August is a 48-year-old Zulu-speaking man who lives with his wife and two sons in an informal settlement near the Sefako Makgatho Health Sciences University Hospital (SMHSU) where you work as a clinical dietitian. August was diagnosed with human immunodeficiency virus (HIV) at the age of 28 (horizontal transmission) and is currently on a fixed-dose combination therapy (FDC) of tenofovir, lamivudine and dolutegravir (TLD). He reports to be compliant with treatment. He is admitted SMHSU hospital with a clinical picture of parapneumonic effusion with a possible etiology of streptococcus pneumonia.
(1 South African Rand (R) is the equivalent of 0.082 Australian Dollars (AUD)
August is unemployed and receives a disability grant of R2090 ($170 AUD) per month, from the South African Social Security Agency (SASSA). August’s wife is employed as a cleaner at the local school and earns a monthly salary of R6000 ($500 AUD). August’s children contribute R7500 ($600 AUD) to the household monthly income. Together, this income covers the living expenses of four people. Typically, 60% of this sum is spent on food, while the remainder goes towards transportation and household expenses.
Nutrition-focused Physical Findings
August presented to emergency three days ago with fever, shortness of breath and severe pain in the left upper quadrant. His chart notes mucositis, oral candidiasis, mouth ulcers, dysgeusia (a distortion of the sense of taste and no appetite. Your assessment August reports a persistent cough, weakness and a feeling of malaise which he has experienced for the past three weeks. He says he hasn't felt like participating in his usual activities and has been spending most of the day resting.
Anthropometry
August reports losing 7.5 kg in the past 6 months. He notes that he has been losing weight during the last month but is unsure how much. He currently weighs 59 kg with a height of 1.72 m. His mid-upper arm circumference (MUAC) is 19 cm. Upon admission, he was initially weighed at 58 kg, but has since regained 1 kg to reach his current weight of 59 kg. A physical examination reveals moderate wasting. Further examination of Me's muscle and fat stores shows the following.
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+ Introduction
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+ 2. Anthropometric Measurements (AD)
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+ Check-in
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+ 4. Nutrition-Focused Physical Findings (PD)
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+ 5. Client History (CH)
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+ Comparative Standards
- Assessment, Monitoring and Evaluation Tools (AT)
- Etiology Category (EY)
- Comparative standards (CS)
- Progress Evaluation (EV)