THE CLIENT WITH INFECTION
Fever typically accompanies an infection. Fevers and infections may be acute or chronic. Fever is a hypermetabolic state in which each degree of fever on the Fahrenheit scale raises the basal metabolic rate (BMR) by 7%. If extra calories are not provided during fever, the body first uses its supply of glycogen, then its stored fat, and finally its own muscle tissue for energy.
Protein intake should be increased because of infections (sepsis). Amounts required need to be individualized. Protein is needed to replace body tissue and to produce antibodies to fight the infection. Minerals are needed to help build and repair body tissue and to maintain acid-base, electrolyte, and fluid balance. Extra calories are needed for the increased metabolic rate. Extra vitamins are also necessary for the increased metabolic rate and to help fight the infection causing the fever. Extra liquid is needed to replace that lost through perspira-tion, vomiting, or diarrhea, which often accompany infection.
Clients with fever usually have very poor appetites, but they will often accept ice water, fruit juice, and carbonated beverages. Some will accept bouillon or consommé.
Usually, the diet during fever and infection progresses from the liquid to the regular diet, with frequent, small meals recommended. It should be high in protein, calories, and vitamins. In some cases, parenteral and enteral feedings are necessary.