When AIDS was first diagnosed in the early 1980s, it was found in a certain population in New York City. The people in this group tended to be homosexuals, intravenous drug users, and debilitated persons with poor hygiene and nutrition habits. Originally, a number of health care practitioners thought that the disease was a syndrome of opportunistic infections that occurred in a population with repeated exposures to infections that naturally deplete the immune system. It was not until several years later that the human immunodeficiency virus (HIV) was identified. Since then, it has been discovered that HIV infection is rampant in many African countries. The infection also has spread throughout the United States in populations that are not homosexual or intravenous drug users and who have good nutrition and hygiene habits. As health care practitioners have learned, HIV is not particular about the body it invades. Once introduced into a body, it infects T cells and causes HIV infection.
The evidence shows that when a patient is diagnosed with HIV infection, the nurse faces a tremendous challenge for patient education and support. The patient and any significant others should be counseled about the risks of transmission and reassured about ways in which the virus is not transmitted. They will need to learn about drug protocols, T-cell levels, adverse drug effects, and anticipated progress of the disease. They also will need consistent support and a telephone number to call with questions at any time. Many communities have AIDS support groups and other resources that can be very helpful; the nurse can direct the patient to these resources as appropriate.
The combinations of drugs that are being used today and the constant development of more drugs make the disease less of a death sentence than it was in the past. The result, however, is that many people must take a large number of pills each day, at tremendous cost and inconvenience. Many people today do live for long periods with HIV infection. An AIDS vaccine is currently being studied and offers hope for preventing this disease in the future. Public education is key for promoting the acceptance and support of patients with HIV infection or AIDS, who need a great deal of support and assistance. Nurses can be role models for dealing with HIV patients and can provide informal public education whenever the opportunity presents.
homosexual – n. 同性恋者
debilitated – a. 极度虚弱的，疲劳不堪的
deplete – v. 耗尽…的精力，减少
rampant – a. 繁茂的；蔓生的；,蔓延的
sentence – n. 判决
Video Treating HIV
Test 1. The home health nurse is making an initial home visit to the client currently living with family members after being hospitalized with pneumonia and newly diagnosed with AIDS. Which statement by the nurse best acknowledges the client's fear of discovery by his family?
A. ''Do you think that I could post a sign on your bedroom door for everyone about the need to wash their hands?''
B. ''Is there somewhere private in the home we can go and talk?''
C. ''I hope that all of your family members know about your disease and how you need to be protected, since you have been so sick.''
D. ''It is your duty to protect your family members from getting AIDS.''
2. The nurse is caring for a patient newly diagnosed with HIV. The patient asks what would determine the actual development of AIDS. The nurse's response is based on the knowledge that what is a diagnostic criterion for AIDS?
A. Presence of HIV antibody
B. CD4+ T cell count below 200/µL
C. Presence of oral hairy leukoplakia
D. White blood cell count below 5000/µl
本期ISPN Review答案： 1. B. ''Is there somewhere private in the home we can go and talk?''
A nonthreatening approach initially to find out whether the client has informed family members or desires privacy is very important.
2. B. CD4+ T cell count below 200/µL.
Diagnostic criteria for AIDS include a CD4+ T cell count below 200/µL and/or the development of specified opportunistic infections, cancers, wasting syndrome, or dementia. The other options may be found in patients with HIV disease but do not define the advancement of HIV infection to AIDS.
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