TROPICAL DESEASE

Nursing Care Of Patient with AIDS

Member Of Group III : 1. Astrilia Diah Kartikasari (130915011) 2. Dian Panorama (130915024) 3. Sisfani Mirzana (130915027) 4. Suci Wulandari (130915047) 5. Tuti Wijaya (130915061) 6. Fayadita Mahdia Izzati (130915071) 7. Agustian Saqurin (130915085) 8. Kinta Astriyati (130915120) 9. Sylvia (130915128) 10.Rizky Putra Prihatama (130915134) 11. Febianca (130915143)

FAKULTAS KEPERAWATAN UNIVERSITAS AIRLANGGA 2010

and the condition of heart or blood vessel. which gives blood its red color. occupation. hormones. there are about 1/13 of total weight body or + 4-5 liter. as well as organic molecules such as metabolites. The major solute of the plasma in terms of its concentration is Na +. And are actually fragments of large cells called megakaryocytes which found in bone marrow. it provides an increased surface area through which gas can diffuse. Leukocytes differ from Erythrocytes in several respects. Vaccines are not available for any of the diseases listed here. leukocytes. The transmission process from the infectious agent through subcutaneous blood exchange. It supports the function of leukocytes as immune function. enzymes. As immune function c. Commonly in the health body. Plasma is a straw colored liquid consisting of water dissolved solutes.2 Composition of the Blood Blood consist of formed elements that are suspended and carried in of fluid called plasma. bacterium or virus that is infectious to humans and animals. This blood flow through the body because of heart activity. The main role of blood: a. In addition to Na+ . Leukocytes contain nuclei and mitochondria and can move ameboid fashion. and platelets-function.000-9. about 7μm in diameter and 2. Erithrocytes are flattened. It has no color. Each erythrocyte contains approximately 280 millions hemoglobin molecules. the amount about 6.1 Blood A tissue of body that exists in the blood vessel and the color is red. The red color depends on the amount of O2 and CO2 inside the blood. Platelets or thrombocytes are the smallest of the formed elements. This condition depends on age.2 μm thick. nutrition. ANATOMY AND PHYSIOLOGY 2.000 . Transport CO2 and O2.TROPICAL DISEASE 1. biconcave discs. DEFINITION Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. 2. The functions are carrying 0 2 from lungs to the body and remove CO2 from tissues trough lungs. Their unique shape relates to the function of transporting oxygen. The amount of Erithrocytes about 5 millions in 1 mm 3 blood. The formed elements are erythrocytes. and remove unuseful substances through skin and kidney b. and other proteins. The platelet count per cubic milimeters of blood ranges from 130. plasma contains many other ions. These disease may carry a parasite. antibodies. Keep the temperature of the body 2.000 in 1 mm3.

intrapartum.to 140. which is not itself a disease.000 but this count can vary greatly under different physiological conditions.g. but rather a series of symptoms and conditions caused. is a sexually-transmitted infection (though it can be transmitted in other ways) whose effects include the decreased functioning of the immune system. -Free sex -Drugs use (e. or HIV.infected mom to the baby (antepartum. ASI) -unsterile medical equipments Decreasing immune system HIV infections Positive AIDS Gb. postpartum. HIV is the root cause of the condition known as AIDS (acquired immune deficiency syndrome). by a poorly or non-functioning immune system. 3. with syringe) -Blood transfusion .1 HIV . SIGN AND SYMPTOMS OF AIDS 3. PATHOPHYSIOLOGY.1 Pathophysiology The human immunodeficiency virus. Platelets play an important role in blood clotting.

Hereditary Diseases 3. Fatigue 9. B5 : Bowel(GI system)nausea. E 1. Lactic Acidosis 7. TBC. Address) II. vomiting. diarhea 6. History of present illness 1. Chief Complain : Fatigue. muscle. Age. Patient Identity (Name. nausea. Thrush 4. B4 : Bladder(genitourinary system)vulvovaginal candida. Sinus Infections 8. B6 : Bone(bone. oral candida III. sifilis 5. Nausea / Vomiting 10. Weight Loss 5. Sign and symptoms 1. Depression 2. V. Religion. and Pneumonia 2. Present illness history : about 3 months continuously diarrhea.b.1 Assessment Nursing History I. B3 : Brain(nervous system)brain toksoplasmosis. Education. Lipodystrophy 6. B1 : Breathing(respiratory system)Dyspnea. weight body 10% per 3 months. Past Nursing History 1. bacterial meningitis 4. Family Health History Observation And P. integument)oedema . Race. Occupation. NURSING PROCESS 4. Allergic History IV. History of contagious diseases 2. dysphagia. B2 : Bleeding(cardiovascular system) cardiomyopathy 3. Diarrhea 3. depression 2. Burning and Tingling of the Feet and Hands 4.

