Page 1152 - Saunders Comprehensive Review For NCLEX-RN

An infant or child infected with HIV is at risk for developing a

life-threatening opportunistic infection. Monitor the infant or child closely
for signs of infection and report these signs immediately if they occur.

B. Assessment (see Box 40-1 and Box 40-2)

C. Diagnostic tests: Before testing, counseling should be

provided to parents; issues that should be addressed include the
causes of HIV, reasons for testing, implications of positive test
results, confidentiality issues, and beneficial effects of early
intervention (Table 40-1).
III. Care of the Child with HIV Infection or AIDS

A. An interprofessional health care approach is taken;

primary goals are to decelerate the replication of the virus, prevent
opportunistic infections, provide nutritional support, treat
symptoms, and treat opportunistic infections.
B. Prophylaxis (P. jiroveci pneumonia and other opportunistic
infections)
1. Provide prophylaxis as prescribed against P. jiroveci
pneumonia and other opportunistic infections,
particularly during the first year of life of an infant
born to an HIV-infected mother.
2. After 1 year of age, the need for prophylaxis is
determined on the basis of the presence and severity
of immunosuppression or a history of P. jiroveci
pneumonia.
3. Continuing prophylaxis is based on the child’s HIV
status, history of opportunistic infections, and CD4 +
counts.
C. Antiretroviral medications (refer to Chapter 63)

Before administering an antiretroviral medication, ensure that the medication is

safe for pediatric administration. Also check the contraindications for use and the adverse
effects.

1. The goal of antiretroviral medications is to

suppress viral replication to slow the decline in the
+
number of CD4 cells, preserve immune function,
reduce the incidence and severity of opportunistic
infections, and delay disease progression.
2. The medications affect different stages of the HIV life
cycle to prevent reproduction of new virus particles.
3. Combination therapy may be prescribed and includes

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