Krause\'s Food and The Nutrition Care Process- 14th Edition Case Study: Mr. B, a
ID: 81573 • Letter: K
Question
Krause's Food and The Nutrition Care Process- 14th Edition
Case Study:
Mr. B, a 47-year-old man, 6 ft 2 in tall and weighing 200 lb, is admitted to the hospital with chest pain. Three days after admission, at patient care rounds, it is discovered that Mr. B has gained 30 pounds over the last 2 years. Review of the medical record reveals the following laboratory data: LDL: 240 (desirable 130), HDL 30 (desirable >50), triglyceride 350 (desirable <200). Blood pressure is 120/85. Current medications: multivitamin/ mineral daily. Cardiac catheterization is scheduled for tomorrow. Diet history reveals frequent consumption of high fat foods.
1. What additional information would you need to develop a nutrition care plan?
2. What foods choices will influence his lipid panel?
3. What behavior therapy focuses on identifying and changing perceptions?
4. Using this counseling strategy, what tool would you use when Mr. B states” I want to follow the new eating pattern, but I just can’t afford it.”?
5. Mr. B states “I just don’t know what to buy once I get to the grocery store. I end up with burgers and chips or stop at fast food after work.” What motivational interviewing tool would you use to respond? What nutrition care goals would be appropriate for Mr B?
6. What would you include as part of the “I” portion of the ADIME documentation?
7. What would you use for the “M” and “E” portion of the ADIME record?
8. What nutritional screening tool at Mr B’s admission to the hospital would allow you to initiate intervention sooner?
Explanation / Answer
Answer 1:-
Additional information needed from the client is as follows:-
Answer 2:-
Food choices that will influence patient’s lipid panel are as mentioned below
Food choices that are recommended
Food Choice
Examples
Effect on lipid panel
Dietary fibre (soluble)
Oats, Dried beans (legumes), Peas, Barley, Citrus fruits, Apples
Reduces total cholesterol and LDL
Dietary fibre (insoluble)
Whole wheat breads and cereals, Beet root, Cauliflower, Carrots, Turnips
No direct effect on levels of lipid, but healthy bowel movement and healthy nutrition.
Monosaturated fats
Olive oil, Canola oil, Avocados, walnuts
Lowers LDL, Maintains HDL level
Polyunsaturated fat
Safflower oil, Sunflower oil, Sesame oil, Corn oil, Soybean oil, Flaxseed oil.
Linoleic acid, found in these oils, can lower LDL if used in moderation.
Omega-3 fats
Fish, especially fatty fish, such as salmon and mackerel.
Plant sources, such as walnuts, canola, and flaxseed oil
Lowers triglycerides
Food choices that are not recomended.
Food Choice
Examples
Effect on lipid panel
Trans fats
Hydrogenated fats, found in some margarines, vegetable shortenings, non-dairy creamers, and whipped toppings
Snack foods (potato chips, cookies, cakes)
Peanut butter that contains hydrogenated fat.
Raises LDL, Little effect on HDL but at high levels can lower HDL
Alcohol
Wine, Beer, any hard liquor
May raise triglyceride levels.
Saturated fats
Fatty meats (beef, pork), Poultry skin, Butterfat (in whole milk, cream, ice cream, cheese), Tropical oils (coconut, palm)
Raises LDL, Little effect on HDL or triglycerides
Dietary cholesterol
Egg yolks, Red meat, Shellfish
Raises total blood cholesterol
Answer 3:-
Behavioral theories can guide clinicians in developing the best strategies for promoting a therapeutic nutritional change. Many models are developed for this theory such as
Food Choice
Examples
Effect on lipid panel
Dietary fibre (soluble)
Oats, Dried beans (legumes), Peas, Barley, Citrus fruits, Apples
Reduces total cholesterol and LDL
Dietary fibre (insoluble)
Whole wheat breads and cereals, Beet root, Cauliflower, Carrots, Turnips
No direct effect on levels of lipid, but healthy bowel movement and healthy nutrition.
Monosaturated fats
Olive oil, Canola oil, Avocados, walnuts
Lowers LDL, Maintains HDL level
Polyunsaturated fat
Safflower oil, Sunflower oil, Sesame oil, Corn oil, Soybean oil, Flaxseed oil.
Linoleic acid, found in these oils, can lower LDL if used in moderation.
Omega-3 fats
Fish, especially fatty fish, such as salmon and mackerel.
Plant sources, such as walnuts, canola, and flaxseed oil
Lowers triglycerides
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