Nutritional Goals for HIV Treatment
HIV infection is characterized by various viral and host-related factors that determine the variability of the infection’s outcomes and disease occurrence in the infected persons (Hernandez-Vargas & Middleton, 2013). Importantly, the condition of AIDS is described by increased viral load, opportunistic infections, and weight loss in the patient (Hernandez-Vargas & Middleton, 2013). Therefore, the signs of diarrhea and opportunistic infections exhibited by the patient, Mr. W indicate, the final stage of the infection.
Major Clinical Complications of Final Stage of AIDS
The various complications exhibited in the final stages of the AIDS infection are mainly due to the suppression of the T cells-mediated immunity.
Mycobacterium Avium Complex
The condition is exhibited by fever, night sweats, weight loss, diarrhea, and anemia. Similarly, the infection reduces a patient’s immune response (Smibert, Trubiano, Cross, & Hoy, 2017). Therefore, the disease limits an infected person’s rate of food consumption due to the lack of appetite.
Gingivitis, Dental, and Salivary Gland Disease
The conditions are among the opportunistic infections caused by the invasive fungi during the late phase of HIV infection (Souza et al., 2017). In essence, as a result of the tongue lesions in the patient, his feeding is limited thus his nutrients intake is reduced.
Goals of Nutritional Therapy based on Assessment Data and Patients History
The patient’s history of diarrhea and reduced immune system that leads to frequent bouts of infectious diseases such as herpes is an indication of the victim’s impaired nutritional balance. Therefore, the primary goal of providing a nutritious diet to the sick is to enhance their immunity. Additionally, provision of a balanced diet helps to prevent malabsorption, facilitate appetite, and minimize diarrhea.
Appropriate Feeding Technique for the Patient
In essence, the condition of the patient is manifested by weight loss, fever, lesions, and vomiting. Hence, the ideal feeding technique is the enteral method. The system helps to enhance patient’s health status, lower costs, and decrease septic complications (Blumenstein, Shastri, & Stein, 2014). Importantly, due to the sores on the patient’s tongue, an enteral nasal method will be used to allow the healing of the wounds.
Dealing with Patient’s Integrity, Confidentiality, and Ethical Issues
Confidentiality and integrity are paramount in enhancing the relationship and trust between patients and doctors. However, the disclosure of a patient’s status without their consent can lead to stigmatization thus prompting low self-esteem. In essence, confidential documents such as theatre lists are to be cast off by paper shredders to avoid exposing the person’s results. Similarly, the client’s hospital data is subjected to strict regulation through the use of trusted health equipment (Blightman, Griffiths, & Danbury, 2013). Further, seeking permission from the patient to record sessions and minimizing the chances of revealing their identity is essential.
Nutritional Supplements to Eradicate the Patient Symptoms
Ready- to-use food (RUTF) supplements are the most appropriate approach for helping the patient increase his nutritional intake, and thus, boost his immune system (Beckett et al., 2016). Importantly, the RUTFs are highly nutritious and do not involve cooking as they contain high calorie-to-weight and calorie-to-volume ratios as compared to blended flours. Additionally, serum-derived bovine immunoglobulin (SBI) is a protein supplement that helps to limit nausea, vomiting, and fecal incontinence (Good & Burnett, 2015).
Effective nutrition helps HIV/AIDS patients to develop immunity against opportunistic infection and gain weight. Additionally, the use of RUTF supplements will assist the patient to achieve a healthy body. Importantly, the enteral nasal feeding technique is appropriate to aid in food intake due to the patient’s critical condition.
Beckett, A. G., Humphries, D., Jerome, J. G., Teng, J. E., Ulysse, P., & Ivers, L. C. (2016). Acceptability and use of ready-to-use supplementary food compared to corn-soy blend as a targeted ration in an HIV program in rural Haiti: A qualitative study. AIDS Research and Therapy, 13(1), 11. Retrieved from: https://aidsrestherapy.biomedcentral.com/articles/10.1186/s12981-016-0096-9
Brightman, K., Griffiths, S. E., & Danbury, C. (2013). Patient confidentiality: When can a breach be justified?. Continuing Education in Anaesthesia, Critical Care & Pain, 14(2), 52-56. Retrieved from: https://academic.oup.com/bjaed/article/14/2/52/271401
Blumenstein, I., Shastri, Y. M., & Stein, J. (2014). Gastroenteric tube feeding: Techniques, problems, and solutions. World Journal of Gastroenterology: WJG, 20(26), 8505. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093701/
Good, L., & Burnett, B. P. (2015). Management of loose, frequent stools and fecal incontinence in a chronic mesenteric ischemia patient with oral serum-derived bovine immunoglobulin. Clinical Medicine Insights Gastroenterol, 8, 7. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309677/
Hernandez-Vargas, E. A., & Middleton, R. H. (2013). Modeling the three stages in HIV infection. Journal of Theoretical Biology, 320, 33-40. Retrieved from: http://www.sciencedirect.com/science/article/pii/S0022519312006170
Smibert, O. C., Trubiano, J. A., Cross, G. B., & Hoy, J. F. (2017). Mycobacterium avium Complex infection and immune reconstitution Inflammatory syndrome remain a challenge in the era of effective antiretroviral therapy. AIDS Research and Human Retroviruses. Retrieved from: http://online.liebertpub.com/doi/abs/10.1089/aid.2017.0030
Souza, A. J. D., Gomes-Filho, I. S., Silva, C. A. L. D., Passos-Soares, J. D. S., Cruz, S. S. D., Trindade, S. C., … & Cerqueira, E. D. M. M. (2017). Factors associated with dental caries, periodontitis and intra-oral lesions in individuals with HIV/AIDS. AIDS Care, 1-8. Retrieved from: http://www.tandfonline.com/doi/abs/10.1080/09540121.2017.1400640
Appendix 1: ADIME Nutritional Plan
Name: Mr. W
Nutrition note: Case study
|Date and Time|
|Assessment||Pertinent information provided by the patient||Intense weight loss, swollen lymph glands, herpes simplex, ulcer in perianal region, HIV infection|
|Age; Gender; Dx; PMH|
|Ht; Wt; BMI||Ht: 7’, Wt: 110Ibs,
|Nutritional focused findings||Pes #1||Depleted total protein serum and albumin|
|Pes #2||Decreased BMI|
|Pes #3||Decreased muscle mass|
|Intervention||Nutrition Prescription||Introduction of RUTF and SBI supplement to increase intake of balanced diet|
|Treatment plan:||Recommend intake of: Carbohydrates 7g, Protein, 2g, Vitamins 7g, Fats 1.5g.|
|Monitoring and evaluation||Plan(s) for assessing
results of the interventions above
|Weekly weighing of the patient with an expectation of increased wait.
Patient to have a meal log to help in enhancing balance diet intake
|Signature and Sign|