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Management of TB Patient - Normal Weight
Learning Objectives-
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a. Recommendation for patient with BMI between 21 and 25 kg/m2
The current body weight is consistent with a BMI in the normal range (18.5-24.9kg/m2). Patients should be advised to maintain their weight in this range
Advise
Diet
- Adequate and balanced
Cereals and Pulses
Milk
Oils and Nuts
Fruits and Vegetables
Eggs, Flesh Foods - Recommended protein-rich foods like pulse, milk and dairy products, eggs, and flesh foods to enable recovery of lost muscle mass
- Frequent feeds initially when appetite is likely to be poor
- Later, when normal appetite returns, advise 3 meals and at least 2 snacks
Supplements
- Costlier foods and nutritional supplements are not necessarily better than locally available foods
- A multivitamin pill is adequate to meet micronutrient requirements if intake is very poor>
Healthy lifestyle
- Advice patient to be active as possible. It improves appetite and muscle mass
- Smoking and alcohol is harmful to TB patients, and should be avoided
Monitor
Weight Gain
- Weigh every month
- If follow up BMI is > 25kg/m2 advise restriction of calories and increase activity levels
- If patients lose weight after returning from work, and BMI falls below 21 kg/m2, advise extra intake of calories and proteins
Drug Toxicity
- Assess patient for drug toxicity if, after initial improvement, appetite decreases or if there is vomiting
b. Recommendation for patient with BMI 18.5-21 kg/m2
The current body weight is consistent with a BMI in the normal range (18.5-24.9kg/m2). Patient should be advised to maintain their weight in this range. Adequate nutrition is crucial for recovery
Assess
- Appetite and Oral intake, performance status, vital signs, anaemia, pedal edema, medical condition
Advise
Diet
- Adequate and balanced
Cereals and Pulses
Milk
Oils and Nuts
Fruits and Vegetables
Eggs, Flesh Foods - Cereals, oils and nuts are energy rich, while pulses, milk and dairy products, eggs and flesh foods are rich in proteins. Underweight patients needs more of these foods
- Frequent feeds initially, when appetite is likely to be poor
- Later, when normal appetite returns, advice 3 meals and at least 2 snacks
Supplements
- Costlier foods and nutritional supplements are not necessarily better than locally available foods•
- A multivitamin pill is adequate to meet micronutrient requirements if intake is very poor
Healthy lifestyle
- Advice patient to be active as possible. It improves appetite and muscle mass
- Smoking and alcohol is harmful for TB patients, and should be avoided
Monitor
Weight Gain
- Weigh every month
- If follow up BMI is > 25kg/m2 advice restriction of calories and increase activity levels
- If patients lose weight after returning from work, and BMI falls below 21 kg/m2, advice extra intake of calories and proteins
Drug Toxicity
- Assess patient for drug toxicity if, after initial improvement, appetite decreases or if there is vomiting
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