A client with AIDS is taking Zovirax (acyclovir). Which nursing intervention is most critical during the administration of acyclovir?
A. Limit the client’s activity
B. Encourage a high-carbohydrate diet
C. Utilize an incentive spirometer to improve respiratory function
D. Encourage fluids
The correct answer and explanation is :
The correct answer is D. Encourage fluids.
Explanation:
Acyclovir (Zovirax) is an antiviral medication commonly used to treat infections caused by herpes viruses, including herpes simplex, varicella-zoster (which causes chickenpox and shingles), and other viral infections. It is also used in the treatment of HIV/AIDS-related conditions, where viral infections can be more frequent and severe.
When administering acyclovir to a client with AIDS, it is particularly critical to encourage fluids for the following reasons:
- Renal Protection: Acyclovir can be nephrotoxic, especially when given in high doses or in clients who are already immunocompromised, such as those with AIDS. It can cause renal impairment, including acute kidney failure, due to crystallization of the drug in the kidneys. Adequate hydration helps to prevent this by ensuring proper renal perfusion and helping to flush out the drug, minimizing the risk of crystallization in the kidneys.
- Hydration and Kidney Function: The client with AIDS may have compromised kidney function due to the disease or other concurrent infections, making them more vulnerable to acyclovir’s nephrotoxic effects. Encouraging the client to drink fluids helps maintain renal function and reduces the likelihood of complications like nephropathy.
- Hydration as a General Supportive Measure: Maintaining hydration is a supportive measure in any client receiving medications, especially for immunocompromised individuals who may be prone to dehydration due to factors like vomiting, diarrhea, or fever.
Why the Other Options Are Not the Best Choice:
- A. Limit the client’s activity: While limiting activity might be important in certain cases to prevent fatigue or reduce the risk of injury, it is not a critical intervention in the context of acyclovir administration. Encouraging fluid intake is far more crucial for renal protection.
- B. Encourage a high-carbohydrate diet: Nutrition is important in managing any illness, including AIDS, but a high-carbohydrate diet is not a specific priority when administering acyclovir. Fluid intake takes precedence to prevent renal complications.
- C. Utilize an incentive spirometer to improve respiratory function: While respiratory function may need to be monitored in an immunocompromised client, the priority during acyclovir administration is to ensure hydration. This intervention is more appropriate for managing respiratory complications rather than the direct effects of acyclovir.
Thus, the most critical nursing intervention during the administration of acyclovir to an AIDS client is to encourage fluids to protect kidney function and prevent potential renal damage.