Mr. H has HIV and is taking a protease inhibitor as part of his ...

[Mr. Wonderful]

Mr. H has HIV and is taking a protease inhibitor as part of his antiretroviral treatment. At his last visit he had a detectable HIV viral load, although he claimed to take all of his medications without missing any doses.
 
  He has been very adherent with his medications over the past several years, so you are concerned about other reasons for the increase in viral load. You ask about any new over-the-counter drugs or nutritional supplements he may be taking. He responds that he has been feeling a little down and decided to try St. John's Wort. You inform him that St. John's Wort: 1. Is a natural product which rarely have adverse effects.
   2. Causes decreased absorption of protease inhibitors and should be avoided.
   3. Has been reported to be helpful with depression and is better than taking chemicals.
   4. Can be used in small amounts with few side effects.

Question 2

The nurse is caring for a 21-year-old female burn victim. Her parents ask why their daughter has to be fed by a nasogastric tube (NG). What would be the best response?
 
  A) Your daughter's intestines are not working normally right now so we have to feed her through a tube.
  B) If your daughter were eating normally, she would get sicker because her intestines are not working right.
  C) We need to get a lot of calories and nutrients into your daughter to help her heal, and this is the best way to do that.
  D) Trying to eat normally would just wear your daughter out, so we feed her through a tube to conserve her energy.

[Jayson]

Answer to Question 1

1
Rationale: St. Johns Wort has been shown to decrease levels of protease inhibitors and contribute to treatment failure. Even all-natural products can cause adverse side effects or interactions with drugs or nutrients. Although there are some reports of successful treatment of depressive symptoms, natural supplements are rarely evaluated using controlled clinical trials, and so claims are usually based on anecdotal reports. Even a small amount may cause adverse effects.

Answer to Question 2

C
Feedback:
Early enteral feedings may help maintain intestinal mucosa and reduce episodes of infection and the degree of hypermetabolic stress response. The formula can also be designed to meet the specific nutritional needs that might not be obtained by oral feedings.

[Mr. Wonderful]

TY

[Jayson]

You're welcome