HESI Case Study: HIV & TB

How Should the nurse respond?
Your partner may stay but he needs to wear a mask.
What teaching should the nurse implement?
TB is spread through the air.
What information should the nurse provide to the UAP on infection control practices?
Possible TB requires negative pressure room.
The nurse notices a UAP about to Jeff’s room to deliver a meal tray w/o wearing any protective apparel. What info should the nurse provide to the UAP?
Healthcare workers need to wear a mask when entering the room of patient suspected of having TB.
What tasks can the nurse delegate to the UAP?
Tell Jeff the sputum will be collected in the morning, set sputum collection cups by bedside, document time and date when each sputum sample is collected.

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What activity should Jeff do in the morning upon wakening?
Obtain the first of three sputum samples for lab testing.
The nurse should based her response about the right of a nurse to refuse to care for clients w/ HIV?
The nurse may refuse to care for a patient in which the risk outweighs a nurse’s responsibility to care for a patient or if the care conflicts with the nurse’s ethical standards.
How should the nursing supervisor respond to the nurse who does not want to care for Jeff?
I understand you want to protect your children. Please tell me your concerns about taking care of patient with HIV.
What statement shows that Jeff understands why he is at risk for TB?
My T-helper cells are diminished from HIV and those cells are needed to fight HIV.
How should the nurse preceptor respond?
This is not always true. 5mm induration is considered positive in an HIV positive client.
How should the nurse respond?
To be most effective, HIV medications should be taken on different schedules.
How should the nurse respond?
The main purpose of these medications is to block the replication of the HIV virus.
What information should the nurse teach Jeff about rifampin/isoniazid/pyrazinamide?
Rifampin can stain urine,stool, saliva, sweat and tears reddish-orange. Liver function test should be monitored and conducted. Supplemental B6 may be prescribed and avoid foods high in tyramine while taking rifampin.
What is the priority nursing diagnosis for Jeff at this time?
Risk for opportunistic infections related to decreased immune function.
What information should the nurse give the UAP?
Following standard precautions will minimize exposure to blood and body fluids
What should the nurse say to the UAP?
I see you are wearing a gown, mask, gloves, and googles before going into the patient’s room. Please help me understand this choice.
Which assessment by the nurse is indicative of oral candidiasis?
white-yellow patches on the tongue or oral mucosa
What instruction should the nurse give Jeff about liquid nystatin?
Place suspension in mouth and swish for several minutes before swallowing.
To achieve the improvement of Jeff’s nutrition, what should the nurse perform for nursing interventions?
Consult w/ Jeff for food preferences, weight daily and monitor for wasting syndrome, and monitor for oral thrush and diarrhea.
Since Jeff has thrush in addition to anorexia and fatigue which food best contributes to improving Jeff’s condition?
Milk shake
Which tasks should be delegated to the UAP?
weigh jeff before breakfast, measure urine output and count and record watery stools.
What is the priority nursing diagnosis?
deficit fluid volume
Which action should the nurse take first?
Take Jeff’s BP to assess for postural hypotension.
What is the gtt/min?
How should the nurse respond?
If used correctly and consistently, latex condoms are highly effective in preventing transmission of HIV
What resource can be provided for Jeff in the event that this complication occurs?
Access to a registered dietitian
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