# A nurse is caring for a client with HIV/AIDS who has a CD4+ count of 180 cells/mm³ and is experiencing frequent opportunistic infections. The client asks about starting antiretroviral therapy (ART). What is the most appropriate nursing intervention?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=541846  
> language: ko  
> subject: Infectious Diseases

## 문제

A nurse is caring for a client with HIV/AIDS who has a CD4+ count of 180 cells/mm³ and is experiencing frequent opportunistic infections. The client asks about starting antiretroviral therapy (ART). What is the most appropriate nursing intervention?

## 보기

1. Inform the client that ART initiation is recommended only when the CD4+ count falls below 100 cells/mm³
2. Explain that ART is indicated solely after the occurrence of an AIDS-defining illness
3. Provide education about the importance of strict adherence to ART regimen and coordinate with the healthcare provider for initiation **✔ 정답**
4. Advise the client to wait for the viral load results before considering the start of ART

**정답: 3**

## 해설

Current guidelines recommend immediate ART initiation for all HIV-positive patients, especially with low CD4+ counts. Other options delay therapy, which can worsen outcomes.

## 심화 해설

Understanding the Clinical Scenario

This client has a confirmed diagnosis of HIV/AIDS with a significantly compromised immune status, evidenced by a CD4+ count of 180 cells/mm³ and a history of frequent opportunistic infections. The client’s question about starting antiretroviral therapy (ART) requires an intervention grounded in current clinical guidelines and a deep understanding of the nurse's role in chronic disease management.

Analysis of the Correct Answer (Option 3)

The most appropriate nursing intervention is to provide education about the importance of strict adherence to the ART regimen and coordinate with the healthcare provider for initiation. This is correct for two fundamental reasons rooted in the provided evidence and standard HIV care principles.

First, the clinical indication for ART is unequivocal. A CD4+ count of 180 cells/mm³ is well below the threshold that defines AIDS (

## 임상 시나리오

ART Initiation in Advanced HIVImmediate Action for CD4 Count Below 200
Current guidelines recommend antiretroviral therapy (ART) for all individuals with HIV, regardless of CD4 count. Initiation is particularly urgent when the CD4 count is below 200 cells/mm³ or an AIDS-defining illness is present.

The nurse's primary role is to provide thorough education on strict adherence, explaining that missing doses can lead to drug resistance and treatment failure, and to immediately coordinate with the healthcare provider to start therapy without delay.

CautionDo not wait for additional lab results like viral load or for the CD4 count to drop further before initiating ART. The presence of frequent opportunistic infections strengthens the indication for immediate intervention.

## 핵심 개념

- **CD4+ T-cell count** — A laboratory marker of immune function in HIV; a count below 200 cells/mm³ defines AIDS and indicates a high risk for opportunistic infections.
- **Antiretroviral Therapy (ART)** — The use of a combination of HIV medicines to control viral replication, improve immune function, and prevent disease progression.
- **Adherence** — The extent to which a patient takes medications exactly as prescribed; strict adherence is critical in ART to prevent drug resistance and treatment failure.
- **Opportunistic Infection** — Infections that occur more frequently and are more severe in individuals with weakened immune systems, such as those with AIDS.
- **AIDS-defining illness** — A specific list of conditions that, when occurring in an HIV-positive individual, lead to a diagnosis of AIDS.

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