ANAC's Core Curriculum for HIV/AIDS Nursing

Carl Kirton, MA, RN, APRN, BC Carl Kirton received his undergraduate degree in nursing at Lehman College, NYC and holds a graduate degree in nursing education and a post-master's certificate in advanced practice nursing from New York University, NYC. Mr. Kirton began his nursing career as a critical care nurse and progressed to the critical care nurse manager at New York University Medical Center. He began his advanced practice career in 1996 and has held a variety of position in substance abuse, internal medicine, cardiology, and HIV. Mr. Kirton joined the nursing faculty at New York University in 1993 and has taught in both the undergraduate and graduate programs in nursing. During his tenure at NYU he was promoted to clinical associate professor and coordinator of the acute care advanced practice program. While on faculty at NYU he maintained a joint appointment to the advanced practice staff at Mount Sinai Medical Center and Hospital in the AIDS Center. Today, he is a nurse practitioner and the clinical manager of the AIDS Center at Mount Sinai Medical Center. He continues to teach in the advanced practice program at NYU as part of its adjunct faculty. Mr. Kirton is the author of Handbook of HIV/AIDS Nursing and has authored or co-authored over 30 publications. He has held a variety of leadership positions in the professional nursing community, notably, President of the Greater New York Chapter of the Association of Nurses of AIDS Care, and the Board of Directors of the National Association or Nurses in AIDS. In 2001 he was awarded the President's award from the National Association of Nurses in AIDS Care for exceptional leadership in accomplishing committee work and dedication to the mission and goals of the association.

Introduction Preface Acknowledgments About the Editors Contributing Authors Section I: HIV Infection, Transmission and Prevention 1.1 Historical Overview of the HIV Pandemic - Jo Anne Bennett, RN, PhD, CS, ACRN 1.2 Epidemiology of HIV Infection and AIDS - Jo Anne Bennett, RN, PhD, CS, ACRN 1.3 Prevention of HIV Infection - Valery Hughes, RN, MS, FNP 1.4 Pathophysiology of HIV Infection - Joseph P. Colagreco, MS, APRN, BC, NP-C 1.5 HIV Testing - Jane Schulz, MPH, RN, CNP, ACRN Section II: Clinical Management of the HIV-Infected Adolescent and Adult 2.1 Baseline Assessment - Thomas P. Young, MS, RN, APRN, BC, ACRN 2.2 Immunizations - Carl A. Kirton, MA, RN, APRN, BC 2.3 Teaching for Health Promotion, Wellness, and Prevention of Transmission - Valery Hughes, RN, MS, FNP 2.4 Health Care Follow-Up - Kristin Grage, MA, RN, CNP, ACRN 2.5 Managing Antiretroviral Therapy - Brian K. Goodroad, PhD, CNP, ACRN Section III: Symptomatic Conditions in Adolescents and Adults With Advancing Disease A. Symptomatic Conditions