Last updated on May 17th, 2022 at 09:21 am
Opportunistic Infection Nursing Care Plans Diagnosis and Interventions
Opportunistic Infection NCLEX Review and Nursing Care Plans
An opportunistic infection by the body’s defensive system. Opportunistic infections can also be characterized by illnesses caused by prevalent and severe organisms.
These are infections in which pathogens reap the benefits of a host’s impaired immune systems or changed microbiota.
Due to diverse environmental exposure to pathogenic organisms and inherent virulence factors, opportunistic infections can exhibit broad geographic diversity, particularly for mycobacteria, fungi, and parasites.
Furthermore, genetic host patterns and the various types, grades, and duration of iatrogenic immunosuppression can influence opportunistic infections’ risk and clinical manifestations.
Signs and Symptoms of Opportunistic Infections
Signs and symptoms vary significantly due to the large variety of opportunistic infections. Nevertheless, some common symptoms are as follows:
- Fever
- Difficulty in swallowing (dysphagia)
- Pain in swallowing (odynophagia)
- Productive cough (cough with phlegm)
- Unknown cause of weight loss
- Fatigue
- Difficulty in breathing
- Extensive headache
- Ulcerations on the skin and around the vaginal area that are painful (cold sores)
- Visual impairment
- Candida infection – oral or vaginal thrush
- Cognitive dissonance
- Rashes and skin infections
- Diarrhea, both severe and chronic
- Convulsions
Types of Opportunistic Infections
Viral, bacterial, fungal, or parasitic diseases are all types of opportunistic infections. They occur secondary to another health problem in patients with an inadequate or weakened immune response.
- Opportunistic Viral Infections
- Cytomegalovirus. An opportunistic virus family that is most generally related to respiratory infection.
- Human polyomavirus. It is known as JC or John Cunningham virus, which has been linked to progressive multifocal leukoencephalopathy (PML).
- Human herpesvirus. It is referred to as Kaposi sarcoma-associated herpes virus, it is also linked to the malignancy Kaposi sarcoma.
- Opportunistic Bacterial Infections
- Clostridioides difficile. It is previously known as Clostridium difficile, a bacteria that induce gastrointestinal infections usually encountered in hospital settings.
- Legionella pneumophila. It is the causative organism of Legionnaire’s disease, an infection of the lungs.
- Mycobacterium avium complex (MAC). It is a combination of M. avium, and M. avium intracellulare, which commonly co-infect, resulting in a respiratory infection known as mycobacterium avium-intracellulare infection.
- Mycobacterium tuberculosis. This is a bacterial species that induces tuberculosis, a pulmonary ailment.
- Pseudomonas aeruginosa. A bacterium that can trigger respiratory problems. It is often linked to cystic fibrosis and hospital-acquired illnesses.
- Salmonella. It is a bacterial species that has been proven to cause gastrointestinal illnesses.
- Staphylococcus aureus. A type of bacterium that has been associated with skin problems and blood infections, among other diseases. Most notably, S. MRSA is among the drug-resistant forms of S. aureus.
- Streptococcus pneumoniae. This is the type of bacteria that induces diseases in the respiratory system.
- Streptococcus pyogenes. It is commonly known as group A Streptococcus, which can cause impetigo and throat infections and other, more bacterial illnesses.
3. Opportunistic Fungal Infections
- Aspergillus. It is a type of fungus that is usually linked to respiratory illnesses.
- Candida albicans. A type of fungus that causes oral candidiasis and intestinal parasites.
- Coccidioides immitis. A fungus that causes coccidioidomycosis, also called Valley Fever.
- Cryptococcus neoformans. A type of fungus that induces cryptococcosis which can result in lung infections and central nervous illnesses such as meningitis.
- Histoplasma capsulatum. A fungus that causes histoplasmosis that can manifest various symptoms, most commonly a respiratory disease.
- Pseudogymnoascus destructans. It is previously known as Geomyces destructans, which induces white-nose disorder in bats.
4. Opportunistic Parasitic Infections
- Cryptosporidium. It is a parasitic microorganism that lives in the gastrointestinal system.
