 Description

 Nursing Interventions
Compiled By: Chedan B. C.
BSN 4, SLU-CON
B.C., Phils.
 References:
 Johnson, Joyce Y. Brunner & Suddarth’s Textbook of Medical-Surgical
Nursing (11th ed.). Philadelphia: Lippincott Williams & Wilkins, 2008.
 Bartlett, John G. "Acquired Immunodeficiency Syndrome."
Microsoft® Encarta® 2009 [DVD]. Redmond, WA: Microsoft
Corporation, 2008.
 All information contained in this compilation is intended only as a
guide (especially for student nurses) regarding nursing
interventions for patients suffering AIDS. Relevant pictures that
are included here were taken from an acknowledged source.
References, as presented above, may be utilized for further
readings. By virtue of the saying “Knowledge is Power,” this
compilation was therefore created.
-
C.B.C.
Description
 defined as the most severe form of a
continuum of illnesses associated with
human immunodeficiency virus (HIV)
infection
 HIV: belongs to a group of viruses known
as RETROVIRUSES (type of viruses that
carry their genetic material in the form of
ribonucleic acid [RNA] rather than
deoxyribonucleic acid [DNA]. [Picture taken from
Encarta Encyclopedia]
Human Immunodeficiency Virus
The human immunodeficiency virus (HIV)
principally attacks CD4 T-cells, a vital part of
the human immune system. As a result, the
body’s ability to resist opportunistic viral,
bacterial, fungal, protozoal, and other
infection is greatly weakened. [Picture taken from Encarta
Encyclopedia]
T-Lymphocyte Infected With
HIV
By infecting CD4 T-
lymphocytes, a type of white
blood cell, HIV weakens the
immune system and leaves
the infected individual open to
deadly infections. The viruses
gain access to a T-lymphocyte
by attaching to CD4 proteins
on the outer surface of the cell
membrane.
Microsoft ® Encarta ®
2009. © 1993-2008
Microsoft Corporation. All
rights reserved.
Pneumocystis carinii pneumonia is the
leading cause of death among people with
HIV infection, but the incidence of certain
types of cancers such as B-cell lymphomas
and Kaposi’s sarcoma is also increased.
Neurological complications and dramatic
weight loss, or “wasting,” are characteristic
of endstage HIV disease (AIDS). HIV can be
transmitted sexually; through contact with
contaminated blood, tissue, or needles;
and from mother to child during birth or
breastfeeding. Full-blown symptoms of
AIDS may not develop for more than 10
years after infection.
According to Johnson (2008), B-cell
lymphomas, such as non-Hodgkin’s
lymphoma, are the second most
common AIDS-related cancer (the
first is Kaposi’s Sarcoma). They
develop outside the lymph nodes
(mostly in the brain, bone marrow,
and GIT), grow aggressively, affect
multiple organs, and exhibit
resistance to treatment, which may
be complicated by severe
hematologic toxicity.
According to Microsoft Encarta
(2009), Kaposi’s sarcoma is a rare
type of cancer of vascular tissue in
the skin or internal organs. A more
aggressive form occurs in about one-
third of patients with acquired
immunodeficiency syndrome (AIDS),
primarily in homosexual or bisexual
men. According to the American
Cancer Society, Kaposi’s Sarcoma
causes or contributes to death in
perhaps 30 percent of AIDS cases.
Magic Johnson
Earvin Johnson, who played his entire National
Basketball Association (NBA) career with the
Los Angeles Lakers, earned the nickname
Magic after an extraordinary performance in a
high school game. Johnson was named NBA
most valuable player in 1987, 1989, and 1990.
In 1991 Johnson learned that he had been
infected with the virus that causes acquired
immunodeficiency syndrome (AIDS), and he
started an educational campaign to raise
awareness of the disease.
Microsoft ® Encarta ® 2009. © 1993-
2008 Microsoft Corporation. All rights
reserved.
Greg Louganis
American diver Greg Louganis is seen
here in the pike position during the 3-
meter springboard competition at the
1987 Pan American Games. His
victory in this event was one of his
many triumphs during the 1980s,
when he dominated international
diving. He also won the springboard
and platform diving events at the
Olympic Games in both 1984 and
1988. In 1993 he appeared in the
Broadway play Jeffrey. Two years
later his memoir Breaking the Surface
was published, and in it he revealed
that he suffered from acquired
immunodeficiency syndrome (AIDS).