in Advanced Disease 3.1 Bartonellosis - Hopkins D. Stanley, RN, MS, ACRN, CNS & Lawrence Marsco, RN, BSN & Ian R. McNicholl, Pharm.D., BCPS (I.D.) 3.2 Herpes Zoster - Hopkins D. Stanley, RN, MS, ACRN, CNS & Lawrence Marsco, RN, BSN & Ian R. McNicholl, Pharm.D., BCPS (I.D.) 3.3 Human Papillomavirus Infection - Doris Carroll, BSN, RN, CCRC & Pamela Dole, EdD, MPH, MSN, FNP, ACRN 3.4 Idiopathic Thrombocytopenia Purpura - Kristin K. Ownby, PhD, RN, ACRN, AOCN, CHPN 3.5 Listeriosis - Hopkins D. Stanley, RN, MS, ACRN, CNS & Lawrence Marsco, RN, BSN & Ian R. McNicholl, Pharm.D., BCPS (I.D.) 3.6 Oral Hairy Leukoplakia - Joyce Keithley, DNSc, RN, FAAN 3.7 Peripheral Neuropathy - Janice M. Zeller PhD, RN, FAAN & Young-Me Lee MSN, RN, DNSc (c) B. AIDS Indicator Diseases Bacterial Infections 3.8 Bacterial Pneumonia - Kelly Fugate, ND, RN 3.9 Mycobaterium Avium Complex (MAC) - Demetrius Porche, DNS, RN, FNP, CS 3.10 Mycobacterium Tuberculosis - Demetrius Porche, DNS, RN, FNP, CS 3.11 Salmonellosis - Hopkins D. Stanley, RN, MS, ACRN, CNS & Lawrence Marsco, RN, BSN & Ian R. McNicholl, Pharm.D., BCPS (I.D.) Fungal Infections 3.12 Candidiasis - Patrick Robinson, PhD, RN, ACRN 3.13 Coccidioidomycosis - Hopkins D. Stanley, RN, MS, ACRN, CNS & Lawrence Marsco, RN, BSN & Ian R. McNicholl, Pharm.D., BCPS (I.D.) 3.14 Cryptococcosis - Hopkins D. Stanley, RN, MS, ACRN, CNS & Lawrence Marsco, RN, BSN & Ian R. McNicholl, Pharm.D., BCPS 3.15 Histoplasmosis - Hopkins D. Stanley, RN, MS, ACRN, CNS & Lawrence Marsco, RN, BSN & Ian R. McNicholl, Pharm.D., BCPS (I.D.) Protozoal Infections 3.16 Cryptosporidiosis - Kristin K. Ownby, PhD, RN, ACRN, AOCN, CHPN 3.17 Isosporiasis - Kristin K. Ownby, PhD, RN, ACRN, AOCN, CHPN 3.18 Pneumocyctosis - Kelly Fugate, ND, RN 3.19 Toxoplasmosis - Hopkins D. Stanley, RN, MS, ACRN, CNS & Lawrence Marsco, RN, BSN & Ian R. McNicholl, Pharm.D., BCPS (I.D.) Viral Infections 3.20 Cytomegalovirus (CMV) - Demetrius Porche, DNS, RN, FNP, CS 3.21 Herpes Simplex Virus (HSV) - Patrick Robinson, PhD, RN, ACRN 3.22 Progressive Multifocal Leukoencephalopathy (PML) - Craig R. Sellers, MS, RN, CS-ANP, ACRN Neoplasms 3.23 Cervical Neoplasia - Theresa Moran, RN, MS, FNP & Pamela Dole, EdD, MPH, MSN, FNP, ACRN 3.24 Kaposi's Sarcoma (KS) - Theresa Moran, RN, MS, FNP 3.25 Non-Hodgkin's Lymphoma - Theresa Moran, RN, MS, FNP 3.26 HIV-Wasting Related Syndrome - Joyce Keithley, DNSc, RN, FAAN & S. K. Glenda Winson, MS, RN, ACRN 3.27 HIV Encephalopathy - Janice M. Zeller PhD, RN, FAAN & Young-Me Lee MSN, RN, DNSc (c) C. Comorbid Complications 3.28 Fat Redistribution Syndrome - Joyce Keithley, DNSc, RN, FAAN & S. K. Glenda Winson, MS, RN, ACRN 3.29 Impaired Glucose Intolerance (IGT) - Debra E. Lyon PhD, RN 3.30 Dyslipidemia - Debra E. Lyon PhD, RN 3.31 Anemia - Richard Ferri, PhD, ANP, ACRN, FAAN 