MNT FOR INFECTIONS.pdf

MEDICAL NUTRITION THERAPY FOR INFECTIONS AND RESPIRATORY DISORDERS Major Public Health Problems: FEVER (PYREXIA) THE RESPIRATORY SYSTEM Pneumonia (4th killer) The r...

MEDICAL NUTRITION THERAPY FOR INFECTIONS AND RESPIRATORY DISORDERS Major Public Health Problems: FEVER (PYREXIA) THE RESPIRATORY SYSTEM Pneumonia (4th killer) The rise of body temp. above normal of Respiration is the act of breathing; Influenza 98.6’F; 99.6’F (oral); 100’F (rectal), 99’F inhaling (inspiration-O2) and exhaling Tuberculosis (6th killer) (armpit). (expiration-CO2). Malaria Low grade fever above 37.1’C but below It is made up of the organs such as nose, Chickenpox 38.2’C pharynx, larynx, trachea, bronchi, and Dengue Fever High grade fever above 38.2’C lungs. Hyper- pyrexia/thermia – very high fever, Upper respiratory tract: nose, nasal INFECTION higher than 40’C. cavity, ethmoidal air cells, frontal sinuses, It is just a symptom of infections. maxillary sinus, larynx, and trachea. The result of successful invasion, establishment, and growth of pathogenic Sepsis occurs when infection has spread Lower respiratory tract: lungs, bronchi, microorganisms (viruses, bacteria, fungi, from one part of the body to other areas and alveoli. protozoa, and helminths) via circulatory system. Right lung has three lobes; left lung has Classification of infections: Metabolic effects: increased BMR (7% or two lobes. 1. Acute – short duration (colds, etc.) 13% for every degree F/C); increased tissue Air enters the nose/mouth – larynx – 2. Chronic – last for mos, yrs, (TB/HT) catabolism (CHON loss), increased low of trachea – bronchi – bronchioles – alveoli. 3. Recurrent – periodic intervals (MLRIA) body water (urine/perspiration), increased Specific Febrile Conditions and Infections electrolyte loss (Na/K), decreased glycogen and adipose tissue stores, decreased UPPER RESPIRATORY INFECTION Principles of Nutrition Therapy activity of the digestive system, poor Known as common cold, most common appetite, general weakness and 1. To provide adequate nourishment to prostration. Caused by a virus, that inflames the counteract patient’s hypermetabolic state membranes in the linings of nose and and support body’s host defense system. Nutrition Therapy for Fever throat. 2. To prevent or correct dehydration, ✓ Calories. 13% for every degree Celsius; 10% Rhinovirus and coronavirus are the major hypoglycemic, complications, and for tissue catabolism; 10-13% (restless); cause of colds. anorexia. 50% caloric increase. No cure for colds and can’t treat by an 3. To replace nutrient losses (K, Na, Mg, P, ✓ Protein. 100% additional CHON; 2 g/kg BW antibiotic. Zn, S). ✓ Carbohydrates. Liberal supply (digestible) 4. To correct IDA, when present Nutrition Therapy for URI ✓ Fats. Emulsified form ✓ Water. 3-4 liters/day ✓ Soft to regular diet w/adequate calories ✓ Minerals. Supply esp. Na/K or Fe ✓ Increased fluid intake ✓ Vitamins. A, C, B ✓ Probiotics  MEDICAL NUTRITION THERAPY FOR INFECTIONS AND RESPIRATORY DISORDERS INFLUENZA Death is due to complications Nutrition Therapy for Cholera (pneumonia) usually under 2 y/o. A flu that is highly contagious airborne ✓ In acute stages, pt. is placed in NPO for 12 95-100% fatality (undernourished) hours with IVF and electrolytes pathogen that cause acute febrile illness and results in systemic flu symptoms: Nutrition Therapy for Measles ✓ Oral fluids are initiated soon fatigue to respi. failure to death. ✓ Oral rehydration therapy (ORT) with ✓ Adequate nourishment in liquid to soft addition of resistant starch to reduce Caused by influenza virus A, B (among consistency and in increasing amounts. fecal fluid loss and shorten duration of humans) or C. H1N1 influenza (swine flu) and avian CHOLERA