Food Administration Final Exam PDF

REVIEWER IN NCM 105 (NUTRITION & DIET THERAPY) FINAL EXAMINATION I. FOOD ADMINISTRATION ORAL FOOD ADMINISTRATION Objectives of Nutritional Care in Disease 1.Supply optimum nutrition 2.Heal tissue; cure the disease 3.Support recovery from the disease 4.Improve th...

REVIEWER IN NCM 105 (NUTRITION & DIET THERAPY) FINAL EXAMINATION I. FOOD ADMINISTRATION ORAL FOOD ADMINISTRATION Objectives of Nutritional Care in Disease 1.Supply optimum nutrition 2.Heal tissue; cure the disease 3.Support recovery from the disease 4.Improve the function of the involved tissue or organ system 5.Reduce work of the affected organ to promote healing Factors in Planning a Modified Diet Disease state, its nature, duration intensity Food form or nutrient modification required by the disease Patient’s individual food tolerance and food habits Nutritional adequacy of modified diet Patient’s physical ability and home situation Responsibilities of the Nursing Department Nurse -the first person to witness how’s the patient’s behavior towards eating -communicate directly to the patient regarding the eating problem -the one who reports to the dietary dept. Nursing aide –the one who see to it that the patient consumed the food and record if the food is consumed or not. The Role of Nurses in Nutritional Care Three Important roles Observing Listening Reporting Diet Therapy aims to: Maintain normal nutrition Correct nutritional deficiency Change body weight Adjust the body’s ability to use one or more nutrients Permit maximum rest to the body or an organ Standard Hospital Diets A. Liquid Diets 1. Clear Liquid Diet Purpose: to relieve thirst and to help maintain water balance Broth: provides sodium Broth and fruit juices: contribute potassium Carbonated beverages, sugar, fruit juices Furnish a small amount of carbohydrate Small amount of fluid are offered every hour or 2 Used only for 24 to 48 hrs following acute vomiting, diarrhea or surgery 2. Full Liquid Diet  nutritionally adequate consist of liquids and foods that liquefy at body temperature used for pt’s with acute infection, fever and difficult to chew ordered after surgery or in treatment for GI upset offered in 6 feedings (breakfast, am snack, lunch, pm snack, dinner, bed time) calorie intake: one pint of light cream substituted for one pint of milk Protein: increase by 30g (3 oz non-fat milk daily maybe added to: fresh milk, cream soup cereal gruels or custard Sample Food allowance for one day -6 cups milk -2 tbsp sugar -2 eggs -1 tbsp butter -1-2 oz strained meat -1 cup strained citrus juice -½ cup tomato juice -½ cup vegetable puree -½ cup strained cereal -2 serving dessert: soft custard, plain ice cream, sherbet or plain gelatin Protein –85g Calories -1,950 B. Soft Diet -Nutritionally adequate -Reduced fiber content -Soft consistency -bland flavor -Used after surgery, acute infections and fever and in GI disturbances Modified normal diet -Meat and poultry are minced or ground. Fish is usually sufficiently tender without further treatment -Vegetables, diced or chopped, are cooked. They may be cooked a little longer than usual to be sure they are soft -Soft raw fruits may be used -Soft rolls, breads, or biscuits are used instead of crisp rolls, crust, breads and toast. -All desserts on a normal diet may be used including pies with tender crust, cakes and puddings Sample Menu Breakfast: fried hotdog and egg; rice; milk and sugar; ripe papaya AM snack: pineapple juice; chicken pie Lunch: fish sinigang; rice; banana PM snack: chicken arroz caldo; kalamansi juice Dinner: almondigas with patola; rice; ripe mango Bedtime: milk C. Test Meals 1. Fecal Fat determination test -it measures fat globules in the stools to detect fat absorption. -100g fat ingested daily for 3 days prior to fecal collection. -2cups whole milk -1 egg -8 oz lean meat -10 exchanges of fat 2. Meat-free Test -used to determine GIT bleeding -a 3-day diet excludes ingestion of meat, poultry and fish 3. Calcium Test -used to determine urinary calcium excretion to diagnose hypercalcemia - Requires 1,000mg calcium intake- 400mg from food sources and 600mg from oral supplements. 4. Serotonin Test -used to detect calcinoid tumors of the intestinal tract. - Food rice in serotonin is excluded in the diet. The normal diet maybe modified for: consistency and texture flavor energy value nutrient level such as fats, proteins, carbohydrates, sodium, and others food categories such as types of fats or elimination diet for allergies The essentials of a good tray service are as follows: A tray of sufficient size for uncrowded arranged of dishes A clean, unwrinkled tray cover and napkin of linen or good quality paper An attractive pattern of spotless chinaware without chips or cracks; clean glassware and shining silverware An orderly arrangement of all items on the tray so that everything can easily be within arm's reach of the px. Portions of food suitable for the px's appetite Food attractively arranged with appropriate garnishes Meals served on time Hot food served on warm plates and kept warm with food cover; cold foods served on chilled dishes. Trays promptly served to the px so that food is at its best ENTERAL AND PARENTERAL FOOD ADMINISTRATION Enteral Feeding It pertains to the delivery of food and nutrients either orally or by the tube directly into the gastrointestinal tract (GIT).  