3.32 Leukopenia - Barbara Swanson, DNSc, RN, ACRN 3.33 Thrombocytopenia - Kristin K. Ownby, PhD, RN, ACRN, AOCN, CHPN 3.34 Cardiomyopathy - Carl A. Kirton, MA, RN, APRN, BC 3.35 Psoriasis - Michelle Agnoli, BSN, RN, ACRN 3.36 Arthritis, Reiter's Syndrome - Michelle Agnoli, BSN, RN, ACRN 3.37 Osteopenia, Osteoporosis, Avascular Necrosis - Barbara Swanson, DNSc, RN, ACRN 3.38 Nephropathy - Wade Leon, RN, MA, ANP-CS, CRRN 3.39 Lactic Acidosis - Barbara Swanson, DNSc, RN, ACRN 3.40 Hepatitis A - Kathleen Barrett MSN, RN 3.41 Hepatitis B - Kathleen Barrett MSN, RN 3.42 Hepatitis C - Kathleen Barrett MSN, RN Section IV: Symptom Management of the HIV-Infected Adolescent and Adult 4.1 Anorexia and Weight Loss - Joyce Keithley, DNSc, RN, FAAN 4.2 Cognitive Impairment - Debra Topham, PhD, RN, CNS, ACRN 4.3 Cough - Kelly Fugate, ND, RN 4.4 Dyspnea - Kelly Fugate, ND, RN 4.5 Dysphagia and Odonophagia - Joyce Keithley, DNSc, RN, FAAN 4.6 Oral Lesions - Barbara Swanson, DNSc, RN, ACRN 4.7 Fatigue - Julie Barroso, PhD, ANP, CS 4.8 Fever - Barbara Holtzclaw, PhD, RN, FAAN 4.9 Sleep Disturbances - Kathleen M. Nokes, PhD, RN, FAAN 4.10 Mobility Impairment - Tracy A. Riley, PhD, RN, CS & Yvonne Smith, MSN, RN, CNS 4.11 Nausea and Vomiting - Bernadette Capili, NP-C, APRN, DNSc 4.12 Diarrhea - S. K. Glenda Winson, MS, RN, ACRN 4.13 Pain - Gail Newshan, PhD, RN, NP 4.14 Female Sexual Dysfunction - Rebekah Shephard, MS, RN, ANP 4.15 Male Sexual Dysfunction - Rebekah Shephard, MS, RN, ANP 4.16 Vision Loss - Tracy A. Riley, PhD, RN, CS & Yvonne Smith, MSN, RN, CNS Section V: Psychosocial Concerns of the HIV-Infected Adolescent and Adult and Their Significant Others A. Responses to HIV Diagnosis 5.1 Response to an HIV Diagnosis: Infected Person - Rebekah Shephard, MS, RN, ANP 5.2 Response to HIV Diagnosis: Family and Significant Other - Rebekah Shephard, MS, RN, ANP 5.3 Caregiver Burden/Strain - Rebekah Shephard, MS, RN, ANP 5.4 Spiritual and Religious Concerns of HIV Infected Persons - Patricia M. O'Kane, MA, RN B. Selected Psychiatric Disorders in HIV Disease 5.5 Depression - Wade Leon, RN, MA, ANP-CS, CRRN & Pamela Dole, EdD, MPH, MSN, FNP, ACRN 5.6 Primary Anxiety-Spectrum Disorders - Pamela Dole, EdD, MPH, MSN, FNP, ACRN & Wade Leon, RN, MA, ANP-CS, CRRN 5.7 Delirium - Rebekah Shephard, MS, RN, ANP & Pamela Dole, EdD, MPH, MSN, FNP, ACRN 5.8 Mental Illness and Substance Use - Carl A. Kirton, MA, RN, APRN, BC Section VI: Concerns of Special Populations 6.1 Adolescents - Mary Geiger, MPH, RN 6.2 The Blind and Visually Impaired Community - Nora Merriam, RN, MSN, MPH 6.3 Commercial Sex Workers - Margaret Dykeman, RN, PhD, FNP, APRN, BC, ACRN 6.4 Gay and Bisexual Men - R. Kevin Mallinson, PhD, RN, ACRN 6.5 HIV-Infected Health Care Workers - Craig E. Nielsen, MS, NP, BC, ACRN 6.6 The Deaf and