An adolescent patient is taking combination retroviral therapy ...

[tfester]

An adolescent patient is taking combination retroviral therapy for HIV infection. He is not responding as expected. Which action by the nurse is most appropriate?
 
  A.
  Asking why he does not take the medications
  B.
  Assessing the patient for noncompliance
  C.
  Consulting a pediatric social worker
  D.
  Starting a simpler drug regimen for the HIV

Question 2

An HIV-positive mother wants to return to work because she is feeling well after starting therapy for her disease. She has a 10-month-old infant.
 
  What does the nurse advise her when selecting a day care or care provider for her child, who also is HIV-positive?
  A.
  Assess their ability to use standard precautions and properly dispose of diapers.
  B.
  Do not disclose the nature of your baby's disease to the day-care providers.
  C.
  Find out their policy on allowing children who are sick to come to day care.
  D.
  Find out if they consistently wear gloves for all diaper changes they perform.

[TINA]

Answer to Question 1

ANS: A
Adolescents are notorious for wanting to fit in with their peers, even at the cost of their health, and are frequently noncompliant with medication regimens. This is compounded by the very complex nature of multi-drug therapy for HIV. The nurse needs to assess for noncompliance first. Asking why questions often puts people on the defensive and may not lead to a truthful response. Consulting a social worker may be needed, but not as the first step. Unfortunately, simple drug regimens for HIV do not exist.

Answer to Question 2

ANS: A
An important concept when caring for babies who are HIV-positive is that diaper changes must include using standard precautions and proper disposal of soiled diapers in biohazard bags and hazardous waste containers. To protect public safety, any day care or care provider the mother chooses must be educated on these procedures. Wearing gloves is not enough. The mother should disclose the baby's illness to protect the day-care workers. Keeping ill children away from her baby is important, too, and most day-care centers have specific guidelines about when sick children can attend. The mother should know these policies and advise the staff to keep her child away from other ill children. But the priority is proper disposal of waste.

[tfester]

Thanks for the timely response, appreciate it

[cpetit11]

TYSM