A nurse is caring for a client who is on anti-retroviral therapy (ART), which includes indinavir sulfate (Crixivan), a protease inhibitor, for the treatment of HIV. Which client statement demonstrates that teaching was effective?
"If I don't take my medication as scheduled, the virus may become resistant to treatment."
"If I don't take my medication as scheduled, it may cause my RNA to convert to DNA."
"If I don't take my medication as scheduled, it may prevent the HIV from being assembled."
"If I don't take my medication as scheduled, my CD4 lymphocyte count may increase."
The Correct Answer is A
A. This statement accurately reflects the importance of adherence to ART; if medication is missed, the virus may replicate unchecked, leading to drug resistance, which is a significant concern in HIV treatment.
B. This statement is incorrect because the conversion of RNA to DNA is a normal part of the HIV life cycle and is not directly prevented by taking medication on time.
C. While protease inhibitors do help prevent the assembly of new virions, the primary concern when missing doses is the risk of resistance rather than assembly prevention.
D. This statement is misleading; while effective ART can lead to an increase in CD4 counts over time, missing doses would not directly cause an increase in CD4 lymphocyte counts.
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Correct Answer is ["B","C","D","E","F"]
Explanation
A. Hanging a bag of 0.9% normal saline with 5% dextrose (D5%NS) is incorrect; only normal saline (0.9% NS) should be used to prime the blood transfusion line to avoid hemolysis.
B. Verifying the client's name and blood type with a second nurse is a critical safety measure to prevent transfusion reactions and ensure the correct blood product is given.
C. Infusing the unit of blood within 4 hours is essential to reduce the risk of bacterial growth in the blood product.
D. Obtaining baseline vital signs prior to starting the transfusion is important to assess the client's condition and monitor for any changes during the transfusion.
E. Continuously monitoring the client during the first 15 minutes of the transfusion is vital for detecting any signs of a transfusion reaction promptly.
F. Inserting an 18-gauge intravenous catheter is recommended for blood transfusions as it provides a sufficient lumen to accommodate the blood flow.
G. Inserting a 22-gauge intravenous catheter is acceptable for some transfusions, but an 18-gauge is preferred for larger blood products.
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.