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Acquired Immunodeficiency Syndrome (AIDS) (Signs/Symptoms (IMMUNOLOGIC …

- - - - Neurological
        Re-orient patient
        Use calendars, clocks, radios in room, objects from home
        Self Esteem
        Help them express feelings and identify positive aspects of themselves.
        Social contact --Often discriminated/ isolated by family friends
        Spend time with him or her, even when not performing a
        procedure or assessment, just to be present.
        Help him or
        her identify support systems, including those already in place
        and those that need to be arranged
        HOME CARE
        TEACH, teach about everything else discussed.
        
        *
        
        Pain
        Drugs & other approaches -used together to manage pain depending on the cause.
        Reasons for pain:
        Due to enlarged organs stretching the viscera or compressing nerves.
        Tumor invasion of bone/tissues ,nerve compression, swollen lymph nodes.
        Many have peripheral neuropathy– from the disease or meds, generalized joint & muscle pain.
        Comfort measures
        1)Pressure-relieving mattress pads, warm baths or hydrotherapy,
        2) Massage, applying heat/ cold to painful areas
        3) Use lift sheets to avoid pulling or grasping the patient with joint pain.
        4) Change positions freq. -pt may be thin & have poor circulation
        Medications
        1) arthralgia and myalgia- NSAIDs reduce inflammation
        RX: pregabalin (Lyrica)-muscle and joint pain.
        Neuropathic pain of peripheral neuropathy- use tricyclic antidepressants
        1) amitriptyline (Elavil)
        2) anticonvulsant: gabapentin (Neurontin )
        3) phenytoin (Dilantin)
        4 carbamazepine (Tegretol)**
        
        Mild to moderate pain -treated with weaker opioids : oxycodone or codeine.
        3) Intense pain is treated w/stronger opioids:
        a) morphine, hydromorphone (Dilaudid), or fentanyl transdermal (Duragesic).
        Combinations of weak/strong opioids w/nonopioid
        drugs provide best sustained relief.
        
        Minimizing Diarrhea
        Antidiarrheals,
        1) diphenoxylate hydrochloride (Diarsed , Lomotil)
        2) loperamide (Imodium)
        Recommended dietary change:
        1) less roughage; less fatty, spicy, and sweet
        food; and no alcohol or caffeine.
        Note:Other forms of relief are:
        eliminating dairy prod, eat smaller meals, drink fluids
        Nursing management:
        1) Assess the perineal skin Q 8 -12 hours -skin integrity
        2) Provide a bedside commode/bedpan.
        3) Teach UAP about perineal care and incontinence, to provide privacy, support & understanding.
        4) Explain the need to keep the patient’s perineal area clean & dry.
        5) Instruct UAP to report any skin changes in the perineal area .Ex. persistent redness, rashes, blisters.
        6) Collaborate with a wound care specialist to manage anal excoriation and discomfort.
        
        Nurtrition *
        1)Administer the drug as prescribed, monitor S.E. N&V which affect nutrition.
        2)Provide mouth care and ice chips, and keep unpleasant
        odors out of the patient’s environment.
        3)Antiemetics -PRN
        Nutrition therapy
        1) Monitor wt, I & O, calorie intake.
        2) Assess food preferences & dietary cultural/religious practices.
        3) Teach the about a high-calorie, high-protein diet.
        4) Encourage- to avoid dietary fat, because fat intolerance
        often occurs as a result of the disease and as a side effect of
        some antiretroviral medications.
        5) Collaborate w/dietitian to provide an appropriate diet
        6) Supplemental vitamins & fluids.
        7) Tube feedings or total parenteral nutrition may be needed.
        8) Mouth care performed frequently can improve appetite.