Assignment on HIV and AIDS

HIV and AIDS assignment.

1. HIV & AIDS

Introduction: Society is like a looking glass.Each and every
phenomenon in societyis very conspicuous and crystal clear
before us.Like many affairs and issues,the vulnerability of
HIV/AIDS patient is blatant and flagrant to us.In a complex and
complicated social fabrics AIDS is spreading by leaps and
bounds mainly because of sexual intercourse,coition and
copulation.As a result,it is noted that an astronomical and
massive change in behavioral cultural pattern in society.

What are HIV and AIDS?
HIV(Human immunodeficiency virus) is a virus that mostly
likely mateted decades ago from a virus that infected
chimpanzees to one that infects human.It began to spread
beyond the African continent in the Lat 1970 and is now
endemic worldwide.HIV causes disease because it attacks
critical immune defense cells and over time overwhelms the
immune system.

AIDS(Acquired immune deficiency syndrome)is a disease
that is incurable and in tricate in nature.If anybody is infected
and afflicated with this disease,the aftermath of him/her is sure
for death.Because of having this dire nature of the disease.I
tried to overhaul the social behavioral and cultural facts and
factors that are intimately associated with this fatal
disease.Besides,I postualted to comprehend and anticipated

2. behaviour that the infected recieve from the remaining social
setting in their way of life and livings.
Cause and symptoms:- Human immunodeficiency
virus(HIV) causes AIDS.This virus attacks the immune system
and leaves the body vulnerable to a variety of life
threatening infections and cancers.
Most common symptoms in men:
 body rash
 fever
 Sore throat
 severe headaches
Less common symptoms may include:
 fatigue
 ulcers in the mouth or on the genitals
 Muscle aches
 Joint pain
 nausea and vomiting
 Night sweats
Most common symptoms in Women:
 Diarrhea
 Nausea and vomiting
 weight loss
 severe headache
 Joint pain
 Muscle aches
 shortness of breath
 Chronic cough
 trouble swallowing

3. In the later stages, HIV can lead to:
 short-term memory loss
 mental confusion
 Coma
When should someone seek medical care for
HIV/AIDS?
All sexually active adults should know their HIV status and
should be tested for HIV routinely at least once. This is the
only way to know whether one is HIV infected. It is not
unusual for a person to get HIV from a person they never
knew could have HIV; again, most people with HIV do not
know it for years. Testing is important yearly or more often if
a person has risk factors for HIV. If someone has a history of
engaging in unprotected sex outside of a mutually
monogamous relationship (meaning both partners have sex
only with each other) or sharing needles while using drugs,
he or she should have an HIV test. Early testing, recognition
of the signs and symptoms of HIV infection, and starting
treatment for HIV as soon as possible can slow the growth of
HIV, prevent AIDS, and decrease the risk of transmission to
another person. If a woman is pregnant and infected with
HIV, she can greatly reduce the risk to her unborn child by
getting treatment.

What tests do health-care professionals use to
diagnose HIV/AIDS?

4. HIV infection is commonly diagnosed by blood tests.
Testing for HIV is usually a two-step process. First, a
screening test is done. If that test is positive, a second test
(Western blot) is done to confirm the result.
There are three common types of screening tests that use a
blood specimen:
1. HIV antibody tests;
2. a fourth-generation combination antibody/antigen test
that detects both antibodies and a piece of the virus called
the p24 antigen;
3. RNA tests (HIV RT PCR or viral load);
4. in addition, a blood test called a Western blot is necessary
to confirm the diagnosis.
**No test is perfect. Tests may be falsely positive or falsely
negative. **

What medications treat HIV/AIDS?
Many drugs have become available to fight both the HIV
infection and its associated infections and cancers. These drugs
have been called highly active antiretroviral therapy (HAART).
More commonly, they are simply referred to as ART. Although
these medications do not cure HIV/AIDS, ART has greatly
reduced HIV-related complications and deaths.

5. The earliest class of ART, reverse transcriptase inhibitor drugs,
inhibit the ability of the virus to make copies of itself. The
following are examples:
 Nucleoside or nucleotide reverse transcriptase inhibitors
(NRTIs): These include medications such as zidovudine
(AZT/Retrovir), didanosine (ddI/Videx), stavudine
(d4T/Zerit), lamivudine (3TC/Epivir), abacavir
(ABC/Ziagen), emtricitabine (FTC/Emtriva), tenofovir
(TDF/Viread), and tenofovir alafenamide (TAF).
 Combination NRTIs include tenofovir/emtricitabine
(TDF/FTC. Truvada), emtricitabine/tenofovir alafenamide
(TAF/FTC, Descovy), zidovudine/lamivudine (Combivir),
abacavir/lamivudine (Epzicom), and
abacavir/zidovudine/lamivudine (Trizivir).
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are
commonly used in combination with NRTIs to help keep the
virus from multiplying. Examples of NNRTIs are efavirenz
(Sustiva), nevirapine (Viramune), delavirdine (Rescriptor),
etravirine (Intelence), and rilpivirine (Edurant). Complete HIV
treatment regimens that combine two NRTIs and one NNRTI in
one pill taken once a day are available for convenience; these
include Atripla (efavirenz/emtricitabine/tenofovir) and
Complera (rilpivirine/emtricitabine/tenofovir).
Older PIs no longer commonly used due to pill burden and side
effects include lopinavir and ritonavir combination (Kaletra),
saquinavir (Invirase), indinavir sulphate (Crixivan),

