Food And Nutrition Nutritional Support Services

Question: Describe about the Food and Nutrition for Nutritional Support Services. Answer: Section 1 The patient Mr. W is a 25 years old male, who has been diagnosed with several infections, weight loss, lowered BMI, fever, massive diarrhea along with esophageal candiasis. In this context, it has been seen that his immune system is severe compromised, thus, he is in the final stage of HIV infection, which is categorized as AIDS. Section 2 In the final stage of AIDs, diverse range of complications takes place, due to the compromised immune system of the patient. These complications include the opportunistic infections, for instance candidiasis and other fungal infection, herpes simplex, recurring fever, swelling of lymph glands, frequent diarrhea and dehydration, dry cough, profound weakness and weight loss. With advancement of the final stage of AIDS, ulcers, cancers, tuberculosis, dyspnea, sore throat, memory loss and hemorrhage becomes common symptoms (Sizer et al. 2012). With the progressive stage of immune compromised symptoms, patients nutritional status is also become compromised. Patients compromised health status is related to the lowered nutritional status. The HAART therapy is generally accomplished for enhancing the nutritional status of the HIV/AIDS patients. In the final stage of AIDS, the chance of malnourishment enhances. There is an association between low albumin level, low body mass index and depress ed T cell level. The compromised nutritional status is accompanied by the side effects of medication, opportunistic diseases and HIV associated anemia. In the case study, it has been revealed that the patient is intolerable to soft foods. In the AIDS patients, resting energy expenditure is increased, which also enhanced energy requirement. On the other hand, infections alters metabolic demands of body. Fever enhances protein utilization and calorie intake. Diarrhea enhances 25% caloric needs and reduces oral intake. Altered functioning of GI tract leads to malabsorption of nutrients in GI tract (Lazzaretti et al., 2012).The painful infection consequences including candidiasis, herpes makes eating difficult. Nausea, vomiting and fatigue contribute in poor oral intake, thereby leading to compromised nutritional status. Section 3 The patient has been diagnosed with the final stage of AIDS, as he is encountering a number of infections, decreased T cell level, continuous weight loss, decreased BMI, frequent diarrhea, fatigue, fecal incontinence and dehydration. It has been revealed that the patient was not able to tolerate a soft diet or nutritional supplements (Weiser et al., 2012). He was also diagnosed with esophageal candidiasis and duodenum infection, indicating a malfunctioning GI tract. Thus, the nutritional therapy of the AIDs patient should focus on increasing the patients nutritional status with an alternative feeding technique appropriate for him. Section 4 Based on the patient diagnosis and assessment, the pareternal feeding technique would be the suitable one for improving his nutritional status. Mr. W has shown intolerance to supplements and soft food. The parenteral feeding technique is also known as the intravenous feeding technique, which is a method of gaining nutrition through veins. Parenteral feeding is one-step up approach of eternal feeding. It is recommended for the patients in critical condition, whose GI tract is compromised anyhow (Anema et al., 2012). In the case of Mr. W, he is experiencing with esophageal candidiasis and duodenum infection, making the gut unhealthy. Thus, eternal feeding cant help this situation, as it needs a functioning GI tract; however, intravenous feeding can help him to get proper level of nutrition, thereby improving his status. While administering parenteral feeding, monitoring is very important, as Mr. Ws immune system is fully compromised, there is a high chance of infection. The site of cat heter insertion should be assessed for the presence of infection further. The key ethical issues raised, while dealing HIV/AIDS patients include informed consent, conflict of interest, end of life care, confidentiality and integrity of work. While working with Mr. W, three principles of bioethics, beneficence, respect for the patient and justice will be followed. As Mr. W is experiencing the final stage of AIDS, the medical team would provide the best possible therapy for extending his life expectancy and improving his health status solely (Young et al., 2014). For instance, perenteral feeding might be painful, but