Subjective
Medical History
Mr. BP, a 42 yr old African American with a seropositive HIV status since 2005, was recently placed on HAART after being hospitalized with bouts of thrush. The HAART regimen consists of Truvada and Kaletra. Shortly after beginning his new pharmacological regimen, the patient began experiencing more fatigue, muscle weakness, and nausea. He came to you seeking help in gaining strength and energy to “get my life back.”
Objective and Laboratory Data
Diagnosis
At the time of hospital admission, the patient’s weight was 187 lb (85 kg), and his blood pressure was 132/90 mmHg.
His laboratory work revealed the following:
Six months after beginning HAART, his laboratory work was as follows:
Exercise Test Results
At the time of the exercise evaluation, Mr. BP’s resting vitals were as follows:
The graded exercise evaluation resulted in the following values:
His resting ECG revealed normal sinus rhythm with nonspecific ST-segment changes. No abnormal ECG changes or arrhythmias were noted during exercise. Before beginning his exercise program, the patient was advised to revisit his primary care provider and have his blood pressure reevaluated. The physician added a diuretic to the patient’s medical regime. When he returned to the exercise facility the next week, his resting blood pressure was 128/90 mmHg.
Assessment and Plan
Exercise Prescription
Case Study Discussion Questions
Aerobic exercises are good for patients suffering from HIV which starts with walking and slight jogging they can extend it to doing crunches, dumbell punch and weight lifting. But any exercise has to be started according to the strength and repetition of the same has to be done daily.
The exercise prescription will include the start from simple exercises like walking that too only for 10 mins in the beginning and extend it to 30 mins with a frequency of 3-5 days every week
The common complications of HAART are -
Hyperlipidemia , lipodystrophy , insulin resistance and changes in bone density is also observed. The conditions may be associated with coronary heart disease due to long term persistence of hyperlipidemia.
Hence exercise plays a very important role over here helping the patient by treating the issues related with cardiovascular diseases or metabolic syndrome.
The factors responsible for low crf in hiv patients are:
Smoking
High triglycerides
Low high density lipoprotein
High blood pressure
Factors limiting the capacity for exercise in HIV patients are:
1.Structural and inflammatory muscle abnormalities.
2. Nucleoside related mitochondrial toxicity
3. Oxidative phosphorylation
Subjective Medical History Mr. BP, a 42 yr old African American with a seropositive HIV status...
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