6. fosamprenavir (Lexiva), tipranavir (Aptivus), and nelfinavir
(Viracept).
Fusion and entry inhibitors are agents that keep HIV from
entering human cells. Enfuvirtide (Fuzeon/T20) was the first
drug in this group and was given in injectable form like insulin.
Maraviroc (Selzentry) can be given by mouth and is used in
combination with other ARTs.

Follow-up:-
People with HIV infection should be under the care of a
physician who is experienced in treating HIV infection. This is
often an infectious-disease subspecialist, but may be a health-
care provider, such as an internal medicine or pediatric
specialist, who has special certification in HIV treatment. All
people with HIV should be counseled about avoiding the spread
of the disease. Infected individuals are also educated about the
disease process, and attempts are made to improve the quality
of their life.

Nursing Management:-
Nursing management includes identification of potential risk
factors,including a history of risky sexual practices or
IV/injection drug use.

7. *Nutritional status:- Nutritional status is assessed by
obtaining a diet history and identifying factors that may affects
the oral intake.
*Skin integrity:- The skin and mucous membranes are
inspected daily for evidence of breakdown,uncleration,or
infection.
*Respiratory Status:-Respiratory status is assessed by for
monitoring the patient for cough,sputum production,shortness
of breath,orthopnea,tachypnea,and chest pain.
*Neurologic status:- Neurologic status is determined by
assessting the level of consciousness;orientation to
person,pace,and time;and memory lapes.
*Fluide and eloctrolyte balance:-F & E status is assessed by
examining the skin and mucous membranes for turgor and
dryness.
*Knowledge level:-The patient’s level of knowledge about
the disease and the modes of disease transmission is evaluated.


Nursing Care Plans:-
There is no cure yet for either HIV or AIDS. However,
significant advances have been made to help patients control
signs and symptoms and impair disease progression.

8. Risk for Infection: At increased risk for being invaded by pathogenic
organisms.
Risk factors may include
 Inadequate primary defenses: broken skin, traumatized tissue,
stasis of body fluids
 Depression of the immune system, chronic disease, malnutrition;
use of antimicrobial agents
 Environmental exposure, invasive techniques
Possibly evidenced by
 Not applicable. A risk diagnosis is not evidenced by signs and
symptoms, as the problem has not occurred and nursing
interventions are directed at prevention.
Desired Outcomes:
 Achieve timely healing of wounds/lesions.
Nursing Interventions Rationale
Assess patient’s ability to
chew, taste, and swallow.
Lesions of the mouth, throat, and
esophagus (often caused by
candidiasis, herpes simplex, hairy
leukoplakia, Kaposi’s sarcoma
other cancers) and metallic or
other taste changes caused by
medications may cause dysphagia,
limiting patient’s ability to ingest
food and reducing desire to eat.
Auscultate bowel sounds.
Hypermotility of intestinal tract is
common and is associated with

9. vomiting and diarrhea, which may
affect choice of diet/route.
Lactose intolerance and
malabsorption (with CMV, MAC,
cryptosporidiosis) contribute to
diarrhea and may necessitate
change in diet or supplemental
formula.
Weigh as indicated. Evaluate weight
in terms of premorbid weight.
Compare serial weights and
anthropometric measurements.
Indicator of nutritional adequacy of intake.
Because of depressed immunity, some blood
tests normally used for testing nutritional
status are not useful.
Note drug side effects.
Medications used can have side effects
affecting nutrition. ZDV can cause altered
taste, nausea and vomiting; Bactrim can
cause anorexia, glucose intolerance and
glossitis; Pentam can cause altered taste and smell;
Protease inhibitors can cause elevated lipids, blood
sugar increase due to insulin resistance.
Plan diet with patient and include
SO, suggesting foods from home if
appropriate. Provide small, frequent
meals and snacks of nutritionally
dense foods and non acidic foods
and beverages, with choice of foods
palatable to patient. Encourage
high-calorie and nutritious foods,
some of which may be considered
appetite stimulants. Note time of
day when appetite is best, and try to
serve larger meal at that time.
Including patient in planning gives sense of
control of environment and may enhance
intake. Fulfilling cravings for noninstitutional
food may also improve intake. In this
population, foods with a higher fat content
may be recommended as tolerated to
enhance taste and oral intake.
Limit food(s) that induce nausea
and/or vomiting or are poorly
tolerated by patient because of
mouth sores or dysphagia. Avoid
Pain in the mouth or fear of irritating oral lesions
may cause patient to be reluctant to eat. These
measures may be helpful in increasing food intake.

