Breaking the Chain
Breaking the Chain: the Patient with an Infectious Communicable Disease Paper counts
as 30% of your grade for this course.
We suggest that you develop and outline and use the following time-line as your guide for
completing your paper:
Week 1: Review the requirements for the paper.
Week 2: Begin developing an outline for your paper.
Week 3: You should have your outline completed.
Week 4: You should be using your outline to write your paper.
Week 5: Continue work on your paper.Human immunodeficiency virus infection/
Acquired Immunodeficiency Syndrome (HIV/AIDS) is the number one infectious killer in the
world with reported 39 million deaths since the first cases were reported in 1981.The majority of
people living with this disease leave in low-income and middle-income countries. (Organization,
2014, pg 16) The following report is about the HIV/AIDS and it is divided into two parts.
The first part is meant to look at the chain of infection of the disease.
The infectious agent for HIV/AIDS is the human immune deficiency virus (HIV). This
virus has a single strand, positive sense and the RNA virus enveloped in the genus Lentivirus
.For the infection to occur, a significant amount and concentration of the virus must be present.
Once in the body the virus affects one’s immune system this is through destroying a special type
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of cells called the T helper lymphocytes (T-cells). The T-cells are crucial in the functioning of
the immune system and the immune response.HIV then replicates itself over a number of times
and eventually outnumbers the number of T-cells. (Lala & Merchant, 2012, pg 39)
The virus leaves in the human blood or other body fluids of the infected person. In the
blood the virus stays in blood cells whereby it is usually able to remain hidden within the cells.
The cells after time adapt the HIV genetic code and remain invisible to the immune defense
mechanisms of the body and become insensitive to the drugs. (Lala & Merchant, 2012, pg 39)
Portal of exit
The HIV leaves the body of the infected person to the body of another person through the
Firstly, it can be through the infected blood that is if the blood of the infected person
comes into contact with the blood of another person. The blood contact can occur through a
number of ways for example, through blood transmission, sharing of syringes and through the
transplantation of body organs and tissues with an infected person.
Secondly, it can be through the semen and other vaginal secretions. This usually occurs
when an infected person has unprotected sex with another person.
Thirdly, it can be through breast milk whereby an infected mother breast feeds a baby.
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Statistics show that the concentration of HIV is usually high in the blood followed by the
semen and vaginal secretions then the breast milk. (Hall, Hall & Cockerell, 2011, pg 57)
Means of transmission
Transmission usually occurs when there is an interaction between the blood or body
fluids of two people and one of them is infected with the virus. There a number of ways through
which the infection can be transmitted and this is as follows.
Firstly, it can be through unprotected sexual contact with an infected person and this is
usually transmitted through the semen, blood or vaginal secretions. Sexual intercourse can either
be through penile, vaginal or rectal tissues. The risk to acquire the infection through this means
of transmission usually depends on: the number of sexual partners, one has, the infection
prevalence among these partners and lastly the probability of the transmission of the virus during
sexual intercourse. Apart from sexual intercourse the virus can also be transmitted through deep
Secondly, it can be through the direct injection of with syringes and needles which
contains HIV infected blood or blood products. This means of transmission has usually been
found to be common among drug users who share such needles and syringes when using drugs
such as cocaine.
Thirdly, it can be transmitted from a HIV-infected mother to the baby and this is usually
through two main ways. Firstly, it can be during the process giving birth. Secondly, an infected
mother can transmit the virus to the baby through breastfeeding. This occurs although, the
concentration of the virus in the breast milk is minimum because the immune system of a
newborn baby is usually very week.
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Fourthly, the transmission can be through the transfusion of blood from an infected
person to another person. The same can also be transmitted through the transplant of body organs
and tissues from an infected person (Hall, Hall & Cockerell, 2011, pg 63)
Portal of entry
There are three main ways through which the HIV can enter into the body of a healthy
person. For the virus to enter into the body of a healthy person, the number of the virus must be
adequate to cause the infection.
Firstly, the main means of entry of the virus is usually through the blood. This occurs
when the blood from an infected person comes into direct contact with the blood of another
person for example, sharing of syringes with an infected person. The entry can also be through
semen, for example, during sexual contact.
Secondly, the entry can be through semen and vaginal secretions. This usually occurs
during sexual contact for example, unprotected sex.
Lastly, the entry can be through the skin membrane which occurs when the membrane is
splashed with a body fluid from an infected person. It has been shown that the entry of the virus
through this means is usually rare and accounts for less than 1% risk of infection. (Lala &
Merchant, 2012, pg 41)
Any person whose blood or body fluids come into contact with HIV infected blood or
body fluids can become infected with the same disease. Statistics show that the people who
usually have unprotected sex with a number of different people are at the highest risk of
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contracting HIV/AIDS. In 2013, an approximated 35 million people worldwide were living with
HIV/AIDS. Out of this population, children under the age of 15 years were 240,000.
