Running head: HIV/AIDS CASE STUDY

HIV/AIDS Case Study

By June Saxton

10/1/2013

Disease Stage

This case study involved Mr. W. who tested positive for HIV infection and is a former

drug user. Mr. W has progressed to AIDS because he is symptomatic and exhibits severe

symptoms which include fever, swollen lymph glands, tongue lesions of herpes simplex and

ulcers in the perianal region. He has also developed several opportunities infections including a

duodenal infection, esophageal candidiasis and Pneumocystis carinni (Mahan, Escott-Stump, &

Raymond, 2012).  

Major Complication of Final Stage

The major clinical complications in the final stage of AIDS which would affect Mr. W’s

nutritional status include esophageal candidiasis, herpes simplex of the tongue and duodenal

infection. He also has wasting syndrome because he has lost 70 pounds and has diarrhea, chronic

weakness and fever. His nutritional status would also be affected by his nausea, vomiting and

anorexia. These complications make it almost impossible for Mr. W. to take oral nutrition as well

as retain the nutrients (Mahan, Escott-Stump, & Raymond, 2012).  

Goal of Nutritional Therapy

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HIV/AIDS CASE STUDY

The goal of nutritional therapy based on Mr. W’s assessment date and history should be

to promote adequate intake of nutrients and fluids in order to increase BMI, muscle mass, protein

intake and increase serum albumin. In order to accomplish this, the symptoms that Mr. W. is

experiencing that make it difficult to take oral nutrition need to be addressed and elevated

(Mahan, Escott-Stump, & Raymond, 2012).  

Administration of Nutrition Support:

Due to the fact that Mr. W. is unable tolerate oral feeding and because of the fact that he

has nausea, vomiting, diarrhea, has not been able to tolerate a soft diet or nutritional supplements

and has continued to lose weight and is already having to have intravenous fluids parenteral

nutrition is probably necessary in order for him to be able to be able to get enough nutrients to

sustain him. If he shows enough improvement, I would then progress to EN through a tube

passed through the nose into the stomach. This way he would be able to take in more nutrients

and take advantage of normal digestive functions. A progressive approach to regaining a normal

diet starting with a pureed diet, then a soft diet and hopefully a regular diet with small frequent

meals (Mahan, Escott-Stump, & Raymond, 2012).  

Nutritional Supplements to increase caloric intake

Several commercial nutritional supplements are available to help Mr. W. increase his

weight and relieve his symptoms. The ones that I feel would be most useful would be liquid such

as Ensure which comes in several formulas including Ensure Plus to help gain weight (Abbot

Laboratories, 2013). There are also weight gain powders and meal replacement powders which

contain protein and nutrients that Mr. W. needs. These things would be more easily tolerated

than a regular diet and could be used instead and in addition to any foods that he was able to

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HIV/AIDS CASE STUDY

tolerate orally. When Mr. W. is able to progress to a soft diet, vitamin and mineral

supplementation of Vitamin A, B12, Zinc and Selenium may be necessary because micronutrient

deficiencies are common with AIDS due to medication and micronutrient malabsorption. Higher

intakes of Vitamins C and B could also be helpful to slow the progression of AIDS (Mahan,

Escott-Stump, & Raymond, 2012).  

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HIV/AIDS CASE STUDY

References

Mahan, L., Escott-Stump, S. & Raymond, J. (2012). Krause’s Food & Nutrition Care Process.

13th Edition. St. Luis, Mo. Elsevier Inc

Abbot Laboratories. (2013). Find the right nutrition shake for you. Retrieved from

http://ensure.com/products

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HIV/AIDS CASE STUDY

Appendix: Nutrition Care Plan/Chart note

Nutritional Care Plan for Mr. W:

A – 25 year old male admitted with history of weight loss, weakness and intractable diarrhea. Ht:

5’10”; Wt: 110 lbs.; BMI 15.8 severely underweight. Patient was in a drug rehabilitation

program one year ago. He has depressed T-cell levels and test positive for HIV infection and

Pneumocystis carinni. He has swollen lymph glands, herpes simplex tongue lesions and ulcers in

the perianal region. He is unable to tolerate a soft diet or nutritional supplements.

D – Inadequate energy intake (N1-1.4); Inadequate oral food and beverage intake (N1-2.1);

Inadequate fluid intake (N1-3.1); Inadequate bioactive substance intake (N1-4.1); Malnutrition

(N1-5.2); Inadequate fat intake (N1-51.1); Inadequate Protein intake (N1-52.1); Inadequate

carbohydrate intake (N1-53.1); Inadequate fiber intake (N1-53.5) and is most likely deficient in

necessary vitamins and minerals as evidenced by decreased BMI, muscle mass and depleted total

protein and serum albumin.

I – Recommend PN to control weight loss and help the patient receive adequate nutrition

progressing to EN, soft diet with nutritional supplements and then regular diet as tolerated.

Patient to return to RD for evaluation after discharge.

ME– Evaluate weight, diet history and nutrient intake, total protein and serum albumin at

discharge and within 2 months of discharge.

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