FOREWORD

Praise the authors say to God for His mercy and His guidance I can finish a paper

entitled "Nursing Care in Patients with AIDS" as well as possible.

The purpose of the preparation of this paper is to fulfill the basic task of nursing

science III as well as the requirement to take the semester exam.

In preparing this paper, the author has experienced good things and bad. The

author realizes that the preparation of this paper will not be completed smoothly and on

time without their help, encouragement, and guidance from the various parties. As

gratitude for terselesainya of this paper, the authors convey sincere thanks to those who

helped writers who can not mention one by one.

In preparing this paper, the authors recognize there are still many shortcomings

either in writing techniques and material. To that criticism and suggestions from all

parties is the authors expect an effort to improve this paper.

Finally, the authors hope that this paper can add to the knowledge and can be

applied to solve a problem related to the title of this paper.

Pangkajene, October 2013

composer
 PART I

PRELIMINARY

1. Background

Acquired Immune Deficiency Syndrome (AIDS) is a collection of symptoms and

infections or syndrome arising from the destruction of the human immune system caused

by HIV infection. The virus is the human immunodeficiency virus HIV is the virus that

weakens the immunity in the human body. People affected by this virus will be susceptible

to opportunistic infections or susceptible to tumors. Although there has been handling

can slow the spread of the virus, but the disease is not completely cured. HIV is generally

transmitted through direct contact between the skin layers (mucous membrane) or the

bloodstream with a bodily fluid containing HIV, such as blood, semen, vaginal fluid,

preseminal, and breast milk. Transmission can occur through sexual intercourse (vaginal,

anal, or oral), blood transfusion, contaminated hypodermic needles, between mother and

baby during pregnancy, childbirth, or breastfeeding, as well as other forms of contact with

the bodily fluids.

AIDS disease has spread to many countries in the world. In fact, according to

UNAIDS and WHO estimate that AIDS has killed more than 25 million people since it

was first recognized in 1981, and this makes AIDS as one of the most devastating
 epidemics in history. Despite recent, improved access to antiretroviral treatment in many

regions of the world, the AIDS epidemic claimed an estimated 2.8 million (between 2.4

and 3.3 million) lives in 2005 and more than half a million (570,000) were children child.

Globally, between 33.4 and 46 million people currently live with HIV.Pada 2005, between

3.4 and 6.2 million people were newly infected and between 2.4 and 3.3 million people

with AIDS died, an increase from 2003 and the highest number since 1981.

In Indonesia, according to a report of cumulative cases of HIV / AIDS until

December 31, 2011 issued by the Directorate General of DC & EH, MoH RI on February

29, 2012 shows the number of AIDS cases has exceeded 100,000. The number of cases

that have been reported 106 758 consisting of 76 979 29 879 HIV and AIDS by 5430 due

penalties. This figure is not surprising because in the early 2000s among epidemiologists

had to make estimates HIV / AIDS cases in Indonesia ranged between 80000-130000.

And now Indonesia is the third, after China and India, the acceleration of HIV / AIDS

cases its highest in Asia.

2. Writing purpose

1. To know the definition of AIDS.

2. To determine the etiology / cause of AIDS

3. To determine the mode of transmission of AIDS

4. To determine the clinical manifestations of AIDS clients

5. To determine the pathophysiology of AIDS

6. To determine the pathway AIDS

7. To determine the client complications with AIDS

8. To determine the diagnostic checks on the client AIDS

 9. To know medical management, nursing and diet on the client AIDS

CHAPTER II

DISCUSSION

A. DEFINITION
 Acquired Immune Deficiency Syndrome (AIDS) is a collection of symptoms and

infections or syndrome arising from the destruction of the human immune system caused

by HIV infection. Understanding AIDS, according to some experts, among others:

1. AIDS is an opportunistic infection that attacks a person's immune system which

decreased underlying (T-cells totaling 200 or less) and have positive antibodies against

HIV. (Doenges, 1999)

2. AIDS is a collection of specific clinical conditions that are the end result of infection by

HIV. (Sylvia, 2005)

B. ETIOLOGY

HIV formerly called human T cell limfotrofik virus type III (HTLV-III) or

limfadenapati virus (LAV), is a cytopathic human retrovirus of the lentivirus family.

