Nu 246 (Exam 3)-Diet Therapy For Hiv + Client

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ASSESSMENT

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1.EVALUATION OF PROTEIN STATUS-MONTITOR ALBUMIN AND BUN LEVELS
2.EVALUATION OF CHOLESTEROL LEVEL-HYPOCHOLESTEROLEMIA IS ASSOCIATED WITH ADVERSE OUTCOMES

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GOAL OF NUTRITIONAL THERAPY

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-PREVENT OR DELAY WASTING AND LOSS OF LEAN BODY MASS
-PROVIDE A WELL BALANCED,NUTRIENT-DENSE DIET TO PRESERVE

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CALORIES

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35 CAL PER KG
-CALORIE NEED IS INCREASED DUE TO INCREASED ENERGY DEMAND AND SHOULD BE EVEN HIGHER IF FEVER IS PRESENT

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PROTEIN

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1.0-2.0 GM PER KG
-INCREASED TO PROTECT AND PREVENT LEAN MUSCLE LOSS

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VITAMINS AND MINERALS

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FAT SOLUABLE VITAMINS
-SHOULD BE TAKEN AT RDA REQUIREMENT
WATER SOLUABLE VITAMINS
-SHOULD BE TAKEN AT 2-5 TIMES THE RDA REQUIREMENT

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DIETARY CHOICES

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-BOILED OR BOTTLED WATER ONLY
-NO RAW MEATS OR VEGETABLES
-NO UNPASTURIZED DAIRY PRODUCTS
-NO RAW EGGS

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CALORIE BOOSTING

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-AVOID LOW CALORIE,LOW NUTRIENT FOODS
-IF HAVING NO GI PROBLEMS,BOOST CALORIES WITH BUTTER,MAYONNAISE,SOUR CREAM SWEETS,ICE CREAM,HONEY

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PROTEIN BOOSTING

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PEANUT BUTTER
HARD BOILED EGGS
**MAY SUPPLEMENT DIET WITH A MULTIVITAMIN BUT SHOULD BE USED WITH CAUTION

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PATIENT TEACHING FOR ANOREXIA

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-EAT SMALL MEALS AT SET INTERVALS
-CHOOSE NUTRIENT RICH FOODS

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PATIENT TEACHING FOR CHANGES IN TASTE

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-AVOID METAL UTENSILS AND CANNED FOODS
-USE SUGAR FREE CANDY TO COUNTERACT TASTE OR GUM
-COLD FOODS AND TART FOODS WORK

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PATIENT TEACHING FOR NAUSEA AND VOMITING

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-AVOID GREASY,HIGH FAT,SPICEY OVERLY SWEET FOOD AND FOODS WITH STRONG AROMA
-COLD FOODS AND DRY CRACKERS
-CLEAR LIQUIDS BETWEEN BUT NOT WITH MEALS
-REST

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PATIENT TEACHING FOR DIFFICULTY SWALLOWING

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-EAT SOFT,HIGH CALORIE,HIGH PROTEIN FOODS LIKE CUSTARD OR BLENDERIZED/MASH
FOOD,EVEN BABY FOOD
-AVOID ROUGH OR ACIDIC FOODS

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MEGACE-MEGESTROL

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MEDICATION FOR APPETITE STIMULANT
-STIMULATES APPETITE,PROMOTES WT.GAIN,AND INCREASES LEAN BODY MASS
-WORKS IN 8-12 WEEKS
S/E:DIARRHEA,FLATULENCE,AND IMPOTENCE

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WHAT ARE NUTRITIONAL SUPPLEMENTS FOR HIV

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-ELECTROLYTE BEVERAGES
-LACTOSE FREE SUPPLEMENTS
-COMPLETE ELEMENTAL SUPPLEMENTS
-MEDIUM LIPID SUPPLEMENT

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ELECTROYTE BEVERAGES

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GATORADE AND PEDIALYTE

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LACTOSE FREE SUPPLEMENTS

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PROVIDE 1 CALORIE PER ML
-SUSTACAL,ENSURE,RESOURCE,1.0 NUTREN
-ADVERA WAS FORMULATED FOR HIV PTS AND PROVIDES 1.26 CALORIES PER ML

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WHAT PROVIDES MORE CALORIES PER ML

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-ENSURE PLUS
-1.5 NUTREN
-RESOURCE PLUS

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COMPLETE ELEMENTAL SUPPLEMENTS

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ARE MORE EXPENSIVE AND HAVE AN UNPLEASANT TASTE
-VIVONEX TEN

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MEDIUM LIPID SUPPLEMENT

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LIPISORB AND PEPTAMEN