DOCUMENTATION

IN
NURSING COMPETENCY
APPRAISAL

SUBMITTED TO:

JUNAH C. VILLANUEVA,RN,MAN

SUBMITTED BY:

RLE GROUP 2-C

ALIGAGA, MICHELLE VALERIE JALANDONI, DAHLIN ACE

APOLONIO, EIA SOFIA LIBAR, JUDITH IRIS

BOTEJA, LLANIE MALONES, ANGEL MAE

CATACUTAN, JOHN MARL PALOMAR PATRICIA ANNE

DINSON, AIRA ROSE SUMBILLO, KAREN

DELEÑA, SAMMY BOY SUPEÑA, THOMAS BENROE

GENTURO, NOCEILE GRACE VILLODRES, MANUEL

Complications

Patients with HIV disease may have disease-related endocrine problems, such as gonadal
dysfunction, body shape changes, adrenal insufficiency, diabetes mellitus, and elevated
triglycerides and cholesterol.

Opportunistic Infections common with HIV

Candidiasis. This is a common fungal infection that’s also known as thrush. It can be treated
with antifungal medications after a simple visual examination.

Coccidioidomycosis. This common fungal infection can lead to pneumonia if left untreated.

Cryptococcosis. This fungal infection often enters through the lungs. It can quickly spread to
the brain, often leading to cryptococcal meningitis. Left untreated, this fungal infection is often
fatal.

Cryptosporidiosis. This diarrheal disease often becomes chronic. It’s characterized by severe
diarrhea and abdominal cramping.

Cytomegalovirus. This common global virus affects most adults during their lifetime. It often
presents with eye or gastrointestinal infections.

HIV-related encephalopathy. This is often referred to as HIV-related dementia. It can be

defined as a degenerative brain condition that affects people with CD4 counts of less than 100.

Herpes simplex (chronic) and herpes zoster. Herpes simplex produces red, painful sores
that appear on the mouth or genital area. Herpes zoster, or shingles, presents with painful
blisters on skin surfaces. While there is no cure for either, medications are available to alleviate
some symptoms.

Histoplasmosis. This environmental fungal infection is commonly treated with antibiotics.

Isosporiasis. This is a parasitic fungus. It develops when people drink or come into contact
with contaminated food and water sources. It’s currently treated with antiparasitic drugs.

Mycobacterium avium complex. This is a type of bacterial infection. It often presents in

people with severely compromised immune systems (CD4 cell counts of less than 50). If these
bacteria enter the bloodstream, it often results in death.

Pneumocystis carinii pneumonia (PCP). This OI is currently the leading cause of death in
people living with HIV. Careful monitoring and antibiotic therapies are currently used to treat
the person following diagnosis.

Chronic pneumonia. Pneumonia is an infection in one or both lungs. It can be caused by

bacteria, viruses, or fungi.

Progressive multifocal leukoencephalopathy (PML). This neurological condition often

affects people with CD4 cell counts below 200. While there is no current treatment for this
disease, some response has been shown with antiretroviral therapies.

Toxoplasmosis. This parasitic infection commonly strikes people with CD4 cell counts below
200. Prophylaxis treatments are used as a preventive measure for people posting low CD4 cell
counts.

Tuberculosis. This disease is most common in low-income areas of the world. It can be
successfully treated in most cases if caught early.

Wasting syndrome (HIV-related). This OI causes a total weight loss of more than 10
percent of your normal body weight. Treatment involves dietary management and continued
antiretroviral therapy.
Kaposi’s sarcoma. This form of cancer often presents with either oral lesions or lesions
covering the skin surfaces. Current treatments include radiation and chemotherapy to shrink the
tumors. Antiretroviral therapy is also used to boost the body’s CD4 cell count.

Lymphoma. A variety of cancers frequently present in people living with HIV. Treatment will
vary based upon the person’s cancer type and health condition.

Cervical cancer. Women living with HIV are at greater risk of developing cervical cancer. An
impaired immune system presents challenges associated with treating this form of cancer.

HIV Transmission

HIV-1 is transmitted in body fluids containing HIV and/or infected CD4+ T lymphocytes. These
fluids include blood, seminal fluid, vaginal secretions, amniotic fluid, and breast milk. These
fluids must come in contact with a mucous membrane or damaged tissue or be directly injected
into the bloodstream (from a needle or syringe) for transmission to occur. Mucous membranes
are found inside the rectum, vagina, penis, and mouth.

HIV is spread mainly by:

 Having anal or vaginal sex with someone who has HIV without using a condom or taking
medicines to prevent or treat HIV.
 For the HIV-negative partner, receptive anal sex (bottoming) is the highest-risk sexual
behavior, but you can also get HIV from insertive anal sex (topping).
 Either partner can get HIV through vaginal sex, though it is less risky for getting HIV
than receptive anal sex.
 Sharing needles or syringes, rinse water, or other equipment (works) used to prepare
drugs for injection with someone who has HIV. HIV can live in a used needle up to 42
days depending on temperature and other factors.

