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Case Study: The Pathophysiology of HIV/AIDS

Case Study: The Pathophysiology of HIV/AIDS

Case Study: The Pathophysiology of HIV/AIDS

QUESTION
Derek Smith, a 31 y.o., Caucasian male injection drug user, who is homeless, presents to the ED with a chief complaint of shortness of breath. He describes a 1-month history of intermittent fevers and night sweats associated with a nonproductive cough. He has become progressively more short of breath, initially only with exertion, but now he feels dyspneic at rest. He appears to be in moderate respiratory distress. His vital signs are abnormal, with fever to 39°C, heart rate of 112 bpm, respiratory rate of 20/min, and oxygen saturation of 88% on room air. Physical examination is otherwise unremarkable but notable for the absence of abnormal lung sounds. Chest x-ray film reveals a diffuse interstitial infiltrate characteristic of pneumocystis pneumonia, an opportunistic infection.
In this discussion:
1. Describe and discuss with your colleagues the underlying disease most likely responsible for this patient’s susceptibility to pneumocystis pneumonia.
2. Describe and discuss the immunosuppression caused by this underlying disease.
3. Describe and discuss the natural history of this disease and some of the common clinical manifestations seen during its progression.
4. Describe your plan of care for this patient following his hospitalization (he will likely be admitted to the “medical respite floor,” of a local homeless shelter, which has the services of a Nurse Practitioner three times per week—with on-call weekend consultation, and a registered nurse, Monday through Friday).
Case Study: The Pathophysiology of HIV/AIDS

ANSWER
Case Study: The Pathophysiology of HIV/AIDS
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The Pathophysiology Of HIV/AIDS and Relation to Pneumocystis Pneumonia
Pneumocystis pneumonia, PCP, is a common opportunistic disease that may develop or is observed in a patient with a condition such as HIV/AIDS (cdc). When a patient contracts HIV/AIDS, they are likely to experience immunosuppression, which contributes to the development of ailments such as PCP. Moreover, the patients’ symptoms represent those triggered by PCP. Signs Such as dry cough, dyspnea, chest tightness, or pain characterize patients with PCP (Huang et al., 2017)
Immunosuppression refers to the reduction in the efficiency of the immune system. HIV/AIDS generally contributes to the weakening of the patients’ immune system. The increased replication and number of viruses and the slow loss of CD4+T cells coupled with the depletion of the T lymphocytes jointly contribute to immune deficiency and the development of AIDS. The condition causes respiratory ailments and makes the host susceptible to other ailments such as tuberculosis and pneumonia.
HIV/AIDS is commonly transmitted through unprotected sexual intercourse, blood transfusion, and the sharing of hypodermic needles with infected persons. In the case of Derek Smith, a laboratory test will confirm the diagnosis, and if positive, one can assume that the patient might have contracted the disease in the shared drug use through injections. Once infected, the virus quickly replicates itself in the hoist s body. It replicates inside and kills the T helper cells that are useful in immunity responses. HIV produces the cellular immune deficiency that is characterized by the loss of the CD4+ cells. The loss of the helper T lymphocytes culminates in neoplastic processes and opportunistic infections such as pneumocystis pneumonia (Huang et al. 2017).
In the above case, nursing practitioners need to take the patient first to test the patient if they have HIV/AIDS. After that, upon diagnosis, the nurses may implement pharmacological and psychological interventions to manage the condition. The doctors treat the condition with medications such as sulfamethoxazole and trimethoprim. The patient may be treated with other drugs such as Dapsone and Mepron, and Pentam breathed through a nebulizer. The drugs may be administered orally or through IV injection. In the event the patient experiences low oxygen levels, the nurse may administer corticosteroids. Considering the patient’s condition, respite care must be provided and characterized by psychological therapy to manage the condition’s mental effects. Additionally, constant patient monitoring is required to track the patients’ general respiratory system’s heart rates and progress.

References
CDC (2020). About HIV. Retrieved from https://www.cdc.gov/hiv/basics/whatishiv.html
Huang, Y. S., Yang, J. J., Lee, N. Y., Chen, G. J., Ko, W. C., Sun, H. Y., & Hung, C. C. (2017). Treatment of Pneumocystis jirovecii pneumonia in HIV-infected patients: a review. Expert review of anti-infective therapy, 15(9), 873-892.

Case Study: The Pathophysiology of HIV/AIDS

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