Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each...
-
Upload
ross-craig -
Category
Documents
-
view
219 -
download
0
description
Transcript of Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each...
![Page 1: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/1.jpg)
HUMAN IMMUNODEFICIENCY
VIRUS (HIV) INFECTION
Zoya Minasyan RN-MSN-Edu
![Page 2: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/2.jpg)
Significance of Problem
Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year
In the United States• 56,000 new infections each year • Since the beginning of the epidemic, sub-Saharan Africa has been the most devastated, but the Caribbean, Asia, Eastern Europe, and South America also have growing epidemics.
• In developing countries, the major route of transmission is heterosexual sex, and women and children bear a large part of the burden of illness.
![Page 3: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/3.jpg)
Transmission of HIV Fragile virus transmitted only through
contact with body fluids Blood, semen, vaginal secretions, and breast
milk Sex with infected partner Exposure to infected blood or blood products Pregnancy, delivery, or breastfeeding
![Page 4: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/4.jpg)
Pathophysiology of HIV RNA virus (retrovirus) discovered in 1983 Binds to specific CD4 and chemokine receptors to enter cell
![Page 5: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/5.jpg)
HIV Proteins Bind to Cell
5
HIV has gp120 glycoproteins that attach to CD4 and chemokine CXCR4 and CCR5 receptors on thesurface of CD4+ T cells. Viral RNA then enters the cell, produces viral DNA in the presence of reversetranscriptase, and incorporates itself into the cellular genome in the presence of integrase, causing permanentcellular infection and the production of new virions. New viral RNA develops initially in long strands that are cutin the presence of protease and leave the cell through a budding process that ultimately contributes to cellulardestruction.
![Page 6: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/6.jpg)
Pathophysiology of HIV Reverse transcriptase assists to make
viral DNA. Viral DNA enters cell nucleus and splices
itself into genome permanently. Integrase
![Page 7: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/7.jpg)
Viral Load in the Blood Initial infection
Viremia (large viral levels in blood) for 2 to 3 weeks Transmission is more likely when viral load is
high. Followed by prolonged period (years) of low
viral load
![Page 8: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/8.jpg)
Pathophysiology of HIV
Cells with CD4 receptor sites are infected CD4+ T cells (T helper cells) Lymphocytes Monocytes/macrophages Astrocytes Oligodendrocytes
Immune problems start when CD4+ T-cell counts drop to below 500 cells/μL. Normal range is 800 to 1200
cells/μL. Allows for opportunistic diseases
![Page 9: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/9.jpg)
Clinical Manifestations and Complications
Acute infection Flulike symptoms
Fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle and joint pain, diarrhea, or a diffuse rash
Occurs about 2 to 4 weeks after infection Lasts for 1 to 2 weeks
![Page 10: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/10.jpg)
Clinical Manifestations and Complications
Early chronic infection Generally asymptomatic
Fatigue, headache, low-grade fever, and night sweats often occur.
Most are not aware of infected status.
![Page 11: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/11.jpg)
Clinical Manifestations and Complications
Intermediate chronic CD4+ T cells drop to 200 to 500 cells/μL.
Viral load increases. HIV advances to a more active state.
![Page 12: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/12.jpg)
Clinical Manifestations and Complications
Intermediate chronic symptoms Thrush Oral hairy leukoplakia Shingles Persistent vaginal candidal infections Herpes Bacterial infections Kaposi sarcoma
![Page 13: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/13.jpg)
Oral Thrush
Oral thrush involving hard and soft palate.
![Page 14: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/14.jpg)
Oral Hairy Leukoplakia
Oral hairy leukoplakia on the lateral aspect of the tongue.
![Page 15: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/15.jpg)
Kaposi Sarcoma
Kaposi sarcoma (KS). Malignant vascular lesions. KS lesions can appear anywhereon the skin surface or on internal organs. Lesions vary in size from pinpoint to very large andmay appear in a variety of shades.
![Page 16: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/16.jpg)
Clinical Manifestations and Complications
Late chronic or AIDS Immune system severely compromised Great risk for opportunistic disease Possible malignancies, wasting, and dementia
![Page 17: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/17.jpg)
Clinical Manifestations and Complications
Common opportunistic diseases Pneumocystis jiroveci pneumonia Cryptococcal meningitis Cytomegalovirus retinitis Mycobacterium avium complex Kaposi sarcoma Influenza virus
![Page 18: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/18.jpg)
Pneumocystis jiroveci
Chest x-ray showing interstitial infiltrates as the result ofPneumocystis jiroveci pneumonia.
![Page 19: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/19.jpg)
Diagnostic Studies Most useful screening tests detect HIV-
specific antibodies May take 2 months (window period) to detect
antibodies
![Page 20: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/20.jpg)
Diagnostic Studies Progression monitored by CD4+ T-cell
counts and viral load Abnormal blood tests common
Neutropenia, thrombocytopenia, and anemia Altered liver function tests
Resistance tests
![Page 21: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/21.jpg)
Collaborative Care Focus Monitoring HIV disease progression and
immune function Initiating and monitoring antiretroviral
therapy (ART) Preventing, detecting, and treating
opportunistic infections
![Page 22: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/22.jpg)
Collaborative Care Focus Managing symptoms Preventing or decreasing complications of
therapies Preventing further transmission
![Page 23: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/23.jpg)
Collaborative Care Initial visit
Gather baseline data Education about spectrum of HIV, treatment,
preventing transmission, improving health, and family planning
![Page 24: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/24.jpg)
Collaborative Care Initial visit
Gather baseline data Education about spectrum of HIV, treatment,
preventing transmission, improving health, and family planning
![Page 25: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/25.jpg)
Drug Therapy Main goals
Decrease viral load. Maintain/raise CD4+ counts. Delay HIV-related symptoms and opportunistic
infections.