would help to regain food tolerance, thereby improving his nutritional status. Thus, the intervention is following the principle of beneficence. In addition, as Mr. W is very weak but in a conscious status, in each and every stage of his treatment, his consent would be collected for providing him justice and showing respect for him. His medical and personal data would be kept confidentially; these would not be used in any research without his co nsent. In case of AIDS patient, counseling and diagnostic tastings might need to use some of his personal details including sexual relationships, as HIV is a sexually transmitted disease . Thus, all the results of his tests and counseling would be kept confidential. Section 5 As Mr. W is experiencing severe diarrhea, he should drink a lot, but should consume slowly with frequent intervals. Vitamin A, C and B group supplements would help him to reduce the opportunistic infections that are reducing the food intake capability of Mr. W. Additionally, iron supplement would help to combat with anemia, selenium supplement would help to boost the immune system and zinc supplement would help to increase appetite (Duggal, Chugh Duggal, 2012). Chart Note Assessment: The patient Mr. W is 25 years old male diagnosed with final stage of AIDS. He has lost 38.8 % weight in last one year, from 180 lbs to 110 lbs. He is 70 inches tall with a BMI 15.7. Thus, he is categorized as an underweight person. All of his nutritional assessments and laboratory values were deficient including increased watery diarrhea, fecal incontinence, no response to antibiotics, necessitating intravenous hydration, esophageal candiasis, duodenal infection, intolerance to soft diet, nutritional supplement, continuous weight loss, decreased muscle mass and low protein content (NC 2.2) (Lagua Claudio, 2012). He is undergoing unwanted weight loss (NC 3.1). He would need 40-50 kcals/kg calorie per day, to improve his situation (Lagua Claudio, 2012). Diagnosis: The patient is undergoing involuntary weight loss (NC 3.1), which is related to food medication interaction (NC 2.3), impaired nutrient utilization (NC 2.1) and altered gastrointestinal function (NC 1.4), which is evidenced by massive weight from 180 lb to 110 lb within one year. Intervention: Based on his intolerance to food and supplements and infected GI tract, perenteral feeding has been recommended for assisting his nutritional status. He would undergo TPN parenteral nutrition, once his condition stabilized, he would be supplemented with iron, zinc and selenium supplements along with the vitamin A, B group and C supplements for enhancing his voluntary oral consumption (Duggal, Chugh Duggal, 2012). Monitoring/ Evaluation: To progress in the therapy, Mr. Ws input/output and lab results would be monitored in a regular basis and follow-ups would be recorded in successive 7 days regarding his improvement in nutritional status, intake amount and tolerance (Young et al., 2014). Reference List Anema, A., Zhang, W., Wu, Y., Elul, B., Weiser, S. D., Hogg, R. S., ... Nash, D. (2012). Availability of nutritional support services in HIV care and treatment sites in sub-Saharan African countries. Public health nutrition,15(05), 938-947. Botros, D., Somarriba, G., Neri, D., Miller, T. L. (2012). Interventions to address chronic disease and HIV: strategies to promote exercise and nutrition among HIV-infected individuals. Current HIV/AIDS Reports, 9(4), 351-363. Duggal, S., Chugh, T. D., Duggal, A. K. (2012). HIV and malnutrition: effects on immune system. Clinical and Developmental Immunology, 2012. Lagua, R. T., Claudio, V. S. (2012). Nutrition and diet therapy reference dictionary. Springer Science Business Media. Lazzaretti, R. K., Kuhmmer, R., Sprinz, E., Polanczyk, C. A., Ribeiro, J. P. (2012). Dietary Intervention Prevents Dyslipidemia Associated With Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Type 1Infected Individuals: A Randomized Trial. Journal of the American College of Cardiology, 59(11), 979-988. Sizer, F. S., Pich, L. A., Whitney, E. N., Whitney, E. (2012). Nutrition: concepts and controversies. Cengage Learning. Weiser, S. D., Tsai, A. C., Gupta, R., Frongillo, E. A., Kawuma, A., Senkungu, J., ... Bangsberg, D. R. (2012). Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting. AIDS (London, England), 26(1), 67. Young, S., Wheeler, A. C., McCoy, S. I., Weiser, S. D. (2014). A review of the role of food insecurity in adherence to care and treatment among adult and pediatric populations living with HIV and AIDS. AIDS and Behavior,18(5), 505-515.