13 AIDS (HIV Positive) Nursing Care Plans

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Acquired immunodeficiency syndrome (AIDS) is a serious secondary immunodeficiency disorder caused by the retrovirus, human immunodeficiency virus (HIV). Both diseases are characterized by the progressive destruction of cell-mediated (T-cell) immunity with subsequent effects on humoral (B-cell) immunity because of the pivotal role of the CD4+helper T cells in immune reactions. Immunodeficiency makes the patient susceptible to opportunistic infections, unusual cancers, and other abnormalities.

AIDS results from the infection of HIV which has two forms: HIV-1 and HIV-2. Both forms have the same model of transmission and similar opportunistic infections associated with AIDS, but studies indicate that HIV-2 develops more slowly and presents with milder symptoms than HIV-1. Transmission occurs through contact with infected blood or body fluids and is associated with identifiable high-risk behaviors.

Persons with HIV/AIDS have been found to fall into five general categories: (1) homosexual or bisexual men, (2) injection drug users, (3) recipients of infected blood or blood products, (4) heterosexual partners of a person with HIV infection, and (5) children born to an infected mother. The rate of infection is most rapidly increasing among minority women and is increasingly a disease of persons of color.

Nursing Care Plans

There is no cure yet for either HIV or AIDS. However, significant advances have been made to help patients control signs and symptoms and impair disease progression.

Here are 13 nursing care plans and nursing diagnosis for patients with AIDS/HIV Positive:

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  1. Imbalanced Nutrition: Less Than Body Requirements
  2. Fatigue
  3. Acute/Chronic Pain
  4. Impaired Skin Integrity
  5. Impaired Oral Mucous Membrane
  6. Disturbed Thought Process
  7. Anxiety/Fear
  8. Social Isolation
  9. Powerlessness
  10. Deficient Knowledge
  11. Risk for Injury
  12. Risk for Deficient Fluid Volume
  13. Risk for Infection
  14. Other Possible Nursing Care Plans
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Impaired Skin Integrity

Nursing Diagnosis

Risk factors may include

  • Decreased level of activity/immobility, altered sensation, skeletal prominence, changes in skin turgor
  • Malnutrition, altered metabolic state

May be related to (actual)

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  • Immunologic deficit: AIDS-related dermatitis; viral, bacterial, and fungal infections (e.g., herpes, Pseudomonas, Candida); opportunistic disease processes (e.g., KS)
  • Excretions/secretions

Possibly evidenced by

  • Skin lesions; ulcerations; decubitus ulcer formation

Desired Outcomes

  • Be free of/display improvement in wound/lesion healing.
  • Demonstrate behaviors/techniques to prevent skin breakdown/promote healing.
Nursing InterventionsRationale
Assess skin daily. Note color, turgor, circulation, and sensation. Describe and measure lesions and observe changes. Take photographs if necessary.Establishes comparative baseline providing opportunity for timely intervention.
Maintain and instruct in good skin hygiene:  wash thoroughly, pat dry carefully, and gently massage with lotion or appropriate cream.Maintaining clean, dry skin provides a barrier to infection. Patting skin dry instead of rubbing reduces risk of dermal trauma to dry and fragile skin. Massaging increases circulation to the skin and promotes comfort. Isolation precautions are required when extensive or open cutaneous lesions are present.
Reposition frequently. Use turn sheet as needed. Encourage periodic weight shifts. Protect bony prominences with pillows, heel and elbow pads, sheepskin.Reduces stress on pressure points, improves blood flow to tissues, and promotes healing.
Maintain clean, dry, wrinkle-free linen, preferably soft cotton fabric.Skin friction caused by wet or wrinkled or rough sheets leads to irritation of fragile skin and increases risk for infection.
Encourage ambulation as tolerated.Decreases pressure on skin from prolonged bedrest.
Cleanse perianal area by removing stool with water and mineral oil or commercial product. Avoid use of toilet paper if vesicles are present. Apply protective creams: zinc oxide, A & D ointment.Prevents maceration caused by diarrhea and keeps perianal lesions dry. Use of toilet paper may abrade lesions.
File nails regularly.Long and rough nails increase risk of dermal damage.
Cover open pressure ulcers with sterile dressings or protective barrier: Tegaderm, DuoDerm, as indicated.May reduce bacterial contamination, promote healing.
Provide foam, flotation, alternate pressure mattress or bed.Reduces pressure on skin, tissue, and lesions, decreasing tissue ischemia.
Obtain cultures of open skin lesions.Identifies pathogens and appropriate treatment choices.
Apply and administer medications as indicated.Used in treatment of skin lesions. Use of agents such as Prederm spray can stimulate circulation, enhancing healing process. When multidose ointments are used, care must be taken to avoid cross-contamination.
Cover ulcerated KS lesions with wet-to-wet dressings or antibiotic ointment and nonstick dressing, as indicated.Protects ulcerated areas from contamination and promotes healing
Refer to physical therapy for regular exercise and activity program.Promotes improved muscle tone and skin health.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans related to communicable and infectious diseases:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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