CD4+ lymphocyte count (previously T4 helper cells): Reduced. CD8+ (CTL) have been strongly implicated in the control of HIV-1 replications. The critical role of Pap smear screening relates to its ability to detect precursor lesions that can precede the diagnosis of invasive carcinoma by several years. bDNA 3. The criterion for positive PPD when immunodeficiency is present is 5-mm indurations. Viral load tests RI-PCR : Detects viral RNA levels as low as 50 copies/mL of plasma. Thus. Pelvic/genital examination: Identifies presence of lesions from sexually transmitted diseases (STDs). Screening tests: Purified protein derivative (PPD): Used to screen for TB exposure. based on rise of viral load or maintenance of a low viral load. counts equal to/or below 200 define progression to AIDS. Some researchers postulate CD4+ cells are eliminated early.) Therapy can be initiated. cervical and vaginal abnormalities. Serologies: Rapid plasma regains (RPR)/VDRL: Determines current/past exposure to syphilis and need for more specific testing. Psychosocial assessment VI. (Seroconversion can occur between 4 wk to 6 mo after exposure. CD4+ cells are a target for HIV infection and destruction. and lipids rise as HIV infection progresses. Levels are measured immediately before and again 4–8 wk after initiation of antiretroviral therapy. Pap smear: Higher incidence (40%) of abnormal cells occurs in HIV-infected women. Albumin/prealbumin and transferring .000/mL. CD8+ CTL (cytopathic suppressor cells): Current quantitative assays allow for rapid evaluation of levels. Sensitivity varies. or changes made in treatment approaches.0 assay: Has a wider range: 50–500. CD8+ (CTL) numbers are reduced.)Western blot test (blood/urine): Confirms diagnosis of HIV-1 in individuals with positive ELISA screening. Toxoplasma and hepatitis B and C serologies may be done. with the incidence of false-positive results being approximately 10%. - DIAGNOSTIC TEST AND MEDICAL TREATMENT - Enzyme-linked immunosorbent assay (ELISA): A positive test result may be indicative of exposure to HIV but is not diagnostic.7. A positive result reflects current or prior exposure to TB. Chemistries: Glucose levels elevated as a result of insulin resistance. They may not contribute to host defense substantially in the late stages of disease. At late stage of infection. it is used to diagnose HIV infection and progression and to monitor effects of drug therapy. (The RI-PCR range is 50–75. Patients with counts below 500 benefit from antiretroviral therapy.000 copies/mL. Endocrine systemdecreasing immunity 8. The role of CD4+ T-cells is unclear. This is currently the leading indicator of effectiveness of therapy.

Nursing Goal Statements Diagnoses (NOC) Altered nutrition -maintain weight less than body between 0. anergic. -make new anthropometric measures.3 Intervention No 1 : Altered nutrition. RBC counts are decreased and abnormalities in iron metabolism can result in anaemia. oral candidas.35 requirements kg loss from weight loss before sick.Problem Etiology Sign and symptoms c. and/or symptomatic individuals. such as gallium scan. 4. Then the immune system decreasing or become weak. .9 – 1. pale.levels are decreased secondary to malabsorption/malnutrition that is usually progressive.pneumocystis carini. moist skin/wet. -determine the proper diet and nutrition knowledge. infections of candida albicans. Rationale -Early weight-loss provisions would not chart weight and normal height. -maintain mass of adequate muscle. cold. It also cause by certain medicine influence : Diarrhea. Problem Etiology Sign and symptoms b. it makes client easily get another infections. herpes simplex. Chest x-ray: Abnormalities suggest presence of TB in PPD-positive. fever. tachycardia.2 Nursing diagnosis a. less than body requirement : Candida as an opportunistic infection usually Appear in the mouth till esophagus it causes client Has impaired swallowing and nausea so the client lack of nutrition. : fatigue. TB : Anxiety death : Powerless over issues related to dying. deep sadness because there is no permanent medicine to cure AIDS : pale. nausea. decrease blood pressure. which occurs in 17% of asymptomatic patients and up to 85% of patients with advanced disease. thereby determining trakhir weight in relation to weight pradiagnosis more useful. -show that laboratory’s test on Intervention (NIC) -determine the general weight before patients diagnosed HIV. loss of body weight.Problem Etiology Sign and symptoms 4. Diagnosis is then verified by sputum cultures or other tests. depression. CBC: Haemoglobin. : Risk for infection : HIV is a virus that attacks our immune system.

-noted side effects of drugs on nutrition. -improve the nutrition of income because of drugs and diseases can alter the sense of smell and taste. -encourage a supportive environment for food. instruct patients to wash their hands -help monitor and determine the decrease in nutritional needs according to disease progression. help patients plan how to maintain the suggestion. -provide information about nutrition with calories. and revenue. vitamins. -reached during wound healing. encourage usage spices for cooking. -report improvement energy level. -drugs commonly used cause anorexia and nausea / vomiting: a few affect the production of human bone marrow. 2. proteins and high minerals. -information can help patients understand the diet balanced. -press the importance of maintaining adequate nutritional balance. -help the patient to formulate a diet plan. -provide assistance and back for increased unmpan sense of control. -no fever and free -administering medicine and antibiotic -wash your hands before and after treatment contacts made. -identification of these factors may help to plans to individual needs. -identify behaviours that reduce the risk of infection. Risk for infection. confidence. -Antibiotics administered at the proper timing interval ensure adequate maintenance of therapeutic levels . -recognize the importance of input of nutrients to maintain health can motivate patients to maintain a proper diet.normal limits.

