ASSIGMENT : ENGLISH

LECTURER : Mutmainnah, S.S, M.Hum , Dr.Azniah SKM, M.Kes

HIV/ AIDS

BY :
GROUP III / CLASS B1

ANDI SURISMA NH 0217012

ANDI VIVI FEBRY ELFIRA NH 0217013
ARDINAYANTI NH 0217014
ARIANTO NH 0217015
ARNI H LATIF NH 0217016

JALUR KONVERSI NERS B

PROGRAM STUDI ILMU KEPERAWATAN

SEKOLAH TINGGI ILMU KESEHATAN

NANI HASANUDDIN

MAKASSAR

2017

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 TABLE OF CONTENTS

TITLE

PREFACE …………………………………………………………………… 1

TABLE OF CONTENT ……………………………………………………….. 2

CHAPTER I : INTRODUTION …………………………………………... 3

1.A. BACKGROUND …………………………………………… 3

1.B. MAIN PROBLEM …………………………………………… 0

CHAPTER II : MEDICAL CONCEPTS …………………………………… 0

II.A. DEFENISION …………………………………………………… 0

II.B. CAUSES …………………………………………………… 0

II.C. CLINICAL MANIFESTATION …………………………… 0

II.D. PATHOPHYSIOLOGI …………………………………… 0

II.E. THERAPY …………………………………………………… 0

II.F. PREVENTION …………………………………………………… 0

II.G. NURSING CARE OF PATIENT’S WITH HIV/AIDS ….. 0

CHAPTER III : CLOSE ………………………………………………….. 0

III.A. CONCLUSION ………………………………………….. 0

III.B. SUGGESTION ………………………………………….. 0

REFERENCE

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 PREFACE

In the name of allah the most beneficient the most merciful,

At the first, give thank you for God’s love and grace for us. Thanks to God for
helping we all group chance to finish this assighment timely. And would like to say
thank you to Ms. Mutmainnah, S.S., M.Hum and Mrs. Dr.Azniah SKM, M.Kes as the
lecturer always teaches us and give much knowledge about how to practice English
well.
The writer wants again to thank to all, because of bless and grace can finish this
papper project of material titled “ HIV /AIDS”.

Finnaly, the writer expects that it can be a medium for the reader to deepen the
knowledge, and can be used as a reference for the reader to understand the material

Makassar, april 2018

Author

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 CHAPTER I
INTRODUCTION
A. BACKGROUND
B. MAIN PROBLEM

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 CHAPTER 1I
MEDICAL CONCEPTS

A. DEFENITION
The global epidemic of AIDS has become one of the most pressing
public health emergencies of this century. Initial reports of AIDS date back of
1981.
AIDS (acquired immunodeficiency syndrome) is a syndrome caused by a
virus called HIV (Human Immudeficiency virus). The disease alters the immune
system, making people much more vulnerable to infections and diseases. This
susceptibility worsens if the syndrome progresses.
HIV is found troughout all the tissues of the body but is transmitted
through the body fluids of an infected person (semen, vaginal fluids, blood, and
breast milk)
HIV is a virus that attacks immune cells called CD-4 cells, which are a
subset of T cells. AIDS is the syndrome, which may or may not appear in the
advanced stage of HIV infection
HIV infection can causes AIDS to develop. However, it is possible to
contract HIV without developing AIDS.without treatment, HIV can progress
and, eventually, it willdevelop into AIDS in the vast majority of cases.

B. CAUSES
HIV is a retrovirus that infects the vital organs and cells of the human
immune system
The virus progresses in the absence of antiretroviral therapy (ART)- a
drug therapy that slows or prevents rhe virus from developing
The rate of virus progression varies widely between individuals and
depends on many factors.
These factors include the age of the individual, the body’s ability to
defend against HIV, acces to healthcare, the presence of other infections, the
individual’s genetic inheritance, resistance to certain strains of HIV and more.