It is intended for patients with functioning GIT but unable to ingest the required nutrients orally or for patients with impaired digesting capacity or unable to absorb nutrients. Types of Enteral Feedings: 1. Ready-to-use Formulation a. Nutritionally complete formulation can be used alone and provides the total needs in a specified volume of formula. b. Modular formulation provides the different forms of individual nutrients to supplement existing formulas. c. Combined formulation meets the therapeutic needs 2. Tube Feedings this type of feeding may be prepared from regular foods. 3. Standard Tube Feeding this type of feeding is fiber-free and high in cholesterol, fat, and sugar. it is a milk-based formulation with sugar and soft cooked eggs. 4. Blenderized Tube Feeding it consists of soft diet allowances which can be blenderized easily. Complications of Enteral Feedings and Interventions: 1.Mechanical a. Nasopharyngeal irritation Intervention: ice chips, topical anesthetic & decongestant b. Luminal Obstruction Intervention: flush; replace tube c. Mucosal erosions Intervention: reposition tube, ice water lavage; remove tube d. Tube displacement - replace tube e. Aspiration – discontinue tube feeding 2. Gastrointestinal a. cramping/distention – change formula, reduce infusion rate. b. vomiting/diarrhea – dilute formula; reduce infusion rate; anti-diarrheal agents c. constipation – promote sufficient fluids and fibers; encourage patient activity 3.Metabolic a. hypertonic dehydration - increase free water * Hypertonic dehydration occurs when there's an imbalance of water and salt in your body. Losing too much water while keeping too much salt in the fluid outside your cells causes hypertonic dehydration. b. Glucose intolerance – reduce infusion rate; give insulin c. Cardiac failure – reduce sodium content; fluid restriction d. renal failure – decrease phosphate, magnesium, potassium, protein restriction, essential amino acids solutions. e. hepatic encephalopathy – decrease amount of protein *Encephalopathy is a broad term for any disease or disorder affecting the brain's structure or function. It refers to a state in which brain function is disrupted due to various causes, leading to symptoms that can range from mild confusion and forgetfulness to severe cases involving seizures, coma, or even death. Enteral Feeding Route Nasogastric Nasoduodenal or nasojejunal Esophagostomy - Used in patients with head and neck cancer Gastrostomy or Percutaneous Endoscopic Gastrostomy (PEG) Jejunostomy or Percutaneous Endoscopic Jejunostomy (PEJ) PARENTERAL FEEDING Parenteral Feeding - is designed for individuals who cannot accept or assimilate nutrients given enterally. Parenteral Feeding Route: 1. Peripheral Vein Route - this route is intended for patients with mild to moderate nutritional deficiency. 2. Parenteral Hyperalimentation (IVH) - this is a long term nutritional support of 2 weeks for patients who cannot be fed through GIT Types of Parenteral Nutrition: 1. Partial Parenteral Nutrition (PPN) is generally delivered via a peripheral intravenous (IV) line (in a peripheral vein), PPN is usually lower in concentration to avoid irritation or damage to smaller peripheral veins. 2. Total Parenteral Nutrition (TPN) (Hyperalimentation) is administered through a central venous catheter (e.g., a PICC line or central line) due to the high osmolality of the solution, which can damage smaller peripheral veins. II. NUTRITION CARE PROCESS Nutritional Assessment is an in-depth analysis of a person’s nutritional status. In the clinical setting, nutritional assessments focus on moderate- to high-risk patients with suspected or confirmed protein-energy malnutrition. 1. Screening ▪ Dietitians obtain much of the preliminary information from the nursing hx and PE. (Ht & Wt; skin integrity; diet prior to admission; difficulty chewing, swallowing, or self-feeding, CC, meds, supplements; OTC drugs, living situation). ▪ Dietitians interview patients and/or families to obtain nutrition hx. 2. Nutrition Assessment ▪ Dietitians usually calculate estimated calorie and protein requirements based on the assessment data. 3. Nutrition Diagnosis ▪ Dietitians determine nutrition diagnoses that define nutrition problem, etiology, and signs and symptoms. A nutrition diagnosis would be more specific e.g., “Inadequate protein-energy intake.” ▪ Dietitians may also determine the appropriate malnutrition diagnosis code for the patient for hospital reimbursement purposes. 