- Toxoplasma gondii. It is a protozoan that causes toxoplasmosis.
Causes of Opportunistic Infections
A compromised immune system causes the majority of opportunistic infections. HIV/AIDS, cancer treatment, and corticosteroid use are all reasons that suppress the immune system. Some individuals have weak immunity that is hereditary and present from birth. While several of the causes of a compromised immune system, which leads to opportunistic infections, are as follows:
- Genetic predisposition
- Cancer chemotherapy
- Patients who use immunosuppressive medications to avoid transplant rejection after the procedure.
- Infection with HIV/AIDS
- Severe cases of malnutrition
- Prolonged antibiotic use – alters the body’s natural bacterial flora, which typically outnumbers pathogens and avoids illness.
- Because of their naturally weakened immune systems, newborns and older adults are particularly vulnerable.
- White cell production is reduced as a result of bone marrow illness (neutropenia)
- Skin discoloration
- Pregnancy
Risks Factors to Opportunistic Infections
The following are risk factors for opportunistic infections:
- Age
- Genetic susceptibility
- Underlying diseases that may trigger the immune system
- HIV/AIDS Diagnosis
- Cancer history
- Immunosuppressant medications and long-term corticosteroid treatment
- Primary immunodeficiency, which includes severe combined immunodeficiency and specific IgA deficiency.
Diagnosis of Opportunistic Infections
Depending on the patient’s symptoms, various tests may be performed to determine the degree of the immunosuppression and to detect an untreated opportunistic infection. The following are examples of clinical suspicion-based investigations:
- CD4 T-cell count. A reduction in CD4 T-cell count might result in opportunistic infections. As a result, a CD4 cell count will be beneficial in identifying the prevalence of reduced immunity and the extent of immunosuppression.
- Chest X-ray. When patients with suspected opportunistic infections complain of congestion and fever for more than four weeks, a chest x-ray is required. The chest x-ray aids in diagnosing opportunistic infections such as tuberculosis of the lung and PCP infection.
- Sputum smear. Microscopic examination of a stained sputum smear aids in detecting TB bacilli, Pneumocystis carinii, and other microorganisms causing severe opportunistic infections in the lung.
- Serology. Serological assays can indicate the presence of pathogenic antigens or antibodies in blood or other bodily fluids. ELISA, agglutination tests, and immunofluorescence assays are accessible in most hospitals and medical facilities.
- CT/MRI Brain. This is a type of imaging system. It is advised for people suffering from fever, headaches, or convulsions. It aids in detecting Toxoplasma lesions, the causative agent of Toxoplasmosis.
- CSF Preparation using Indian Ink. In individuals with Cryptococcal meningitis, CSF fluid on Indian Ink preparation reveals the Cryptococcus and thus aids in the identification of the causative pathogen.
- Fecal analysis. In individuals with symptomatic diarrhea, a feces examination for ova and cysts may be indicated to screen for cryptosporidium cysts and other microorganisms triggering waterborne diseases.
- Cultures. To identify the causal organism, microbial cultures of specimens such as sputum, CSF, or other body fluids may be performed.
- Ophthalmoscopic examination. This examination may be suggested in individuals with suspected CMV retinitis.
Treatment for Opportunistic Infections
If an individual develops an opportunistic infection, antiviral, antibiotic, anti-parasitic, and antifungal medicines are prescribed. The type of opportunistic infection will determine the kind of medicine prescribed by the health care professional.
Once an opportunistic infection has been effectively treated, a person may remain to use the same or a different treatment to keep the opportunistic illness from recurring. Getting an opportunistic infection can be a severe medical scenario and treating it can be difficult.
Prevention of Opportunistic Infections
The nurse may advise the patient to:
- Regularly take prescribed medications.
- Use the recommended immunizations and preventive treatments.
- When handling cat feces, wear gloves.
- Opportunistic infections can be avoided by practicing safe sex.
- Wash hands thoroughly before handling food
- Consume no raw, unpasteurized milk or eggs, and only drink bottled water.
- Avoid interaction with sick people.
