A nurse is educating a client who has HIV about the infection process. Which of the following features of the virus should the nurse explain can result in opportunistic infection?
Conversion of the virus's RNA into DNA
Having reverse transcriptase enzyme
Containing only a single strand of genetic material
Ability to target and destroy CD4 lymphocytes
The Correct Answer is D
A. The conversion of RNA into DNA is a critical step in the HIV lifecycle, but it does not directly lead to opportunistic infections; instead, it allows the virus to integrate into the host’s genome.
B. Having reverse transcriptase enzyme is a characteristic of retroviruses like HIV that facilitates replication, but it does not cause opportunistic infections directly.
C. HIV containing a single strand of genetic material is a feature of its classification as a retrovirus but is not related to the risk of opportunistic infections.
D. The ability of HIV to target and destroy CD4 lymphocytes is the key reason for opportunistic infections. CD4 cells are crucial for the immune response, and their depletion leads to immunosuppression, making the client susceptible to infections that would not typically affect an individual with a healthy immune system.
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Correct Answer is A
Explanation
A. The CD4-T-cell count of 180 cells/mm3 is a critical measure of immune function in an HIV-positive client, indicating progression of the disease and risk for opportunistic infections. Values below 200 cells/mm3 signify the client has progressed to AIDS.
B. A positive Western blot test confirms the presence of HIV but does not indicate the immediate health risk or necessary interventions.
C. A platelet count of 150,000/mm3 is within the normal range, thus not indicative of any urgent concerns.
D. A WBC count of 5,000/mm3 is also within normal limits and does not highlight an immediate issue that needs addressing compared to the CD4 count.
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.