Question: CONCERNS FOR LABOR AND DELIVERY with a patient wih HIV. Title: Care of pregnant clients with Human Immunodeficiency Virus Focus Area: Obstetric Nurse Station Margerie Ramos, a 32-year-old female, who, on her 34th week of pregnancy was transferred to the hospital after coming from a prenatal clinic and reported to be experiencing continuous regular contractions for almost 2 days. This is her third pregnancy. The labor and delivery team were planning to admit her to observe and monitor her baby through a fetal Non-Stress Test and to exclude complications associated with preterm labor. The patient previously agreed to a scheduled repeat C-section since she already had two prior ones. Upon admission, the patient verbalized, “I'm cold, I feel so hot.” Temperature was taken, T=38.5 C. She also reported to be having diarrhea for 3 days now. She weighs 55kgs and has a BP of 120/80 mmHg. She was also observed to be coughing a few times during the interview. Before she met her current live in partner Margerie Ramos admitted she was into drugs, specifically Shabu (Methamphetamine HCL- also known as “poor man's cocaine”) but has also tried marijuana during her High School days and has been engaging in promiscuous sexual activity. She submitted herself for HIV testing in 2015 and was diagnosed positive. She had herself tested again for HIV during this present pregnancy at 20 weeks and was immediately started on co-formulated TDF/FTC (brand name Truvada®) and Raltegravir (Isentress®) on the day of diagnosis per current recommendation. Her most recent HIV viral load was 1,200 copies/mL last month, up from the previous 840 copies/mL a month prior. The patient reported poor compliance to ART regimen and usually forgets to take her evening Raltegravir dose. Patient verbalized, “Last year, I was able to check up with my OB once because my private part was very itchy. My doctor said that I have a fungal infection. He prescribed a medicine that I put inside my private part, but I can't remember what it was." To this day, I still itch a lot and when I wash I always see something white like cheese in my panties.”
Question: CONCERNS FOR LABOR AND DELIVERY with a patient wih HIV.
Title: Care of pregnant clients with Human Immunodeficiency Virus
Focus Area: Obstetric Nurse Station
Margerie Ramos, a 32-year-old female, who, on her 34th week of pregnancy was transferred to the hospital after coming from a prenatal clinic and reported to be experiencing continuous regular contractions for almost 2 days. This is her third pregnancy. The labor and delivery team were planning to admit her to observe and monitor her baby through a fetal Non-Stress Test and to exclude complications associated with preterm labor. The patient previously agreed to a scheduled repeat C-section since she already had two prior ones.
Upon admission, the patient verbalized, “I'm cold, I feel so hot.” Temperature was taken, T=38.5 C. She also reported to be having diarrhea for 3 days now. She weighs 55kgs and has a BP of 120/80 mmHg. She was also observed to be coughing a few times during the interview.
Before she met her current live in partner Margerie Ramos admitted she was into drugs, specifically Shabu (Methamphetamine HCL- also known as “poor man's cocaine”) but has also tried marijuana during her High School days and has been engaging in promiscuous sexual activity. She submitted herself for HIV testing in 2015 and was diagnosed positive. She had herself tested again for HIV during this present pregnancy at 20 weeks and was immediately started on co-formulated TDF/FTC (brand name Truvada®) and Raltegravir (Isentress®) on the day of diagnosis per current recommendation. Her most recent HIV viral load was 1,200 copies/mL last month, up from the previous 840 copies/mL a month prior. The patient reported poor compliance to ART regimen and usually forgets to take her evening Raltegravir dose.
Patient verbalized, “Last year, I was able to check up with my OB once because my private part was very itchy. My doctor said that I have a fungal infection. He prescribed a medicine that I put inside my private part, but I can't remember what it was." To this day, I still itch a lot and when I wash I always see something white like cheese in my panties.”
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