- Get regular hospital exams and CD4 counts because the doctor would advise taking preventive antibiotics if the CD4 count drops to avoid opportunistic infections.
- Good nutrition, rest, exercise, and a stress-free lifestyle are vital.
- When immunosuppressive therapy is used, the dosages of these medicines may need to be adjusted to limit the chance of infection.
Opportunistic Infection Nursing Diagnosis
Opportunistic Infection Nursing Care Plan 1
Risk for Infection
Nursing Diagnosis: Risk for Infection related to insufficient primary defenses, damaged skin, injured tissue, fluid retention in the body, immune system weakening, chronic illness, malnourishment, and usage of antimicrobial medicines secondary to opportunistic infection.
As a risk nursing diagnosis, the Risk for Infection is entirely unrelated to any signs and symptoms since it has not yet developed in the patient, and safety precautions will be initiated instead.
Desired Outcomes:
- Heal wounds or lesions as soon as possible.
- Be able to ambulate and free of pus-filled discharge or secretions and other symptoms of infectious disease.
- Identify and engage in practices that lower the risk of infection.
| Nursing Interventions for Opportunistic Infection | Rationale |
| Examine the patient’s ability and knowledge to adhere to the opportunistic infection preventative regimen. | Maintaining a multiple medicine regimen over a lengthy period is tough. Patients’ pharmaceutical regimens may be adjusted based on side effects, contributing to poor prophylaxis, active disease, and resistance. |
| Hands should be washed before and after any medical encounters. Instruct the patient and significant others to wash their hands as directed. | This intervention reduces the possibility of cross-contamination. |
| Make sure the environment is hygienic and well-ventilated. Visitors and staff should be screened for evidence of infection, and isolation procedures should be followed as directed. | This intervention reduces the number of microorganisms exposed to the immune system and the likelihood of nosocomial pathogens in the patient. |
| Discuss the implications and rationale for infection control measures and personal cleanliness. | This approach encourages regimen compliance. |
| Keep an eye on critical indications, such as the patient’s temperature. | Baseline data is provided with this intervention; repeated temperature increases and the onset of new fever suggest that the body reacts to new invasive infection or that drugs are not adequately managing incurable diseases. |
| Examine breathing rate and rhythm; take note of dry spasmodic coughs on deep inhalation, alterations in sputum qualities, and the existence of wheezes or rhonchi. When the cause of a productive cough is uncertain, begin pulmonary isolation. | Pulmonary congestion or distress may suggest the development of PCP; however, tuberculosis (TB) is on the rise, and other fungal, viral, and bacterial diseases that damage the respiratory system may occur. CMV and PCP can coexist in the lungs, and if PCP treatment is ineffective, adding CMV medication may be beneficial. |
| Look for white spots or lesions on the skin and oral mucous membranes. | Commonly diagnosed opportunistic infections affecting the cutaneous membranes include oral thrush, herpes, CMV, and cryptococcosis. |
| Frequently clean the patient’s nails. File instead of cut nails, and avoid clipping cuticles. | This intervention minimizes the likelihood of infection spread through skin fractures. Fungal infections are frequent along the nail bed. |
| Complaints of indigestion, difficulty in swallowing, pericardial pain during swallowing, increased stomach cramping, and copious diarrhea should be closely monitored. | Close monitoring of these symptoms is beneficial in the early diagnosis of opportunistic infections; Esophagitis can develop due to oral candidiasis, CMV, or herpes. Cryptosporidiosis is a parasite infection that causes watery diarrhea. |
| Examine wounds and the location of intrusive devices for local infection and inflammation symptoms. | Sepsis may be avoided if secondary infections are identified and treated early. |
Opportunistic Infection Nursing Care Plan 2
Deficient Knowledge
Nursing Diagnosis: Deficient Knowledge related to a deficiency of exposure or recall, a misreading of information, a cognitive restriction, and unawareness of available information resources secondary to opportunistic infection as evidenced by questions or requests for information, statements of misconception, incorrect execution of orders, and the emergence of avoidable problems
Desired Outcomes:
- Explain the condition or disease progression and any probable complications.