Retrovirus change ribonukleatnya acid (RNA) into deoxyribonucleic acid (DNA) after

entry into host cells. HIV-1 and HIV-2 is cytopathic lentiviruses, HIV-1 is a major cause

of AIDS throughout the world.

Nine HIV genome encodes a protein that is essential for every aspect of the life cycle

of the virus. In terms of genomic structure, the viruses have differences, such that the

protein of HIV-1 Vpu, which helps release the virus, it seems to be replaced by VPX

protein on HIV-2. VPX increase the infectivity (infectiousness) and perhaps a duplication

of another protein, VPR. Vpr is expected to increase transcription of the virus. HIV-2,

which was first identified in the serum of the west African women (citizens senegal) in

1985, leading to clinical disease but seems to be less pathogenic than HIV-1 (Sylvia, 2005)

1. Modes of Transmission
 The modes of transmission of AIDS (Arif, 2000) are as follows:

a. Sexual intercourse, with 0.1-1% risk of transmission per sexual intercourse

b. Through blood, namely:

· Blood transfusions containing HIV, the risk of transmission of 90-98%

· Needle containing HIV, the risk of transmission of 0.03%

· Mucosal exposure to containing HIV, the risk of transmission of 0.0051%

· Transmission from mother to child:

a. during pregnancy

b. During labor, the risk of transmission of 50%

c. Through breast milk (ASI) 14%

C. Pathophysiology

AIDS is caused by HIV virus. AIDS incubation period is estimated at between 10

weeks and 10 years. It is estimated that approximately 50% of HIV-infected people will

show symptoms of AIDS within the first 5 years, and reach 70% in ten years will get AIDS.

In contrast to other viruses that attack the target cells in a short time, HIVmenyerang

virus targets cells in the long term. In order for an infection, the virus must enter the cell,

in this case white blood cells called lymphocytes. Viral genetic material is inserted into

the DNA of infected cells. Inside the cell, the virus multiplies and eventually destroy the

cell and release of new virus particles. The new virus particles then infect other

lymphocytes and destroy it.

The virus attaches to lymphocytes have a receptor protein called CD4, which is found

in the outer membranes. CD4 is a marker or markers on the surface of white blood cells

of human, especially the cells limfosit.Sel-cells that have CD4 receptor is usually called
CD4 + cells or helper T lymphocytes. T helper lymphocyte activating and regulate other

cells in the immune system (such as B lymphocytes, macrophages and cytotoxic T

lymphocytes), all of which help destroy malignant cells and foreign organisms. HIV

infection causes destruction of helper T lymphocytes, resulting in weakness in the body's

systems to protect themselves against infection and cancer.

A person infected by HIV will lose helper T lymphocytes through three stages over

several months or years. A healthy person has a CD4 lymphocyte 800-1300 cells / mL of

blood. In the first few months after infection with HIV, the numbers are decreasing as

much as 40-50%. During these months the patient can transmit HIV to others because

there are a lot of viral particles in the blood. Although the body is trying to fight the virus,

but the body is not able to relieve the infection. After about 6 months, the number of virus

particles in the blood reaches a stable level, which is different in every patient. The

destruction of CD4 + cells and the spread of disease to others continues. High levels of

virus particles and levels of CD4 + lymphocytes low assist physicians in determining those

who are at high risk of suffering from AIDS. 1-2 years before the onset of AIDS, the

number of CD4 + lymphocytes usually dropped dramatically. If the level reaches 200 cells

/ mL of blood, the patient becomes susceptible to infections.

HIV infection also causes disturbances in the function of B lymphocytes

(lymphocytes that produce antibodies) and often causes excessive production of

antibodies. These antibodies are mainly directed against HIV and infections experienced

by patients, but these antibodies are not much help in the fight against various

opportunistic infections in AIDS. At the same time, the destruction of CD4 + lymphocytes

by the virus cause a reduction in the ability of the immune system in recognizing

organisms and new targets should be attacked.

