Anemia In Hiv/aids

AN EMIA I N H IV

ANEMIA •

ANEMIA IS A CONDITION IN WHICH THE

NUMBER OF RED BLOOD CELLS (RBCs) OR THE

AMOUNT

OF

HEMOGLOBIN

IS

DECREASED IN THE BLOOD. • RED BLOOD CELLS AND HEMOGLOBIN ARE RESPONSIBLE FOR CARRYING OXYGEN TO VITAL ORGANS THROUGHOUT THE BODY. •

ANEMIA IS ONE OF THE MOST COMMON

BLOOD ABNORMALITIES SEEN IN PEOPLE

INCIDENCE IT HAS BEEN ESTIMATED THAT UP TO 95% OF PEOPLE INFECTED WITH HIV WILL

EXPERIENCE

ANEMIA

AT

SOME

POINT. THE INCIDENCE OF ANEMIA RANGES FROM 10% IN PEOPLE WHO HAVE NO SYMPTOMS

TO

92%

WITH ADVANCED AIDS.

IN

INDIVIDUALS

CAUSES FOR ANEMIA IN HIV NORMAL PROGRESSION OF THE DISEASE. THE VIRUS CAN INFECT PARTS OF THE BONE MARROW RESPONSIBLE FOR THE PRODUCTION OF RBCs. DEFICIENCY OF ERYTHROPOEITIN. AUTOIMMUNE DESTRUCTION OF BLOOD CELLS OPPORTUNISTIC

INFECTION

SUCH

AS

MYCOBACTERIAL AND FUNGAL DISEASES. CANCERS OF BONE MARROW SUCH AS NONHODGKINS LYMPHOMA. NUTRITIONAL DEFICIENCIES. BLEEDING.

• DRUGS USED IN THE TREATMENT OF HIV / AIDS Zidovudine Amphotericin Interferon Dapsone & Pyrimethamine Septron Chemotherapy

drugs

and

Radiation used to treat HIV related cancers.

RISK FACTORS FOR DEVELOPING ANEMIA IN HIV LOWER CD4 CELL COUNTS. HIGHER VIRAL LOAD. TAKING ZIDOVUDINE. BEING A WOMAN.

WHY ANEMIA IS IMPORTANT IN HIV? DECREASED SURVIVAL RATE POOR QUALITY OF LIFE HIGH RISK FOR DEVELOPING HEART COMPLICATIONS DISEASE PROGRESSION IS 5 TIMES MORE IN PATIENTS WITH ANEMIA REDUCED ADHERENCE TO

SIGNS & SYMPTOMS FATIGUE & LETHARGY GIDDINESS & HEADACHE ANOREXIA COLDNESS OF HANDS AND FEET DYSPNEA (EXERTIONAL / AT REST) TACHYCARDIA GLOSSITIS & ANGULAR STOMATITIS IRRITABILITY & DEPRESSION PALLOR

MEDICAL MANAGEMENT IDENTIFICATION AND TREATMENT OF THE CAUSE. BLOOD TRANSFUSION. ERYTHROPOEITIN. VITAMIN & IRON SUPPLEMENTS. DIETARY SUPPLEMENTS.

NURSING MANAGEMENT IMPORTANT NURSING DIAGNOSES Activity intolerance related to imbalance between oxygen supply and demand. Imbalanced nutrition less than body requirements related to inadequate nutritional intake / disease progression / side effects of the drugs. Ineffective management of therapeutic regimen related to lack of knowledge

NURSING DIAGNOSIS: Activity intolerance related to imbalance between oxygen supply and demand. SUBJECTIVE DATA: Patient will complain of fatigue, tiredness, loss of interest, shortness of breath, palpitations, anorexia. OBJECTIVE DATA: Reduced activity of the patient, apathy, tachycardia, reduced Hb% level, pale complexion and lips. GOAL: 1. Participation in normal activities of daily living without any abnormal increase in pulse and respiration. 2. Reporting of less weakness and fatigue. INTERVENTIONS

RATIONALE

Monitor Cardio respiratory response to activity

To evaluate activity intolerance

Limit patient’s activity and assist with regular physical activities. Encourage alternate rest and

Reduces undue physical exertion

activity periods Plan activity for periods when patient has the most energy and educate on energy saving techniques. Provision of oxygen supplementation according to

Provides activity without tiring the patient Reduces the fatigue, tiredness and reduces oxygen demand. Provides supplementary oxygen.

NURSING DIAGNOSIS: Imbalanced nutrition less than body requirements related to inadequate nutritional intake / disease progression / side effects the drugs. of nausea, vomiting, SUBJECTIVE DATA: Patientof will complain anorexia. OBJECTIVE DATA: Patient doesn’t eat food, weight loss, Decreased Hb% & Hct levels. GOAL: 1. Maintains dietary intake that provides minimum daily requirements of nutrition. 2. Maintains Normal blood Hemoglobin and Hematocrit INTERVENTIONS RATIONALE values. Plan with dietician the number To meet the dietary of calories and type of nutrients requirements of the patient and needed. to intervention. Encourage increased intake of To plan provided nutrients needed protein, iron and vitamin-c resources. Encourage small frequent feeds and to add flavor such as salt, sugar or the lemon. Educate patient about maintaining the food diary and monitor the recorded intake for nutritional contents. Provide health education

for the production of hemoglobin. To increase the intake of the patient. Helps to evaluate nutritional intake.

Helps the patient to identify regarding easily available foods good nutritious food and eat. rich in nutrition. Provide supplementary Provides supplementation and medications as prescribed by

helps to improve the nutritional

NURSING DIAGNOSIS: Ineffective management of therapeutic regimen related to lack of knowledge about medications. SUBJECTIVE DATA: Patient will say that he stopped medications because his condition has worsened after taking medications. OBJECTIVE DATA: Patient will have excess medications at bed side without consuming. GOAL: Verbalizes the knowledge necessary for the management of medication regimen INTERVENTIONS Identify the patient knowledge regarding the medication regime. Instruct the patient on the

RATIONALE Helps to plan the intervention.

purpose and action of each medication. Instruct the patient on possible

Helps the patient to improve their knowledge about the medications. Helps the patient to identify

adverse reactions of the drugs and to approach health care professionals if it occurs. Educate the patient about the

the serious complications of the drug therapy and will approach the healththe care professionals. Improves medication

ill effects of stopping the drugs without the physician’s advice.

compliance.

Provide counseling and handout in their language on discharge regarding drug

For future reference of the patient.

SUMMARY Apart

from

Nutritional

Deficiencies,

Anemia in HIV is caused by various factors such

as

Bone

marrow

depression,

Deficiency of Erythropoietin, autoimmune disorder,

opportunistic

infections

and

even the drugs which are used to treat HIV. So it must be treated and proper nursing care to be given to the patient so as to not only improve their quality of life but also to increase their survival rate.