A nurse is caring for a client who has HIV infection and has progressed to AIDS. Which of the following findings should the nurse expect?

Choice A rationale HIV infection and progression to AIDS typically cause a decrease in hemoglobin levels, leading to anemia. This occurs due to chronic inflammation, bone marrow suppression by the virus, or the side effects of antiretroviral medications. A normal hemoglobin range for adults is roughly 12 to 18 g/dL. Anemia in AIDS patients contributes to fatigue and decreased exercise tolerance. Increased hemoglobin would be an unexpected finding, as the disease process and secondary infections generally tax the hematologic system and reduce red cell production. Choice B rationale Progression to AIDS is characterized by a significant decrease in the white blood cell count, particularly the CD4+ T-lymphocyte count. A normal CD4 count is 500 to 1,500 cells/mm, whereas an AIDS diagnosis is made when the count drops below 200 cells/mm. This depletion of immune cells leaves the body vulnerable to opportunistic infections. An increased WBC count would only be seen if the patient had an acute bacterial infection, but the underlying trend in AIDS is profound lymphopenia. Choice C rationale AIDS-related wasting syndrome is a common manifestation of the disease, characterized by involuntary weight loss of more than 10 percent of body weight. This occurs due to a combination of decreased food intake, malabsorption, and altered metabolism caused by the virus and opportunistic infections. Weight gain is not expected; instead, healthcare providers monitor for cachexia and malnutrition. Maintaining adequate caloric intake is a major challenge for patients as the disease progresses and impacts their overall systemic health. Choice D rationale Night sweats are a classic constitutional symptom of HIV progression and the onset of AIDS. They are often associated with the body's response to the virus itself or the presence of opportunistic infections like Mycobacterium avium complex or tuberculosis. These episodes of profuse sweating during sleep are often accompanied by fever and chills, reflecting a state of chronic immune activation and systemic illness. Identifying night sweats is crucial for clinicians to screen for secondary infections that commonly affect immunocompromised individuals.