 Once the virus into the body HIVmasuk takes 3-6 months before titers of antibodies

to HIV-positive. This phase is called the "window period" (window period). After that the

disease seems to stop growing for about 1-20 months, but when examined titer antibodies

against HIV remains positive (this phase is called the latent phase) Several years later, the

new signage complete clinical picture of AIDS (the syndrome / collection of symptoms).

HIVsampai trip to AIDS infection takes at least 26 months, even more than 10 years after

HIV positive note. (Heri: 2012)

D. SIGNS AND SYMPTOMS

AIDS disease symptoms vary greatly. The following symptoms encountered in patients

with AIDS:

Heat over 1 month, cough-cough, thrush and painful swallowing,

Agency became skinny, diarrhea, shortness of breath, Enlarged lymph nodes, decreased

awareness, decrease in visual acuity, purple-black patches on the skin.

The AIDS disease symptoms should be interpreted with caution, because it can be a

symptom of other diseases that are common in Indonesia, for example, heat symptoms

can be caused by typhoid or pulmonary tuberculosis. If there are several symptoms

together with someone and he has a history of behavior or behavior that is easily

infected with AIDS, it is recommended he HIV.Pasien AIDS blood tests typically have a

history of symptoms and signs of disease. On infection of Human Immunodeficiency

Virus (HIV) acute primary duration of 1-2 weeks the patient will feel flu-like illness. And

while immunosuppression symptomatic phase (3 years) patients will have fever,

sweating at night, weight loss, diarrhea, neuropathy, fatigue, skin rashes

 limpanodenopathy, increase cognitive and oral lesions.

And while the infection phase of the Human Immunodeficiency Virus (HIV) AIDS

(bevariasi first 1-5 years of the determination of AIDS) there will be symptoms of

opportunistic infections, the most common is Pneumocystic carinii (PCC), interstitial

pneumonia caused by a protozoan, other infections including menibgitis, candidiasis,

cytomegalovirus, mikrobakterial, atypical

1.Infeksi Human Immunodeficiency Virus (HIV) acut atypical symptoms and similar

signs and symptoms of common diseases such as fever, sweating, drowsiness lethargy,

joint pain, headache, diarrhea, sore throat, inflammation of lymph glands, and rash

ditubuh.2. infection of Human Immunodeficiency Virus (HIV) without gejalaDiketahui

by examiner levels of Human Immunodeficiency Virus (HIV) in the blood will result

positif.3.Radang thorough lymph node and settled, with symptoms of swollen lymph

nodes throughout the body for more than 3 months.

E. CLINICAL

The clinical features of HIV infection could be due to their own HIV (acute retroviral

syndrome, HIV dementia), ofortunistik infection, or AIDS-related cancers. HIV disease

course is divided into stages based on clinical circumstances and CD4 cell count. (Arif

Mansjoer, 2000)

1. Acute retroviral infection

Gelaja frequency of acute retroviral infection around 50-90%. The clinical picture

indicates a fever, enlarged glands, hepatoplemagali, sore throat, myalgia, rash like
 morbili, mucocutaneous ulcers, diarrhea, leukopenia, and atypical lymphocytes. Most

patients have disorders such as mrningitis asepik neorologi, Gillain Barre syndrome, or

acute psychosis. This syndrome usually resolves itself without treatment.

2. The period of asymptomatic

At this time the patient shows no jegala, but can occur general lymphadenopathy. CD4

decline occurred gradually, also called the window period (window period).

3. The period of early symptoms

In this period ranged between 100-300 CD4 julah. The symptoms are due to bacterial

pneumonia infection, vaginal candidiasis, thrush, herped zoster, leukoplakia, ITP, and

pulmonary tuberculosis. This period used to be called AIDS-Related Complex (ARC)

4. The period of further symptoms

At this time the decline in CD4 count below 200. This causes the durability of the high

and low risk of serious opportunistic infections or malignancies

F. COMPLICATIONS

The complications kien with HIV / AIDS (Arif Mansjoer, 2000) include:

1. pneumocystis pneumonia (PCP)

2. Tuberculosis (TB)

3. Esophagitis

4. Diarrhea

5. Toksoplasmositis
 6. The multifocal leukoencephalopathy prigesif

7. Kaposi Sarcoma

8. Cancer Lymph

9. Cancer of the cervix (women with HIV)

G. DIAGNOSTIC

A diagnostic assay for AIDS (Arif Mansjoer, 2000)

1. Do anamnesi symptoms of opportunistic infections and cancers associated with AIDS.

2. Browse memmungkinkan transmission risk behaviors.

3. A physical examination to look for signs of opportunistic infections and related cancers.

Do not forget to change the glands, oral examination, skin, and fundoscopy.

