what lab value should be prioritized for monitoring in a patient with hiv

ATI RN

ATI Capstone Adult Medical Surgical Assessment 2

1. What lab value should be prioritized for monitoring in a patient with HIV?

A. CD4 T-cell count below 180 cells/mm3
B. Hemoglobin levels
C. Serum albumin levels
D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring CD4 T-cell count is crucial in patients with HIV as it reflects the status of their immune system. A CD4 count below 200 cells/mm3 is indicative of severe immunocompromise, necessitating close monitoring and potential intervention. Choices B, C, and D are less specific to HIV management and do not directly reflect the immune status in these patients. Hemoglobin levels are more relevant for assessing anemia, serum albumin levels for nutritional status, and white blood cell count for overall immune response, but none are as directly tied to HIV disease progression as the CD4 T-cell count.

2. What should a healthcare professional monitor for in a patient with compartment syndrome?

A. Unrelieved pain, pallor, and pulselessness
B. Localized redness and swelling
C. Fever and signs of infection
D. Loss of deep tendon reflexes

Correct answer: A

Rationale: Unrelieved pain, pallor, and pulselessness are classic signs of compartment syndrome. In this condition, increased pressure within a muscle compartment impairs blood flow, leading to severe pain that is not relieved by usual measures, pallor from decreased blood flow, and pulselessness due to compromised circulation. These signs indicate a medical emergency requiring immediate intervention. Localized redness and swelling (Choice B) are more characteristic of inflammation or infection rather than compartment syndrome. Fever and signs of infection (Choice C) are not typical manifestations of compartment syndrome. Loss of deep tendon reflexes (Choice D) is associated with conditions affecting the nervous system, not compartment syndrome.

3. What is the priority lab value to monitor in a patient with HIV?

A. CD4 T-cell count 180 cells/mm3
B. White blood cell count 4,500/mm3
C. Potassium levels 3.5-5.0 mEq/L
D. Hemoglobin levels below 12g/dL

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV to assess the status of their immune system. A CD4 count of 180 cells/mm3 indicates severe immunocompromise and a high risk of opportunistic infections. This value is used to guide treatment decisions and assess the need for prophylaxis against specific infections. Choices B, C, and D are incorrect because monitoring white blood cell count, potassium levels, and hemoglobin levels, although important in HIV patients, are not as crucial as monitoring the CD4 T-cell count for assessing immune function and disease progression.

4. A nurse is planning care for a client who has acute post-streptococcal glomerulonephritis. Which of the following interventions should the nurse include in the client's plan?

A. Encourage a high-protein diet
B. Increase the client's fluid intake
C. Administer diuretics
D. Weigh the client twice a week

Correct answer: C

Rationale: Administering diuretics is a crucial intervention for a client with acute post-streptococcal glomerulonephritis as it helps reduce edema by increasing urine output and managing symptoms of glomerulonephritis. Encouraging a high-protein diet (Choice A) is not recommended in this case because it can put additional stress on the kidneys. Increasing fluid intake (Choice B) may worsen edema in these clients. Weighing the client twice a week (Choice D) is important for monitoring fluid balance but is not as immediate and directly beneficial as administering diuretics.

5. What dietary instructions should be provided for a patient with pre-dialysis end-stage kidney disease?

A. Limit phosphorus intake to 700 mg/day
B. Increase protein intake to 1g/kg/day
C. Increase sodium intake
D. Avoid potassium-rich foods

Correct answer: A

Rationale: Patients with pre-dialysis end-stage kidney disease should limit phosphorus intake to manage their condition. Excessive phosphorus can lead to mineral and bone disorders in patients with kidney disease. Choices B, C, and D are incorrect. Increasing protein intake is not recommended as it can burden the kidneys. Increasing sodium intake is usually discouraged due to its association with hypertension and fluid retention in kidney disease. Avoiding potassium-rich foods is more relevant in advanced kidney disease stages when potassium levels are high, not in pre-dialysis end-stage kidney disease.