![Page 26: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/26.jpg)
Drug Therapy Nucleoside, non-nucleoside, and
nucleotide reverse transcriptase inhibitors Inhibit the ability of HIV to make a DNA copy
early in replication Protease inhibitors
Interfere with activity of enzyme protease
![Page 27: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/27.jpg)
Drug Therapy Fusion inhibitors
Interfere with HIV CD4 receptor site binding and entry into cells
![Page 28: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/28.jpg)
Drug Therapy Combination antiretroviral therapy
Three or more drugs from different groups are prescribed at full strength.
![Page 29: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/29.jpg)
Drug Therapy Prophylactic medication given to prevent
opportunistic infection Ongoing research seeks a biochemical
means of preventing HIV transmission.
![Page 30: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/30.jpg)
Nursing Management Assessment
Ask at-risk patients: Received blood transfusion or clotting factors
before 1985? Shared needles, syringes, or other injection
equipment with another person?
![Page 31: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/31.jpg)
Nursing ManagementAssessment
Ask at-risk patients: Had a sexual experience with your penis,
vagina, rectum, or mouth in contact with these areas of another person?
Had a sexually transmitted disease (STD)?
![Page 32: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/32.jpg)
Nursing ManagementAssessment
Assess diagnosed patients Repeat assessments over time as
circumstance changes
![Page 33: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/33.jpg)
Nursing Management Planning
Interventions Adhere to drug regimens. Promote healthy lifestyle. Prevent transmission to others. Have supportive relationships.
![Page 34: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/34.jpg)
Nursing Management Planning
Interventions Maintain productive activity. Explore spirituality. Come to terms with living with disease,
disability, and death. Cope with symptoms and treatments.
![Page 35: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/35.jpg)
Nursing ManagementImplementation
HIV is a highly variable chronic disease. Holistic and individualized approach is best.
![Page 36: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/36.jpg)
Health Promotion Major goal: Prevention
Four strategies Use testing as routine health care. Use rapid testing. Work to modify risky behaviors. Offer tests universally to pregnant women.
![Page 37: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/37.jpg)
Health Promotion Prevention of HIV
Decreasing risks: Sexual intercourse Use of barriers
![Page 38: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/38.jpg)
Health Promotion Prevention of HIV
Decreasing risks: Drug use Do not use drugs. Do not share equipment. Do not have sexual intercourse under the
influence of any impairing substance.
![Page 39: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/39.jpg)
Health Promotion Prevention of HIV
Decreasing risks: Perinatal transmission Prevent HIV in women. Appropriately medicate HIV-infected pregnant
women.
![Page 40: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/40.jpg)
Health Promotion Prevention of HIV
Decreasing risks: Work Adhere to precautions and safety measures to
avoid exposure. Postexposure prophylaxis with combination ART.
![Page 41: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/41.jpg)
HIV Testing and Counseling Testing is only sure method to determine
infection. Negative results: Opportunity for prevention
education Positive results: Treatment and education to
protect sexual and drug-using partners All testing should be accompanied by pretest
and posttest education
![Page 42: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/42.jpg)
Acute Intervention Early intervention promotes health and
delays disability. Reactions to positive HIV test
Similar to any life-threatening, chronic illness Panic, anxiety, fear, guilt, depression, denial,
anger, hopelessness
![Page 43: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/43.jpg)
Antiretroviral Therapy Multidrug therapy can reduce viral load
and disease progression, but it Is complex Has interactions Does not work for everyone Is expensive
![Page 44: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/44.jpg)
Antiretroviral Therapy When to start therapy
Patient readiness is the most important concern.
To avoid burnout and nonadherence, treatment is recommended when immune suppression is great.
![Page 45: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/45.jpg)
Antiretroviral Therapy Adherence to drug regimens is critical to
prevent Disease progression Opportunistic disease Viral drug resistance
![Page 46: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/46.jpg)
Antiretroviral Therapy Ways to improve adherence
Understand each patient is unique. Provide electronic reminders or timers.
![Page 47: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/47.jpg)
Acute Exacerbations Recurring problems of infection, cancer,
debility, and psychosocial/economic issues affect ability to cope.
![Page 48: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/48.jpg)
Ongoing Care Social stigma
Behaviors may be viewed as immoral, illegal, or uncontrolled by infected person.
![Page 49: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/49.jpg)
Ongoing Care Discrimination causes loss of jobs,
homes, and insurance. Most severe for women Americans with Disabilities Act makes
discrimination illegal.
![Page 50: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/50.jpg)
Disease and Drug Side Effects
Common physical problems Anxiety, fear, depression Diarrhea Peripheral neuropathy Pain Nausea/vomiting Fatigue
![Page 51: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/51.jpg)
Disease and Drug Side Effects
Common metabolic disorders Lipodystrophy Hyperlipidemia Insulin resistance Bone disease Lactic acidosis Cardiovascular disease
![Page 52: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/52.jpg)
Lipodystrophy
FiLipodystrophy manifestations.
![Page 53: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/53.jpg)
Disease and Drug Side Effects
Management of metabolic disorders Early detection Dealing with symptoms Helping to cope
![Page 54: Zoya Minasyan RN-MSN-Edu. Globally 33 million living with HIV 2.7 million new infections each year 2 million HIV-related deaths each year In.](https://reader036.fdocuments.us/reader036/viewer/2022062523/5a4d1b0c7f8b9ab05998b963/html5/thumbnails/54.jpg)
End-of-Life Care Focus of nursing intervention
Patient comfort Promoting acceptance of finite nature of life Helping significant others deal with loss Maintaining safe environment