hiv nutritioncare

Views:
 
Category: Education
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

Care of Women with HIV Living in Limited-Resource Settings HIV and Nutrition: Care and Support: 

Care of Women with HIV Living in Limited-Resource Settings HIV and Nutrition: Care and Support Dorcas Lwanga, MSc, RD Nutrition Advisor Academy for Educational Development

Objectives: 

Objectives Review goals and components of nutrition care and support Discuss nutrition recommendations for the symptoms associated with each stage of HIV disease Provide information on how to manage nutrition-related symptoms of HIV

Role of Nutrition Care and Support: 

Role of Nutrition Care and Support Studies have shown that the clinical outcome of HIV is poorer in individuals with compromised nutrition Improving nutrition can help prevent weight loss, strengthen the immune system and delay HIV disease progression. Nutrition care should be part of a comprehensive program that helps the HIV-infected individual and her family

Goals of Nutrition Care and Support : 

Goals of Nutrition Care and Support Improve nutritional status Maintain weight, prevent weight loss Preserve muscle mass Ensure adequate nutrient intake Improve eating habits and diet Replenish stores of essential nutrients Prevent food-borne illnesses Enhance quality of life Treat opportunistic infections Manage symptoms affecting food intake Provide palliative care

Components of Nutritional Care and Support: 

Components of Nutritional Care and Support Nutrition assessment Weight Mid-arm circumference Nutrition education and counseling Adequate diet Proper food handling and safety Hygiene Water Sanitation

Components of Nutritional Care and Support continued: 

Components of Nutritional Care and Support continued Nutrition supplementation Food Vitamin and mineral supplements Food and nutrition support for families Food-for-work Community kitchens Home-based care Food baskets Home-delivered, ready to eat meals

Stages of HIV Disease and Nutrition: 

Stages of HIV Disease and Nutrition Specific nutrition recommendations vary according to the underlying nutritional status and extent of HIV disease progression: Early - no symptoms, stable weight Middle - weight loss Late - symptomatic AIDS

Nutrition Care and Support Priorities by Stage of Disease : 

Nutrition Care and Support Priorities by Stage of Disease Early stage – “stay healthy” Build stores of essential nutrients Maintain weight and lean body mass Ensure understanding of food and water safety Middle stage – “minimize consequences” Maintain dietary intake during acute illness Increase nutrient intake for recovery/weight gain Continue physical activity Late stage – “provide comfort” Treat opportunistic infections Modify diet according to symptoms Encourage eating and physical activity

Recommendations for Nutrition Care and Support: Early Stage: 

Recommendations for Nutrition Care and Support: Early Stage Identify locally available and acceptable foods Promote a diet adequate in energy, protein and other essential nutrients Energy requirements are increased by 10-15% Protein requirements are increased ~ 50% Requirements for vitamins and minerals used by the immune system are also increased Maintain physical activity Weight-bearing exercise builds lean body mass Exercise stimulates appetite Prevent food-borne illnesses through safe food handling practices

Recommendations for Safe Food Handling Practices: 

Recommendations for Safe Food Handling Practices Wash hands before preparing and eating food, after using the toilet or changing nappies or diapers Wash all food preparation surfaces, utensils and dishes Wash all fruit and vegetables before eating, cooking or serving Avoid letting raw food come in contact with cooked food Cook food thoroughly Serve food immediately after preparation

Recommendations For Safe Food Handling Practices continued: 

Recommendations For Safe Food Handling Practices continued Keep food covered and away from insects, rodents and other animals Do not store cooked food Always use boiled or bottled water for drinking, cooking, and cleaning dishes and utensils Never use bottles with teats for feeding infants. Use a cup instead

Recommendations for Nutrition Care and Support: Middle Stage: 

Recommendations for Nutrition Care and Support: Middle Stage Maintain intake during periods of acute illness and depressed appetite Increase nutrition intake to promote weight and muscle mass gain, and nutritional recovery Make every bite count Daily vitamin-mineral supplements Continue physical activity as able

