THE INFANT OF AN HIV POSITIVE MOTHER

THE INFANT OF AN HIV POSITIVE MOTHER -...

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THE INFANT OF AN HIV-POSITIVE MOTHER Frequently, the newborn who is subsequently determined to be HIV-positive will be asymptomatic during the  nursery stay. The CDC classifies HIV-positive newborns as indeterminate, asymptomatic, or symptomatic. Between  20% and 65% of infants born to HIV-positive mothers are themselves infected. This plan of care is to be used in conjunction with the previous newborn plans of care. NEONATAL ASSESSMENT DATA BASE As a rule, the neonate is asymptomatic at birth, although a few may show signs of opportunistic infections within  several days of birth. In addition, the effects of maternal substance use/abuse and/or prematurity may be present. Circulation Prolonged bleeding, petechiae (thrombocytopenia) noted on occasion Elimination Diarrhea Enlarged liver, spleen may be noted Food/Fluid LBW Feeding difficulties Oral lesions (candidiasis) Neurosensory Neurological deficits Microcephaly Respiration Varied degree of impairment (relative maternal drug use, cesarean birth) Safety Swollen glands (lymphadenopathy) noted on occasion MATERNAL FACTORS History of high-risk behaviors, STDs Seropositive HIV Sexuality MATERNAL FACTORS History of multiple sexual partners Teaching/learning Prematurity Developmental delays MATERNAL FACTORS History of parental drug use (mother or partner)
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DIAGNOSTIC STUDIES CBC and Total Lymphocyte Count:  Provides baseline immunologic data regarding WBC and lymphocyte counts to  monitor disease progression. Enzyme Immunoassay or Enzyme-Linked Immunosorbent Assay and Western Blot Test (EIA/ELISA):  May be  positive, but invalid because test does not distinguish between maternal and infant antibodies. (The infant may  test negative by 9–15 mo of age.) HIV Cultures (with peripheral blood mononuclear cells and, if available, plasma):  Diagnostic for infants under 15  mo of age. Polymerase Chain Reaction Test:  Detects nucleic acid in small quantities of infected peripheral mononuclear cells. Serum or Plasma p24 Antigen:  Increased quantitative values can be indicative of progression of infection (may not  be detectable during very early stages of HIV infection) in infants 30 days or older and who have had the second  dose of hepatitis vaccine. Quantitative Serum IgG, IgM, and IgA Determinations:  Nondiagnostic in newborns, but provide baseline  immunologic data. Blood/Lesion/Urine Cultures:  Diagnostic for opportunistic infections.
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THE INFANT OF AN HIV POSITIVE MOTHER -...

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