Hearing Impaired Community - R. Kevin Mallinson, PhD, RN, ACRN 6.7 People With Hemophilia - Beverly Christie, RN, BSN 6.8 Homeless Persons - Margaret Dykeman, RN, PhD, FNP, APRN, BC, ACRN 6.9 Incarcerated Persons - Pamela Dole, EdD, MPH, MSN, FNP, ACRN 6.10 Lesbians and Bisexual Women - Christine A. Balt, MS, RN, ACRN, APRN, BC 6.11 Migrant and Seasonal Farm Workers - Susan Gaskin, MPH, DSN, ACRN 6.12 Older Persons - Kathleen M. Nokes, PhD, RN, FAAN 6.13 Rural Communities - Susan Gaskin, MPH, DSN, ACRN 6.14 The African American Community - Carl A. Kirton, MA, RN, APRN, BC 6.15 Pregnant Women - Pamela Dole, EdD, MPH, MSN, FNP, ACRN 6.16 Recent Immigrants - Susanne Rendiro, MSN, FNP, BC 6.17 Substance Users - Donna Taliaferro, RN, PhD & Gail B. Williams, RN, PhD 6.18 Transgender/Transsexual Persons - Eric G. Leach, MSN, RN, NP 6.19 Women - Pamela Dole, EdD, MPH, MSN, FNP, ACRN Section VII: Clinical Management of the HIV-Infected Infant and Child 7.1 Perinatal Transmission of HIV Infection - Carolyn Keith Burr, EdD, RN & Dawn D'Orlando, RN, MSN, MPH 7.2 Clinical Manifestations and Management of the HIV-Infected Infant and Child - Carolyn Keith Burr, EdD, RN & Dawn D'Orlando, RN, MSN, MPH 7.3 Managing Antiretroviral Therapy in HIV-Infected Infants and Children - Carolyn Keith Burr, EdD, RN & Dawn D'Orlando, RN, MSN, MPH 7.4 Adherence to Medical Regimens - Elaine Gross, RN, MS, CNS-C Section VIII: Symptomatic Conditions in Infants and Children With Advancing Disease A. Symptomatic Conditions in HIV Disease 8.1 Anemia - Dawn D'Orlando, RN, MSN, MPH 8.2 Cardiomyopathy - Dawn D'Orlando, RN, MSN, MPH 8.3 Dermatitis - Dawn D'Orlando, RN, MSN, MPH 8.4 Diarrhea, Recurrent or Chronic - Dawn D'Orlando, RN, MSN, MPH 8.5 Hepatitis - Dawn D'Orlando, RN, MSN, MPH 8.6 Hepatomegaly - Dawn D'Orlando, RN, MSN, MPH 8.7 Herpes Virus - Dawn D'Orlando, RN, MSN, MPH 8.8 Leiomyosarcoma - Dawn D'Orlando, RN, MSN, MPH 8.9 Lymphadenopathy - Dawn D'Orlando, RN, MSN, MPH 8.10 Lymphoid Interstitial Pneumonitis (LIP) - Dawn D'Orlando, RN, MSN, MPH 8.11 Nephropathy - Dawn D'Orlando, RN, MSN, MPH 8.12 Neutropenia - Dawn D'Orlando, RN, MSN, MPH 8.13 Nocardiosis - Dawn D'Orlando, RN, MSN, MPH 8.14 Otitis Media, Recurrent - Dawn D'Orlando, RN, MSN, MPH 8.15 Parotitis - Dawn D'Orlando, RN, MSN, MPH 8.16 Sinusitis, Recurrent - Dawn D'Orlando, RN, MSN, MPH 8.17 Splenomegaly - Dawn D'Orlando, RN, MSN, MPH 8.18 Thrombocytopenia - Dawn D'Orlando, RN, MSN, MPH 8.19 Upper Respiratory Infection, Recurrent - Dawn D'Orlando, RN, MSN, MPH 8.20 Varicella, Disseminated (Complicated Chickenpox) - Dawn D'Orlando, RN, MSN, MPH B. AIDS-Defining Conditions in Children With HIV Infection Bacterial Infections 8.21 Bacterial Infections, Recurrent - Dawn D'Orlando, RN, MSN, MPH 8.22 Mycobacterial Avium Complex (MAC) - Dawn