LBM. influenza (bird flu): influenza A subtypes. DENGUE FEVER Known as El Tor Symptoms: chills and fever (2-5 days), Self-limiting, acute dehydrating disease Acute infectious mosquito-borne fever malaise (2-3 weeks), myalgia, nasal of the intestines (small) Found in tropical/sub regions stiffness, sore throat, nausea, nonproductive cough, and headache. Caused by vibrio cholerae (powerful Peak season (July to Dec) exotoxin causes hypersecretion H20 and In Phil. during rainy season. Most common Aedes aegypti Na of the gut leading to diarrhea) Self-limiting illness Children/infants: may have nonfebrile Peak incidence rainy season (July-Sept) No cure for influenza illness with rash. Highest incidence, 0-9 y/o and elderly Amantadine & rimantadine: medications Older children/adults: may have febrile Transmitted thru ingestion of water and syndrome with abrupt onset/high fever. Nutrition Therapy for Influenza food contaminated with feces or vomitus. It can cause also bleeding known as Symptoms: profuse, brown watery stools, dengue hemorrhagic fever (DHF), repeated ✓ Soft to regular diet w/adequate calories becoming rice-water like and mucoid with dengue patient. ✓ Provide fluids and electrolytes little solids and fishy odor. Critical stage coincides with a decline of MEASLES Stool volume 1500 ml (severe) fever. Acute highly infectious communicable Vomiting occurs after diarrhea Skin is cold and the fingers/toes are Nutrition Therapy for Fever disease Symptoms: fever, rash and colds wrinkled, severe muscle cramps, and ✓ High calorie, liquid diet, and ample prostration to fluid loss. amounts of water and fruit juices to Eruption is preceded by about 2 days of Due to fluid-electrolyte disturbances, the prevent dehydration is given. coryza, during w/c stage grayish pecks (Koplik spots) may appear on cheeks. pt. experience dehydration, restlessness, ✓ Diet changed to soft high-calorie diet, extreme thirst, circulatory collapse and moderate in fat. 3rd and 4th day, morbilliform rash become anuria leading to shock, coma, and even ✓ Candies to stop vomiting. visible on overall body. death. Common in children, spread through secretions of nose and throat  MEDICAL NUTRITION THERAPY FOR INFECTIONS AND RESPIRATORY DISORDERS DIPHTHERIA PERTUSSIS Preventive measures: immunization by TAB vaccine An acute infectious and communicable Whooping cough, an acute serious disease caused by Corynebacterium communicable disease involving respi. Nutrition Therapy for Typhoid Fever diphtheria. tract. ✓ Same for acute fever plus low fiber diet to Affects the respi. system, esp. the local Caused by Bordatella pertussis and B. prevent intestinal irritation. production of the membrane and the parapertussis spread through droplet. ✓ Diarrhea and payer’s patches (ulceration myocardium or the CNS. Symptoms: paroxysm (outburst) of and hemorrhage of intestinal walls) Symptoms: mod. Temp., malaise, sore coughing or whoop. throat, and pharyngeal paralysis. Three stages: (1) catarrhal, (2) paroxysmal, POLIOMYELITIS (3) convalescence. Nutrition Therapy for Diphtheria A highly contagious enterovirus disease, Catarrhal/coryzal stage: sore throat, caused by poliovirus. ✓ Fluid diet (milk, broth, juices, gelatin) malaise, anorexia, and sneezing, and Transmitted via direct personal contact, ✓ Pharyngeal paralysis, a soft diet or highly contagious. eating contaminated food/water. dysphagia diet is given. Paroxysmal stage: coughing occurs, Affects the brain stem and spinal cord ✓ Glucose and AA are administered IV for cyanosis (infants), vomiting, febrile, additional source of nutrients. Paralysis may or may not occur Convalescence: coughs may be mild, ✓ Nasogastric feeding for severe cases. Symptoms: headache, sore red throat, paroxysmal and