Nursing Adults with Long Term Disease

Running Head: NURSING ADULTS WITH LONG TERM DISEASE
NURSING ADULTS WITH LONG TERM DISEASE
Name of the Student
Name of the University
Author’s Note

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Essay:
Human Immunodeficiency Virus (HIV) is the virus that is responsible for causing
Acquired Immune Deficiency Syndrome (AIDS). It gradually damages and kills the T helper
cells, which are responsible for all adaptive immune responses of the body, and hence reduces
the immune system of the body (Lima and Melo 2012). This results in gradual destruction of the
ability of the body in fighting infection and certain types of cancers. HIV can be transmitted
through contaminated syringes or needles, sexual contact, transmission from an infected mother
to child during pregnancy or breast milk. Initially the affected individual will suffer from an
illness similar to influenza, which is followed by a latent, asymptomatic phase. HIV get
progressed to AIDS when the count of CD4 lymphocyte falls below 200 cell per ml of blood
(Gray and Cohn 2013). The characteristics ofAIDS include increased opportunistic infection
susceptibility and cell mediated immunity deficiency, which eventually lead to Cancer.
According to research,in U.K., about 88,769 that includes 315 children below the age of 15, have
been found to suffer from HIV and consequently are recieving specialist care (Wannheden et al.
2013). The total number of people receiving specialist care for HIV has grown steadily over the
last decade. There has been a sharp rise in the number of people accessing HIV care by 73%
between the periods of 2006 to 2015. One third of the HIV affected people in UK has reportedly
been the victim of social discrimination. The major victims are the health care workers. The fatal
effect of the HIV has given rise to various negative attitude like fear and anxiety in public
(Shankar et al. 2014).
The case study is about Mr. X, a 40 years old businessperson who resides in Bahia
situated in Brazil. For business purposes, he used to travel frequently to West Africa. In 2005,
Mr. X was diagnosed with HIV. He admitted to have licentious behavior with numerous African

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sex workers along with maintaining a stable sexual relation with his wife. He was initially treated
in Mali for Chancroid. Mr. X started experiencing flu like symptoms along with
lymphadenopathy and splenomegaly after the fourth week of being diagnosed with Chancroid.
He reported even a loss of 12 kg of body weight. Soon he got severely ill and started
experiencing terrible clinical condition and hence had to be admitted in a health care center in
Mali.Laboratory test was performed and he was diagnosed with HIV 1 infection. In the following
days Mr. X also started experiencing various kinds of opportunistic infectious issues and was
diagnosed with Tuberculosis. A terrible decrease of his CD4-CD8 ratio to .16 (the normal value
lies between the range of 0.81-3.00) is recorded within 3 years.
The fact that Mr. X was suffering from opportunistic infection (OI) has resulted in
gradual damage of his immune system and eventually has taken the form of tuberculosis (TB).
Mycobacterium Tuberculosis bacteria cause the disease, Tuberculosis, which causes infection in
lung when inhaled by an individual.Though lungs are the primary parts of the body that is
infected by the bacteria, the bacteria gradually moves to other parts of the body through
bloodstream (Law et al. 2013). Both Having TB and HIV both was speeding up the decay of
immune system of the patient and thus latent TB eventually takes the form of active TB. Mr. X
was at a higher risk of death as the risk of death is double for individuals who are suffering from
both TB and HIV when compared to patients suffering only from HIV. Considering the fact that
Mr. X initially was not receiving antiretroviral treatment, within a span of two weeks the TB
which was in latent phase got converted to active phase.
According to research performed by WHO, about 78 percent patients suffering from both
HIV and TB are on antiretroviral therapy globally and 90 percent of patients are from Malawi,
Mozambique, Swaziland, Namibia and India (O’Cleirighet al. 2013). The fact that patients

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suffering from both HIV and TB lacks in showing classic symptoms of pulmonary TB infection,
initially it was difficult to access that Mr. X is suffering from TB along with HIV. Being a
sufferer of sub clinical TB, the chest X-ray of Mr. X did not show TB symptoms initially.
Because of the fact that current availability of tools for sub clinical TB is less, especially for
patients with both TB and HIV, several HIV patients like Mr. X has to go through a fatal
condition due to the late detection of the disease. Before initiating thetreatment, the nursing
assessment is performed by taking account of a number of factors discussed here. Firstly, tests
are done to find out if Mr. X has symptoms of only TB or any other opportunistic infection along
with HIV. Secondly, all the existing treatments of Mr. X are taken into account. Thirdly, a
physiological counseling was conducted with the patient in order to understand the way in which
he is dealing with both HIV and Tuberculosis simultaneously. Finally, Tuberculosis Preventive
Treatment (TPT) was provided to Mr. X.
Considering the fact that patients infected with both HIV and TB have higher risk of
active TB development, crucial clinical management have in such situations (Mahnkeet al.
2012). The first step that had been taken once after it had been detected that Mr. X is suffering
from TB along with HIV was to put him on Tuberculosis Preventive Treatment (TPT) with once
daily usage of isoniazid 10 mg/kg (Maximum 600 mg) since prompt treatment of active TB will
reduce the TB related mortality and transmission risk. Mr. X was treated based on the drug with
proper bioavailability. The phases of treating Mr. X for TB comprised of initial phase and
continuation phase. The duration of initial phase was 2 to 3 months and that of the continuation
phase lasted for 4 to 5 months. After continuation of the treatment for about 5 months by a
regimen, which includes rifampicin throughout the treatment course, Mr. X was almost cured
and no sign of relapse of Tuberculosis is seen until now.