Are there any tips to detirmine if patient is HIV+ w/o DX??

[mopsi]

i am in ltc now and there is an increasing number of suspected patients that could be hiv+..i recently saw a show where unprotected sex, and blood transfusions prior to testing make the geriatric group a higher risk but non traditional...it is next to impossible to get a family to sign a permission slip to test. the doc's shy away from this, too. plus administration doesn't want to deal with it. sad situation because we could be structuring care better based on the proper dx. i do profess my lack of knowledge in this area. are the any lab values that could be an indicator...signs and symptoms that would be more aids specific verus cancer? i know we all use universal precautions so the risk for infection should be minimised, however i can be honest and say that i am more careful if i know a patient has say c-diff than no dx. i would appreciate any facts that someone may know...even those working on a aids unit.....any help???

[nicola]

I worked in home care and saw lots of elders (mostly women) who had AIDS... There are several things that could raise a flag, but unless you have the diagnostic test done, there is no way to be absolutly certain.

The flags are:

Personal history - You hit it on the nail about the age and lack of knowledge. If you have an older man who had many partners or a woman who had boyfriends after her husband died, consider that to be high risk behavior. (Yeah, I know I'm being sexist and agist here, but I've known many widows who had boyfriends after their husbands died and got HIV that way. Very sad!)

Unexplained phenomena - If you have a person who bruises and/or bleeds easily, gets REALLY sick from a common cold or in other ways exhibits a depressed immune system, think twice. The catch here is that elders tend to have a "lazier" immune system than younger folks, so that isn't the best indicator in the world.

Look at the teeth! - Do you see oral yeast? Hairy leukoplakia? Black spots (KS) on the gums and roof of the mouth? REAL red flags there! This is a strong indicator of HIV infection. I would recommend you look for info on HIV dental indicators. Study the photos - they're gross, but you learn a lot from them!

Good luck!

[CashewLPN, LPN]

ok... there is one, and only one failsafe way to know if anyone has hiv+, hbv, hcv, et al....

assume everyone has it, or some form of it...

why do i say it like this???

well... universal precautions should be observed... and remember modes of contracting the disease... wash your hands, use gloves, use safety needles et al...

most of all....

be careful... some people you would never imagine could have a raging case of hepatitis, and, you'd never know it if they never consented to labs.

--barbara

[LilgirlRN, ADN, RN]

Take precautions, wear the appropriate garb, assume everyone has something communicable. Could be HIV, HepC, TB, whatever, something none of us want to acquire from our patients. Remember, there is no one more important than you when you are taking care of a patient, ALWAYS take the time to put on gloves, if you think you will come in contact with body fluids with someother part of your body, ie eyes, wear goggles. Make like a boy scout, be prepared!!