short-lived. fever, vomiting, and neck/back pain. MUMPS Occurs in children, highest incidence Post-polio syndrome produces under 7 y/o and mortality in infants. An acute generalized viral infection neuromuscular symptom, 25-30 y/o after usually diagnosed by the sudden onset of Nutrition Therapy for Pertussis attack, serious swallowing difficulty painful swelling in one or both parotid Has no cure or anti-viral drugs ✓ Soft diet when oral feedings are tolerated glands. ✓ Eat slowly to avoid triggering symptoms Risks: no immunization Tropism: nervous and testes ✓ Small, frequent meals if appetite is poor Nutrition Therapy for Poliomyelitis Transmitted through saliva, contagious TYPHOID FEVER ✓ With acute paralysis, high calorie, Symptoms: modest rise in temp., and in severe cases headache, photophobia, and protein, liquid diet or tube feeding A food-borne infection caused by abdominal discomfort; severe parotid ✓ Vit. supp. (1-2 times reco.) Salmonella typhosa. pain ✓ Extra calcium and phosphorus Transmitted through contaminated food ✓ Liquid to soft bland diet Nutrition Therapy for Mumps and water. ✓ Dysphagia diet with varying levels of 7-14 days incubation period ✓ Liquid diet to soft bland diet thickened liquids to enhance swallowing Symptoms: high fever, sever prostration, GI disturbances, and delirium.  MEDICAL NUTRITION THERAPY FOR INFECTIONS AND RESPIRATORY DISORDERS RHEUMATIC FEVER Can spread through blood transfusion or EMPHYSEMA hypodermic needle An autoimmune disease-causing Degenerative disease that develops after Symptoms: profuse sweating, chills, inflammatory condition affecting many years of lung tissue exposure to liver/spleen swelling, debility, and connective tissue and causing joint pain, cigarette smoke or other toxins. hypochromic anemia. swelling, fever, rash, jerky movements, Overdistention of the pulmonary alveoli facial grimacing, and carditis. Nutrition Therapy for Malaria Can be inherited called A1AD, lack of Antibodies reacts with body’s antigen alpha 1-antitrypsin protein, an enzyme ✓ High calorie diet (50% over RENI) Usually in children, esp. poor children, that fights bacteria and cleans up dead ✓ High protein diet, mod. fat children/adults younger than 30 y/o are lung tissue. ✓ With vitamin-mineral supp. at risk. (mitral valve damage) Symptoms: SOB, coughing up sputum, ✓ Liberal fluid intake Long term effects result in RHD. swelling of hands/feet, pink skin, thin Respiratory Disorders appearance and barrel-shaped chest. Nutrition Therapy for Rheumatic Fever BRONCHITIS Nutrition Therapy for Emphysema ✓ High calorie, protein, full liquid diet (acute infection) to soft diet then to Inflammation of the airways (bronchi) ✓ Soft diet high in nutrient density regular diet. Increased production of mucus ✓ Small, frequent feedings Acute bronchitis: inflammation of mucus ✓ Provide adequate kcal [BEE x 1.5] and MALARIA membranes of the bronchial tube caused protein (1.2 to 1.5 g/kg BW) to correct any A recurrent infection caused by by bacteria/viruses, dusts, allergens, fumes tissue wasting Plasmodium (parasitic protozoa found in Chronic bronchitis: inflammation of the ✓ Avoid hypercaloric feeding of foods high mosquitoes – Anopheles). bronchial tubes that connect the in carbohydrates Parasite has two cycles: sexual and asexual windpipe with lungs (less air is able to ✓ Avoid gas forming vegetables Sexual: occurs in mosquito flow and produces mucus/sputum); ✓ 2-3 liters of water per day Asexual: occurs in person’s bloodstream producing cough for mos. to 2 years. ✓ Restrict sodium if pul. edema is present Over 45 y/o are more likely to have CB ✓ Vitamins and minerals if necessary Settles in liver for 7-9 days (pre- erythrocytic cycle) then invade blood and Can lead to emphysema if not