-check the skin of white spot.from purulent expenses and other signs of infection conditions. herpes. -provide basic data information. and avoid cutting cuticles. -maintain personal health and discuss the rational level and preventive isolation. CMV. -check the wound and watch the signs of local infection. -examine the frequency of respiratory. the most common diseases occur. -reduce the risk of transmission of pathogens through the skin. increased abdominal cramps. note change in mentality and behaviour. including temperature. -provide a clean environment and a well-ventilated. -oesophagitis may occur secondary to oral candidacies or herpes. -label on the tube of blood. -reduce the risk of cross contamination. -oral candidiasis. dysphagia. nearest appropriate indications. -check vital signs. soiled bandages and wrapped properly. -wear gloves and skort for direct contact with secretions or whenever there is damage to the skin of the nurse's hand. body fluid containers. KS. -general and neurological abnormalities may be associated with HIV or sekuner infection. diarrhoea. -monitor complaints heartburn. -reduce pathogens in the immune system and the possibility of infection. retrosternal pain during swallowing. -early identification of secondary infections may prevent the . and change in vision. the increase temperature repeatedly. -clean nails every day. and Cryptococcus is a common disease and effect on the skin membrane. -respiratory congestion may indicate the development of PCP. stiff neck. -oversee disposal syringes and blades. -investigate complaints of headache. -improve cooperation and try to reduce the sense of isolation. -clean spray of body fluids or blood with a bleach solution.

-recognize and support phase of the patient / family in the grieving process. -assure patient confidentiality within the limits of a particular situation. provide an opportunity to ask and answer honestly. occurrence of sepsis. -use of masks. improve selfconfidence -give the opportunity to solve the problem -reduce patient anxiety and inability to make decisions based on reality -sense of guilt and spiritual stress may cause patients to withdraw and believe that suicide is one of the alternatives -helps patients to feel welcome without feeling judged and enhance self-esteem and feelings of control -acceptance would make the patient feel accepted the situation -choice of intervention is determined by the . -using the resources effectively. -avoid crosscontamination. despair. -shows the normal range of feelings and less fear.3. determine the incidence of suicide ideation and examine its potential on a scale of 1-10. without confrontation. -prevent accidental inoculation from caregivers. -showed the ability to overcome the problem. -allow patients to express anger. Anxiety Death -express feelings and awareness about healthy ways to deal with it. -explain procedures. fear. -maintain good relationships with patients. -provide accurate and consistent information about prognosis. -control of microorganisms on hard surfaces. -provide an open environment where patients feel safe to discuss their feelings. gloves skort and conducted by OSHA for direct contact with body fluids. -show a sense of respect and accept these people. -alert to signs of rejection / depression.

grieving stage. coping behaviour -accurate information will make the patient can be effective in dealing with the reality of the situation -reduce feelings of isolation -interpersonal interactions create a better and reduce the anxiety and fear -guarantee the existence of support systems for patients and allows people closest to participate in the life of the patient 4. -Similar people involved in the decision-making are major.-encourage interaction with the patient's support system. -provide reliable information and consistent support for the nearest.4 Evaluation Subjective Objective Assessment : Interview and symptoms : Laboratory test and sign : Goal met  stop planning Goal partially met  continue and modify Goal not met  modify New Problem  new assesment : stop planning  Goal met continue and modify  Goal partially met modify  Goal not met new assessment  New Problem Planning .

L. Jean. 2000. M. Pearson Prentice Hall.1997. Asuhan Keperawatan pada pasien terinfeksi HIV/AIDS. V. London :Chapman & Hall. Mosby. R. J. Ian & Faugjer. 2005.REFERENCES Brashers. 1999. L. Ninuk Dian. Pathophisiology. Philadelphia : Lippincot Carpenito. Anatomi Fisiologi. Rencana Asuhan Keperawatan. Philadelphia: Lippincott. AIDS And HIV The Nursing Response. Nursing Diagnosing Handbook.L.2000. Bullock.2010. J. 1998. B. 1996.English in Nursing-Midwifery Sciences And Technology. Nursing Diagnosis Aplication to Clinical Practice. Jakarta: Salemba Medika Nursalam & Kurniawati. Jakarta : EGC Hicken. Jakarta: Salemba Medika Syaifudin. Jakarta : EGC Wilkinson. Doenges. Nursalam. . Clinical Application Of Phatophysiology.2008. Marilynn.L & Henze.

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