A nurse is caring for a client who has HIV and a CD4-T-cell count of 150/mm³. Which of the following conditions should the nurse monitor the client for?
Hepatitis
Tuberculosis
Gonorrhea
Chlamydia
The Correct Answer is B
A. Hepatitis is a concern for individuals with HIV, but it is not specifically indicated by a low CD4-T-cell count.
B. A CD4-T-cell count of 150/mm³ indicates severe immunosuppression, making the client highly susceptible to opportunistic infections like tuberculosis, which is common in individuals with HIV.
C. While gonorrhea is a risk for sexually active individuals, it is not specifically related to the low CD4-T-cell count.
D. Chlamydia is also a sexually transmitted infection, but similar to gonorrhea, it is not directly linked to the immunocompromised state indicated by the CD4-T-cell count.
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Correct Answer is C
Explanation
A. While knowing the location of the assault may be relevant for police reports, it does not directly pertain to the client’s health and potential exposure to HIV.
B. Permission to contact the police is important for legal reasons, but the priority is to address the client's health needs first.
C. Identifying the individual who assaulted the client is critical for assessing the risk of HIV exposure and determining the need for post-exposure prophylaxis (PEP). This question directly impacts the client’s immediate health care.
D. Understanding the day and time of the assault is useful for legal documentation but is less critical than assessing potential exposure to HIV.
Correct Answer is B
Explanation
A. Respiratory alkalosis is characterized by a high pH and low PaCO2, which is not evident in this scenario where the pH is low and PaCO2 is elevated.
B. The low pH of 7.3 indicates acidemia, and the elevated PaCO2 of 50 mm Hg suggests respiratory acidosis, where the body is retaining carbon dioxide, leading to an increase in acidity.
C. Metabolic acidosis would present with a low pH and a normal or decreased PaCO2, which is not the case here since the PaCO2 is elevated.
D. Metabolic alkalosis would show a high pH and elevated HCO3 levels, which is not consistent with the given ABG results.