The nurse will most likely prepare a medication teaching plan ...

[CORALGRILL2014]

The nurse will most likely prepare a medication teaching plan about antiretroviral therapy (ART) for which patient?
 
  a. Patient who is currently HIV negative but has unprotected sex with multiple partners
  b. Patient who was infected with HIV 15 years ago and now has a CD4+ count of 840/L
  c. HIV-positive patient with a CD4+ count of 160/L who drinks a fifth of whiskey daily
  d. Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV) retinitis

Question 2

A patient who is human immunodeficiency virus (HIV)-infected has a CD4+ cell count of 400/L. Which factor is most important for the nurse to determine before the initiation of antiretroviral therapy (ART) for this patient?
 
  a. HIV genotype and phenotype
  b. Patient's social support system
  c. Potential medication side effects
  d. Patient's ability to comply with ART schedule

[flannelavenger]

Answer to Question 1

ANS: D
CMV retinitis is an acquired immunodeficiency syndrome (AIDS)-defining illness and indicates that the patient is appropriate for ART even though the HIV infection period is relatively short. An HIV-negative patient would not be offered ART. A patient with a CD4+ count in the normal range would not typically be started on ART. A patient who drinks alcohol heavily would be unlikely to be able to manage the complex drug regimen and would not be appropriate for ART despite the low CD4+ count.

Answer to Question 2

ANS: D
Drug resistance develops quickly unless the patient takes ART medications on a strict, regular schedule. In addition, drug resistance endangers both the patient and the community. The other information is also important to consider, but patients who are unable to manage and follow a complex drug treatment regimen should not be considered for ART.