Human Immunodeficiency Virus RAPID Reasoning Michelle Johnson, 36-years old includes all Gas Exchange  Infection  Clinical Judgment  Patient Education.

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Gas Exchange  Infection  Clinical Judgment  Patient Education NCLEX Client Need Categories Percentage of Items from Each Category/Subcategory Covered in Case Study Safe and Effective ... Care Environment  Management of Care 17-23%   Safety and Infection Control 9-15%  Health Promotion and Maintenance 6-12%  Psychosocial Integrity 6-12%  Physiological Integrity  Basic Care and Comfort 6-12%   Pharmacological and Parenteral Therapies 12-18%   Reduction of Risk Potential 9-15%   Physiological Adaptation 11-17%  History of Present Problem: Michelle Johnson is a 36-year-old African American female with no prior medical history who presents to the emergency department complaining of extreme fatigue for the past several months and experiencing occasional night sweats. During the past week, she has developed a sore throat, dry, nonproductive cough, fever at night with increasing shortness of breath. Michelle embarrassingly admits that she has had a vaginal yeast infection that she has tried to treat with over the counter medications with no success. Michelle states to the triage nurse, “I came in today because I am worried something is wrong with me, I hope it’s nothing serious!” Personal/Social History: Michelle has been divorced for five years and has two daughters (ages 14 and 16) who works full time as a legal secretary. She has recently been working longer hours, skipping meals, and stressed over the possibility of not being able to provide for her two daughters. She has been involved in only one relationship since her divorce. She is engaged to Ken, who has hemophilia and plan to get married next year. What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse? RELEVANT Data from Present Problem: Clinical Significance: Extreme fatigue over past several months, occasional night sweats New onset—sore throat, nonproductive cough, fever at night, increasing SOB Vaginal yeast infection, unsuccessfully treated with over the counter medication Night sweats and prolonged unexplained fatigue are early symptoms of an acute HIV infection. Potential for development of respiratory infection due to decreased immune system strength due to HIV infection. Sore throat, cough, fever, and SOB are clinical manifestations associated with HIV. Difficult to treat infections are common in patients with HIV due to the suppression place on the immune system, decreasing the bodies ability to fight off infections. Recurring difficult to treat vaginal yeast infections could persist in female patients with HIV RELEVANT Data from Social History: Clinical Significance: Longer hours at work, skipping meals, stressed about financially providing for two daughters High stress level and poor nutrition will negatively impact patient health, further decreasing ability to fight off infection. [Show More]

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