In this article, we will discuss the critical steps involved in nursing diagnosis for HIV, explore common nursing diagnoses for HIV, and explore the nursing interventions and nursing management for HIV.
What is HIV and AIDS?
Acquired immunodeficiency syndrome (AIDS) is a serious secondary immunodeficiency disorder caused by the retrovirus, the 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.
There is no cure yet for either HIV or AIDS. However, significant advances have been made to help patients control signs and symptoms and delay disease progression.
Nursing Care Plans
The nursing care planning goals for a patient with HIV/AIDS may include preventing the progression of the disease, managing symptoms, decreasing the risk of complications and infections, promoting compliance with medication and treatment regimens, and providing emotional and social support. The goals may also focus on educating the patient and the family members about HIV/AIDS, its transmission, and prevention, as well as addressing any stigma or discrimination that the patient may experience.
Here are thirteen (13) nursing care plans and nursing diagnosis for patients with AIDS/HIV Positive:
- Imbalanced Nutrition: Less Than Body Requirements
- Acute/Chronic Pain
- Impaired Skin Integrity
- Impaired Oral Mucous Membrane
- Disturbed Thought Process
- Social Isolation
- Deficient Knowledge
- Risk for Injury
- Risk for Deficient Fluid Volume
- Risk for Infection
Imbalanced Nutrition: Less Than Body Requirements
A patient with HIV/AIDS may experience Imbalanced Nutrition: Less Than Body Requirements due to a variety of factors, including decreased appetite, malabsorption, diarrhea, nausea, vomiting, and metabolic changes caused by the disease or its treatments. Additionally, HIV/AIDS can weaken the immune system, making it more difficult for the body to absorb and utilize nutrients properly.
- Imbalanced Nutrition: Less Than Body Requirements
May be related to
- Inability or altered ability to ingest, digest and/or metabolize nutrients: nausea/vomiting, hyperactive gag reflex, intestinal disturbances, GI tract infections, fatigue
- Increased metabolic rate/nutritional needs (fever/infection)
Possibly evidenced by
- Weight loss, decreased subcutaneous fat/muscle mass (wasting)
- Lack of interest in food, aversion to eating, altered taste sensation
- Abdominal cramping, hyperactive bowel sounds, diarrhea
- Sore, inflamed buccal cavity
- Abnormal laboratory results: vitamin/mineral and protein deficiencies, electrolyte imbalances
- The patient will maintain weight or display weight gain toward the desired goal.
- The patient will demonstrate positive nitrogen balance, be free of signs of malnutrition, and display improved energy levels.
Nursing Assessment and Rationales
1. Assess the patient’s ability to chew, taste, and swallow.
Lesions of the mouth, throat, and esophagus (often caused by candidiasis, herpes simplex, hairy leukoplakia, Kaposi’s sarcoma other cancers) and metallic or other taste changes caused by medications may cause dysphagia, limiting the patient’s ability to ingest food and reducing the desire to eat.
2. Auscultate bowel sounds.
Hypermotility of the intestinal tract is common and is associated with vomiting and diarrhea, which may affect the choice of diet/route. Lactose intolerance and malabsorption (with CMV, MAC, and cryptosporidiosis) contribute to diarrhea and may necessitate a change in diet or supplemental formula.
3. Weigh as indicated. Evaluate weight in terms of premorbid weight. Compare serial weights and anthropometric measurements.
Indicator of nutritional adequacy of intake. Because of depressed immunity, some blood tests normally used for testing nutritional status are not useful.
4. Note drug side effects.
Medications used can have side effects affecting nutrition. ZDV can cause altered taste, nausea, and vomiting; Bactrim can cause anorexia, glucose intolerance, and glossitis; Pentam can cause altered taste and smell; Protease inhibitors can cause elevated lipids, and blood sugar increase due to insulin resistance.
5. Record ongoing caloric intake.
Identifies the need for supplements or alternative feeding methods.
Nursing Interventions and Rationales
1. Plan diet with the patient and include SO, suggesting foods from home if appropriate. Provide small, frequent meals and snacks of nutritionally dense foods and non-acidic foods and beverages, with a choice of foods palatable to the patient. Encourage high-calorie and nutritious foods, some of which may be considered appetite stimulants. Note the time of day when appetite is best, and try to serve a larger meal at that time.
