Define clinical manifestations of rheumatic fever. Outline four feeding advice for a mother of a child with HIV.

Clinical manifestations of rheumatic fever include:

1. Fever
2. Joint pain and swelling
3. Chest pain
4. Shortness of breath
5. Fatigue
6. Skin rash
7. Sydenham's chorea (involuntary movements)
8. Carditis (inflammation of the heart)

Feeding advice for a mother of a child with HIV:

1. Ensure a balanced and nutritious diet: Provide a variety of foods that are rich in essential nutrients such as fruits, vegetables, whole grains, lean proteins, and healthy fats to support the child's immune system and overall health.

2. Encourage frequent small meals: Due to the potential side effects of HIV medication and the impact of the virus on the child's appetite, it may be helpful to offer smaller, more frequent meals throughout the day to ensure adequate nutrient intake.

3. Maintain good food safety practices: It is important to practice proper food handling and storage techniques to prevent foodborne illnesses, which can be particularly harmful to individuals with compromised immune systems.

4. Stay hydrated: Encourage the child to drink plenty of fluids, such as water and herbal teas, to stay hydrated and support overall health. Avoid sugary drinks and excessive caffeine, as they can have negative effects on the immune system.

Clinical Manifestations of Rheumatic Fever

- Major Manifestations:
- Carditis (heart inflammation)
- Arthritis (joint inflammation)
- Chorea (involuntary movements)
- Erythema marginatum (skin rash)
- Subcutaneous nodules

- Minor Manifestations:
- Fever
- Fatigue
- Muscle pain
- Abdominal pain
- Nosebleeds
- Headache
- Sore throat

Feeding Advice for a Mother of a Child with HIV

1. Exclusive Breastfeeding for the First 6 Months:
- Breast milk provides optimal nutrition and protective antibodies.
- Avoid formula or animal milk, as they can expose the child to HIV.

2. Introduce Complementary Foods Gradually:
- Start introducing solid foods around 6 months of age, as recommended by a healthcare professional.
- Choose nutrient-rich foods such as fruits, vegetables, whole grains, and lean protein.

3. Maintain Good Hygiene and Safety:
- Wash hands thoroughly before preparing and handling food.
- Keep surfaces, feeding utensils, and food clean.
- Avoid giving raw or undercooked foods.

4. Provide a Balanced and Varied Diet:
- Encourage the child to eat a variety of foods from all food groups.
- Include foods rich in iron, zinc, and vitamin A, which are essential for immune function.