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Diagnosis

By Marilyn Sommers

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However, whether this is the result of socioeconomic, genetic, or combined factors remains unclear. ASSESSMENT HISTORY. Obtain an obstetric history. Determine the date of the last menstrual period to calculate the estimated day of delivery and gestational age of the infant. Inquire about alcohol, tobacco, and drug usage, and any trauma or abuse situations during pregnancy. Ask the patient to describe the onset of bleeding (the circumstances, amount, and presence of pain). When obtaining a history from a patient with an abruption, recognize that it is possible for her to be disoriented from blood loss and/or cocaine or other drug usage.

Metabolic alkalosis can also be caused by prolonged vomiting, hyperaldosteronism, and diuretic therapy. Respiratory acidosis is a pH imbalance that results from alveolar hypoventilation and an accumulation of carbon dioxide. It can be classified as either acute or chronic. Acute respiratory acidosis is associated with a sudden failure in ventilation. Chronic respiratory acidosis is seen in patients with chronic pulmonary disease, in whom long-term hypoventilation results in a chronic elevation (Ͼ45 mm Hg) of PaCO2 levels (hypercapnia), which renders the primary mechanism of inspiration, an elevated PaCO2, unreliable.

The time from the onset of HIV transmission to the development of AIDS varies from a few months to years. The median incubation period is 10 years. High-risk behaviors that are linked to HIV infection include unprotected anal and vaginal intercourse, having multiple sex partners, and using nonsterile drug injection equipment. GENETIC CONSIDERATIONS Susceptibility to HIV infection and progression to full-blown AIDS varies among people. Investigators are finding genetic variants that increase or mitigate susceptibility to HIV infection.

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