HIV AIDS MNT Case Study
HIV AIDS MNT Case Study
HIV AIDS MNT Case Study
■ Sex: Male
■ Occupation: Janitor
■ Pt. lives alone and reports smoking 1 PPD and drinks alcohol socially.
■ Prefers eating out and dislikes to cook. Pt. states he “eats whatever he feels like.”
■ History of diverticulosis.
■ Persistent fever
■ Fatigue
■ Decreased appetite
■ Diarrhea
■ Abdominal pain
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Anthropometrics
■ Height: 70” (5’10”)
■ %IBW: 115%
■ %UBW: 115%
■ Breakfast: ham, egg and cheese on a plain bagel and small coffee with
cream and sugar
■ Dinner – 5 oz baked chicken (legs and thighs), 1 cup white rice, 1 cup
cooked broccoli, 1 tbsp. butter and two 12 oz light beers.
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Dietary History
Consumed Estimated Needs
Vitamin D 1 μg 15 μg
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Pertinent Lab Values and Significance
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Medications Reviewed
■ Fluid:
*All needs calculated using current body weight for starting treatment and to
prevent over feeding.
Snack ¼ C Hummus
1 oz. unsalted pretzels
■ Inadequate Fluid Intake as related to 24-hour recall and S/S of water loss via
N/V/D as evidenced by intake of 1064 mL compared to recommended 2,058-
2926 mL.
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Intervention
■ Inadequate Energy Intake
■ 1. Labs to monitor
■ Albumin - monitor progression of malnourishment and catabolism.
■ BUN - monitor protein loss and catabolism
■ Creatinine - monitor protein loss and catabolism
■ HIV-1 RNA - monitor progression of infectious virus
■ Total T cells - monitor state of immunity response in relation to deterioration from HIV/AIDS
■ 2. RD to assess patient’s perceived level of difficulty of following lifestyle changes x 1 week and to make
modifications as needed
■ 3. Assess daily caloric intake via food diary in 3 weeks to see if patient is consuming at least 2508 kcal, 125 g
protein/d and 2500 mL of fluid.
■ 4. RD to monitor intake and tolerance to diet progression promoting diet tolerance and providing adequate
kcal and protein to prevent protein wasting x 3 weeks. Monitor Albumin, BUN and Creatinine.
■ 5. Patient will use a 24 oz refillable water bottle to consume twice per day. Patient will record in food diary
until next visit in one week the level of difficulty to consume this volume of water per day on a scale of 1-5
(No issue - difficult)
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Clinical Pearls-the key take aways
■ Intervention should focus on:
■ Treating wasting, catabolic state
■ Restoring nutrient balance
■ Restoring healthy body weight
■ HIV Life Cycle. (2013, April 9). Retrieved April 26, 2016, from http://www.aidsinfonet.
org/fact_sheets/view/106
■ HIV/AIDS U.S. Statistics. (2014, December 2). Retrieved April 26, 2016, from https:
//www.aids.gov/hiv-aids-basics/hiv-aids-101/statistics/
■ The Stages of HIV Infection | HIV/AIDS Fact Sheets | Education Materials | AIDSinfo.
(2015, September 15). Retrieved April 26, 2016, from https://aidsinfo.nih.
gov/education-materials/fact-sheets/19/46/the-stages-of-hiv-infection