4. Nutrition Intervention ▪ Nutrition interventions may include requesting a diet order change, requesting additional laboratory tests to monitor nutritional repletion and performing nutrition counseling or education. Nutrition in the Nursing Process There is currently no single, universally agreed upon method to assess or diagnose malnutrition. Subjective Global Assessment (SGA): a clinical method of assessing nutritional status based on findings in a health history and physical examination NUTRITION CARE PROCESS: 1. Assessment Medical History and Diagnosis BMI Weight Change Dietary Intake Physical Findings *Prone to malnutrition are patients having gastrointestinal symptoms such as nausea, vomiting, diarrhea and anorexia for more than 2 weeks. *Body Mass Index: an index of weight in relation to height that is calculated mathematically by dividing weight in kilograms by the square of height in meters. Weight Change Dietary Intake Assessment Question: “Has the type or amount of food you eat recently changed? If so, please explain.” X Do not ask: “Are you on a diet?” rather ✓ “Do you avoid any particular foods?”/ “Do you watch you eat in any way?” Physical Findings NUTRITION CARE PROCESS: 2. Nursing Diagnosis NUTRITION CARE PROCESS: 3. Nursing Interventions Nutrition Therapy Nutrition therapy recommendations are usually general suggestions to increase/decrease, limit/avoid, reduce/encourage, or modify/maintain aspects of the diet because exact nutrient requirements are determined on an individual basis. Client Teaching  NUTRITION CARE PROCESS: Monitoring and Evaluation III. THERAPEUTIC DIETS NUTRITION THERAPY FOR OBESITY AND WEIGHT CONTROL Obesity is a condition in which the natural energy reserve is increased, is a hazard to health. Obese people are prone to heart diseases or other chronic diseases. An obese pregnant woman is more likely to have complications than a woman of normal weight. The degree of obesity is often judged by comparing what one weighs with the height- weight table. If one weighs 10%-19% more than the average for his/ her height and body frame, he/ she is overweight; if he/ she weighs 20% or more, he/she is therefore, considered obese. ❖ Losing weight simply means balancing food calorie intake with the body’s needs for calories. ❖ One pound of fat is equal to about 3,500 calories. If one has 500 calories less everyday, he/ she will lose about 1 lb/ week. ❖ The state of being overweight and obese is a condition in which the body stores of fat are enlarged. ❖ Underweight or under nutrition results when intake does not meet the energy requirement. Usually, an underweight person weighs 10%-20% below the desirable weight. Some Reasons for Excessive Calorie Intake 1. Family pattern of rich, high calorie foods; the mother or any household member being a good cook. 2. Good appetite; likes to eat; likes many rich foods, may dislike fruits and vegetables. 3. Ignorance of calorie value foods 4. Skips breakfast; is a frequent nibbler; takes coffee break with high calorie snacks. 5. Pattern of living a. Sedentary occupation; idleness b. Riding to work or school c. Little exercise during leisure d. Often sleeps more as person becomes older 6. Emotional outlet: eats to overcome worries and problems, boredom, loneliness, or grief 7. Many social events serving rich foods; frequent eating at restaurants 8. Lower metabolism with increasing age, but failure to reduce intake 9. Influenced by advertising of many high- calorie foods. here should be a change in the eating patterns of families so that the recommended calorie intake for members is followed.. hildren should be encouraged to get more exercise and should be assigned to perform some chores requiring daily physical activity.. Pre school children should not be bribed or rewarded with food. hey should have a variety of activities so that they take their minds off the excessive pleasure of eating NUTRITION THERAPY FOR DIABETES MELLITUS D I I I formation of plaques containing cholesterol and other liquid material within the lumina of the arteries. A high blood glucose level that develops during pregnancy. sually there is a return to normal following childbirth, but these women may develop IDD later in life. condition that occurs when the glucose in the blood exceeds the normal range the normal range for blood sugar levels is or. mmol/L to mg/dL or. mmol/L. condition that occurs when the glucose in the blood falls below normal range. NUTRITION THERAPY FOR GASTROINTESTINAL