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 How the transmission of HIV can go through :
1. Sexual transmission
It can happen when there is contact with infected sexual fluids (recta,
genital, or oral mucous membranes). This can happen while having
sex without a condom, including vaginal, oral, and anal sex, or
sharing sex toys with someone who is HIV positive
2. Perinatal transmission
A mother can transmit HIV to her child during childbirth, pregnancy,
and also trough breastfeeding.
3. Blood transmission
The risk of transmitting HIV through bloo transfusion is extremely
low in developed countries, thanks to meticulous screening and
precautions. However, among peoplewho inject drugs, sharing and
reusing syringes contamined with HIV-infected blood is extremely
hazardous.

C. CLINICAL MANIFESTATIONS
For the most part, the later symptoms of HIV infection are the result of
infectios caused by bacteria, viruses, fungi, and / or parasites.
The early symptoms of HIV infection when some people with HIV
infection have no symptoms until several months or even years after contracting
the virus. Hoeover 80% may develop symptoms similar to flu 2 – 6 weeks after
cathing the virus. This called acute retroviral syndrome.
The symptoms of early HIV infection may include
1. Fever
2. Chiils
3. Joint pain
4. Muscle aches
5. Sore throat
6. Sweats (particularly at night)
7. Enlarged glands

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 8. A red rash
9. Tiredness
10. Unintentional weight loss
11. Thrush
It is important to remember that these symptoms appear when the body is
fighting off many types of viruses, not jus HIV. However, if you have several of
these symptoms and believe you could have been at risk of contracting HIV in
the last few weeks, you should take a test .
If left untreated, HIV weakens the ability to fight infection. The person
becomes vulnerable to serious illnesses. This stageis known as AIDS or stage 3
HIV
Symptoms of late – stage HIV infection may include:
1. Blurred vision
2. Diarrhea, which is usually persistent or chronic
3. Dry cough
4. Fever of above 100’F (37’c)lasting for weeks
5. Night sweats
6. Permanent tiredness
7. Shortness of breath (dyspnea)
8. Swollen glands lasting for weeks
9. Unintentional weight loss
10. White spots on the tongue or mouth
Durring late – stage HIV infection, the risk of developing a life
threatening illness is much greater. Serious conditions may be controleed
avoided, and / or treated with other medications alongside HIV treatment

D. PATHOPHYSIOLOGI
HIV produces cellular immune deficiency characterized by the depletion
of helper T lhymphosites (CD4+ cells). The loss of CD4+ cells results in the
development of opportunistic infection and neoplastic processes.

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 In early infection HIV does not cause immediate death of cells in the
infection but priorexperiance of replication (duplication), to allow time to
develop in the patients body, which will eventually spend or damage up to a
certain number of T4 cells lymfosit, after a few months to several years
later,then the patient will be seen as a result I of clinical symptoms of disease
(incubation period) is 6(six) months to more than 10(ten) years, an average 21
(twenty one) months in children and 60 (sixty) months in adults. Infection by the
HIV virus causes impaired immune function resulting in reduced endurance or
lost, concepquently susceptible to other diseases such as infection diseases
caused by bacteria and fungi.

E. THERAPY
Several types of tests check your blood or body fluids to see if you’re
infected. Most can’t detect HIV right away, because it takes time for you body to
make antibodies or for enough virus to grow inside you. It may be up to 6 (six)
months before you’ll see a positive result, which means an early tes could be
negative even tough you’re infected.
If you do have the virus, finding out quickly means you can start
treatment to help you live a long and full life. You can also take precautions so
that you don’t pas HIV to other people
In addition to the primary therapy described below other medical
management of HIV infection includes the use of antibiotics, antivirals, and
antifungals for secondary or opportunistic infections, vaccination against ither
etiologic agents, prophylaxis of pneumocystis pneumonitis, and psychological
support. Although treatment of HIV-infected patiens with recombinant ( r ) IL-2
or polyethylene glycol-modifed rlL-2, alone or in combination with
antiretroviral therapy, has produced some transient, beneficial changes in
immunologic functions and CD4 counts, no substantial decrease in viral burden
has been associated with IL-2 therapy
Primary therapy for HIV infection involves combinations of various
antiretroviral drugs. Early antiviral therapy of HIV infection is likely to be

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 beneficial even is asymptomaticsubjects. The mainstay of HIV treatmenr has
been the use of RT inhibitors. RT inhibitorsprevent the virus derived enzyme,
RT, from synthesizing viral DNA from the HIV genomic RNA template, thus
preventing integration of subsequent viralcDNA into host’s genomis DNA.

