laboratory and clinical booklet - Fort Scott Community College

FORT SCOTT COMMUNITY COLLEGE
DEPARTMENT OF NURSING EDUCATION
NUR 2509 – ACUTE & EXTENDED HEALTH CARE ISSUES
CASE STUDY HIV#1
Scenario: You are working at a physician‟s office, and you have just taken C.Q., a 38-
year-old woman, into the consultation room. C.Q. has been divorced for 5
years, has 2 daughters (ages 14 and 16), and works full-time as a legal
secretary. Two weeks ago she visited her doctor for a routine physical
examination and requested that an HIV (human immunodeficiency virus) test
be performed. C.Q. stated that she was in a serious relationship, is
contemplating marriage, and just wanted to make certain she was “okay”. No
abnormalities were noted during C.Q.‟s physical examination and blood was
drawn for routine blood chemistries, hematology studies, and an ELISA
(enzyme-linked immunosorbent assay) test, also known as the EIA (enzyme
immunoassay) test. C.Q. is at the office to receive her lab results. The
physician informs you that C.Q. EIA was positive.
1. What is an EIA test? Does a positive EIA mean that C.Q. definitely has HIV?
2. You explain to C.Q. that one of her tests needs to be repeated and you need to draw
another blood sample. Why wouldn‟t you tell C.Q. that her first test result was
positive and that another test is needed before the diagnosis can be confirmed?
The physician informs you that C.Q.‟s Western blot test results confirm that she is HIVpositive;
he requests that you be present when he talks to her. Before leaving C.Q.‟s
room, the physician requests that you obtain another blood sample for further testing,
give C.Q. verbal and written information about local AIDS support groups, and help C.Q.
call a friend to accompany her home this evening. She looks at you through her tears and
states, “I can‟t believe it. J. is the only man I‟ve had sex with since my divorce. He told
me I had nothing to worry about. I can‟t believe he would do this to me.”
3. C.Q.‟s statement is based on three assumptions: that J. is HIV-positive, that he
intentionally withheld the information from her, and that he intentionally transmitted
the HIV to her through unprotected sex. Based on your knowledge of HIV infection,
how would you counsel C.Q.?
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