TRACT DISEASES Peptic Ulcer An ulcer is an erosion of the stomach, pylorus, or duodenum. Ulcers occur only in areas affected by excess hydrochloric acid and pepsin (an enzyme). The most common location is the duodenal bulb, because the gastric contents emptying through the pyloric valve are most concentrated in acid at this point DIET: Bland Diet with emphasis on: Recommended Foods: Fats from: cream, milk, butter, and eggs Foods to Omit: Meat extractives, caffeine, and tannins in coffee, tea, and cola beverages; some spices; alcohol; and tobacco. Diverticular Diseases Diverticulosis are herniations (pockets/ pouches/sacs) of intestinal mucosa through the muscles of the bowel wall. Diverticulitis happens when these pouches are inflamed. Diet for diverticulosis: High-fiber diet include bran, whole grains, and fruits and vegetables. Avoid: Pepper and chili powder, sometimes nuts and corn. Diverticulitis diet during acute periods: limited to clear liquids when vomiting is present, progressing to full liquids, then to low-residue and to regular high-fiber diet as the inflammation subsides. Severe diverticulitis is usually treated by surgical methods (colostomy, bowel resection). Nursing implications are as follows: 1. Patient education is most important here, as all diverticular disease was formerly treated with a low-residue diet. 2. The older patient should be especially reassured, as most diverticulosis occurs in the elderly, and they become most anxious on a high-fiber diet. 3. A symptomatic patient should be encouraged to rest and to take medicines as prescribed. 4. Patients who are malnourished on admission should be replenished nutritionally to facilitate healing and recovery. Malabsorption Syndrome (Celiac Sprue) Ulcerative Colitis is a disorder characterized by widespread ulceration and inflammation of the colon, fever, chronic bloody diarrhea, edema, and anemia. The patient is severely malnourished, suffering from avitaminosis, negative nitrogen balance, dehydration, electrolyte imbalances, and skin lesions. Patients are nervous, anorexic, and in pain. The obvious need for maximum nutrition for a patient who cannot eat is a challenge to the health team. Treatment: includes rest, sedation, antibiotics, antidiarrheal drugs, and rigorous diet therapy. Surgical removal of the diseased portion of the bowel is the treatment of choice, if other medical procedures fail. Diet Therapy: 1. High protein of 120 to 150 grams per day for extensive colon lesions 2. High caloric diet of about 2500 to 3000 calories per day 3. Increased vitamins and minerals supplement and food sources such as grains, fruits, vegetables, protein foods. 4. Low-residue diet in acute stages with gradual increase avoiding heavy roughage to prevent irritation. Lactose Intolerance - is a condition where the body has difficulty digesting lactose, a sugar found in milk and dairy products. It occurs due to a deficiency of lactase, an enzyme produced in the small intestine that breaks down lactose into simpler sugars (glucose and galactose) for absorption. - May be congenital or may arise from other disease conditions like celiac sprue, or can occur after gastric surgery. Treatment: Nutritional management Diet Therapy: 1. Lactose-restricted diet: avoid milk, milk products, lactose, whey, and casein. 2. Cottage cheese, aged cheddar cheese, and fermented milk products like yogurt as tolerated. Diarrhea - refers to loose, watery stools that occur more frequently than usual. It is a common condition that can range from a mild inconvenience to a potentially serious health issue, depending on its severity and duration. Types: 1. Acute - 2 weeks duration - may be caused by viral, bacterial, or protozoan infections; medication side effects; or altered dietary intake. 2. Chronic - More than 2 weeks duration - May be caused by malabsorption, Protein Energy Malnutrition (PEM) or medical treatments Treatment: Nutritional management NUTRITION THERAPY FOR CARDIOVASCULAR DISEASES Atherosclerosis - thickening of the inside walls of arteries by deposits of fat or cholesterol substances (plaques) - the most common cause of heart attacks Risk Factors: 1. Male between ages 45 to 64 years 2. Overweight 3. Diabetics 4. Hypertensive persons 5. High saturated fats consumption 6. High cholesterol levels  7. Family history of cardiovascular diseases 8. Sedentary lifestyle 9. Heavy smokers 10. Tension, frustrations and stress Treatment: Drug and diet Diet Therapy: 1. Low-fat diet, low in saturated fat and cholesterol 2. Increase in monounsaturated fatty acids to lower plasma total cholesterol and LDL cholesterol levels 3. Increase in polyunsaturated fats, the omega-6 (corn oil, soybean oil, safflower oil, and sunflower oil) and omega-3 fatty acids (salmon, tuna, mackerel, sardines, trout, and herring) at least 2 servings per week to decrease plasma cholesterol levels. 