A patient has Human Immunodeficiency Virus infection and the viral load is reported as undetectable. What patient teaching should be provided by the nurse related to this laboratory study results?

The patient has the virus but the infection is well controlled and not currently transmissible

The syndrome has gone from Stage 3 back to stage 2

The patient can discontinue with antiretroviral therapy until the viral load rises again

The patient will be prescribed lower doses of antiretroviral medications for 2 months

Answer and Explanation

The Correct Answer is A

A) "The patient has the virus but the infection is well controlled and not currently transmissible."
An undetectable viral load means that the amount of HIV in the blood is so low that it cannot be detected by standard laboratory tests, typically due to effective antiretroviral therapy. However, the patient still has the HIV virus in their body, and it is essential to continue treatment. An undetectable viral load reduces the risk of transmission, particularly to partners, but it does not eliminate the virus entirely. Hence, the infection is well controlled, but ongoing medication is still necessary to maintain viral suppression.

B) "The syndrome has gone from Stage 3 back to stage 2."
An undetectable viral load does not change the HIV stage. HIV is classified into three stages, with Stage 3 representing AIDS. While effective antiretroviral therapy can prevent the progression to AIDS and help control the viral load, it does not "reverse" the stage of HIV infection. Once a person progresses to Stage 3 (AIDS), they remain in this category even if their viral load becomes undetectable.

C) "The patient can discontinue with antiretroviral therapy until the viral load rises again."
An undetectable viral load indicates successful treatment, but it is crucial for the patient to continue taking antiretroviral medications to maintain viral suppression. Discontinuing therapy increases the risk of viral rebound and drug resistance. Long-term adherence to antiretroviral therapy is essential for keeping the virus under control.

D) "The patient will be prescribed lower doses of antiretroviral medications for 2 months.". The goal of antiretroviral therapy is to maintain viral suppression indefinitely, not to reduce the dose or discontinue it temporarily. Lowering the dose of antiretroviral medications could result in viral rebound and loss of viral suppression. Therefore, consistent, full-dose therapy is required for optimal HIV management.

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Correct Answer is A

Explanation

A) "Administer IV hydralazine and monitor blood pressure":
. The patient's elevated blood pressure (172/92 mmHg), along with headaches and blurred vision, could indicate a hypertensive emergency, a serious condition where extremely high blood pressure can cause acute organ damage. Hydralazine is a common intravenous antihypertensive medication used to lower blood pressure quickly in these situations. The nurse should administer hydralazine as prescribed and closely monitor the blood pressure to prevent complications like stroke, heart failure, or kidney damage. Blood pressure management is the priority, as the patient's symptoms are likely related to the elevated BP.

B) "Administer oxygen at 10 liters/minute by non-rebreather mask":
. While oxygen therapy may be appropriate for patients with respiratory distress or hypoxia, the patient's SpO2 is 97% on room air, indicating that there is no immediate oxygenation issue. Administering oxygen unnecessarily could lead to oxygen toxicity, and it is not the priority in this case. The patient's main concern is their elevated blood pressure, which requires urgent management.

C) "Administer acetaminophen 650 mg PO re-check temperature":
. While headaches are one of the patient's complaints, there is no indication of fever (the temperature is 98.6°F). Administering acetaminophen would be appropriate for pain relief, but it is not the priority in this case. The elevated blood pressure and potential hypertensive emergency are the primary issues that need to be addressed first.

D) "Infuse 0.9% sodium chloride at 120 mL/hour":
. Normal saline (0.9% sodium chloride) is typically used for hydration, but there is no indication that the patient is dehydrated or that intravenous fluids are the priority. In cases of hypertensive emergency, the goal is to lower blood pressure using antihypertensive medications, not to infuse fluids. Fluid administration could potentially worsen the situation if the elevated blood pressure is not addressed first.

A. A patient with hypertension B. A patient with diabetes C. A patient with asthma D. A pregnant patient

Correct Answer is D

Explanation

A. A patient with hypertension:
Valproic acid is not contraindicated in patients with hypertension. While it is important to monitor for potential side effects, including those that may affect the liver or blood pressure, hypertension alone does not directly impact the safety or efficacy of valproic acid. Therefore, it is generally considered safe to prescribe in patients with well-controlled hypertension.

B. A patient with diabetes:
Valproic acid is also not contraindicated in patients with diabetes. While it is important to monitor blood glucose levels, as anticonvulsants can sometimes affect metabolic processes, there is no absolute contraindication for valproic acid in diabetic patients. However, appropriate monitoring of blood sugar levels would be necessary to adjust any diabetic treatment as needed.

C. A patient with asthma:
There is no direct contraindication to using valproic acid in a patient with asthma. While asthma medications and their interactions should always be considered, valproic acid does not typically exacerbate asthma symptoms. The prescription would be based on the clinical need for seizure management and monitored for any potential respiratory side effects.

D. A pregnant patient:
Valproic acid is contraindicated in pregnancy due to its high risk of causing fetal harm. It has been associated with an increased risk of birth defects, including neural tube defects, and other complications such as developmental delays. The U.S. FDA classifies valproic acid as a Category D drug for pregnancy, indicating that it should only be used when the potential benefits outweigh the risks. Thus, it should be avoided in pregnant patients unless no safer alternatives are available.

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A patient has Human Immunodeficiency Virus infection and the viral load is reported as undetectable. What patient teaching should be provided by the nurse related to this laboratory study results?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

In which client would a prescription of valproic acid for seizure disorder be contraindicated?

Correct Answer is D

Explanation

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