Susan is a 65 years old diabetic patient with right AKA. She Weighed 245 lbs., H
ID: 126591 • Letter: S
Question
Susan is a 65 years old diabetic patient with right AKA. She Weighed 245 lbs., Height 5’7’’ at admission to the hospital. High blood glucose (450mg/dl) and blood pressure reading were 170/110 mm/hg. The doctor placed Susan on an 1800 Kcal, 2 gm. Sodium and 14 servings CHO diet and ordered a dietitian consult.
1. What are the 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.Write a menu for each diet, taking into account patient disease state, and also color, texture and aesthetics
3.what are the 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
Explanation / Answer
1. ANS: 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: 5 feet, 7 inch
Weight: 245 pounds
Age: 65Years
Gender: Female
Calculation:
Susan BMI is 38.4, it is indicating susan weight was present in the Obese category for adults according to her height.
Ideal Weight: 145 lbs
Ideal Weight Range: 118 lbs-156 lbs
Calories required:
Calories required maintaining Susan current weight 2551 cal/day. But the doctor was prescribed 1800 Kcal/day; through this amount of Calories/day she can lose 1 lb per week.
Carbohydrates:
Susan needs 1,861 Calories/day to lose 1 lb per week. So Susan should take 198 (40%) - 372 (75%) grams (7.00 - 13.13 Oz or 0.438 - 0.821 Lb) of carbohydrate for Susan 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 Susan 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 Susan 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
2. ANS: Diet menu for Susan:
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.
3. ANS: 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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