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.

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

  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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Disturbed Thought Process

Nursing Diagnosis

May be related to

Possibly evidenced by

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  • Altered attention span; distractibility
  • Memory deficit
  • Disorientation; cognitive dissonance; delusional thinking
  • Sleep disturbances
  • Impaired ability to make decisions/problem-solve; inability to follow complex commands/mental tasks, loss of impulse control

Desired Outcomes

  • Maintain usual reality orientation and optimal cognitive functioning.
Nursing InterventionsRationale
Assess mental and neurological status using appropriate tools.Establishes functional level at time of admission and provides baseline for future comparison.
Consider effects of emotional distress. Assess for anxiety, grief, anger.May contribute to reduced alertness, confusion, withdrawal, and hypoactivity, requiring further evaluation and intervention.
Monitor medication regimen and usage.Actions and interactions of various medications, prolonged drug half-life and/or altered excretion rates result in cumulative effects, potentiating risk of toxic reactions. Some drugs may have adverse side effects: haloperidol (Haldol) can seriously impair motor function in patients with AIDS dementia complex.
Investigate changes in personality, response to stimuli, orientation and level of consciousness; or development of headache, nuchal rigidity, vomiting, fever, seizure activity.Changes may occur for numerous reasons, including development or exacerbation of opportunistic diseases or CNS infection. Early detection and treatment of CNS infection may limit permanent impairment of cognitive ability.
Maintain a pleasant environment with appropriate auditory, visual, and cognitive stimuli.Providing normal environmental stimuli can help in maintaining some sense of reality orientation.
Provide cues for reorientation. Put radio, television, calendars, clocks, room with an outside view if necessary. Use patient’s name. Identify yourself. Maintain consistent personnel and structured schedules as appropriate.Frequent reorientation to place and time may be necessary, especially during fever and/or acute CNS involvement. Sense of continuity may reduce associated anxiety.
Discuss use of datebooks, lists, other devices to keep track of activities.These techniques help patient manage problems of forgetfulness.
Encourage family and SO to socialize and provide reorientation with current news, family events.Familiar contacts are often helpful in maintaining reality orientation, especially if patient is hallucinating.
Encourage patient to do as much as possible: dress and groom daily, see friends, and so forth.Can help maintain mental abilities for longer period.
Provide support for SO. Encourage discussion of concerns and fearsBizarre behavior and/or deterioration of abilities may be very frightening for SO and makes management of care or dealing with situation difficult. SO may feel a loss of control as stress, anxiety, burnout, and anticipatory grieving impair coping abilities.
Provide information about care on an ongoing basis. Answer questions simply and honestly. Repeat explanations as needed.Can reduce anxiety and fear of unknown. Can enhance patient’s understanding and involvement and cooperation in treatment when possible.
Reduce provocative and noxious stimuli. Maintain bed rest in quiet, darkened room if indicated.If patient is prone to agitation, violent behavior, or seizures, reducing external stimuli may be helpful.
Decrease noise, especially at night.Promotes sleep, reducing cognitive symptoms and effects of sleep deprivation.
Maintain safe environment: excess furniture out of the way, call bell within patient’s reach, bed in low position and rails up; restriction of smoking (unless monitored by caregiver/SO), seizure precautions, soft restraints if indicated.Provides sense of security and stability in an otherwise confusing situation.
Discuss causes or future expectations and treatment if dementia is diagnosed. Use concrete terms.Obtaining information that ZDV has been shown to improve cognition can provide hope and control for losses.
Administer medications as indicated:
  • ZDV (Retrovir) and other antiretrovirals alone or in combination
Shown to improve neurological and mental functioning for undetermined period of time.
  • Antipsychotics: haloperidol (Haldol), and/or antianxiety agents: lorazepam (Ativan).
Cautious use may help with problems of sleeplessness, emotional lability, hallucinations, suspiciousness, and agitation.
Refer to counseling as indicated.May help patient gain control in presence of thought disturbances or psychotic symptomatology.
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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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