treated. CHRONIC OBSTRUCTIVE PULMONARY DISEASE later other erythrocytes (erythrocyte Cigarette smoking is common cause of CB cycle) causes massive RBC destruction Presence of airflow obstruction due to Symptoms: persistent cough, produces Plasmodium falciparum major malaria chronic bronchitis or emphysema mucus, dyspnea, tightness case in Phil. followed by P. vivax. Progressive, airway hyperactivity, may be Nutrition Therapy for Bronchitis partially reversible Chloroquine and primaquine resistance among these two-protozoan parasite. ✓ Liberal calorie and protein Symptoms: dyspnea, hypoxemia, dec. F. vector (Anopheles minimus flavirostris) ✓ Small feedings and allow frequent rest forced expiratory vol., destruction of ACB  MEDICAL NUTRITION THERAPY FOR INFECTIONS AND RESPIRATORY DISORDERS Nutrition Therapy for COPD Zinc deficiency is associated with TUBERCULOSIS incidence and severity of pneumonia. ✓ To balance O2 and eliminate CO2 while Highly infectious chronic disease caused correcting malnutrition problem Signs/symptoms: difficult, painful by tubercle bacillus (mycobacterium respirations, SOB, chills and high-grade ✓ For under malnourished, provide high tuberculosis and M. africanum through fever, tachypnea, convulsion, malaise, calorie (BEE x 1.5-1.7) and high protein humans and M. bovis from cattle) anorexia, abdominal distention, (1.2-1.5 g/kg) to promote weight gain Formation of tubercles and caseous restlessness, and productive cough with ✓ The diet should be 40-50% CHO, 30-40% necrosis in the tissues green/yellow sputum to pink, brown, or fat, 15-20% CHON Bacteriology test is being done, sputum rust color. ✓ CHO metabolism results more CO2 smear microscopy, and then culture and production than fat or protein. Nutrition Therapy for Pneumonia drug susceptibility testing. ✓ Due to difficulty in swallowing from SOB, A respiratory disease (PTB) common soft diet may be given ✓ Acute stage, 3-3.5 liters of fluid daily ✓ High calorie soft diet to prevent wt. loss among under malnourished individuals. ✓ No gas forming vegetables ✓ OW pts. normal caloric intake Symptoms: persistent cough (>3 weeks), ✓ Small, frequent feedings mostly with sputum or with bloodstain ✓ Limit salt intake to prevent water ✓ Multivitamins/mineral may be necessary ✓ Adequate fruits/vegetables as source of (hemoptysis); SOB, chest/back pains; loss retention. of appetite and weight; night sweats; ✓ Include antioxidants and Omega-3 FA fiver to prevent constipation, K, and antioxidants fatigue; fever and cough. ✓ Suppl. with vit. A and C to support lung Transmitted through droplet nuclei of TB function, allow healing, and improve SEVER ACUTE RESPIRATORY SYNDROME persons’ coughs or sneezes. tissue repair. A respiratory illness caused by a new Extrapulmonary TB: affects various ✓ B-complex may be necessary for energy coronavirus. organs such as lymph nodes, pleura, production larynx, meninges, spinal cord, bones and ✓ Adequate fluid intake is crucial First reported in Asia (2003) joints, eye and skin, urogenital tract, and Begin with fever >100.4’F or 38’C PNEUMONIA intestines. Symptoms: headache, overall feeling of Medicines: isoniazid, rifampicin, Acute infectious disease of the respiratory discomfort, body aches, others such as pyrazinamide, ethambutol, and tract caused by pneumococcus bacteria dry cough and pneumonia later on. streptomycin. resulting in the inflammation of the Close-to-close person contact Common among AIDS pts. alveolar spaces of the lungs. transmission. BCG vaccination to prevent TB for Majority of causes are due to diplococcus Nutrition Therapy for SARS children (about 6 y/o) pneumonia or others (e.g., viruses) TB is caused of death among HIV pts. Malnutrition, fatigue, exposure to polluted ✓ High calorie, protein