4. A total of 300 mg cholesterol intake per day a. More egg whites than egg yolks b. Organ meats taken once a month only c. Shrimps consumed occasionally d. Meat and poultry limited to 5-6 oz/day 5. Increase in complex carbohydrate intake and restriction of simple sugars 6. Dietary fibers -25-30 g/day 7. Restriction of calories to 1200-1600 for women and 2000- 2500 for men. Congestive Heart Failure - is a chronic condition in which the heart's ability to pump blood efficiently is impaired, leading to a buildup of fluid in the body. This condition can affect the lungs, liver, abdomen, and lower extremities. - CHF typically arises from underlying conditions that damage or overwork the heart, such as coronary artery disease, high blood pressure, diabetes, or cardiomyopathy. Diet Therapy 1. Sodium-restricted diet a. Mild restriction (2-3g Na) No added table salt (light use in cooking) No salted foods All other foods as desired b. Moderate restriction (1,000mg Na) Same as above plus elimination of salt in cooking and canned vegetables Basic foods as desired, unprocessed with salt c. Strict restriction (500mg Na) Same as that of moderate restriction plus increased control of food with higher amounts of natural sodium (smaller amounts of eggs, meat, milk, limited to 2 cups) and vegetables such as leafy green, beets, carrots, and celery. d. Severe restriction (250mg Na) All of the previous restrictions, plus tighter control of natural food sources. Meat limited to 2-3 oz daily 2-3 eggs per week 2. Calorie control to reduce heart workload 3. Texture control in acute stages to aid in digestion 4. Limit caffeine Hypertension - Also known as high blood pressure. - Common in males than in females, 55 years and below Treatment: Lifestyle modifications, nutritional therapy Diet Therapy 1. Mild restriction of Na an occasionally 1g Na diet may be ordered 2. Weight reduction 3. Low-fat diet: unsaturated fat is recommended Sources of Na: 1. Salt (40% Na): 6 g of salt is equal to 2,400mg Na. Salt is used in: processed foods (bacon, ham, dried fish, etc) baking and cooking the table 2. Milk 3. Mest, fish, poultry 4. Shellfish 5. Eggs 6. Beets and spinach Myocardial Infarction (MI) - Or heart attack, results from atherosclerosis of the coronary arteries Treatment: Reduced workload of the heart Diet Therapy: 1. liquid diet for initial stages; progress to regular food as the condition improves 2. small, frequent meals 3. caffeinated beverages restrictions to avoid myocardial stimulation 4. restrictions on Na, cholesterol, fat, and calories 5. omega-3 fatty rich-foods consumption to reduce blood clots NUTRITION THERAPY FOR KIDNEY DISEASES Acute Glomerulonephritis (AGN) - may be a deferred hypersensitivity reaction initiated by infectious agents related with tonsilitis or scarlet fever or is a consequence when antigen-antibody complex reaction in which some of the complexes become ensnared in the glomeruli leads to swelling. Treatment: Nutritional therapy Diet Therapy: 1. adequate protein 2. no Na restriction except with edema 3. high calorie diet from carbohydrates and fat to save tissues from being used as an energy source. Nephrotic Syndrome - Describes a composite of symptoms that can occur as a result of injury to the capillary walls of glomerulus. - Characterized by massive loss of protein in the blood and edema. - Nephron lesions with massive albuminuria as well as protein losses in urine are observed resulting to general malnutrition. Treatment: Nutritional therapy Diet Therapy: 1. High protein, 100-150g daily 2. High calorie intake to spare proteins for tissue synthesis and to provide energy 3. Na restriction (500mg) Acute Renal Failure (ARF) - is a sudden decline in kidney function or abrupt loss of kidney function. - an abrupt renal malfunction because of infection, trauma, injury, chemical poisoning, severe allergic reaction, or pregnancy. - The symptoms are nausea, lethargy, and anorexia. Oliguria may be present at first, followed by diuresis. Azotemia (elevated level of nitrogen-containing waste products in the blood, primarily urea and creatinine) may also be present. - Acute renal failure is a life-threatening situation and requires immediate medical management. Three Phases: 1. Oliguric Phase - characterized by acidosis, high serum potassium, high serum phosphorus, hypertension, anorexia, edema that lasts from 24 hours to 3 weeks 2. Diuretic Phase - urine output gradually increases and lasts from 2-3 weeks 3. Recovery Phase - the kidney function improves gradually and lasts from 3-12 months. Chronic Renal Failure - Chronic renal failure results from a slow destruction of kidney tubules and may be due to infection, hypertension, hereditary