4. In investigations sought limfosot sum total, HIV antibodies, and X-ray examination.

If the antibody test result is positive then examined CD4 count, purufied protein

derivative (PPD), serological toxoplasmosis, cytomegalovirus serology, serology STDs,

hepatitis, and pap smear.

While at the last follow-up CD4 count checked. If> 500 then checks repeated every

6 months. Meanwhile, when the amount of 200-500 then repeated every 3-6 months, and

when <200 given pneumocystis carinii pneumonia prophylaxis. Award INH prophylaxis

is not dependent on CD4 count.

There should also be examined to determine the viral load early antiretroviral drug

treatment and monitor treatment outcome.

If there is no equipment for CD4 (a fluorescence microscope or flowcytometer) for

AIDS cases can be used formula CD4 = (1/3 x total lymphocyte count) -8.
H. MEDICAL MANAGEMENT

1. When infected with Human Immunodeficiency Virus (HIV), the treatment of (Endah

Istiqomah: 2009):

a. Control of opportunistic infections

Aiming eliminate, control, and recovery of opportunistic infections, nasokomial, or

sepsis. Tidakan safe infection control to prevent bacterial contamination and

complications cause of sepsis, patients should be maintained for the critical care

environment.

b. Zidovudine (azidothymidine)

Approved FDA (1987) for the use of antiviral drugs that are effective against AIDS AZT,

these drugs inhibit the replication of antiviral Human Immunodeficiency Virus (HIV) by

inhibiting the enzyme inverting traskriptase. AZT available for AIDS patients whose T4

cell count is <> 3. Now, AZT available for patients with Human Immunodeficiency Virus

(HIV) positive asymptomatic and T4 cells> 500 mm3

c. New Antiviral Therapy

Several new antiviral that increases the activity of the immune system by inhibiting viral

replication / break the chain of virus reproduction in the process. These medications are:

- didanosine

- Ribavirin

- Diedoxycytidine

- Recombinant soluble CD4

d. Virus Vaccines and Reconstruction

 Reconstruction efforts and vaccine immune to such agents as interferon, the special unit

critical care nurses can use the expertise in the nursing process and research to support

the understanding and therapeutic efficacy of AIDS.

2. Diet

Management of the diet for people with AIDS (UGI: 2012) is

a. General Purpose Diet HIV / AIDS are:

· Providing nutrition interventions quickly to consider all aspects of nutritional support at

all stages of HIV infection disease early.

· Achieving and maintaining body weight in the composition expected, especially muscle

tissue (Lean Body Mass).

· Meet the needs of energy and all nutrients.

· Encourage healthy behavior in the diet, exercise and relaxation.

b. Special Purpose Diet HIV / AIDS are:

· Coping with the symptoms of diarrhea, lactose intolerance, nausea and vomiting.

· Improving the ability to focus, which looks at: the patient can distinguish between the

symptoms of anorexia, a feeling of fullness, changes in sense of taste and difficulty

swallowing.

· Achieve and maintain a normal weight.

· Preventing excessive weight loss (especially muscle tissue).

· Giving patients the freedom to choose the food that is adequate in accordance with ability

to eat and the type of treatment given.

c. The terms of Diet HIV / AIDS are:

· High energy. In the calculation of energy needs, attention stress factors, physical activity,

and body temperature rise. Add energy by 13% for every 1 ° C rise in temperature.
· High protein, namely 1.1 to 1.5 g / kg body weight to maintain and replace damaged body

tissue. Giving protein adjusted when there are abnormalities in the kidneys and liver.

