In addition to highly active antiretroviral therapy (HAART), a ...

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In addition to highly active antiretroviral therapy (HAART), a client with HIV demonstrates a need for antidepressant medication.
 
  The nurse understands that the client's diagnosis of HIV and HAART will have what effect on the client's planned antidepressant regimen?
 
  A) The client will require a higher initial dose (bolus) in order to achieve therapeutic effect.
  B) The client will begin with a lower dose and increase it more slowly than in other clients of his or her age.
  C) Antidepressant therapy is likely to be contraindicated while the client is receiving HAART.
  D) The client will require higher doses than an otherwise healthy individual because HAART inhibits the pharmacokinetics of psychotropic drugs.

Question 2

The nurse is working with a client who was found to be seropositive a few days earlier, and the nurse is currently planning the client's care.
 
  In the client's present and future care, which of the following nursing diagnoses is best addressed within the context of a community support group for people with HIV/AIDS? (Select all that apply.)
 
  A) Hopelessness related to deterioration of physical condition due to HIV/AIDS
  B) Disturbed Thought Processes related to neurological changes secondary to HIV/AIDS
  C) Imbalanced Nutrition, Less Than Body Requirements, related to loss of appetite secondary to HIV/AIDS
  D) Impaired Social Interaction related to alienation from others secondary to low self-concept
  E) Ineffective Coping related to altered appearance due to HIV/AIDS

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Answer to Question 1

Ans: B
Because of the potential for medication interactions, appropriate dosages for psychotropic agents (eg, antidepressants, antianxiety agents, neuroleptic agents) are calculated based on the guidelines used for older adult populations. A medication typically starts with a low dose, builds up slowly, and achieves a significantly lower peak than that targeted in seronegative individuals.

Answer to Question 2

Ans: A, D, E
Numerous psychosocial needs can be addressed effectively in the context of support group. Neurological changes and malnutrition would be addressed in a medical setting.

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