The nurse is preparing a teaching plan for a group of clients who were found to be HIV positive within the last year. Members of the group express an interest in learning about the pathology of AIDS.
The nurse should explain that HIV acts in which way to suppress the immune system?

Proliferation of suppressor T-cells.

Deficiency of cytotoxic T-cells.

Increase in B-lymphocytes and IgM.

Destruction of helper T-cells and CD4 cells.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Incorrect. Suppressor T-cells (also known as regulatory T-cells) play a role in regulating the immune response, but their proliferation is not the primary mechanism by which HIV suppresses the immune system. In fact, HIV can disrupt the function of suppressor T-cells, leading to an impaired ability to control immune responses.

Choice B rationale:

Incorrect. Cytotoxic T-cells (also known as CD8+ T-cells) are important for killing infected cells, but their deficiency is not the direct cause of immune suppression in HIV. However, HIV can indirectly lead to a deficiency of cytotoxic T-cells by disrupting their production and function.

Choice C rationale:

Incorrect. B-lymphocytes produce antibodies, and IgM is an early antibody produced in response to infection. However, an increase in B-lymphocytes and IgM is not characteristic of HIV infection. In fact, HIV can impair B-cell function, leading to decreased antibody production.

Choice D rationale:

Correct. HIV primarily targets and destroys helper T-cells (also known as CD4+ T-cells). These cells play a crucial role in coordinating the immune response by activating other immune cells, such as cytotoxic T-cells and B-cells. The depletion of helper T-cells leads to a progressive weakening of the immune system, rendering the body vulnerable to opportunistic infections and cancers.

Specific mechanisms of CD4+ T-cell destruction by HIV:

Direct infection and lysis: HIV can directly infect CD4+ T-cells and replicate within them, eventually leading to the death of the infected cells.

CD4+ T-cell apoptosis: HIV can induce programmed cell death (apoptosis) in CD4+ T-cells through various mechanisms, including the activation of pro-apoptotic pathways and the disruption of anti-apoptotic signals.

Immune dysregulation: HIV infection can also dysregulate the immune system, leading to chronic inflammation and immune activation. This can further contribute to CD4+ T-cell depletion and dysfunction.

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Correct Answer is ["B","E","G"]

Explanation

B. Position the patient with the head of the bed elevated. Rationale:

Promotes lung expansion: Elevating the head of the bed by at least 30 degrees utilizes gravity to assist in diaphragmatic descent and lung expansion. This allows for greater intake of air, optimizing oxygen intake and facilitating better gas exchange.

Reduces work of breathing: When upright, the abdominal muscles can more effectively aid in breathing, reducing the workload on the diaphragm and accessory muscles. This conserves energy and decreases the patient's respiratory effort.

Enhances secretion drainage: Gravity also aids in the movement of secretions from the lower lobes of the lungs towards the upper airways, where they can be more easily coughed up or suctioned. This helps to clear the airways and improve ventilation.

E. Teach the patient to cough at least once an hour. Rationale:

Clears secretions: Coughing is a natural mechanism to clear secretions from the lungs and airways. It helps to prevent mucus buildup and potential obstruction, which can lead to atelectasis (collapse of lung tissue) and further compromise ventilation.

Improves gas exchange: By removing secretions, coughing allows for better airflow and gas exchange within the lungs. This enhances oxygenation and helps to prevent respiratory complications.

G. Assist the patient in ambulating safely. Rationale:

Mobilizes secretions: Ambulation encourages movement of secretions from the lower lobes of the lungs, promoting their clearance and preventing mucus buildup.

Prevents atelectasis: Walking and movement help to expand the lungs, reducing the risk of atelectasis and improving overall ventilation.

Enhances circulation: Ambulation also improves circulation, which can help to deliver oxygen to the tissues more effectively and aid in healing.

A. Serum Helicobacter pylori (H. pylori) antibody results and urine output amounts. B. Reports of chronic constipation and serum gastrin levels. C. Severity of nausea and vomiting and serum amylase results. D. Presence of bowel sounds and degree of abdominal pain.

Correct Answer is C

Explanation

Rationale for Choice A:

Serum Helicobacter pylori (H. pylori) antibody results are not directly relevant to the diagnosis or management of acute pancreatitis. While H. pylori infection can cause gastritis and peptic ulcers, it is not a common cause of pancreatitis.

Urine output amounts are important to monitor in patients with pancreatitis to assess for dehydration and kidney function. However, they are not as specific to the diagnosis of pancreatitis as other findings.

Rationale for Choice B:

Reports of chronic constipation are not typically associated with acute pancreatitis.

Serum gastrin levels are used to diagnose conditions such as Zollinger-Ellison syndrome, which is characterized by excessive acid production in the stomach. They are not relevant to the diagnosis of pancreatitis.

Rationale for Choice C:

Severity of nausea and vomiting are key symptoms of pancreatitis. The severity of these symptoms can help to gauge the severity of the pancreatitis and guide treatment decisions.

Serum amylase results are a highly sensitive and specific marker for pancreatitis. Elevated levels of amylase in the blood strongly suggest the presence of pancreatitis.

Rationale for Choice D:

Presence of bowel sounds can be variable in patients with pancreatitis and are not always reliable indicators of the severity of the condition.

Degree of abdominal pain is a subjective symptom that can be difficult to assess accurately. While it is an important symptom of pancreatitis, it is not as objective as other findings such as serum amylase levels.

Therefore, the most valuable information to report to the healthcare provider in this case is the severity of nausea and vomiting and serum amylase results.

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The nurse is preparing a teaching plan for a group of clients who were found to be HIV positive within the last year. Members of the group express an interest in learning about the pathology of AIDS.The nurse should explain that HIV acts in which way to suppress the immune system?

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Correct Answer is ["B","E","G"]

Explanation

Correct Answer is C

Explanation

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The nurse is preparing a teaching plan for a group of clients who were found to be HIV positive within the last year. Members of the group express an interest in learning about the pathology of AIDS.
The nurse should explain that HIV acts in which way to suppress the immune system?