HEALTH QUESTION U6

Instructions:

Review the following case study patient details

Mr. W is a 25 year old male who was in a drug rehabilitation program last year. He has been admitted to the hospital with a history of weight loss, weakness, and intractable diarrhea. His height is 70 inches and his weight has dropped from 180 lbs. to 110 lbs. He is also suffering from fever and night sweats. Physical examination reveals swollen lymph glands, tongue lesions of herpes simplex and ulcers in the perianal region. Further tests indicated depressed T-cell levels and the presence of Pneumocystis carinni. He was tested for HIV infection and the blood test for HIV infection antibodies was positive.

While in the hospital he developed several other symptoms: anorexia, fever, fatigue, nausea, vomiting, watery diarrhea, and rectal incontinence. His temperature was 103°F (39.8°C) and was treated with antibiotics to which he did not respond. The amount of diarrhea increased markedly, necessitating intravenous hydration. He developed esophageal candiasis and a duodenal infection.

The patient did not tolerate a soft diet or nutritional supplements, continued to lose weight, and had severe anorexia, abdominal cramping, and bloating. Nutritional assessment was deficient in all aspects, showing a decreased BMI, decreased muscle mass, and depleted total protein and serum albumin.

1. In which stage of HIV infection would you categorize Mr. W?
2. Name and describe the major clinical complications in the final stage of AIDS and explain how these complications profoundly compromise a patient’s nutritional status.
3. What should be the goal of nutritional therapy based on assessment data and the patient’s history?
4. Utilize your critical thinking skills to determine the most appropriate route of feeding to administer nutrition support. Defend your choice with evidence from the patient description and the knowledge you have gained regarding alternative feeding routes.
5. List several nutritional supplements that might be used to alleviate some of Mr. W’s symptoms and increase his caloric intake when he is able to tolerate a diet again.
6. Write a Nutrition Care Plan/Chart note on the HIV patient that addresses the patient’s current clinical situation. Write this note as though you were a nutrition professional caring for this patient in a hospital setting. Please refer to Table 11-3 and 11-4 in your textbook for information on the ADIME chart note process.

Requirements

Paper format: Answer questions numbers 1–5 in a 2–3 page paper using APA format and citation guidelines. Include a title page, introduction, body, conclusion, and reference page. Include number 6, the Nutrition Care Plan/ Chart note, as an appendix. Be aware that the title page, reference page, and appendix/chart note DO NOT count towards the 2–3 page minimum.

Please organize your paper in the following paragraph format. Please see KUs Writing Center for more information regarding essay and paragraph format.

Section 1: Introductory paragraph (incorporate your answer to question 1)

Section 2: Body paragraph(s) (incorporate your answer to question 2)

Section 3: Body paragraph(s) (incorporate your answer to question 3)

Section 4: Body paragraph(s) (incorporate your answer to question 4)

Section 5: Concluding paragraph (incorporate your answer to question 5)

Appendix: Nutrition Care Plan/Chart note

References: Include a minimum of 4 quality references. Your textbook may count towards this requirement. You can use reputable websites or other textbooks/ scientific or medical journal articles. Please use APA style citations within the paper itself and also on the reference page. See Writing Center Resources found in Doc Sharing and the Kaplan University Writing Center for complete details and examples regarding APA style references.