Recommendations for Nutrition Care and Support: Middle Stage continued: 

Recommendations for Nutrition Care and Support: Middle Stage continued Manage the symptoms that affect food intake Loss of appetite Nausea Mouth sores Diarrhea Seek medical attention immediately High fever or fever for more than 3 days Persistent diarrhea Other symptoms of infection Avoid unhealthy behaviors Alcohol, smoking and drug use Unsafe sexual practices

Recommendations for Nutrition Care and Support: Late Stage : 

Recommendations for Nutrition Care and Support: Late Stage Treat all infections that affect appetite, ability to eat and retention of nutrients Consider the food and nutritional interactions with medicines Consider the side effects of medications that affect intake Maintain intake during periods of acute illness and depressed appetite Modify diet according to symptoms Encourage physical activity Provide psychological and emotional support

Recommendations for Symptom-Based Nutrition Care and Support: 

Recommendations for Symptom-Based Nutrition Care and Support

Recommendations for Symptom-based Nutrition Care and Support continued: 

Recommendations for Symptom-based Nutrition Care and Support continued

Recommendations for Symptom-Based Nutrition Care and Support continued: 

Recommendations for Symptom-Based Nutrition Care and Support continued If diarrhea is severe, food may be withheld for 24 hrs or restricted to only clear fluids, such as, soups, tea or soft foods (mashed fruit, potatoes, white rice, porridge)

Recommendations for Symptom-Based Nutrition Care and Support continued: 

Recommendations for Symptom-Based Nutrition Care and Support continued

Recommendations for Symptom-Based Nutrition Care and Support continued: 

Recommendations for Symptom-Based Nutrition Care and Support continued

Source of Various Vitamins and Minerals: 

Source of Various Vitamins and Minerals

Source of Various Vitamins and Minerals continued: 

Source of Various Vitamins and Minerals continued

Some Recommended Foods: 

Some Recommended Foods

Recommendations on Foods to Avoid: 

Recommendations on Foods to Avoid The aim of good nutrition care and support is to ensure adequate intake and to maintain weight and lean body mass. Therefore, other than the following, no foods should be eliminated unnecessarily. Raw eggs Foods that have not been thoroughly cooked, especially meats and chicken Water that is not boiled or juices that are made from water that is not boiled Alcohol and coffee “Junk” foods such as chips, biscuits and sweets with little nutritional value Foods that aggravate symptoms related to diarrhea, nausea/vomiting, bloating, loss of appetite, and mouth sores

Nutrition and Medication: 

Nutrition and Medication Medications used to treat HIV opportunistic infections may result in negative drug-nutrient interactions or cause side effects. Vitamin B6 supplementation should be administered with isoniazid therapy for tuberculosis to avoid Vitamin B6 deficiency Iron and zinc-containing supplements should not be taken with ciproflaxacin Sulfadoxine and Pyrimethamine (Fansidar) used for treatment of malaria is not recommended if the patient is folate deficient. Some antiretroviral drugs have: Dietary requirements Side effects with nutritional consequences An effect on red blood cell production, increasing risk of anemia (e.g. Zidovudine (AZT)).

Summary: 

Summary Maintaining adequate nutrition may be one of the most important things a newly infected person can do to prolong well-being. Good nutrition and healthy lifestyle can: Preserve health Improve quality of life Prolong independence Delay disease progression Prevention of food and water-borne infections reduces the risk of diarrhea, a common cause of weight loss, malnutrition and HIV disease progression in people living with HIV and AIDS.

Summary continued: 

Summary continued Managing common symptoms related to HIV/AIDS can minimize their impact on nutritional status. Continuing physical activity and exercise, as appropriate, increases energy, stimulates appetite and preserves and builds lean body mass. Providing psychosocial and emotional support as part of nutrition care at all stages of HIV disease can help to improve quality of life. Nutritional care and support should be part of a comprehensive program that deals with the needs of the patient and her family.

authorStream Live Help