D'Orlando, RN, MSN, MPH 8.23 Mycobacterial Tuberculosis - Dawn D'Orlando, RN, MSN, MPH 8.24 Salmonellosis - Dawn D'Orlando, RN, MSN, MPH Fungal Infections 8.25 Candidiasis - Dawn D'Orlando, RN, MSN, MPH 8.26 Coccidiodomycosis - Dawn D'Orlando, RN, MSN, MPH 8.27 Crytpococcosis - Dawn D'Orlando, RN, MSN, MPH 8.28 Histoplasmosis - Dawn D'Orlando, RN, MSN, MPH Protozoal Infections 8.29 Cryptosporidiosis - Dawn D'Orlando, RN, MSN, MPH 8.30 Isosporiasis - Dawn D'Orlando, RN, MSN, MPH 8.31 Pneumocystis Carinii Pneumonia (PCP) - Dawn D'Orlando, RN, MSN, MPH 8.32 Toxoplasma Gondii Viral Infections - Dawn D'Orlando, RN, MSN, MPH 8.33 Cytomegalovirus Disease (CMV) - Dawn D'Orlando, RN, MSN, MPH 8.34 Progressive Muitifocal Leukoencephalopathy (PML) - Dawn D'Orlando, RN, MSN, MPH Neoplasms 8.35 Malignancies - Dawn D'Orlando, RN, MSN, MPH 8.36 HIV-Related Wasting Syndrome - Dawn D'Orlando, RN, MSN, MPH 8.37 HIV-Related Encephalopathy - Dawn D'Orlando, RN, MSN, MPH Section IX: Symptom Management of the HIV-Infected Infant and Child 9.1 Pain - Lynn Czarniecki, RNC, MSN, CNS- C 9.2 Anorexia - Rachel Davis, RN, ACRN 9.3 Weight Loss - Rachel Davis, RN, ACRN 9.4 Cognitive Impairment and Developmental Delay - Pamela J. Bachanas, Ph.D., RN, MSN, ARNP 9.5 Fever - David J. Sterken, MN, CNS, CPNP 9.6 Skin Lesions - David J. Sterken, MN, CNS, CPNP Section X: Psychosocial Concerns of the HIV-Infected infant and child and their significant others 10.1 Decision Making and Family Autonomy - Lisa Perry, MSW, LCSW & Catherine R. Bataille, MSW, LCSW 10.2 Stress Reduction Pediatric HIV Infection - David J. Sterken, MN, CNS, CPNP & Rhys VanDemark, BA, CCLS & Brooke Vanburen-Hay, Ph.D. 10.3 Isolation and Stigmatization - Barbara E. Berger, PhD, RN, ACRN 10.4 Surrogate Caregivers - Catherine R. Bataille, MSW, LCSW 10.5 Disclosure to the Child - Marion Donohoe, RN, MSN, CPNP 10.6 Multiple Hospitalizations - Lisa Perry, MSW, LCSW 10.7 Community-Based Care Issues - Marion Donohoe, RN, MSN, CPNP 10.8 End of Life Issues - Heidi J. Haiken, MSW, MPH Section: XI: Nursing Management Issues 11.1 Case Management - Tom Emanuele, BSN, RNC, ACRN & Connie Highsmith, RN, BSN, ACRN 11.2 Ethical and Legal Concerns - Craig R. Sellers, MS, RN, CS-ANP, ACRN & Richard MacIntyre, RN, PhD 11.3 Preventing Transmission of HIV in Patient Care Settings - Leslie Schor, RN, MSN, ACRN Appendixes Appendix A: Public Health Service Revised Classification System for HIV Infection (Adolescents & Adults), 1993 Revised Appendix B: Selected Laboratory Values - Martin Lewis, M.Ed, MSN, ANP, ACRN Appendix C: Treatment of Tuberculosis [TB in Adult and Adolescent Patients Coinfected With the Human Immunodeficiency Virus (HIV)] - New Jersey Medical School National Tuberculosis Center Appendix D: Medications - Sande Gracia Jones, PhD, ARNP, ACRN, C, CS Index