A nurse is caring for a client with AIDS (acquired immunodeficiency syndrome) who is complaining about chills, night sweats, fever, and diarrhea. The client has significant weight loss and malabsorption. Which of the following may have caused the client’s symptoms?
A. Tuberculosis
B. Cryptosporidiosis
C. Candidiasis
D. Pneumocystis carinii
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Correct Answer: B.
Cryptosporidiosis
AIDS (acquired immunodeficiency syndrome) occurs in the last stage of HIV (human immunodeficiency virus) infection. The CD4 T-cell that fights infection fall below 200/mm. Various opportunistic infections arise due to the insufficient number of T-cells and the overall immunocompromised status of the infected client. Opportunistic infections include tuberculosis, cryptosporidiosis, candidiasis, and pneumocystis carinii. Cryptosporidiosis is the major cause of wasting syndrome. It is caused by the Cryptosporidium parasite that thrives in the intestine. It absorbs nutrients causing weight loss and eventual wasting of body tissues. Typical symptoms of this opportunistic infection include nausea, vomiting, abdominal cramps, and diarrhea.
Incorrect Answers:
A, C, D. Tuberculosis, candidiasis, and pneumocystis carinii are less likely to be associated with diarrhea.
Vital Concept:
Cryptosporidium is a parasite that is associated with severe diarrhea with weight loss and malabsorption in immunocompromised clients. In clients with AIDS and cryptosporidium infection, antiretroviral therapy should be instituted. Loperamide is frequently used for control of diarrhea. Electrolyte losses should be replaced by either oral or intravenous routes in clients who experience significant volume loss associated with severe diarrhea. Cholera-like diarrhea seen with cryptosporidium can be life-threatening without aggressive replacement therapy. Total parenteral nutrition should be considered in clients with chronic disease associated with weight loss.
References:
Lemone PT, Burke KM, Bauldoff G, Gubrud P. Medical-Surgical Nursing: Clinical Reasoning in Patient Care, 6th Edition. Pearson 2014.
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