Jackie is a fifty-five years old female patient who visited your outpatient clin
ID: 126465 • Letter: J
Question
Jackie is a fifty-five years old female patient who visited your outpatient clinic. Her lab results reflected 190 LDL, 30 HDL and 220 total cholesterol and triglycerides of 450mg/dl. The doctor prescribed an 1800 Kcal therapeutic lifestyle changes diet. Wt. 150 lbs. H: 4’ 9’’
1.Do calculations to determine patient’s caloric needs, Protein, Fat, and any other calculations (BMI, % weight change, UBW, % involuntary weight loss, % UBW) necessary to determine patient’s needs
2. Research each patient disease state and write a 1 to 2 pages report for each disease
3. Write a menu for each diet, taking into account patient disease state, and also color, texture and aesthetics.
4. Provide computer analysis for each diet. First computer analysis should be the diet as you write it before alterations and a second to show appropriate changes to better fit patient diet order. (Computer analysis should be closely related to the diet prescribed for the patient by the doctor).
5. Check over your diet to ensure that RDA’s and AMDR’s are met for specific nutrients (CHO, Fat& Sat Fat, fiber, cholesterol, protein, Ca, Na,) and any other nutrient pertinent to the patient’s care
6. Provide a written comparison report on the written menu and the computer analysis. State the difference in nutrient content and any challenges you encountered in standardizing the menu to meet patient’s needs. Also, state whether the prescribed diet meets patients’ needs based on your own nutrition assessment of patient and provide recommendations if needs are not met
Explanation / Answer
Patient needs:
BMI Categories:
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater
BMI = Weight in kilograms / (Height in meters) 2
Height: 4 feet, 9 inch
Weight: 150 pounds
Age: 55Years
Gender: Female
Calculation:
Jackie BMI is 32.5, it is indicating jackie weight was present in the Obese category for adults according to her height.
Ideal Weight: 108 lbs
Ideal Weight Range: 86 lbs-116 lbs
Calories required:
Calories required maintaining Jackie current weight 2361 cal/day. But the doctor was prescribed 1800 Kcal/day; through this amount of Calories/day she can lose 1 lb per week.
Carbohydrates:
Jackie needs 1,861 Calories/day to lose 1 lb per week. So Jackie should take 198 (40%) - 372 (75%) grams (7.00 - 13.13 Oz or 0.438 - 0.821 Lb) of carbohydrate for Jackie energy needs. (55% = 273 grams (9.63 Oz or 0.602 Lb), 65% = 323 grams (11.38 Oz or 0.711 Lb))
Proteins: According to the American Dietetic Association (ADA) recommendations based on Jackie weight she should take at least 68 - 122 grams of protein per day.
According to the Centers for Disease Control and Prevention (CDC) recommendations based on Jackie condition she should take 39 - 135 grams of protein per day, which is 10% - 35% of her daily Calorie intake.
Fat:
Daily Fat Allowance (20-35%): 36 - 63 grams
Saturated Fat Allowance (10%): <18 grams
Saturated Fat Allowance to Help Reduce Heart Disease (7%): <13 grams
Diet menu for Jackie:
Breakfast: 1 Protein +1 Protein Snack+ 1 Fruit (+ vegetables if desired)
Lunch: 2 Protein + Leafy Greens + 2 Vegetable + 1 Starch/Grain +1 Protein Snack + 1 Taste Enhancer + 1 Fruit +1 Fruit or Vegetable.
Dinner: 1 Starch/Grain + 2 Proteins + Leafy Greens + 2 Vegetable + 1 Taste Enhancer +1 Fruit.
Daily Totals: 5 Protein, 2 Starch/Grain, 3 Fruit, 4-5 Vegetable, Leafy Greens – no limit, 2 Protein Snack, , 2 Taste Enhancer.
Specific nutrients levels in diet comparison with RDA’s and AMDR’s values:
Generally for men less than 1200-1600 and for women less than 1000-1200 daily caloric intakes is not advisable because the diet should meet values of basal metabolic rate. BMI is the basic needed energy amount while resting in a temperate environment when the digestive system is inactive.
According to the Acceptable Macronutrient Distribution Ranges for Adults (as a percentage of Calories) is as follows Protein: 10-35%, Fat: 20-35% and Carbohydrate: 45-65%. So based on the RDA’s and AMDR’s guidelines the 1800 cal/day can meet maximum amount of nutrients (CHO, Fat& Sat Fat, fiber, cholesterol, protein, Ca, Na,) and any other micro nutrient taking can helpful for patient’s care.
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