F. PREVENTION
1. Prevention of HIV infection through sexual relations
 you stay away from sex
 be faithful toeach other with a partner
 prevented by condoms
2. prevention of HIV infection through blood
 call for a high risk group for contracting AIDS is not a blood donor
 syringes and equipment contamined with body fluids must be
sterilized by default every time consumables
3. prevention of HIV infection through mother
 effort to prevent transmission occurs only with the appeal that HIV –
infected mother who are non pregnant.

G. NURSING CARE OF PATIENT’S WITH HIV/AIDS

SESSION 1: COMPREHENSIVE NURSING CARE OF PEOPLE LIVING
WITH HIV OR AIDS
1. Purpose
This session introduces the concept of comprehensive HIV care. It also
explores the various roles nurses play within comprehensive care as well as
caring for caregivers.
2. Objectives
 List the different areas that should be addressed in comprehensive
HIV care.
 Identify the needs of people with HIV across the continuum of care
and discuss how to meet those needs.
 Define the roles of nurses in comprehensive care.

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  Discuss the needs of caregivers and how to meet those needs.
 Apply the topics in exercises and role plays.
3. Content
a) HIV Care Overview (Slide 1)
 Before antiretroviral treatment (ART ) is needed, care of the HIV-
infected patient is focused on prophylaxis against opportunistic
infections (OIs), management of OIs, ongoing prevention, and
hospice or end-of-life care.
 There is no known cure for HIV/AIDS disease.
 As the immune system becomes increasingly compromised,
symptomatic treatment becomes essential.
 Palliative and end-of-life care can increase quality of life for
patients and families.
b) HIV Care Overview (Slide 2)
 When ART is widely available (with patients ready to start
treatment), HIV is a chronic, manageable disease.
 Not all people infected with HIV are eligible for ART due to disease
stage, other infections, toxicity, and other reasons.
c) HIV Care Overview (Slide 3)
 Until eligible for ART , patients should be encouraged to engage in
positive health behaviors such as
 adherence to clinical appointments
 adherence to current medication schedule (e.g., prophylactic
medications)
 proper nutrition
 prevention for positives
 psychosocial support
 standard precautions
Note: Care of people living with HIV or AIDS (PLHA) should
include ART as well as other essential elements of care and support.

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d) HIV Care Overview (Slide 4)
 When patients are ready and eligible for ART treatment, care is
focused upon the management of ART :
 the most effective combination of drugs
 the fewest side effects
 the greatest potential for adherence
e) HIV Care Overview (Slide 5)
 Care includes ongoing prevention to reduce the risk of transmission
of HIV and other disease.
 Care also includes prophylaxis for OIs and, if an OI occurs,
aggressive treatment of the infection.
 Care includes palliation (management of distressing symptoms such
as thrush) beginning at disease diagnosis.
 Care moves from primarily the acute healthcare setting (hospital) to
the ambulatory healthcare and home settings.
f) HIV Care Overview (Slide 6)
 At the end of life, the goal is to provide care and support to enable
the patient to live life as fully and comfortably as possible.
 Care and support are comprehensive and multidisciplinary, and aim
to achieve comfort in all areas: physical, psychological, and spiritual.
 Family support is essential to prepare for the patient’s death and
provide bereavement
 support after the patient’s death.
g) Comprehensive Care of HIV (Slide 1)
 To serve the multitude of biologic and socioeconomic factors
involved in HIV disease, a comprehensive and multidisciplinary
approach is used to best assist HIV-positive patients and their
families, including
 HIV testing and counseling
 regular medical care, including OI treatment, OI prophylaxis,
palliative care, and ART either in the clinic or home (or both)