is given. air, and over exposure to heat/cold. ✓ Soft diet in small, frequent feedings  MEDICAL NUTRITION THERAPY FOR INFECTIONS AND RESPIRATORY DISORDERS Nutrition Therapy for Tuberculosis Nutrition Therapy for MERS LEPTOSPIROSIS ✓ Liberal amounts of protein (1.2-1.5 g/kg) ✓ Undercooked animal products are high Rare bacterial infection that affects to restore plasma protein and promote risk of infections, then it should undergo people and animals wound healing pasteurization for safe consumption Can pass from animals to humans when ✓ Adequate calories (1.5 x the normal needs) in contact with water/soil, or urine ZIKA VIRUS DISEASE ✓ It is a cachexic condition that impairs One of the species is Leptospira protein and vitamin D metabolism Caused by Zika Virus ✓ Sufficient calcium for calcification of Nutrition Therapy for Leptospirosis Spread to people primarily thru bite of an lesions infected mosquito (Aedes ✓ Adequate fluid intake to avoid volume ✓ Adequate iron and vitamin C for aegypti/albopictus) depletion hemoglobin formation and wound healing Can cause microcephaly during ✓ Severe cases: electrolyte and protein ✓ Provides B-complex esp. B6 to counteract pregnancy and other birth defects restriction in cases for renal insufficiency isonicotinic acid hydrazide or isoniazid Can trigger paralysis (Guillan-Barre ✓ Patients with hypotension or clinical therapy (antagonist for B6) Syndrome) shock should not be fed enterally until ✓ Use rifampicin in Tb treatment can adequate perfusion is restored. Fever, rash joint pain and red eyes increase uric acid that can lead to gouty arthritis Nutrition Therapy for Zika Virus SCRUB TYPHUS ✓ Provide adequate fluids about 2 liters ✓ Fluids and medications such as Know as bush typhus, caused by bacteria Other Currently Infectious Diseases acetaminophen Orientia tsutsugamushi Spread to people through bites of infected MIDDLE EAST RESPIRATORY SYNDROME CHIKUNGUNYA chiggers (larval mites) A viral respiratory disease caused by a Spread to people thru bite of an infected Symptoms: fever, headache, body aches, novel coronavirus (MERS-CoV) mosquito rash First identified in Saudi Arabia (2012) Symptoms: fever, joint pain, headache, ENCEPHALITIS Symptoms: fever, cough, SOB, pneumonia is muscle pain, rash common, diarrhea, usually asymptomatic Inflammation of the brain Nutrition Therapy for Chikungunya Human-to-human infections Caused by viral infection Dromedary camels are major reservoir for ✓ Omega-3 FA Mild flu-like symptoms: fever, headache MERS-CoV and an animal source of MERS ✓ IV vitamin C, bromelain, and curcumin (turmeric) Nutrition Therapy for Encephalitis infection in humans Transmission is unknown ✓ Eat antioxidant foods, such as fruits and Does not easily pass from person to vegetables person unless close contact ✓ Use health oild  MEDICAL NUTRITION THERAPY FOR INFECTIONS AND RESPIRATORY DISORDERS ✓ Eat whole grains breads and cereals ✓ Eat at lest 5 servings of fruits/vegetables ✓ Lean meats HISTOPLASMOSIS Type of lung infection caused by inhaling Histoplasma capsulatum fungal spores (found in soils, bats, birds) Grows in the central southeastern, and mid-Atlantic states. Nutrition Therapy for Histoplasmosis ✓ Essential vitamins or vitamin supplements RICKETTSIOSIS Caused by intracellular bacteria, rickettsia rickettsii (gram-negative, coccobacilli) Symptoms: sudden onset fever with severe headache, malaise, prostration, rash Transmitted to humans by bite of infected ticks and mites and by feces of infected lice and fleas Enter via skin and spread through bloodstream to infect vascular endothelium in the skin, brain, lungs, heart, kidneys, liver, GI tract and other organs Feeds on blood 6-10 hours can be infected Seasonal occurrence (April-October)