HIV EXPOSED BABIES .pptx

educative

1. CARE OF HIV/AIDS EXPOSED BABIES

2. INTRODUCTION Increasing number of newborns are born infected with HIV or are a risk for acquiring it in the early infancy period. Transmission during perinatal and newborn periods can occur ;across placenta, breast milk or contaminated blood. The risk of transmission can be decreased if the mothers take zidovudine during gestation.

3. Causes of mortality in HIV infected babies: Gram-negative sepsis Prematurity Most infants infected by maternal-fetal transmission suffer from severe immunodeficiency leading to rapid progression of HIV especially during the first year of life.

4. DIAGNOSIS: Testing by HIV deoxyriboneucleic acid (DNA) polymerase chain reaction(PCR) is the most preferred test (DNA-PCR). Results are available within the first 24 hours. Viral culture, but is more expensive . DNA PCR test is repeated when the infant is 1 month of age.

5. NB; DO NOT USE UMBILICAL CORD BLOOD FOR TESTING HIV. 3. p24 antigen test. Can be used if PCR or Viral culture test are unavailable. It assesses HIV infection status in infants older than 1 month. But it is less sensitive than the others. For infants with 3 negative- at birth, at 1 month and at 4 months of age are further tested using ,4. Virologic antibody tests and 5. Negative –specific IgG assay (ELISA) at 18 months of age to rule out HIV in exposed infants.

6. AZT( zidovudine ZDV) is started prophylactically 2mg/kg/dose PO in every 6 hours ie 4 times a day. If the infant is confirmed to be HIV positive, change the ZDV to ANTIRETRIVIRAL regimen. .

7. NURSING CARE MANAGEMENT: Nursing assessment and diagnosis; Most newborns exposed to HIV/AIDS are premature and therefore show failure to thrive. SIGNS AND SYMPTOMS include: Splenomegaly and Hepatomegaly. Swollen glands. Recurrent respiratory tract infections

8. Rhinorrhoea . Interstitial pneumonia Diarrhea and weight loss. Urinary system infections. Recurrent oral and genital candidiasis. Loss of developmental milestones.

9. NURSING DIAGNOSES; Altered nutrition less than body requirement related to inadequate intake. Risk for impaired skin integrity related to chronic diarrhea. Risk for infection related to perinatal exposure to HIV/ AIDS . Impaired physical mobility related to decreased neuromuscular development.

10. IMPLEMENTATIONS: Use standard precautions when caring for the newborn immediately after birth till all maternal blood is removed. Keep babies well nourished and protected from opportunistic infections to facilitate growth and development. Wear gloves when changing and cleaning diaper area especially in presence of diarrhoea coz blood may be in the stool. Skin care to prevent rashes.

11. Home based care; Hand hygiene before handling a newborn at risk of AIDS. Proper nutrition to avoid failure to thrive and weight loss. Weigh the baby 3times a week Health education on signs of feeding intolerance e.g. increasing regurgitation, abdominal distension, loose stool as well as of infection especially oral thrush. Administer fluids and antipyretics to manage fever. Irritability is the first sign of fever. Administer topical mycostatin for diaper rashes and oral mycostatin for oral thrush. Baby should have his or her own skin care items e.g. towels, soap, washing clothes.

12. 6. Routine immunization but avoid the live polio vaccine. 7. Keep toys as clean as possible and free from sharp edges. 8.Emotional support for the family coz of the stress and social isolation. 9. Parent should hold the baby gently during feeding. 10. The nurse should offer information to the family about support groups, counseling and information resources. 11. Provide therapeutic information about HIV disease to the family.

13. 12. Infants of infected mothers are given ARV drug therapy such as Zidovudine (AZT) beginning 8-12 hours of life till 6 weeks. 13. All infants born of HIV-infected mothers require regular clinical, immunologic and virologic monitoring. At 1 month, they are done physical exam + developmental assessment, compete blood count including: CD4+ count, platelet count. 14. Prophylaxis for pneumonia should be adm to all infants born of HIV –infected women, 4-6 weeks of age regardless of their CD4+ lymphocyte count

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