Microsoft ® Encarta ® 2009. ©
1993-2008 Microsoft Corporation.
Nursing Interventions
 Assess respiratory status, mental status,
and skin color at least daily.
 Note and document presence of cough
and quantity and characteristics of
sputum; send specimen for analysis as
ordered.
 Encourage adequate rest (this minimizes
energy expenditure and prevents
fatigue).
 Provide pulmonary therapy, such as
coughing, deep breathing, postural
drainage, percussion, and vibration,
every 2 hours (this prevents stasis of
 Assist patient into a position (high- or
semi-Fowler’s) that facilitates breathing
and airway clearance.
 Evaluate fluid volume status; encourage
intake up to 3 liters daily.
 Provide humidified oxygen, suctioning,
intubation, and mechanical ventilation as
necessary. [Picture taken from Encarta Encyclopedia]
 Assess skin and oral mucosa for changes
in appearance, location and size of lesions,
and evidence of infection and breakdown;
encourage and reinforce regular oral care.
 Keep bed linen free of wrinkles, and avoid
tight or restrictive clothing to reduce skin
friction. [Picture taken from Encarta Encyclopedia]
 Advise patients with foot lesions to wear
white cotton socks and shoes that do not
cause feet to perspire.
 Encourage patient to avoid scratching, to
use nonabrasive, and nondrying soaps ,
and to use nonperfumed skin moisturizes
on dry skin; administer antipruritic agents,
antibiotic medication, analgesics,
medicated lotions, ointments, and
dressings as prescribed; avoid excessive
use of tape.
 Encourage patient to balance rest and
mobility whenever possible; assist
 Assess perianal region for impaired skin
integrity and infection.
 Instruct patient to keep the area as clean
as possible, to cleanse after each bowel
movement, to use sitz bath or irrigation,
and to dry the area thoroughly after
cleaning.
 Assist debilitated patients in maintaining
hygienic practices.
 Promote healing with prescribed topical
ointments and lotions.
 Assess bowel patterns for diarrhea
(frequency and consistency of stool, pain
or cramping with bowel movements).
 Assess factors that increase frequency of
diarrhea.
 Measure and document volume of liquid
stool as fluid volume loss.
 Counsel about ways to decrease diarrhea
(rest bowel, avoid foods that act as bowel
irritants, including raw fruits and
vegetables; encourage small, frequent
feedings.
 Administer ordered medications:
anticholinergic antispasmodics, antibiotics,
antifungal agents.
 Monitor lab values indicating presence of
infection such as white blood cell count
and differential.
 Maintain strict aseptic technique for
invasive procedures.
 Instruct patient and caregivers to monitor
for signs and symptoms of infection.
Strongly urge patients and sexual partners
to avoid exposure to body fluids and to
use condoms for any sexual activities.
 Strongly discourage IV/injection drug use
because of risk to patient of other
infections and transmission of HIV
 Assess patient for quality and severity of
pain, along with exacerbating and
relieving factors.
 Encourage to use soft cushions or foam
pads while sitting and topical anesthetics
or ointments as prescribed.
 Administer NSAIDs as ordered. Use also
nonpharmacologic approaches like
relaxation techniques.
 Administer TCAs as prescribed and
recommend elastic stockings as ordered in
dealing with neuropathic pain.
 Assess weight, dietary intake,
anthropometric measurements, serum
albumin, BUN, protein, and transferrin
level.
 Instruct about ways to supplement
nutritional value of meals (eg, add eggs,
butter, milk).
 Encourage oral hygiene before and after
meals.
 Encourage rest before meals; do not
schedule meals after painful or unpleasant
 Monitor ability to ambulate and perform
ADLs.
 Assist in planning daily routines to
maintain balance between activity and
rest.
 Educate about energy conservation
techniques like sitting while washing or
preparing a meal.
 Help decrease anxiety that contributes to
weakness and fatigue by using measures
such as relaxation and guided imagery.
 Assess for alterations in mental status.
 Reorient to person, place, and time as
necessary; maintain and post a regular
daily schedule.
 Give [clear] instructions, and instruct
family to speak to patient, in a slow,
simple, and clear manner.
 Provide night lights for bedroom and
bathroom as necessary.
 Help patients explore and identify
resources for support and mechanisms for
coping.
 Encourage patient to maintain contact
with family, friends, and coworkers and to
continue usual activities whenever
possible.
 Encourage to use local or national AIDS
support groups.