Question

Read the following scenario:

K.D. is a 56-year-old professional man who has been human immunodeficiency virus (HIV) infected for 6 years. He had been on antiretroviral therapy (ART) with Combivir (zidovudine and lamivudine) and nelfinavir (Viracept). He stopped taking his medications 6 months ago because of depression. The appearance of purplish spots on his neck and arms persuaded him to make an appointment with his physician. At the physician's office, K.D. stated he had been feeling fatigued for several months and was experiencing occasional night sweats. He also related he had been working long hours, skipping meals, and was stressed over a project at work. Other than the purplish spots, the remainder of K.D.'s physical examination findings were within normal limits. The doctor took three skin biopsy specimens and ordered a chest x-ray examination, a complete blood count (CBC), lymphocyte studies including CD4 T-cell count, an ultrasensitive viral load, a cytomegalovirus (CMV) assay, and a tuberculin test.

Over the next week, K.D. developed a nonproductive cough and increasing dyspnea. Last night, he developed a fever of 102° F and was acutely short of breath, so his roommate brought him to the emergency department. He was admitted to the medical unit with probable Pneumocystis jiroveci pneumonia (PJP), which was confirmed with bronchoalveolar lavage examination under light microscopy. K.D.'s admission white blood cell count (WBC) and lymphocyte studies demonstrate an increased pattern of immunodeficiency compared with earlier studies. K.D. is on nasal oxygen, intravenous (IV) fluids, and IV trimethoprim-sulfamethoxazole (Bactrim). His current vital signs (VS) are 138/86, 100, 30, 100.8° F (38.2° C) and Spo2 92.

Think through the following related to K.D.'s condition:

Etiology and pathophysiology

Risk factors

Signs and symptoms

Diagnostic procedures

Medication and treatment

Nursing interventions, including patient education

Potential complications

Complete a concept map

Answer 1

The patient here seems to be affected by kaposi’s sarcoma associated with HIV infection.

Etiology : Kaposi’s sarcoma is caused due to HHV8 (human herpes virus 8). It mostly affects the people who are immunocompromised, in diseases like HIV snd organ transplant.

Pathophysiology : The lesions contain tumor cells with presence of spindle cells. The lesion contains RBCs which gives it purple colour.

Risk factors : immunocompromised individuals, AIDS patient, organ transplant

Signs and symptoms : purple rash, shortness of breath, dyspnea, GIT symptoms like nausea, vomiting, diarrhoea, fever, cough, hemoptysis.

Diagnostic tests : biopsy, blood tests, tumor marker test

Treatment : highly active antiretroviral therapy, radiotherapy, chemotherapy

Nursing interventions : include assessment and monitoring of vital parameters, inspect skin for new lesions and care of old lesions, practice of hygienic hanits, safe sex education, monitor for adverse reaction of chemo snd radiotherapy.