(Organization, 2014, pg 16)
The second part is meant to look at the treatment options that can be used to break down
the chain of infection and prevent contagion for the disease, explore evidence based practice
nursing interventions when managing short-term and long term consequences for the patients
suffering from the disease and describe how a registered professional nurse can support patient
adherence to the treatment options.
Treatment options utilized to prevent transmission of HIV
The main treatment use to break down the chain of infection of the disease and prevent
contagion is the antiretroviral treatment (ART). The treatment usually works through minimizing
the number of microorganisms (HIV) in the blood, semen, vaginal and rectal fluid to an
undetectable number. There are a number of options in using this treatment and this is as
Treatment can be given to infected pregnant mothers and a newborn baby so at to prevent
transmission through the mother to child infection. The pregnant mother and the baby is given
zidovudine (AZT). It has been shown that this treatment has been able to reduce the mother to
child prevention from 25% to 8%. Infected mothers using Antiretroviral drugs (ARVs) have also
been found to reduce the risk of a mother to transmit the disease while breastfeeding.
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The other treatment option used is the Pre-exposure prophylaxis (PrEP). This treatment
usually works through people who are HIV-negative using ARV drugs before being exposed to
HIV. This treatment has been showed to reduce the risk of the disease up to 92%.
Post-exposure prophylaxis treatment is also used although it is a short term treatment It
usually involves using the ARV after being exposed to the virus. Initially, this treatment was
used by health workers who had been exposed to infected fluids. Recently, treatment has been
used on those who might have been exposed in only one event for example, in cases of sexual
assault (Sachdeva & Dutta, 2012, 377)
Evidenced based practice nursing interventions
There are two types of nursing interventions based on whether the consequences are
short-term or long-term.
For the long-term consequences, the following nursing interventions would be necessary;
Firstly there is the recommending of the patient to guidance and counseling sessions so
as to boost their morale. This will be very useful when it comes to taking the treatment since the
patient would now be able to positively appreciating the disease.
Secondly, there would be need to subject the patient to HIV/AIDS awareness education
and this is so as to minimize the risk of the patient in transmitting the disease to other people.
Thirdly, the infected person should be supplied with sex protection such as condoms so
as to reduce the risk of one infecting his/her spouse. There is also need of counseling the spouse
of an infected person and this is also aimed at reducing the risk of infection to the spouse.
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Lastly, there is the need of making the patient to appreciate the importance of the
treatment that is prescribed to him/her and ensure that the patient adheres to the treatment as
As for the short term consequences, the following interventions would be necessary;
Firstly, the nurse can conduct once in a while visits to the patient’s home so as to ensure
that the patient is using drugs as prescribed.
Secondly, the nurse can prescribe preferable nutrition to the patient that will ensure that
the immune system of the patient is properly working so as to prevent the patient from being
infected with other diseases which are related to HIV/AIDS such as Tuberculosis (TB).
Lastly, the nurse could ensure that he/she has the contacts of the close family of the
infected person and this is to help in case of any emergency or any other problem (J & S, 2012,
Supporting of the patients to adhere to the treatments
There are a number of ways through which a registered professional nurse would support
patients in the adherence to the treatment options. Some of these ways are as follows.
The nurse can conduct some guidance and counseling sessions on the patient. During
these sessions, the nurse could explain to the patient the importance of adhering to the treatment
and also remember to explain to the patient the danger of not taking the treatment.
The nurse can carry out some follow-up on patients. This can be achieved in a number of
ways for example, through carrying out of routine visits to the home of the patient so as to ensure
that the patient adheres to the treatment.
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A professional nurse can keep in touch with the close family of an infected person; the
importance is so as to make sure that the patient uses the prescribed treatment. The nurse has to
make sure that he/she has explained to the family the importance of the infected person to take
the treatment and also remember to explain to this family the danger of the patient in failing to
take the treatment. (M, C & M, 2012, pg. 904). In conclusion, although HIV/AIDS has no cure it
can easily be prevented once its chain of infection has been understood.
Organization, W. H. (2014). World Health Statistics 2014. Geneva: World Health Organization.
Lala, M. M. & Merchant, R. H. (2012). Principles of perinatal and pediatric HIV/AIDS. New
Delhi. Jaypee Brothers Medical Publishers.
Hall, J. C., Hall, B. J., & Cockerell, C. J. (2011). HIV/AIDS in the post-HAART era:
Manifestations, treatment, and epidemiology. Shelton, CT: People’s Medical Pub. House-
Sachdeva, A., & Dutta, A. K. (2012). Advances in Pediatrics. New Delhi: Jaypee Brothers
In foster, J. G. W., & In Prevost, S.S. (2012). Advanced practice nursing of adults in acute care.
In Alexander, M.F., In Brooker, C., & In Nicol, M.(2012). Alexander’s nursing practice.