A young female patient with HIV does not want to see the gynecologist because, she says, "I'm going to die anyway." How should the nurse respond?
1. "Having a PAP smear will help detect the onset of cervical cancer."
2. "Why do you think you are going to die?"
3. "The gynecologist will help diagnose any Hodgkin disease."
4. "But you still should be on birth control."
Correct Answer: 1
Cervical cancer develops frequently in women with HIV infection and tends to be aggressive. Women with concurrent HIV infection and cervical cancer usually die of the cervical cancer, not AIDS. Because of this, it is recommended that women with HIV infection have Papanicolaou (Pap) smears every 6 months and aggressive treatment of cervical dysplasia with colposcopic examination and cone biopsy. While the nurse should investigate the patient's feelings, the emphasis is on preventive treatments. The gynecologist does not focus on the diagnosis of Hodgkin disease. Safe sex practices and the use of contraceptives are within the scope of the gynecologist; however, this is not the primary focus of the interaction.
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