- Disturbed Body Image related to Distrust of body function and Fear of disease progression as evidenced by Preoccupation with past strengths and functions and
Perceptions that reflect an altered view of appearance - Imbalanced Nutrition: Less Than Body Requirements related to Altered taste perception and Inability to digest food as evidenced by Body weight below ideal weight range for age and gender and Muscle hypotonia
- Ineffective Protection related to Impaired immunity and Engagement in risky behaviours (i.e., unprotected sex, sharing of needles) as evidenced by Detectable HIV viral load and Decreased CD4 count
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective Data: -Expresses concerns about sexuality -Expresses fear of rejection by others Objective Data: -Preoccupation with past strengths and functions -Preoccupation with changes/loss -Perceptions that reflect an altered view of appearance -Nonadherence to treatment | Disturbed Body Image related to Distrust of body function and Fear of disease progression as evidenced by Preoccupation with past strengths and functions and Perceptions that reflect an altered view of appearance | Patient will demonstrate acceptance of body changes by adhering to their medication and treatment plan. Patient will verbalize acceptance of their progressive disease | 1. Allow the patient to express emotions and feelings. Expression of feelings and emotions relieves anxiety and reduces depressive behavior. It also helps nurses better understand what the patient is going through. 2. Provide education and support. Patients with HIV infection often feel rejected or stigmatized by society. Provide support to the patient about their disease and educate them that patients can live normal lives with treatment. 3. Interact as you would with any other patient. Patients can sense if a healthcare provider is judgmental or stereotyping them. Patients with HIV deserve the same care and interaction as all patients. Contact with a patient with HIV does not require anything beyond standard precautions and the nurse must educate themselves if they recognize feelings of assumption or prejudice. 4. Encourage support groups. Social support is important in learning to live with HIV. Encourage the patient to interact with others who are HIV positive by joining online groups and community programs to gain confidence and recognize their diagnosis does not define them. | Patient demonstrated acceptance of body changes by adhering to their medication and treatment plan. Patient verbalized acceptance of their progressive disease |
| Subjective Data: -Reported increased appetite and interest in food Objective Data: -Body weight below ideal weight range for age and gender -Constipation -Mouth sores/ulcers -Diarrhea -Food intake less than recommended daily allowance (RDA) -Muscle hypotonia | Imbalanced Nutrition: Less Than Body Requirements related to Altered taste perception and Inability to digest food as evidenced by Body weight below ideal weight range for age and gender and Muscle hypotonia | Patient will consume an ideal amount of calories for height/weight and activity level. Patient will report increased appetite and interest in food. | 1. Educate the patient about the side effects of the current medication regimen. Drug therapy for HIV often causes altered taste, anorexia, nausea, and vomiting. 2. Provide an environment conducive to eating. Ensure uninterrupted mealtimes, provide small frequent meals and snacks, and remove noxious odors to help improve appetite and promote nutritional intake. 3. Encourage oral hygiene. Patients with HIV infection often develop mouth sores, disrupting the patient’s ability to eat. Good oral hygiene can enhance appetite and promote a desire to eat. 4. Administer medications as indicated. Antiemetics administered before meals can help reduce nausea and vomiting and promote appetite. Appetite stimulants may also be prescribed to enhance appetite. 5. Consult with a dietitian. Collaborating with a dietitian ensures the formulation of a nutritionally balanced diet that prevents nutrient deficiencies in patients with HIV. | Patient consumed an ideal amount of calories for height/weight and activity level. Patient reported increased appetite and interest in food. |
| Subjective Data: -Expresses concerns about sexuality -Expresses fear of rejection by others Objective Data: -Preoccupation with past strengths and functions -Preoccupation with changes/loss -Perceptions that reflect an altered view of appearance -Nonadherence to treatment | Ineffective Protection related to Impaired immunity and Engagement in risky behaviours (i.e., unprotected sex, sharing of needles) as evidenced by Detectable HIV viral load and Decreased CD4 count | Patient will not acquire opportunistic infections. Patient will maintain a CD4 count of > 500 cells/mm3. Patient will demonstrate precautions preventing AIDs and HIV transmission. | 1. Observe standard precautions. Healthcare-associated infections are commonly due to the transmission of harmful microorganisms through the hands of health workers. Handwashing is the first step to reducing this risk. When starting IVs or performing invasive procedures, adhere to aseptic or sterile techniques to prevent the transmission of pathogens. 2. Provide meal planning with high-calorie and high-protein foods. PLHIV experience wasting syndrome, especially with the progression to AIDS. Once muscle and fat are lost, it’s difficult to regain. Providing high-calorie and high-protein foods will help replace lost fat, muscle, and nutrients. 3. Administer antimicrobials and antifungals. Patients may require prophylactic antibiotics and antifungals against opportunistic infections when CD4 counts become suboptimal. 4. Administer immunizations. PLHIV have decreased protection against opportunistic infections. The CDC recommends that PLHIV be vaccinated against hepatitis B, human papillomavirus (HPV), influenza, meningitis, pneumonia, tetanus, diphtheria, and pertussis. 5. Referrals to community resources. HIV’s devastating effects on the socioeconomic status of the patient can be addressed by linking them to social services, free health clinics, financial services, food banks, and more. 6. Encourage proper hygiene. Bathing and oral hygiene are essential to prevent the development of oral thrush and skin rashes and sores that can occur with HIV and AIDS | Patient minimized from acquiring opportunistic infections. Patient maintained a CD4 count of > 500 cells/mm3. Patient demonstrated precautions preventing AIDs and HIV transmission. |