A nurse is caring for a client who has human immunodeficiency virus (HIV). Which laboratory value should the nurse alert the provider of?
Positive Western blot test
CD4-T-cell count 180 cells/mm³ (Range: 500 to 1500 cells/mm³)
Platelets 150,000/mm³ (Range: 150,000-400,000 cells/mm³)
WBC 5,000/mm³ (Range: 5,000-10,000 cells/mm³)
The Correct Answer is B
A. A positive Western blot test indicates an HIV diagnosis, which is expected in a client with HIV and does not require urgent intervention.
B. A CD4-T-cell count of 180 cells/mm³ is significantly low (normal range: 500 to 1500 cells/mm³) and indicates severe immunosuppression, putting the client at increased risk for opportunistic infections, warranting immediate attention from the provider.
C. A platelet count of 150,000/mm³ is at the lower end of the normal range and does not typically require immediate intervention unless there are clinical symptoms associated.
D. A WBC count of 5,000/mm³ is within the normal range and does not indicate a need for urgent intervention.
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Correct Answer is A
Explanation
A. Viral load count is the primary test used to assess the effectiveness of HIV therapy by measuring the amount of HIV RNA in the blood, indicating how well the treatment is controlling the virus.
B. The Western blot is used as a confirmatory test for HIV diagnosis rather than monitoring therapy effectiveness.
C. The Enzyme immunoassay (EIA) test is used for initial HIV screening but does not measure viral load or therapy effectiveness.
D. Platelet count can be affected in HIV infection, especially with advanced disease, but it does not directly measure the effectiveness of HIV therapy.
Correct Answer is B
Explanation
A. While legumes are a good source of protein, they do not provide the high-calorie density needed for someone experiencing wasting syndrome.
B. Consuming high-calorie snacks between meals is the most appropriate suggestion as it helps increase overall caloric intake, which is essential for clients with wasting syndrome to help maintain weight and improve nutritional status.
C. Using canola oil instead of butter may not significantly impact caloric intake, and clients with wasting syndrome may need higher-calorie options.
D. Adding celery to soups or salads adds volume but is low in calories and may not contribute significantly to the dietary needs of someone experiencing wasting syndrome.