Less commonly, HIV may be spread

 From mother to child during pregnancy, birth, or breastfeeding. Although the risk can be
high if a mother is living with HIV and not taking medicine, recommendations to test all
pregnant women for HIV and start HIV treatment immediately have lowered the number
of babies who are born with HIV.
 By being stuck with an HIV-contaminated needle or other sharp object. This is a risk
mainly for health care workers.

In extremely rare cases, HIV has been transmitted by

 Oral sex—putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus
(rimming). In general, there’s little to no risk of getting HIV from oral sex. But
transmission of HIV, though extremely rare, is theoretically possible if an HIV-positive
man ejaculates in his partner’s mouth during oral sex. To learn more about how to lower
your risk, see CDC’s Oral Sex and HIV Risk.
 Receiving blood transfusions, blood products, or organ/tissue transplants that are
contaminated with HIV. This was more common in the early years of HIV, but now the
risk is extremely small because of rigorous testing of the US blood supply and donated
organs and tissues.
 Eating food that has been pre-chewed by an HIV-infected person. The contamination
occurs when infected blood from a caregiver’s mouth mixes with food while chewing.
The only known cases are among infants.
 Being bitten by a person with HIV. Each of the very small number of documented cases
has involved severe trauma with extensive tissue damage and the presence of blood.
There is no risk of transmission if the skin is not broken.
 Contact between broken skin, wounds, or mucous membranes and HIV-infected blood
or blood-contaminated body fluids.
  Deep, open-mouth kissing if both partners have sores or bleeding gums and blood from
the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is
not spread through saliva.

Risk factors

When HIV/AIDS first appeared in the United States, it mainly affected men who had sex
with men. However, now it's clear that HIV also spreads through heterosexual sex.

Anyone of any age, race, sex or sexual orientation can be infected. However, you're at
greatest risk of HIV/AIDS if you:

 Have unprotected sex. Use a new latex or polyurethane condom every time you
have sex. Anal sex is more risky than is vaginal sex. Your risk of HIV increases if
you have multiple sexual partners.

 Have an STI. Many STIs produce open sores on your genitals. These sores act
as doorways for HIV to enter your body.

 Use intravenous drugs. People who use intravenous drugs often share needles
and syringes. This exposes them to droplets of other people's blood.

 Are an uncircumcised man. Studies suggest that lack of circumcision increases

the risk of heterosexual transmission of HIV.

The symptoms of HIV and AIDS vary, depending on the phase of infection.

Primary infection (Acute HIV)

Most people infected by HIV develop a flu-like illness within a month or two after the
virus enters the body. This illness, known as primary or acute HIV infection, may last for
a few weeks. Possible signs and symptoms include:

 Fever

 Headache

 Muscle aches and joint pain

 Rash

 Sore throat and painful mouth sores

 Swollen lymph glands, mainly on the neck

These symptoms can be so mild that you might not even notice them. However, the
amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the
infection spreads more easily during primary infection than during the next stage.
Clinical latent infection (Chronic HIV)

In some people, persistent swelling of lymph nodes occurs during this stage. Otherwise, there
are no specific signs and symptoms. HIV remains in the body and in infected white blood cells.

This stage of HIV infection generally lasts around 10 years if you're not receiving antiretroviral
therapy. But sometimes, even with this treatment, it lasts for decades. Some people develop
more severe disease much sooner.

Symptomatic HIV infection

As the virus continues to multiply and destroy your immune cells — the cells in your body that
help fight off germs — you may develop mild infections or chronic signs and symptoms such as:

 Fever

 Fatigue

 Swollen lymph nodes — often one of the first signs of HIV infection

 Diarrhea

 Weight loss

 Oral yeast infection (thrush)

 Shingles (herpes zoster)

Progression to AIDS

Thanks to better antiviral treatments, most people with HIV in the U.S. today don't develop
AIDS. Untreated, HIV typically turns into AIDS in about 10 years.

When AIDS occurs, your immune system has been severely damaged. You'll be more likely to
develop opportunistic infections or opportunistic cancers — diseases that wouldn't usually
trouble a person with a healthy immune system.

The signs and symptoms of some of these infections may include:

 Soaking night sweats

 Recurring fever

 Chronic diarrhea

 Persistent white spots or unusual lesions on your tongue or in your mouth

 Persistent, unexplained fatigue

 Weight loss

 Skin rashes or bumps

REFERENCES:

Smeltzer, S., Bare, B., Hinkle, J., Cheever K, Textbook of Medical Surgical Nursing

Ignativitius., Workman., Medical-Surgical Nursing, Patient-Centered Collaborative Care, 7 th

Edition

Retrieved from: https://www.healthline.com/health/hiv-aids/most-dangerous-complications-of-

hiv#staying-healthy

https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/how-is-hiv-transmitted