When the body undergoes stress and endures disease or injury, changes to the chemical environment impact nutritional status. Metabolic stress alters the metabolic rate, heart rate, blood pressure, hormonal status, and the body’s ability to metabolize nutrients. Nutrient needs at this stage are often so high that the metabolically stressed, critically ill patient is unable to meet needs through oral intake alone and nutrition support becomes an integral part of the treatment plan.
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In respiratory distress, problems arise that disrupt the process of exchange of gases between the air and blood. Respiratory distress results in a lowered oxygen supply in the blood and a rise in carbon dioxide levels. Increased carbon dioxide in the blood can disrupt breathing such that it impacts and interferes with food intake. Weight and optimal nutrition status are often casualties of both metabolic and respiratory distress.
The arenas of cancer and HIV/AIDS present separate but unique nutritional challenges that may range from optimizing the diet to lower cancer risk to manipulating diet to manage treatment side effects or treating chronic diseases. This chapter addresses the evidence-based nutrition therapies indicated in the prevention, treatment, and management of metabolic and pulmonary stress, and critical illness, cancer, and HIV/AIDS.