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  social work
 nutrition support, including food resources
 spiritual support
 psychosocial support
 economic support
 PLHA support
 ongoing prevention support
 adherence counseling and ongoing support
Note: Nurses work in many of these areas. We will explore
nursing roles later in this session.
h) Comprehensive Care of HIV (Slide 2)
 HIV not only affects the patient, it affects the family and household
as well. For example, children with HIV may be cared for by parents
with HIV who may be ill. Nurses must think beyond the patient and
include the context of the patient’s family and household as a unit.
 Assess: Have household members been tested? Do they need
assistance in accessing care and treatment for themselves or
the patient? What challenges do they face within the home?
Intervene: Refer to testing and other services, counsel on
issues related to care of whole family/household.
i) Teamwork (Slide 1)
 The nurse is a member of a team of healthcare providers that, with
patients and their families, address the full spectrum of needs. The
team may include
 Nurses
 Doctors
 clinical/medical officers
 lab technicians
 pharmacy technicians
 nutritionists
 social workers

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  adherence counselors
 PLHA support group members
 community healthcare workers
 lay volunteers
 others
j) Teamwork (Slide 2)
 As part of the team, nurses
 participate as active team members
 raise issues related to patient care to improve service delivery
 consult with other team members on difficult patient
issues/cases
 support colleagues

4. Goals of Nursing in Comprehensive Care

a) The goals of nursing care related to HIV/AIDS include reducing
morbidity and mortality and increasing the quality of life of people at
risk for HIV and those affected by the disease. These goals are achieved
through a focus on assessment and implementation of interventions,
including education on both prevention and care.
b) Nursing Roles in Comprehensive Care (Slide 1)
 chronic disease management, including health monitoring and
symptom management
 acute care
 health promotion and education
 disease prevention
 palliative care
 mental health support
 patient support/advocacy
 referral management

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c) Chronic Disease Management
 HIV is a chronic disease that cannot be cured, but it can be
managed. Important
d) aspects of chronic disease management include
 testing and counseling
 health monitoring
 symptom management
 medication adherence monitoring
 health promotion/patient education
 empowering and supporting patients to make their own choices
e) Nursing Roles in Acute Care (Slide 1)
 Assess and manage symptoms. Many of the symptoms that HIV-
infected patients report as most distressing are not easily treated
with drugs:
 Anorexia
 emotional distress
 weight loss
 skin lesions
 oral sores/lesions
 difficulty swallowing
 altered taste
 night sweats
 peripheral neuropathy (numbness, tingling, or pain in the
hands or feet)
 dizziness
 impaired mobility
 bad dreams
 difficulty concentrating
 sexual dysfunction
 confusion

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f) Nursing Roles in Acute Care (Slide 2)
 Non-pharmacologic, nurse-led interventions can assist with other
problems (in addition to medications) such as
 nausea/vomiting
 diarrhea
 Fever
 Cough
 dyspnea (difficulty breathing)
 headache
 Pain
 Insomnia
 Rash
 Depression
 Anxiety
 Alternative or local therapies can also be used to ease symptoms.
However, caution should be exercised, because interactions
between some ARVs and herbal therapies/ drugs are possible.
Note: Information on management of common conditions is
included in Session 5.

g) Nursing Roles in Acute Care (Slide 3)

 Monitor medication use and provide patient education for all
medications, whether prophylaxis, antibiotics, narcotics, etc.:
 reason for taking drug/drug action
 dose
 schedule
 food restrictions
 possible side effects: those to report to the health facility
and nursing interventions for those that can be managed
at home
 adherence counseling

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5. Nursing Roles in Health Promotion and Education
a) Teach health promotion. Promoting healthy practices (also called
positive living) that prolong the asymptomatic stage, reduce HIV-related
conditions (OIs, STDs, etc.) and avoid behaviors that can transmit HIV.
 Assess and use patient’s and involved family members’ current
knowledge as the basis for teaching.