· Enough fat, which is 10-25% of total energy needs. The type of fat adjusted to patient

tolerance. If there is malabsorption of fat, use fat with medium chain bond (Medium

Chain Triglyceride / MCT). Fish oil (omega 3) is supplied with MCT oil can improve

immune function.

· Vitamin and Mineral high, which is 1 ½ times (150%) Nutrition Adequacy Score that the

recommended (RDA), especially vitamin A, B12, C, E, Folate, Calcium, Magnesium, Zinc

and Selenium. If necessary, may be added in the form of vitamin supplements, but

megadosis should be avoided because it can suppress the immune system.

· Enough fiber; use convenient fiber digestibility.

· Enough fluids, according to the patient's condition. In patients with impaired swallowing

function, the liquids should be cautious and gradual given the appropriate consistency.

Liquid consistency can be fluid viscous (thick fluid), semi-viscous (thick semi fluid) and

liquid (thin fluid).

· Electrolyte. Electrolytes lost through vomiting and diarrhea need to be replaced (sodium,

potassium and chloride).

· Form of food modified to suit the patient's condition. This should be done by an individual

approach, with the condition and the patient's tolerance. In the event of a rapid weight

loss, it is recommended feeding through a pipe or sonde as a main meal or snack.

· Food is given in small portions and often.

· Avoid foods that stimulate digestion either by mechanical, thermic, or chemical.

d. Type Diet and indications Giving

Diet given to patients with acute AIDS after infection with HIV, namely to patients with:
a. Positive HIV infection without symptoms.

b. HIV infection with symptoms (eg hot longer, cough, diarrhea, difficulty swallowing,

mouth sores and enlarged lymph nodes).

c. HIV infection with neurological disorders.

d. HIV infection with tuberculosis.

e. HIV infection with cancer and HIV Wasting Syndrome.

Food for AIDS patients may be given in three ways, namely orally, enteral (sonde) and

parenteral (intravenous). Oral food intake should be routinely evaluated. When

insufficient, it is recommended enteral or parenteral feeding as an addition or as a main

meal. There are three kinds of diets are diets AIDS AIDS I, II and III.

1) Diet AIDS I

Diet Aids I administered to the patient of acute HIV infection, dengangejala high

fever, mouth sores, difficulty swallowing, shortness of breath severe, acute diarrhea,

decreased consciousness, or as soon as the patient can be given in the form of liquids and

slurries makan.Makanan milk, administered for several days in accordance with the

patient's condition, in small portions every three hours. If there is difficulty in swallowing,

the food is given in the form of a sonde or in the form of a combination of liquid foods and

food probe. Food sonde can make your own or use a commercial enteral feeding energy

and high protein. The food is reasonably energy, iron, thiamine and vitamin C. When it

takes more energy can be added glucose polymers (eg polyjoule).

2) Diet Aids II

AIDS Diet Diet II is given as the displacement of AIDS I, after the acute phase is

resolved. Food is given in the form of filter or chopped every 3 hours. These foods lower
 nutritional value and boring. To meet the needs of energy and nutrients, given enteral or

sonde addition to, or as a main meal.

3) Diet AIDS III

AIDS Diet III are given as displacement of AIDS II diet or to patients with

asymptomatic HIV infection. Form of soft or regular diet, given in small portions and

often. This diet is high-energy, protein, vitamins and minerals. If the limited ability to eat

by mouth and are still going on weight loss, it is recommended feeding sonde as a food

supplement or main meals.

I. NURSING CARE

1. Nursing assessment

Nursing assessment for patients with AIDS (Doenges, 1999) is

1. Activity / rest.

Tiredness, reduced tolerance to activity normally, malaise

2. Circulation.

Tachycardia, postural BP changes, pallor and cyanosis.

3. Integrity ego.

Alopecia, disability lesions, weight loss, despair, depression, anger, crying.

4. Elimiinasi.

Stool watery diarrhea that is often concentrated, painful abdominal pressure, rectal

abscess.

5. Food / fluid.

Dysphagia, bowel, poor skin turgor, lesions of the oral cavity, oral health / gum bad, and

edema.

6. Neurosensori.

Dizziness, tingling in the extremities, poor concentration, apathy, and slowed response.

