, and more.
• Encourage proper hygiene.
❖ Bathing and oral hygiene are essential to prevent the development of oral thrush and skin
rashes and sores that can occur with HIV and AIDS.

Nursing Diagnosis: Imbalanced Nutrition related to difficulty swallowing

HIV infection affects the body’s ability to effectively absorb nutrients due to various infections. Malabsorption,
altered metabolism, and weight loss caused by loss of appetite and mouth ulcers are common in patients with
HIV infection.

Nursing intervention:

• Assess the patient’s potential barriers to eating.

❖ HIV patients often develop lesions in the mouth and throat caused by infections like candidiasis,
limiting the patient’s ability to chew, swallow and ingest food.
• Determine previous weight before HIV diagnosis.
❖ Early wasting in patients with HIV cannot be determined by normal weight-to-height charts. It
is vital to determine the pre-diagnosis weight and current weight to determine muscle wasting
and assess nutritional needs.
• Educate the patient about the side effects of the current medication regimen.
❖ Drug therapy for HIV often causes altered taste, anorexia, nausea, and vomiting.
• Provide an environment conducive to eating.
❖ Ensure uninterrupted mealtimes, provide small frequent meals and snacks, and remove noxious
odors to help improve appetite and promote nutritional intake.
• Encourage oral hygiene.
❖ Patients with HIV infection often develop mouth sores, disrupting the patient’s ability to eat.
Good oral hygiene can enhance appetite and promote a desire to eat.
• Administer medications as indicated.
❖ Antiemetics administered before meals can help reduce nausea and vomiting and promote
appetite. Appetite stimulants may also be prescribed to enhance appetite.
• Consult with a dietitian.
❖ Collaborating with a dietitian ensures the formulation of a nutritionally balanced diet that
prevents nutrient deficiencies in patients with HIV.