Including patients in planning gives a sense of control of the environment and may enhance intake. Fulfilling cravings for noninstitutional food may also improve intake. In this population, foods with a higher fat content may be recommended as tolerated to enhance taste and oral intake.
2. Limit food(s) that induce nausea and vomiting or are poorly tolerated by the patient because of mouth sores or dysphagia. Avoid serving very hot liquids and foods. Serve foods that are easy to swallow like eggs, ice cream, and cooked vegetables.
Pain in the mouth or fear of irritating oral lesions may cause the patient to be reluctant to eat. These measures may be helpful in increasing food intake.
3. Schedule medications between meals (if tolerated) and limit fluid intake with meals, unless fluid has nutritional value.
Gastric fullness diminishes appetite and food intake.
4. Encourage as much physical activity as possible.
May improve appetite and general feelings of well-being.
5. Provide frequent mouth care, observing secretion precautions. Avoid alcohol-containing mouthwashes.
Reduces discomfort associated with nausea and vomiting, oral lesions, mucosal dryness, and halitosis. A clean mouth may enhance appetite and provide comfort.
6. Provide a rest period before meals. Avoid stressful procedures close to mealtime.
Minimizes fatigue; increases the energy available for work of eating and reduces chances of nausea or vomiting food.
7. Remove existing noxious environmental stimuli or conditions that aggravate the gag reflex.
Reduces stimulus of the vomiting center in the medulla.
8. Encourage the patient to sit up for meals
Facilitates swallowing and reduces the risk of aspiration.
9. Maintain NPO status when appropriate.
May be needed to reduce nausea and vomiting.
10. Insert or maintain a nasogastric (NG) tube as indicated.
May be needed to reduce vomiting or to administer tube feedings. Esophageal irritation from existing infection (Candida, herpes, or KS) may provide site for secondary infections and trauma; therefore, NG tube should be used with caution.
11. Administer medications as indicated:
- 11.1. Antiemetics: prochlorperazine (Compazine), promethazine (Phenergan), and trimethobenzamide (Tigan)
Reduces the incidence of nausea and vomiting, possibly enhancing oral intake.
- 11.2. Sucralfate (Carafate) suspension; a mixture of Maalox, diphenhydramine (Benadryl), and lidocaine (Xylocaine)
Given with meals (swish and hold in mouth) to relieve mouth pain, and enhance intake. The mixture may be swallowed for the presence of pharyngeal or esophageal lesions.
- 11.3. Vitamin supplements
Corrects vitamin deficiencies resulting from decreased food intake and/or disorders of digestion and absorption in the GI system. Avoid megadoses and the suggested supplemental level is two times the recommended daily allowance (RDA).
- 11.4. Appetite stimulants: dronabinol (Marinol), megestrol (Megace), oxandrolone (Oxandrin)
Marinol (an antiemetic) and Megace (an antineoplastic) act as appetite stimulants in the presence of AIDS. Oxandrin is currently being studied in clinical trials to boost appetite and improve muscle mass and strength.
- 11.5. TNF-alpha inhibitors: thalidomide
Reduces elevated levels of tumor necrosis factor (TNF) present in chronic illness contributing to wasting or cachexia. Studies reveal a mean weight gain of 10% over 28 wk of therapy.
- 11.6. Antidiarrheals: diphenoxylate (Lomotil), loperamide (Imodium), octreotide (Sandostatin)
Inhibit GI motility subsequently decreasing diarrhea. Imodium or Sandostatin are effective treatments for secretory diarrhea (secretion of water and electrolytes by intestinal epithelium).
- 11.7. Antibiotic therapy: ketoconazole (Nizoral), fluconazole (Diflucan)
May be given to treat and prevent infections involving the GI tract.
Recommended nursing diagnosis and nursing care plan books and resources.
Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans related to communicable and infectious diseases:
- Acquired Immunodeficiency Syndrome (AIDS) (HIV Positive) | 13 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Dengue Hemorrhagic Fever | 2 Care Plans
- Herpes Zoster (Shingles) | 4 Care Plans
- Influenza (Flu) | 5 Care Plans
- Pulmonary Tuberculosis | 5 Care Plans
3 thoughts on “13 AIDS (HIV Positive) Nursing Care Plans”
Very informative thumbs up 👍
Thank you! Please do check also the study guide for HIV/AIDS here.
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