NURS 4050 answer-key-hiv-aids-unfolding-reasoning. 1
Human Immunodeficiency Virus
UNFOLDING Reasoning
Michelle Johnson, 36-years old
Primary Concept
Immunity
Interrelated Concepts (In order of emphasis)
• Gas Exchange
• Infection
• Stress
• Coping
• Clinical Judgment
• Patient Education
• Communication
• Collaboration
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
• Management of Care 17-23% ✓
• Safety and Infection Control 9-15% ✓
Health Promotion and Maintenance 6-12% ✓
Psychosocial Integrity 6-12% ✓
Physiological Integrity
• Basic Care and Comfort 6-12% ✓
P a g e 1 | 14
, 2
• Pharmacological and Parenteral Therapies 12-18% ✓
• Reduction of Risk Potential 9-15% ✓
• Physiological Adaptation 11-17% ✓
UNFOLDING Clinical Reasoning Case Study:
History of Present Problem:
Michelle Johnson is a 36-year-old African American female with no prior medical history who presents to the emergency
department complaining of extreme fatigue for the past several months and experiencing occasional night sweats. During
the past week, she has developed a sore throat, dry, nonproductive cough, fever at night with increasing shortness of
breath. Michelle embarrassingly admits that she has had a vaginal yeast infection that she has tried to treat with over the
counter medications with no success. Michelle states to the triage nurse, “I came in today because I am worried
something is wrong with me, I hope it’s nothing serious!”
Personal/Social History:
Michelle has been divorced for five years and has two daughters (ages 14 and 16) who works full time as a legal
secretary. She has recently been working longer hours, skipping meals, and stressed over the possibility of not being able
to provide for her two daughters. She has been involved in only one relationship since her divorce. She is engaged to
Ken, who has hemophilia and plan to get married next year.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Extreme fatigue for the past several months All of these problems can be caused by exposure to almost any virus
and experiencing occasional night sweats. (e.g., influenza)—not just to HIV, BUT, these may be the first indications
of the acute HIV infection several months ago. About 50% to 90% of
people who are first infected with HIV develop an acute infection within
four weeks. Manifestations of this acute HIV infection can be fever, night
sweats, chills, headache, and muscle aches.
During the past week, she has developed a Potential respiratory infection with a dry cough and exertional dyspnea
sore throat, dry, nonproductive cough, fever at in the weeks before the development of other symptoms, fever plus a
night with increasing shortness of breath. headache, malaise, night sweats, general fatigue, weight loss, and chest
pain are among the clinical manifestations typically seen with HIV.
Vaginal yeast infection that she has tried to Vaginal infection that has not been able to be corrected by treatment is a
treat with over the counter medications with clinical RED FLAG for HIV. Women often have gynecological conditions
no success. as a result of HIV infection. These can include persistent, reoccurring
and difficult-to-treat vaginal yeast infections. Immunizations are also
difficult as these patients can develop the condition you are trying to
prevent: AKA chicken pox.
RELEVANT Data from Social History: Clinical Significance:
Working longer hours, skipping meals, and Sole provider for her daughters, difficult financial burden. Is
stressed over the possibility of not being able experiencing significant situational stress working long hours and
to provide for her two daughters. intimate relationship with an individual with a significant chronic
illness.
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment:
T: 99.6 F/37.6 C Provoking/Palliative: Denies
(oral)
P a g e 2 | 14
Human Immunodeficiency Virus
UNFOLDING Reasoning
Michelle Johnson, 36-years old
Primary Concept
Immunity
Interrelated Concepts (In order of emphasis)
• Gas Exchange
• Infection
• Stress
• Coping
• Clinical Judgment
• Patient Education
• Communication
• Collaboration
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
• Management of Care 17-23% ✓
• Safety and Infection Control 9-15% ✓
Health Promotion and Maintenance 6-12% ✓
Psychosocial Integrity 6-12% ✓
Physiological Integrity
• Basic Care and Comfort 6-12% ✓
P a g e 1 | 14
, 2
• Pharmacological and Parenteral Therapies 12-18% ✓
• Reduction of Risk Potential 9-15% ✓
• Physiological Adaptation 11-17% ✓
UNFOLDING Clinical Reasoning Case Study:
History of Present Problem:
Michelle Johnson is a 36-year-old African American female with no prior medical history who presents to the emergency
department complaining of extreme fatigue for the past several months and experiencing occasional night sweats. During
the past week, she has developed a sore throat, dry, nonproductive cough, fever at night with increasing shortness of
breath. Michelle embarrassingly admits that she has had a vaginal yeast infection that she has tried to treat with over the
counter medications with no success. Michelle states to the triage nurse, “I came in today because I am worried
something is wrong with me, I hope it’s nothing serious!”
Personal/Social History:
Michelle has been divorced for five years and has two daughters (ages 14 and 16) who works full time as a legal
secretary. She has recently been working longer hours, skipping meals, and stressed over the possibility of not being able
to provide for her two daughters. She has been involved in only one relationship since her divorce. She is engaged to
Ken, who has hemophilia and plan to get married next year.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Extreme fatigue for the past several months All of these problems can be caused by exposure to almost any virus
and experiencing occasional night sweats. (e.g., influenza)—not just to HIV, BUT, these may be the first indications
of the acute HIV infection several months ago. About 50% to 90% of
people who are first infected with HIV develop an acute infection within
four weeks. Manifestations of this acute HIV infection can be fever, night
sweats, chills, headache, and muscle aches.
During the past week, she has developed a Potential respiratory infection with a dry cough and exertional dyspnea
sore throat, dry, nonproductive cough, fever at in the weeks before the development of other symptoms, fever plus a
night with increasing shortness of breath. headache, malaise, night sweats, general fatigue, weight loss, and chest
pain are among the clinical manifestations typically seen with HIV.
Vaginal yeast infection that she has tried to Vaginal infection that has not been able to be corrected by treatment is a
treat with over the counter medications with clinical RED FLAG for HIV. Women often have gynecological conditions
no success. as a result of HIV infection. These can include persistent, reoccurring
and difficult-to-treat vaginal yeast infections. Immunizations are also
difficult as these patients can develop the condition you are trying to
prevent: AKA chicken pox.
RELEVANT Data from Social History: Clinical Significance:
Working longer hours, skipping meals, and Sole provider for her daughters, difficult financial burden. Is
stressed over the possibility of not being able experiencing significant situational stress working long hours and
to provide for her two daughters. intimate relationship with an individual with a significant chronic
illness.
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment:
T: 99.6 F/37.6 C Provoking/Palliative: Denies
(oral)
P a g e 2 | 14
