What is a possible disease trajectory for these patients? Pe
What is a possible disease trajectory for these patients? Pete is… What is a possible disease trajectory for these patients?Pete is 65 years old and has been HIV positive for 10 years. He lived in a heterosexual world the majority of his life. Married at age 22; worked at a bank and generated a sizeable income in a short period of time. He has two children. His wife died at age 54 of ovarian cancer. He was raised in a strict Southern Baptist home, was a star athlete in high school and was well known and respected in the community. After the death of his wife, he struggled with his sexuality. He thought about suicide often rather than coming out as a gay male at this stage of his life. Pete began to travel to larger urban cities and began exploring his sexuality with many men. He partnered with one man who became quite ill six months after they started seeing each other on a more consistent basis. The partner told Pete he had pneumonia. The partner actually had pneumocystis carinii and was admitted to the hospital. Pete did not visit the man after he was hospitalized; the man died within the month. Three months later, Pete tested positive for HIV. Pete routinely goes to his PCP/infectious disease provider for medical surveillance. He is well groomed, appears to be in good health, reports a good nutritious diet high in fruit and vegetables, he exercises regularly and had begun to meditate to destress the past few years. He does not smoke but does drink alcohol occasionally. Pete is retired from the bank. He is involved in a few men’s groups who play cards and golf. He is an avid reader. His son is estranged since learning about his HIV but his daughter remains actively engaged in his life. Rita is also 65 and has been HIV positive for 10 years. She has never been married and has 5 children from three different partners. She did not complete high school and has worked odd jobs as a house keeper throughout most of her life. Child support was a rarity thus she struggled to provide her children with basic necessities of life (food, clothing, healthcare). 10 years ago, Rita had a housekeeping position in a hospital and while emptying the trash bin she was stuck by a dirty needle that had been inappropriately disposed of in the trash. Rita was bleeding heavily from the needle stick. She reported the incident to her supervisor and following protocol both Rita and the patient were tested for HIV. The patient was negative but Rita was not. Rita had to disclose to the employer that she had had multiple partners and unprotected sex with several men. She had frequented a local pub and would often leave with a man for the evening but stated she had not engaged in risky sexual behaviors for about 5 years. The HIV diagnosis was devastating to Rita. She quit her job due to the embarrassment she felt surrounding her diagnosis. She has limited health insurance which doesn’t cover the majority of the cost for her antiviral medications so she frequently rations her medications to last longer than prescribed. She rarely leaves her apartment and drinks cheap wine most of her waking hours. Her oldest daughter visits regularly but she does not see her other children. Rita has not disclosed her HIV status to any of her children. Recently the daughter mentions to Rita that she finds her to be more forgetful, is stumbling more and the daughter believes she has been falling based on bruises she sees on her arms. Rita’s daughter is concerned because her grandmother, Rita’s mom, had Altheimer’s disease. Health Science Science Nursing NURS 6746
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