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 #2
Scenario: K.D. is a 36-year-old gay professional man who has been HIV-positive for
6 years. Until recently, he demonstrated no s/s of AIDS. The appearance of
purplish spots on his neck and arms persuaded him to make an appointment
with his physician. Upon arrival at the doctor‟s office, the nurse performs a
brief assessment. His VS are 138/86, 100, 30, 100.8 degrees F. K.D. states
that he has been feeling fatigued for several months and is experiencing
occasional night sweats but he also has been working long hours, has skipped
meals, and has been particularly stressed over a project at work. K.D.‟s
physical is WNL except for his low-grade fever and skin lesions. The doctor
orders a CBC, lymphocyte studies, and a PPD. K.D. made an appointment to
return in 5 days to discuss the results of his tests.
Over the next 2 weeks, K.D. develops a fever of 101 degrees F.,
nonproductive cough, and increasing SOB. Late one night he becomes
acutely SOB, so his roommate, J.F., takes him to the ED where he is
subsequently admitted to the hospital with probable Pneumocystis carinii
pneumonia. Bronchoalveolar lavage examined under light microscopy
confirms the diagnosis. K.D.‟s admission WBC and lymphocyte studies
demonstrate an increased pattern of immunodeficiency from earlier studies.
K.D. is placed on nasal oxygen, IV fluids, and IV
trimethoprim/sulfamethoxadole.
1. What is Pneumocystis jiroveci pneumonia (PCP)?
2. What is the significance of the purplish spots over K.D.‟s neck and arms?
3. Identify four nursing diagnoses for K.D.:
4. What precautions will you need to use when caring for K.D.?
5. What will be the focus of your ongoing assessment? (list five.)
6. What major side effects of his antibiotic should you monitor K.D. for?
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