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eTABLE 15-7

NURSING INTERVENTIONS IN HIV INFECTION

Nursing Care and Goals


Health Promotion

Assessment

Interventions

1. Prevent HIV infection.

Risk factors: What behaviors or social,


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.

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