- Determine the link between clinical symptoms and the disease process and associate the symptoms with underlying factors.
- Explain the comprehension of treatment options.
- Execute necessary procedures appropriately and explain the actions.
- Make the essential lifestyle modifications and follow the treatment plan.
| Nursing Interventions for Opportunistic Infection | Rationale |
| Educate the patient and guardians about preventing infection, including proper handwashing strategies for everybody (patient, family, caregivers). Moreover, advise the patient about the proper wearing of gloves while handling bedpans, dressings, or dirty bed linen, wearing masks if the patient has a persistent cough, putting soiled or wet linens in a trash bag, and separating from household laundry, washing with detergent and hot water. Lastly, teach the patient to sanitize surfaces with a bleach and water solution of a 1:10 ratio and sterilize the toilet bowl and bedpan. | This intervention minimizes the danger of transmission of infection and improves well-being in the presence of a compromised immune system’s ability to manage flora levels. |
| Assess the degree of independence or reliance and physical health. Take note of the extent of support and care provided by family and significant others and the need for additional care providers. | This intervention aids in the planning of the quantity of treatment and symptom control required, as well as the requirement for more resources. |
| Examine illness transmission modes, especially if the condition is just diagnosed. | This intervention dispels myths and preconceptions while also promoting patient and public safety. In order to target preventative efforts, reliable epidemiological statistics are required. |
| Examine dietary requirements (high-protein, high-calorie) and approaches to improve consumption when anorexia, diarrhea, lethargy, or depression impede intake. | This strategy ensures the proper nourishment required for recovery and immune system support. It also improves feelings of well-being. |
| Emphasize the significance of adequate rest. | This intervention aids in the management of fatigue and improves coping capacities and energy levels. |
| Emphasize the importance of ongoing healthcare and follow-up. | Allows for the modification of a regimen to accommodate individual and changing demands. |
| Encourage smoking cessation. | Smoking raises the incidence of infectious diseases and weakens the immune response. |
Opportunistic Infection Nursing Care Plan 3
Hyperthermia
Nursing Diagnosis: Hyperthermia related to anesthesia, dehydration, constant exposure to hot temperatures, illness or trauma, inability to produce sweat, elevated metabolic rate, medicines, and strenuous activity secondary to opportunistic infection as evidenced by high body temperature, heated, flushed skin, accelerated heart and respiratory rate, decreased appetite, lethargy or weakness, and convulsions.
Desired Outcomes:
- The patient’s body temperature remains below 38.0° C.
- The patient’s blood pressure and heart rate remain within normal ranges.
| Nursing Interventions for Opportunistic Infection | Rationale |
| Examine for indications of hyperthermia. | Examine for signs and symptoms of hyperthermia, such as flushed skin, weakness, rash, respiratory difficulty, palpitations, lethargy, migraine, and restlessness. Keep an eye out for reports of excessive perspiration, hot and dry skin, or being overheated. Since hyperthermia can be a sign of infection, it is essential to monitor its clinical manifestations. |
| Administer the antibiotics and antipyretics as directed. | Take the antibiotics as directed to combat the opportunistic infection causing hyperthermia. |
| Determine the causes of hyperthermia and analyze the client’s medical history, diagnosis, or treatments. | Recognizing the temperature variations or the etiology of hyperthermia will aid in the therapy and nursing interventions. Hyperthermia could be a sign of an underlying opportunistic infection. |
| Ice packs should be placed in the groin, axillary regions, and on the surface of the head. | Ice packs are a vital step in lowering internal body temperature. If the hyperthermia persists despite this intervention, consult a doctor right away because it could result from an underlying cause of opportunistic infection. |
| When hypothermia or cooling blankets are required, provide them. | When the body temperature has to be reduced quickly, use cooling comforters that circulate water. Set the temperature controller to 1oC lower than the patient’s current temperature to prevent trembling. |
Opportunistic Infection Nursing Care Plan 4
Fatigue
Nursing Diagnosis: Fatigue related to reduced metabolic energy production, increased energy requirements, excessive psychological or emotional demands, and altered body chemistry as a result of medicine or chemotherapy secondary to opportunistic infections as evidenced by unending or overpowering exhaustion, inability to sustain typical routines, poor performance, impaired capacity to focus, and lethargy
Desired Outcomes:
- Report improved sense of energy.
