The patient at 9 weeks' gestation has been told that her HIV test ...

[Deast7027]

The patient at 9 weeks' gestation has been told that her HIV test was positive. The patient is very upset and tells the nurse, I didn't know I had HIV What will this do to my baby? The nurse knows teaching has been effective when the patient states:
 
  1. I cannot take the medications that control HIV during my pregnancy because they will harm the baby.
  2. My baby will probably be born with anti-HIV antibodies, but that doesn't mean it is infected.
  3. The pregnancy will increase the progression of my disease and will reduce my CD4 counts.
  4. The HIV won't affect my baby, and I will have a low-risk pregnancy without additional testing.

Question 2

During her first antepartal visit, a patient who is at 10 weeks' gestation reports that she is HIV-positive. Which statement made by the patient indicates an understanding of the plan of care both during the pregnancy and postpartally?
 
  1. I'm supposed to take highly active antiretroviral therapy (HAART), but only during the first trimester.
  2. I should not breastfeed my baby.
  3. If I have a cesarean section, there's an increased risk that my HIV will be passed to my baby.
  4. When my baby is 2 months old, he or she will be tested for HIV.

[brittanywood]

Answer to Question 1

Correct Answer: 2
Rationale 1: Most of the medications that control HIV progression are safe to take during pregnancy. Antiretroviral medications are recommended during pregnancy to prevent perinatal transmission.
Rationale 2: Babies of HIV-positive women or women with AIDS are born with maternal anti-HIV antibodies. These antibodies clear over time, and an accurate test can be obtained by 15 months of age.
Rationale 3: There is no evidence to indicate that pregnancy increases the progression of HIV/AIDS.
Rationale 4: Pregnancy affected by HIV/AIDS is considered complicated, and the fetus is monitored closely. Fetal assessments include weekly nonstress tests beginning at 32 weeks.

Answer to Question 2

Correct Answer: 2
Rationale 1: Longer duration therapy is preferable to shorter duration approaches, and it is best to start prophylaxis after the first trimester and no later than 28 weeks' gestation in women who do not require immediate therapy for their own health.
Rationale 2: HIV transmission can occur during pregnancy and through breast milk; however, it is believed that the majority of all infections occur during labor and birth.
Rationale 3: Cesarean section reduces the transmission of HIV from mother to infant.
Rationale 4: Following birth, HIV infection in infants should be diagnosed using HIV virologic assays as soon as possible, with initiation of infant antiretroviral prophylaxis immediately if the test is positive.