7. Pain / comfort.
 Headache, pain in pleurisy, swelling in the joints, decreased range of motion, and muscle

movement to protect the affected part.

8. Breathing.

Cough, productive / non-productive, tachypnea, respiratory distress.

2. Diagnosis, Intervention and Rational Measures Nursing.

Diagnosis, intervention and rational act of nursing (Doenges, 1999) is

1. Nursing Diagnosis: pain related to inflammation / tissue damage characterized by

pain, changes in heart rate, muscle spasms, ataxia, muscle weakness and anxiety.

Expected results: complaints disappear, relaxed facial expression, can sleep or rest

adequately.

INTERVENTION RATIONAL

Assess complaints of pain, note the location, Indicate the need for intervention and also sign

intensity, frequency and time. Mark nonverbal development of complications.

symptoms eg anxiety, tachycardia, grimacing.

Instruct the patient to use visualization or Increase the feeling of relaxation and healthy.

imagination, progressive relaxation, deep breathing

techniques.

Encourage disclosure of feelings Can reduce anxiety and pain, so that the percep

the intensity of pain.

 Give narcotic analgesics or antipyretics. Use ADP M, emberikan decrease in pain / discomfort, re

(patient-controlled analgesia) to provide 24-hour fever. Based on the patient-controlled drug wit

analgesia. hours to maintain steady blood levels of analge

prevent deficiency or excess drugs.

Perform palliative measures eg changing position, Increase or decrease muscle tension relaxation
massage, range of motion in the joints that hurt.

2. The nursing diagnosis : Changes in nutrition less than body requirements associated

with intestinal disorder characterized by weight loss, decreased appetite, abdominal

cramps, hyperactive bowel sounds, reluctance to eat, inflammation of the buccal cavity.

Results are expected : Maintaining weight loss or weight gain shows that refers to

the desired goal, demonstrating the balance of nitrogen po; acquisitive, free from signs

of malnutrition and showed improved levels of energy.

NURSING INTERIVENSI RATIONAL

Assess the ability to chew, and swallow perasakan. Lesions of the mouth, throat and esophagus can

cause dysphagia, a decrease in the patient's

ability to process food and reduce the desire to

eat.

Auscultation of bowel sounds Hopermotilitas intestinal tract is common and is

associated with vomiting and diarrhea, which

may influence the choice of diet or way of

eating.
Plan your diet with those close, if memungkinakan Involving people closest to plan members a

recommend the food from home. Provide food a little but feeling of control environment and may

often in the form of nutrient-dense foods, is not acidic and increase revenue. Meet the need for food

also drinks with the preferred choice of patients. nonistitusional may also increase revenue.

Encourage the consumption of high-calorie foods that can

stimulate the appetite

Limit foods that cause nausea or vomiting. Avoid serving Pain in the mouth or fear of irritating lesions in

food hot and hard to swallow the mouth may be causing patients are reluctant

to eat. This will be useful to increase the food

intake.

Revisit survey laboratory, such as BUN, glucose, liver Indicates the nutritional status and organ

function, electrolytes, protein, and albumin. function, and identify needs replacement.

Give anti-emetic drugs eg metoclopramide. Reducing the incidence of vomiting and improve

gastric function

3. Nursing Diagnosis : High risk of fluid volume deficiency associated with severe

diarrhea

Expected results : Maintain hydration evidenced by moist mucous membranes, skin

turgor good, good vital signs, urine output is adequate personally.

Nursing intervention RATIONAL

Monitor income and oral fluid intake Maintaining fluid balance, reduce

at least 2,500 ml / day. thirst and moisten the mucous

membrane.
 Create a simple fluid administered to Specific increased fluid intake may

the patient; use liquid easily tolerated be too painful for consumption due

by patients and that replace to lesions in the mouth.

electrolytes that are needed, such as

Gatorade.

Skin turgor, mucous membranes and Indirect indicator of fluid status.

thirst.