6. Nursing Roles in Prevention for Patients

a) Assessment:
 Identify risks for HIV infection.
b) Interventions:
 Counsel on the benefits of HIV testing.
 Educate on HIV transmission and risk reduction.
 Refer those testing HIV+ to care and support.
 Educate those testing HIV– about prevention (how to stay
negative).

7. Nursing Roles in Disease Prevention in the Clinical Setting

a) Reduce transmission of infection:
 Practice standard precautions at work.
 Model optimum standard precautions and advise colleagues on
proper use.
 Know the postexposure prophylaxis (PEP) protocol of the health
facility.
 Encourage implementation of PEP if needed.

8. Nursing Roles in Mental Health

a) Psychological or mood disorders are common in patients with HIV.
b) Nurses can assess and intervene for a variety of mental health issues.
Note: More information on nursing management of mental health issues
is included in Session 5.

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9. Nursing Roles in Patient Support/Advocacy
a) Identify needs (along with the patient and family) and refer to
appropriate services within the clinical or community setting.
b) Advocate for patient when needed.
c) Take measures to support the patient’s achievement of needs, such as
informing patient of cost-sharing schemes.

10. Nursing Roles in Referral Management

a) A functional referral system with links to other facilities/services and
feedback is critical to serve all the comprehensive care needs of patients.
Examples of services include community- and home-based services and
PLHA support groups.
b) A referral system should include feedback to the referring clinician to
determine whether the patient’s needs were met.

11. Nursing Roles in Palliative and End-of-Life Care

a) Palliative care begins at time of diagnosis and provides comfort and
symptom management throughout life.
b) End-of-life care is focused on assisting the patient and family to have the
highest quality of life possible.
c) Note: More information on nursing management of palliative care is
included in Session 6.

12. Nursing Roles in Documenting Care

a) Complete and accurate documentation of the nursing care provided
during each patient visit contributes to quality service delivery.
b) Recording assessment findings and interventions over time is requisite
for managing HIV/AIDS as a chronic disease.

13. Nursing Roles Realized: Four Steps for “Getting It Right”

a) Make time for the patient.

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 b) Use an open, supportive, nonjudgmental approach.
c) Maintain current knowledge.
d) Believe in the importance of your role.
Note: Nurses are very important to all types of healthcare, especially
HIV care. Believingin the importance of your role is essential, not only
in maintaining your own job satisfaction but supporting your colleagues
as well.

14. Importance of Nursing Roles in Care of PLHA

a) Some nurses may feel their role is unimportant or that they are “just
nurses.” Nurses need to remember that the roles they fill in caring for
PLHA and their families are vital for patient care and family wellbeing.
b) Nurses are the front line of trained healthcare workers for PLHA: they
assess signs and symptoms of serious disease, ensure communication
between the patient and the rest of the comprehensive healthcare team,
administer medications, and teach patients how to correctly take their
medications.

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 CHAPTER III
CLOSING

A. CONCLUSION
B. SUGGESTION

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 REFERENCE

Bannett, N. J. (2018, March 27). Pathophysiology Of Hiv/Aids. Retrieved April 20,

2018, From Emedicane.Medscape.Com: Https://Emedicane.Medscape.Com

Bernstein, L. (2016, Oct 25). Hiv Test For Diagnosis. Retrieved April 20, 2018, From
Www.Webmd.Com: Https://Www.Webmd.Com

Fhi, F. B. (2011). Nursing Care Of Patients With Hiv/Aids ; Participants Guide. In F. B.

Fhi, Nursing Care Of Patients With Hiv?Aids ; Participants Guide (Pp. 5 - 17).
Arlington, Va 22201: Family Health International.

Myron S, C. D. (2016). Antiretroviral Therapy For The Prevention Of Hiv-1

Transmition. The New England Journal Of Medicine .

Stanley A, M. P. (1999). Minireviews; Current Concepts In Human

Immunodeficiency Virus Infection And Aids. American Society For Microbyology ,
Pp. 295-305.

Unaids (2016) Global AIDS Update 2016. Retrived April 21, 2018, from www.
unaids.org

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