physical, emotional, pathogenic, or immune factors place the patient at risk?
2. Detect HIV infection early.
Does the patient need to be tested for HIV?
Education, including knowledge, attitudes, and behaviors, with
emphasis on risk reduction to the following: General population: Cover general information Pregnant women: General information and information specic to HIV infection and pregnancy Individual patient: Specic to assessed need Empower patients to take control of prevention measures. Provide HIV antibody testing with appropriate counseling.
Acute Intervention 1. Promote health and limit disability.
Physical health: Is the patient experiencing
problems? Mental health: How is the patient coping? Resources: Does the patient have family or social support? Is the patient accessing community services? Is money or insurance a problem? Does the patient have access to spiritual support as desired?
2. Manage problems caused
by HIV infection.
Physical health: Has the patient experienced
acute exacerbation of problems related to immunodeciency, opportunistic disease, or risk factors (e.g., substance use)? Mental health status: Has the patients ability to cope with psychosocial issues deteriorated?
Provide case management.
Teach regarding HIV, the spectrum of infection, options for care, signs and symptoms to report, treatment options, immune enhancement, risk reduction, and ways to adhere to treatment regimens. Refer to needed resources. Establish long-term, trusting relationship with patient, family, and signicant others. Provide emotional and spiritual support. Develop resources for legal needs: discrimination prevention, wills and powers of attorney, child care wishes. Empower the patient to identify needs, direct care, and seek services. Provide care during acute exacerbations: recognition of lifethreatening developments, life support, rapid intervention with treatments and drugs, comfort, and hygiene needs. Support patient and family during crisis. Assist the patient with mental health issues and provide referral to mental health specialist as needed.
Ambulatory and Home Care
1. Maximize quality of life.
Physical health: Are new symptoms
developing? Is the patient experiencing drug side effects or interactions?
2. Resolve life and death
issues.
Mental health: How is the patient coping?
What adjustments have been made? Finances: Can the patient maintain health care and basic standards of living? Family, social, and community supports: Are these available? Is the patient using supports in an effective manner? Do family or signicant others need teaching, encouragement, or stress relief? Spirituality issues: Does the patient desire support from a religious organization or spiritual counselor? What assistance does the patient desire?
Continue case management.
Teach about changing treatment options and continued adherence. Empower patient to continue to direct care and to make desires known to family members and signicant others. Continue physical care for chronic disease process: treatments, drugs, comfort, and hygiene needs. Encourage health promotion measures (as above). Refer the patient to resources to support nances. Support patient and family or signicant others in a trusting relationship. Assist with end-of-life issues: resuscitation orders, comfort measures, funeral plans, estate planning, child care continuation, etc. Assess desires and refer to resources that will assist in meeting identied spiritual needs.