- Perform activities of daily living with the aid of others as needed.
- Engage in meaningful activities to the best of the patient’s ability.
| Nursing Interventions for Opportunistic Infection | Rationale |
| Encourage a healthy diet. | Adequate nutritional consumption or utilization is required to fulfill increasing energy requirements for activity. Constant immune system stimulation from opportunistic infection leads to a hypermetabolic condition. |
| Examine sleep habits and note any changes in cognitive processes or behavior. Lack of sleep, opportunistic infections, mental trauma, chemotherapy drugs side effects, and the development of Central nervous system disease are all factors that can exacerbate fatigue. | |
| Schedule activities for times when the patient has the most energy. Plan care regimen to include rest periods. Engage the patient and significant others in the scheduling process. | Planning helps the patient be active while their energy levels are higher, which may reestablish a perspective of well-being and control. Acquiring opportunistic infections may drain someone’s energy. That is why rest times are required regularly to repair or conserve energy. |
| Encourage the patient to do whatever he or she can, such as self-care, sitting in a chair, or taking brief walks. Increase activity level as indicated. | Having opportunistic infections of any kind is a complicated medical condition. Therefore, this intervention aims to preserve strength, enhance stamina, and allow the patient to be more active without becoming fatigued or discouraged. |
| Monitor any problems with blood pressure, respiration rate, or heart rate since these are indicators of a physiological reaction to the infection. | Tolerance varies considerably depending on the phase of the disease process, dietary status, water balance, and the number or kind of opportunistic infections to which the patient has been exposed. |
Opportunistic Infection Nursing Care Plan 5
Anxiety or Fear
Nursing Diagnosis: Anxiety or Fear related to harm to one’s self-concept, the threat of death, alteration in health or socio-economic status, role functioning, interpersonal transmissions and contamination, disconnection from one’s support network, and worry of transmission of infection to family or loved ones secondary to opportunistic infections as evidenced by heightened anxiety, uncertainty, feelings of hopelessness, stated concern about life changes, fear of unspecified repercussions, physical problems, sleeplessness, sympathetic activation, and agitation.
Desired Outcomes:
- The patient will learn to acknowledge feelings and constructive ways to cope with anxiety or fear.
- The patient will demonstrate an acceptable range of emotions and less fear or anxiety.
- The patient will be able to show his problem-solving abilities.
| Nursing Interventions for Opportunistic Infection | Rationale |
| Assure the patient that confidentiality will be maintained within the parameters of the circumstances. | This intervention gives the patient confidence and the chance to problem-solve solutions to predicted scenarios. |
| Maintain regular communication with the patient. Communicate to and touch the patient. The use of isolation gear and masks should be limited. | This approach assures the patient that, despite having opportunistic infections, they are not alone or abandoned; it expresses respect for and tolerance of the individual, promoting confidence. |
| Deliver reliable and timely prognosis information. Avoid debating about how the patient perceives the problem. | This intervention can alleviate the anxiety caused by having an opportunistic infection and allow the patient to make choices and decisions based on reality. |
| Be alert for the potential of retreat, hostility, or inappropriate comments, as they can indicate denial or despair. Identify the presence of suicidal thoughts and rate them on a scale of 1–10. | Patients with opportunistic infection may employ denial as a defensive measure and remain hopeful that the diagnosis is incorrect. Feelings of remorse and spiritual anguish may induce the patient to retreat and consider suicide as a possible option. Although the patient may be too ill to put thoughts into action, ideation must be regarded properly, and necessary intervention should be undertaken. |
| Create an open environment in which the patient feels secure to express feelings regarding his or her medical condition. | This intervention makes the patient feel accepted in their current situation without feeling criticized, and it creates a sense of confidence and authority. |
Nursing References
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon
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