10. serving very hot liquids and foods.
Serve foods that are easy to swallow
like eggs, ice cream, cooked
vegetables.
Schedule medications between
meals (if tolerated) and limit fluid
intake with meals, unless fluid has
nutritional value.
Gastric fullness diminishes appetite and food
intake.
Encourage as much physical activity
as possible.
May improve appetite and general feelings
of well-being.
Provide frequent mouth care,
observing secretion precautions.
Avoid alcohol-containing
mouthwashes.
Reduces discomfort associated with nausea
and vomiting, oral lesions, mucosal dryness,
and halitosis. Clean mouth may enhance
appetite and provide comfort.
Provide rest period before meals.
Avoid stressful procedures close to
mealtime.
Minimizes fatigue; increases energy available for
work of eating and reduces chances of nausea or
vomiting food.
Remove existing noxious
environmental stimuli or conditions
that aggravate gag reflex.
Reduces stimulus of the vomiting center in
the medulla.
Encourage patient to sit up for
meals
Facilitates swallowing and reduces risk of
aspiration.
Record ongoing caloric intake.
Identifies need for supplements or
alternative feeding methods.
Maintain NPO status when
appropriate.
May be needed to reduce nausea and
vomiting.
Insert or maintain nasogastric (NG)
tube as indicated.
May be needed to reduce vomiting or to
administer tube feedings. Esophageal
irritation from existing infection (Candida,
herpes, or KS) may provide site for
secondary infections and trauma; therefore,
NG tube should be used with caution.
Administer medications as indicated:-
 Antiemetics:
prochlorperazine
(Compazine), promethazine
Reduces incidence of nausea and vomiting,
possibly enhancing oral intake.

11. (Phenergan),
trimethobenzamide (Tigan)
 Sucralfate (Carafate)
suspension; mixture of
Maalox, diphenhydramine
(Benadryl), and
lidocaine (Xylocaine);
Given with meals (swish and hold in mouth)
to relieve mouth pain, enhance intake. Mixture
may be swallowed for presence of pharyngeal or
esophageal lesions.
 Vitamin supplements
Corrects vitamin deficiencies resulting from
decreased food intake and/or disorders of
digestion and absorption in the GI system.
Avoid megadoses and suggested
supplemental level is two times the
recommended daily allowance (RDA).
 Appetite stimulants:
dronabinol (Marinol),
megestrol (Megace),
oxandrolone (Oxandrin)
Marinol (an antiemetic) and Megace (an
antineoplastic) act as appetite stimulants in
the presence of AIDS. Oxandrin is currently
being studied in clinical trials to boost
appetite and improve muscle mass and
strength.
 TNF-alpha inhibitors:
thalidomide;
Reduces elevated levels of tumor necrosis
factor (TNF) present in chronic illness contributing
to wasting or cachexia. Studies reveal a mean
weight gain of 10% over 28 wk of therapy.
 Antidiarrheals:
diphenoxylate (Lomotil),
loperamide (Imodium),
octreotide (Sandostatin);
Inhibit GI motility subsequently decreasing
diarrhea. Imodium or Sandostatin are
effective treatments for secretory diarrhea
(secretion of water and electrolytes by
intestinal epithelium).
 Antibiotic therapy: ketoconazol
e (Nizoral),
fluconazole (Diflucan).
May be given to treat and prevent infections
involving the GI tract.
 Be afebrile and free of purulent drainage/secretions and
other signs of infectious conditions.

12.  Identify/participate in behaviors to reduce risk of
infection.
In this post, are 13 AIDS/HIV Positive Nursing Care Plans
(NCP):
1. Imbalanced Nutrition: Less Than Body Requirements
2. Fatigue
3. Acute/Chronic Pain
4. Impaired Skin Integrity
5. Impaired Oral Mucous Membrane
6. Disturbed Thought Process
7. Anxiety/Fear
8. Social Isolation
9. Powerlessness
10. Deficient Knowledge
11. Risk for Injury
12. Risk for Deficient Fluid Volume
13. Risk for Infection
14. Other Possible Nursing Care Plans
Imbalanced Nutrition:- Less Than Body
Requirements