Hilangakan potential food causes May reduce diarrhea

diarrhea, which is spicy, high in fat,

beans, cabbage, milk. Set the speed or

the concentration of food given later if

needed

Nerikan anti-diarrhea drugs for Lowering the amount and dilution of

example ddifenoksilat (Lomotil), feces, may reduce intestinal spasm

loperamide Imodium, paregoric. and peristalsis.

4. Nursing Diagnosis : High risk Ineffective breathing pattern related to the

infection process and muscular imbalance (weakening of the respiratory muscles)

Expected results : Maintain effective breathing patterns and not experiencing

shortness of breath.

INTERVENTION RATIONAL
 Auscultation of breath sounds, mark Estimating the development of

lung regions that are declining or loss complications or respiratory

of ventilation, and the advent of infections, such as pneumonia,

sound adventisius. For example

krekels, wheezing, crackles.

Record the respiratory rate, cyanosis, Tachypnea, cyanosis, can not rest,

increased respiratory work and the and enhancement of breath,

emergence of dyspnea, anxiety difficulty breathing menuncukkan

and the need to improve the

supervision or medical

intervention

Elevate the head of the bed. Keep the Improving the optimal respiratory

patient to turn, cough, breathing in as function and reduce aspiration or

needed. infection caused due to atelectasis.

Give supplemental O2 Yng dampened Maintain effective oxygenation to

through appropriate means, for prevent or ameliorate respiratory

example a cannula, mask, incubation crisis

or mechanical ventilation

5. Diagnose nursing : Intolerance aktovitas metabolism associated with

decreased production is characterized by a shortage of energy that does not change or

excessive, the inability to maintain a daily routine, lethargy, and an imbalance of the

ability to concentrate.
Expected results : Reported increased energy, participate in the desired

activity in levels of ability.

INTERVENTION RATIONAL

Assess and record perunahan sleep Various factors may increase fatigue,

patterns in the process of thinking or including lack of sleep, emotional

behaving stress, and drugs efeksamping

Plan of care to provide a resting Rest periods are often very necessary

phase. Set the activity at the time the to improve or conserve energy.

patient is energized Planning will make the patient

becomes active when energy is

higher, so it can improve a healthy

feeling of self-control.

Encourage the patient to do whatever Enable energy savings, increased

is possible, for example, self-care, stamina, and allow patients to be

sitting in a chair, walk, go eat more active without causing fatigue

and frustration.

Monitor the psychological response to Tolerance varies depending on the

the activities, eg change in BP, status of the disease process,

respiratory rate or heart nutritional status, fluid balance, and

type of disease.

Refer to the physical or occupational Exercise every day programmed and

therapy activities that help patients maintain

or improve muscle strength and tone

 CHAPTER III

COVER

A. CONCLUSION

1. AIDS is a collection of symptoms and infections or syndrome arising from the

destruction of the human immune system caused by HIV infection.

2. The etiology of AIDS is caused by HIV-1 and HIV-2 is cytopathic lentiviruses, HIV-1 is

a major cause of AIDS throughout the world.

3. How AIDS transmission is through sexual contact, through blood (blood transfusions,

sharing needles and exposed mucous containing AIDS), transmission from mother to

child with AIDS.

B. RECOMMENDATION

Based on the above conclusion, the author has some suggestions, such as:
1. So that readers can recognize on the definition of AIDS.

2. So that readers can apply the nursing care of AIDS on AIDS clients.

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(http://ndandahndutz.blogspot.com/2009/07/asuhan-keperawatan-pada-klien-

dengan.html, Accessed October 20, 2012)

Mansjoer, Arif. 2000. Capita Selecta Medicine. Jakarta: Media Sculapius

Marilyn, Doenges, et al. 1999. Nursing Care Plans and Documentation Guidelines for

Patient Care Planning. Jakarta: EGC

Price, Sylvia A and Lorraine M.Wilson. 2005. Patofissiologis Concept Clinical Process -

The process of disease. Jakarta: EGC

UGI.2012. "Diet HIV / AIDS", (Online) (http: // ugiuntukgiziindonesia.

blogspot.com/2012/05/diet-penyakit-hivaids.html, Accessed October 20, 2012)

http://shinichiranmouri.blogspot.co.id/2013/10/askep-hiv-aids.html