defect, or drugs. - Dietary management involves the balancing of fluid and electrolytes, correction of metabolic acidosis, minimization of the toxic effect of uremia, and implementation of nutritional rehabilitation. Treatment: diuretics, nutritional therapy Diet Therapy: 1. Protein low to moderate according to tolerance: 30-50g 2. Carbohydrates relatively high for energy: 300-400g 3. Fat relatively moderate: 70-90g 4. Calories adequate for maintenance to prevent tissue breakdown: 2000-2500g daily 5. Na control according to serum levels and excretion capacities varying from 1300- 1900mg 6. Potassium control according to serum levels and excretion capacities varying from 1300 to 1900mg 7. Water control according to excretion about 800-1000ml; careful intake-output records vital General Diet Management 1. General protein and electrolyte control 2. Low-protein, essential amino acid diet to sustain patients with uremia, a severe condition resulting from the accumulation of waste products (such as urea, creatinine, and other nitrogenous substances) and toxins in the blood due to impaired kidney function; and alleviate their difficult situations. 3. Very low protein, 20g  4. Controlled potassium: 1500mg fed only essential amino acids causing the body to use its own excess urea nitrogen to synthesize the non-essential amino acids needed for tissue protein production Foods used: 1 egg, 6oz milk, low-protein bread, 2-4 fruits, and 2-4 vegetables from special list to control protein and potassium. NUTRITION THERAPY FOR CANCERS Cancer is a group of many dissimilar diseases categorized by unfettered replication of cells. - Generally seen as an atypical growth of cells resulting in a mass that invades and destroys normal tissues. - Carcinogen is any substance, agent, or exposure that can cause or promote the development of cancer. Carcinogens work by inducing changes in a cell's DNA, leading to mutations that disrupt normal cell growth and regulation. Over time, these mutations can result in uncontrolled cell division and tumor formation. - Carcinogenesis is the formation of tumor from initiation, promotion, and progression process. ❖ Initiation happens when a carcinogen-like virus becomes activated in the body and binds to the DNA. ❖ Promotion is the growth of cancer cells ❖ Progression is the uncontrolled growth of cancer cells until malignant tumor develops. Kinds of Tumor: 1. Benign tumor – confined to an area where it originated; does not spread to the rest of the body; slow growth; does not come back once removed. 2. Malignant tumor – multiplies slowly or rapidly; it invades and injure tissues and organs nearby and enters the bloodstream. Types of Cancer: 1. Carcinoma – arises from the cells of the skin, glandular organs, and inner linings of internal organs 2. Sarcoma – develops in the muscles, cartilages, connective tissues, and bones 3. Glioma – originates in the central nervous system and supporting tissues in the brain 4. Lymphoma – growth in the lymph nodes and other tissues of the lymphatic system. Nutritional Management: 1. Oral Nutrition a. High-calorie, high protein beverages b. In case of lactase deficiency, Lactaid may be given 2. Tube Feedings a. Complete products – meal replacements that require digestion and absorption b. Chemically-defined products – minimal or no digestion; for pancreatic patients c. Modular products – used in combination with other tube feeding products to enhance calorie or protein intake d. Specialty products – vary in terms of specific amino acid, carbohydrate, and fat content; for patients with hepatic or renal failure. 3. Total Parenteral Nutrition a. Used when the digestive tract is not functioning b. Nutrients administered intravascularly. NUTRITION FOR ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) Acquired Immune Deficiency Syndrome (AIDS) - is a chronic and life-threatening condition caused by the Human Immunodeficiency Virus (HIV). - AIDS represents the most advanced stage of HIV infection, characterized by severe damage to the immune system, making the body highly vulnerable to opportunistic infections and certain cancers. Modes of Transmission: a. Sexual intercourse b. Blood transfusion c. Sharing contaminated needles d. Placental transfer, childbirth, or breastfeeding * It cannot spread through kissing, coughing, sneezing, touching, and sharing of utensils. Nutritional Management: 1. Dietary Management a. Energy – 35 to 45 kcal/kg/BW b. Protein – 2-2.5g/kg BW c. Fats – increase omega-3 sources and decrease saturated fats in the diet d. Vitamins and Minerals – increase to be recommended in case of altered metabolism 2. Alternative Management a. Common in patients with chronic and terminal illnesses b. May range from vitamin and mineral supplementations