A patient who is diagnosed with acquired immunodeficiency ...

[Jkov05]

A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the nurse, I feel obsessed with thoughts about dying. Do you think I am just being morbid? Which response by the nurse is best?
 
  a. Thinking about dying will not improve the course of AIDS.
  b. It is important to focus on the good things about your life now.
  c. Do you think that taking an antidepressant might be helpful to you?
  d. Can you tell me more about the kind of thoughts that you are having?

Question 2

A pregnant woman with a history of asymptomatic chronic human immunodeficiency virus (HIV) infection is seen at the clinic. The patient states, I am very nervous about making my baby sick.
 
  Which information will the nurse include when teaching the patient?
  a. The antiretroviral medications used to treat HIV infection are teratogenic.
  b. Most infants born to HIV-positive mothers are not infected with the virus.
  c. Because she is at an early stage of HIV infection, the infant will not contract HIV.
  d. It is likely that her newborn will become infected with HIV unless she uses antiretroviral therapy (ART).

[parker125]

Answer to Question 1

ANS: D
More assessment of the patient's psychosocial status is needed before taking any other action. The statements, Thinking about dying will not improve the course of AIDS and It is important to focus on the good things in life discourage the patient from sharing any further information with the nurse and decrease the nurse's ability to develop a trusting relationship with the patient. Although antidepressants may be helpful, the initial action should be further assessment of the patient's feelings.

Answer to Question 2

ANS: B
Only 25 of infants born to HIV-positive mothers develop HIV infection, even when the mother does not use ART during pregnancy. The percentage drops to 2 when ART is used. Perinatal transmission can occur at any stage of HIV infection (although it is less likely to occur when the viral load is lower). ART can safely be used in pregnancy, although some ART drugs should be avoided.