Deficient Knowledge — AIDS

Nursing Diagnosis: Deficient Knowledge regarding disease, prognosis, current therapies, and self-care needs

May be related to

• Lack of exposure/recall; information misinterpretation
• Cognitive limitation
• Unfamiliarity with information resources

Possibly evidenced by

• Questions/request for information; statement of misconception
• Inaccurate follow-through of instructions, development of preventable complications

Desired Outcomes

• Verbalize understanding of condition/disease process and potential complications.
• Identify relationship of signs/symptoms to the disease process and correlate symptoms with causative factors.
• Verbalize understanding of therapeutic needs.
• Correctly perform necessary procedures and explain reasons for actions.
• Initiate necessary lifestyle changes and participate in treatment regimen.

Nursing Interventions	Rationale
Review disease process and future expectations.	Provides knowledge base from which patient can make informed choices.
Determine level of independence/dependence and physical condition. Note extent of care and support available from family/SO and need for other caregivers.	Helps plan amount of care and symptom management required and need for additional resources.
Review modes of transmission of disease, especially if newly diagnosed.	Corrects myths and misconceptions; promotes safety for patient/others. Accurate epidemiological data are important in targeting prevention interventions.
Instruct patient and caregivers concerning infection control, e.g.: using good handwashing techniques for everyone (patient, family, caregivers); using gloves when handling bedpans, dressings/soiled linens; wearing mask if patient has productive cough; placing soiled/wet linens in plastic bag and separating from family laundry, washing with detergent and hot water; cleaning surfaces with bleach/water solution of 1:10 ratio, disinfecting toilet bowl/bedpan with full-strength bleach; preparing patient’s food in clean area; washing dishes/utensils in hot soapy water (can be washed with the family dishes).	Reduces risk of transmission of diseases; promotes wellness in presence of reduced ability of immune system to control level of flora.
Stress necessity of daily skin care, including inspecting skin folds, pressure points, and perineum, and of providing adequate cleansing and protective measures, e.g., ointments, padding.	Healthy skin provides barrier to infection. Measures to prevent skin disruption and associated complications are critical.
Ascertain that patient/SO can perform necessary oral and dental care. Review procedures as indicated. Encourage regular dental care.	The oral mucosa can quickly exhibit severe, progressive complications. Studies indicate that 65% of AIDS patients have some oral symptoms. Therefore, prevention and early intervention are critical.
Review dietary needs (high-protein and high-calorie) and ways to improve intake when anorexia, diarrhea, weakness, depression interfere with intake.	Promotes adequate nutrition necessary for healing and support of immune system; enhances feeling of well-being.
Discuss medication regimen, interactions, and side effects	Enhances cooperation with/increases probability of success with therapeutic regimen.
Provide information about symptom management that complements medical regimen; e.g., with intermittent diarrhea, take diphenoxylate (Lomotil) before going to social event.	Provides patient with increased sense of control, reduces risk of enbarrassment, and promotes comfort.
Stress importance of adequate rest.	Helps manage fatigue; enhances coping abilities and energy level.
Encourage activity/exercise at level that patient can tolerate.	Stimulates release of endorphins in the brain, enhancing sense of well-being.
Stress necessity of continued healthcare and follow-up.	Provides opportunity for altering regimen to meet individual/changing needs.
Recommend cessation of smoking.	Smoking increases risk of respiratory infections and can further impair immune system.
Identify signs/symptoms requiring medical evaluation, e.g., persistent fever/night sweats, swollen glands, continued weight loss, diarrhea, skin blotches/lesions, headache, chest pain/dyspnea.	Early recognition of developing complications and timely interventions may prevent progression to life-threatening situation.
Identify community resources, e.g., hospice/residential care centers, visiting nurse, home care services, Meals on Wheels, peer group support.	Facilitates transfer from acute care setting for recovery/independence or end-of-life care.