Imbalanced Nutrition: Less Than Body Requirements: Intake of
nutrients insufficient to meet metabolic needs.
May be related to

13.  Inability or altered ability to ingest, digest and/or
metabolize nutrients: nausea/vomiting, hyperactive gag
reflex, intestinal disturbances, GI tract infections, fatigue
 Increased metabolic rate/nutritional needs
(fever/infection)
Possibly evidenced by
 Weight loss, decreased subcutaneous fat/muscle mass
(wasting)
 Lack of interest in food, aversion to eating, altered taste
sensation
 Abdominal cramping, hyperactive bowel sounds, diarrhea
 Sore, inflamed buccal cavity
 Abnormal laboratory results: vitamin/mineral and protein
deficiencies, electrolyte imbalances
Desired Outcomes
. Maintain weight or display weight gain toward desired goal.
. Demonstrate positive nitrogen balance, be free of signs of
malnutrition, and display improved energy level.

What Can People Do to Prevent an HIV Infection?
Despite significant efforts, there is no effective vaccine
against HIV. The only way to prevent infection by the virus is to

14. avoid behaviors that put one at risk, such as sharing needles or
having unprotected sex. Unprotected sex means sex without a
barrier such as a condom. Because condoms break, even they
are not perfect protection. Many people infected with HIV
don't have any symptoms and appear healthy. There is no way
to know with certainty whether a sexual partner is infected.
Here are some prevention strategies:
 Abstain from oral, vaginal, and anal sex. This obviously has
limited appeal, but it is the only 100% effective way to
prevent HIV.
 Have sex with a single partner who is known to be
uninfected. Mutual monogamy between uninfected
partners eliminates the risk of sexual transmission of HIV.
 Use a condom in other situations. Condoms offer some
protection if used properly and consistently. Occasionally,
they may break or leak. Only condoms made of latex
should be used. Only water-based lubricants should be
used with latex condoms; petroleum jelly dissolves latex.
 Use condoms the right way every time you have sex. Learn
the right way to use a male condom.
 Choose less risky sexual behaviors. Anal sex is the highest-
risk sexual activity for HIV transmission, especially for the
receptive partner (bottom). Oral sex is much less risky than
anal or vaginal sex. Sexual activities that don't involve
contact with body fluids (semen, vaginal fluid, or blood)
carry no risk of HIV transmission.

15.  Do not inject street drugs. When people are high, they're
more likely to have risky sex or share unsterile needles,
which increases the chance of getting or transmitting HIV.
 If you do inject drugs, never share your needles or works.
Use only sterile needles. You can get them at many
pharmacies without a prescription, or from community
needle-exchange programs. Use a new sterile needle and
syringe each time you inject. Clean used needles with full-
strength laundry bleach, making sure to get the bleach
inside the needle, soak at least 30 seconds (sing the
"happy birthday" song three times), and then flush out
thoroughly with clean water. Use bleach only when you
can't get new needles. Needles and syringes aren't
designed to be cleaned and reused, but it is better than
sharing uncleaned needles and works.
 Use sterile water to fix drugs.
 Clean skin with a new alcohol swab before injecting.
 Be careful not to get someone else's blood on your hands
or your needle or works.
 Dispose of needles safely after one use. Put them in an old
milk jug and keep used needles away from other people.
Pharmacies accept used needles in containers for safe
disposal.
 If you work in a health-care field, follow recommended
guidelines for protecting oneself against needle sticks and
exposure to contaminated fluids.

References:-

16. Google,Wikipedia.

Conclusion:-
It can be said that HIV/AIDS has done more harm than good
in terms of the lives it has taken, yet it catalyzed long-term
policies that are on track to improve the quality of life
compared to before HIV/AIDS. If only it did not take a crisis to
necessitate progress in equality (in terms of gender, healthcare,
etc.), governments worldwide would be far more responsible.
Even though they are drastically different, the United States
and South Africa handled the same crisis in a nearly identical
way, until the resources and development of the United States
overwhelmed the prevailing sense of prejudice and negligence
towards HIV/AIDS. Extrapolating on this idea, it is most likely
that if South Africa had the resources that the United States
did, treating HIV/AIDS would be a much smaller problem, as the
politics of the disease would fade into the background. Dr.
James Mason, the Director of the CDC during the HIV/AIDS
crisis, stated, “there are certain areas which, when the goals of
science collide with moral and ethical judgment, science has to
take a time out” (Francis 2012). Although this is a discouraging
claim, especially from the head of one of the most important
science departments in the world, it proved to be true. It is a
testament to the prejudice of the society at the time that
saving lives and preventing the spread of disease would be
considered immoral simply because of the nature of the lives

17. being saved. Choice, not ignorance, was the main factor at play
in the HIV/AIDS crisis.
*