The nurse is caring for a patient with AIDS who was prescribed nevirapine two weeks ago. While assessing the patient, the nurse should be alert for:

Jaundice.
Raised pinkish-brown nonpruritic patches on the skin or mucous membranes.
White patches in the mouth.

Explanation

• White patches in the mouth are a sign of thrush, caused by Candida albicans. Thrush is an opportunistic infection and often develops in patients with immunosuppression.

• Raised pinkish-brown nonpruritic patches on the skin or mucous membranes are indicative of Kaposi's sarcoma, an opportunistic infection caused by Human herpes virus 8, an oncovirus. It causes tumor cells to form lesions on the skin or mucous membranes.

• Jaundice is a sign of liver disease. Nevirapine (Viramune) is a non-nucleoside reverse transcriptase inhibitor (NNRTI), which is an antiretroviral drug used in the treatment of AIDS. It is associated with liver failure, especially in the first month. During the 2-week period, the patient must be carefully monitored for signs of hepatotoxicity due to nevirapine.

• Incorrect: Patients with AIDS commonly develop pneumonia, which produces a productive cough, not a dry cough.

• Incorrect: High urine specific gravity is more likely to occur due to inadequate nutrition and hydration.

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