A nurse is presenting a community-based program about HIV and AIDS. A client asks the nurse to describe the initial symptoms experienced with HIV infection. Which of the following manifestations should the nurse include in the explanation of initial symptoms?
Flu-like symptoms and night sweats
Fungal and bacterial infections
Pneumocystis lung infection
Kaposi’s sarcoma
The Correct Answer is A
Choice A: Flu-like symptoms and night sweats
The initial symptoms of HIV infection often resemble those of the flu. These symptoms, known as acute retroviral syndrome (ARS) or primary HIV infection, typically occur within 2 to 4 weeks after the virus enters the body. Common symptoms include fever, chills, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and a rash. These symptoms are the body’s natural response to the virus and indicate that the immune system is reacting to the infection. Night sweats, in particular, are a common symptom during the early stages of HIV infection.
Choice B: Fungal and bacterial infections
Fungal and bacterial infections are more commonly associated with later stages of HIV infection, particularly when the immune system has been significantly weakened. As HIV progresses and the immune system deteriorates, individuals become more susceptible to opportunistic infections, which are infections that occur more frequently and are more severe in people with weakened immune systems. These infections are not typically seen in the initial stages of HIV infection.
Choice C: Pneumocystis lung infection
Pneumocystis pneumonia (PCP) is a serious infection that occurs in people with weakened immune systems, including those with advanced HIV/AIDS. It is caused by the fungus Pneumocystis jirovecii. PCP is not an initial symptom of HIV infection but rather a complication that can arise when the immune system is severely compromised. This infection is more indicative of the later stages of HIV, particularly when the CD4 cell count drops significantly.
Choice D: Kaposi’s sarcoma
Kaposi’s sarcoma is a type of cancer that forms in the lining of blood and lymph vessels. It is caused by the human herpesvirus 8 (HHV-8) and is commonly associated with advanced HIV infection or AIDS. Kaposi’s sarcoma presents as purple, red, or brown blotches or tumors on the skin and can also affect internal organs. This condition is not an initial symptom of HIV infection but rather a manifestation of severe immune system damage in the later stages of the disease.
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Correct Answer is B
Explanation
Choice A: Take naproxen for generalized discomfort
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can help with generalized discomfort. However, NSAIDs can cause fluid retention and worsen heart failure symptoms. They can also increase the risk of kidney damage and gastrointestinal bleeding, especially in individuals with heart failure. Therefore, it is generally advised to avoid NSAIDs and use alternative pain relief methods, such as acetaminophen, under the guidance of a healthcare provider.
Choice B: Notify the provider of a weight gain of 0.5 kg (1 lb) in a week
Monitoring weight is crucial for individuals with heart failure, as sudden weight gain can indicate fluid retention and worsening heart failure. A weight gain of 0.5 kg (1 lb) in a week is significant and should be reported to the healthcare provider immediately. This allows for timely intervention to adjust medications or other treatments to prevent further complications. Regular weight monitoring helps in early detection of fluid buildup and effective management of heart failure.
Choice C: Take diuretics early in the morning and before bedtime
Diuretics are commonly prescribed to help reduce fluid buildup in individuals with heart failure. However, taking diuretics before bedtime can lead to frequent nighttime urination, disrupting sleep. It is generally recommended to take diuretics early in the morning to minimize this issue. If a second dose is needed, it should be taken in the early afternoon to avoid nighttime disturbances.
Choice D: Exercise at least three times per week
Regular exercise is beneficial for individuals with heart failure as it helps improve cardiovascular health, increase stamina, and reduce symptoms. However, the exercise regimen should be tailored to the individual’s condition and capabilities. It is important to consult with a healthcare provider to develop a safe and effective exercise plan. Cardiac rehabilitation programs can also provide structured exercise guidance and support.
Correct Answer is C
Explanation
Choice A reason: Using the palm of the hand, feel for lumps using a circular motion:
This instruction is incorrect. The correct method for a breast self-exam involves using the pads of the three middle fingers, not the palm of the hand. The fingers should move in a circular motion to feel for lumps or abnormalities.
Choice B reason: Expect some breast dimpling or discharge with age:
This is misleading and potentially harmful advice. While some changes in the breast can occur with age, dimpling or discharge can also be signs of breast cancer and should be reported to a healthcare provider immediately.
Choice C reason: Breasts can be examined in the shower with soapy hands:
This is correct. Examining the breasts in the shower with soapy hands can make it easier to feel for lumps or changes. The soapy water helps the fingers glide smoothly over the skin, making it easier to detect any abnormalities.
Choice D reason: For those who have a menstrual cycle, perform a BSE every month, 2 or 3 days before menstruation:
This instruction is incorrect. The best time to perform a breast self-exam is a few days after the menstrual period ends, when the breasts are least likely to be swollen or tender.
