Complete the sentence using the drop-down selections
When caring for a HIV+ patient the nurse is aware that dropdown indicates an opportunistic infection. It is caused by dropdown and treated withdropdown
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A","dropdown-group-3":"C"}
A. Pneumocystis pneumonia is a common opportunistic infection in HIV+ patients, particularly when CD4 counts fall below 200 cells/mm³, signaling severe immunosuppression. This aligns with the patient’s HIV+ status, as opportunistic infections exploit weakened immune systems. The DSM-5 does not directly address physical infections but notes that medical conditions like HIV can exacerbate mental health issues, which may be relevant in holistic care.
B. Tuberculosis is an opportunistic infection in HIV+ patients, often occurring at CD4 counts below 350 cells/mm³. However, it is less specific than Pneumocystis pneumonia as a hallmark of AIDS-defining illness in HIV+ patients, making it a less precise choice for this context.
C. Influenza is not typically an opportunistic infection in HIV+ patients. It affects immunocompetent individuals and does not specifically indicate HIV-related immunosuppression, making this choice incorrect.
D. Pneumocystis jirovecii is the causative organism of Pneumocystis pneumonia, directly linked to the opportunistic infection in HIV+ patients. This fungal pathogen thrives in immunocompromised hosts, aligning with the patient’s condition.
E. Mycobacterium tuberculosis causes tuberculosis, which is an opportunistic infection in HIV+ patients but less commonly the primary indicator compared to Pneumocystis jirovecii for Pneumocystis pneumonia, making it less accurate here.
F. Influenza virus causes influenza, which is not an opportunistic infection specific to HIV+ patients. This makes it an incorrect choice for the causative organism.
G. Trimethoprim-sulfamethoxazole is the first-line treatment for Pneumocystis pneumonia in HIV+ patients, effectively targeting Pneumocystis jirovecii. It is widely recommended in clinical guidelines for both treatment and prophylaxis, fitting the patient’s needs.
H. Isoniazid is used for tuberculosis treatment or prophylaxis, not Pneumocystis pneumonia. Since the correct infection is Pneumocystis pneumonia, this choice is inappropriate.
I. Oseltamivir treats influenza, which is not an opportunistic infection in HIV+ patients, making this an incorrect treatment option for the context of the question.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: A nasal cannula at 2 L/min delivers low-flow oxygen (24-28% FiO2), insufficient for a COPD exacerbation, where hypoxemia is severe due to airway obstruction and ventilation-perfusion mismatch. It cannot provide precise, high FiO2 needed to correct hypoxia while avoiding excessive oxygen, which may suppress respiratory drive in COPD patients.
Choice B reason: A simple face mask at 10 L/min delivers 40-60% FiO2 but lacks precision in oxygen concentration. In COPD, excessive oxygen can reduce respiratory drive, causing CO2 retention due to the hypoxic drive mechanism. This makes it less suitable than a Venturi mask, which provides controlled oxygen delivery.
Choice C reason: A non-rebreather mask at 15 L/min delivers near 100% FiO2, which is excessive for COPD exacerbation. High oxygen levels can suppress the hypoxic drive in COPD patients, leading to hypercapnia and respiratory failure. Controlled oxygen delivery is needed to balance oxygenation and CO2 retention risks.
Choice D reason: A Venturi mask at 40% FiO2 delivers precise oxygen concentrations, ideal for COPD exacerbations. It balances hypoxemia correction with the risk of CO2 retention by providing controlled FiO2. This prevents suppression of the hypoxic respiratory drive while ensuring adequate oxygenation, making it the preferred method for acute COPD management.
Correct Answer is A
Explanation
Choice A reason: Cleaning the tracheostomy site every 8 hours prevents infection by removing secretions and debris that can harbor bacteria. The site is prone to colonization due to its exposure to air and secretions. Regular cleaning with sterile technique maintains skin integrity and reduces the risk of tracheitis or skin breakdown, a key complication.
Choice B reason: Suctioning every 2 hours is excessive unless clinically indicated by excessive secretions or obstruction. Over-suctioning can cause mucosal trauma, bleeding, or hypoxia. Suctioning should be performed as needed, based on assessment of airway patency, to avoid complications while ensuring effective clearance of mucus from the tracheostomy.
Choice C reason: Changing the tracheostomy tube daily is not standard practice. Tubes are typically changed every 1-4 weeks, depending on the device and patient condition, to avoid trauma and infection. Daily changes increase the risk of airway injury and site irritation, making this an inappropriate routine action for tracheostomy care.
Choice D reason: Applying a tight dressing around the tracheostomy is incorrect, as it can obstruct airflow or cause pressure injury to the surrounding skin. A loose, clean dressing or tracheostomy collar is used to protect the site while allowing air exchange and preventing skin breakdown, ensuring airway patency and patient safety.
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