03-31-2009, 01:56 PM
Can someone please tell me what questions to ask for HIV drug refill case and what should counseling. Thanks so much for your help.
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HIV drug refill - kris09_us
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03-31-2009, 02:13 PM
Ask them what medication they are taking? dosage? per day? for how long?
are they taking them on time as told by the physician? are they seeing any side effects since they started taking HIV cocktail? When were they diagnosed with HIV? Ask them if they have seen any changes in their vision or having pain in their eye? (CMV retinitis) Ask them if they are having any difficulty swallowing? (CMV, Candida esophagitis) have they seen any white patches in their mouth or throat while brushing? (Oral thrush) Any recent SOB? CP? dyspnea? tachypnea? fever? r/o pneumonia Any nightsweats? recent weightloss? chronic cough (>3 wks duration): r/o TB Any yellowing of skin, RUQ pain o& mid epigastric Pain: r/o HIV drug induced hepatitis or pancreatitis. Have they taken MMR vaccine? Are they currently on any prophylactic antibiotics? When was the last time they had viral load & CD 4 count done? Councel Ask patient to have protective sex at all time. Take meds regularly as prescribed. anything else?
03-31-2009, 02:18 PM
there is a mnemonic DDDMECDE
drug ,dose,durationof HIV infection and initiation of HAART ,monitoring, education about the drug includes adherence,complications about the drug and the disease progression look for OIs, diet and exercise this is in addition to the above and easy way of rembering
03-31-2009, 02:26 PM
Khan, yegeta .. thats good history
For counseling we can use mnemonic "STRIP BIMBO" ! Safe Sex Practice Transmission Risks Immunizations Prevention Behavior counselling Interventional counselling Medications Barrier methods Oppurtunistic Infections Anybody want to add anything else?
03-31-2009, 07:13 PM
Do we need to do physical (screening) eaxam for HIV refill case
04-01-2009, 05:45 AM
sahil44
yes. physical exam is required for every case except the phone case if I am accurate. for HIV refill case..... check HEENT: ophthalmoscope for retinitis, NT for Oral thrush & leukoplakia check Neck for LAD. Do detail complete lungs to r/o pneumonia & reactivated TB. Listen to heart quickly. dont waste any time here. Do detail Abd exam, make sure to percuss for liver span if pt is IVDA hx to r/o underlying chr hep b/c. When done with abd, make sure you lift pts neck to see any neck pain,stiffness & do quick 90 degrees leg raise (r/o meningitis signs) Do Skin inspection. HIV pts often have rashes & stuff as med side effects or just pure dermatological skin pathos & also rules out Herpes shingles Do Neuro: AAox3, muscle strength & DTRs. anything else?
04-01-2009, 06:51 AM
thanks khan2020.
can u email me at neverstop4life' |
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