Nutritional Assessment
Ricci Abines
Maryville University
Nutritional Assessment
Description of Client:
The client’s initials will only be used. EA lives in a suburban, middle-class neighborhood with his wife and three children. This household purchases groceries almost weekly and he prepares breakfast for everybody in the house on weekdays before leaving for work. His adequacy for food purchase and preparation is within middle range; not to the point of starvation but also not too extravagant.
Brief History:
EA is from the Philippines and has only been in the United States since 2010. Traditional Filipino foods include a lot of meat and a moderate-to-high amount of oils. This is what EA prefers to eat. His family medical history states that his father suffered from lung cancer and his mother suffered from bone cancer. Both parents are deceased and have passed away at the age of 59 and 35, respectively. It is not known whether cancer was the cause of death for both individuals. EA’s father also had diabetes and his sister was diagnosed with hypertension.
EA’s current health issues include gastroesophageal reflux disease (GERD), hyperlipidemia, hypertension, obstructive sleep apnea (OSA), pre-diabetes, and hypercholesterolemia. EA suffered from a gastric ulcer in 2010. He is a former smoker and consumes alcohol on rare occasions. EA has not underwent any surgery with the exception of tooth removal and replacement in 2016.
EA states that he follows his doctor’s medication instructions and is currently prescribed 4 medications:
EA’s Prescription Medication
Medication Instructions What this medication treats (WebMD, 2018)
Metoprolol succinate XL 24hr 50 MG tablet (TOPROL XL) 1 tablet by mouth once daily • High blood pressure
• Angina
• Heart failure
Amlodipine 5 MG tablet (NORVASC) 1 and ½ tablet by mouth once daily • High blood pressure
• Angina
Simvastatin 20 MG tablet (ZOCOR) 1 tablet by mouth daily at bedtime • High cholesterol and triglyceride levels
Omeprazole EC 20 MG tablet (PRILOSEC OTC) 1 tab by mouth daily before breakfast • Heartburn
• Damaged esophagus
• Gastric ulcers
• GERD
Nutrition Assessment:
EA states that he has a height of 5’10” with a weight of about 220 pounds. This appears to be true, which makes his Body Mass Index (BMI) to be 31.6, which is in the overweight category. He has a medium frame. The ideal weight for an individual with this height that will put them into the normal BMI category is about 173 pounds. He does light exercise 3 days a week with lifting weights and running on the treadmill.
Prior to this assessment, EA was contacted and instructed to list out all the foods and drinks he consumed in the span of 24 hours. The following table is the result:
EA’s 24 Hour Food Recall
Food/Drink Calories Carbs (g) Fats (g) Protein (g)
Slim Jim Mild Beef N’ Cheese Sticks 160 3 12 9
4 slices of Spam 180 2.6 16 7.5
4 pieces Tocino 256.7 9.8 10.5 28.3
3 eggs 216 1.1 14.4 18.9
1 cup of white rice 205 45 0.4 4.3
2 rolls of King’s Hawaiian Bread 91 15 2 3
3 Oreos 160 25 7 1
1 cup coffee (with CoffeeMate) 100.4 19.3 5 0.4
1 can of Sprite 140 38 0 0
Total 1,509.1 158.8 67.3 72.4
% 53.2 22.5 24.3
According to ATI’s Nutrition for Nursing, the recommended range for carbohydrates is 45% to 65% of calories, for fats is 20% to 35% of calories, and for proteins is 10% to 35% of calories (2016). EA’s percent carbohydrate, fat, and protein intake fall within these recommended ranges with 53.2%, 22.5%, and 24.3%.
Evaluation of Assessment Information:
The overall findings from the nutrition assessment indicates that EA has a generally positive nutrition status at this moment. Although they are on the lower aspect of the recommended ranges of carbohydrates, fats, and proteins, EA’s maintenance of these percentages will help him lose weight and reach his goal of being 173 pounds. Knowledge of his current illnesses will help EA in treating them and living with them.
It calculated that EA’s BMI is 31.6, which places him as overweight. Healthy People 2020’s goal for nutrition and weight status is to “promote health and reduce chronic disease risk through the consumption of healthful diets and achievement and maintenance of healthy body weights” (2018). EA was given a handout on tips to start and maintain a healthful diet which highlighted the consumption of nutrient-dense foods from all food groups (grains, fruits, vegetables, dairy, and protein), limitation of saturated and trans fats, cholesterol, and alcohol, and limit caloric intake. From EA’s 24 hour recall, EA did not indicate that he consumed any fruits, vegetables, or dairy products. The protein choices he listed also has a high number of fats, which could also contribute to the worsening of his cardiovascular condition by increasing the amount of cholesterol and fats in his blood vessels. In order to achieve a healthy nutrition status, EA will need to start replacing those foods with high amounts of saturated and trans fats with more fruits, vegetables, and dairy products such as strawberries, asparagus, and low-fat yogurt
As stated before, EA is diagnosed with hypertension, hypercholesterolemia, and hyperlipidemia. These are all risk factors for heart disease and stroke and are controllable. According to Healthy People 2020, their goal in improving heart disease and stroke is through “prevention, detection, and treatment of risk factors” for cardiovascular disease (2018). Along with nutrition and weight status, healthy eating and exercise can also help in preventing and treating cardiovascular issues. EA was given a blood pressure log provided by the American Heart Association (AHA) in order for him to track his blood pressure. Committing to this logging of his blood pressure and presenting it to his doctor at every visit will help EA achieve and maintain a healthy heart.
Evaluation of Experiences:
During this teaching session, it was very frustrating that it seemed like there was nothing to improve; EA seems to be very self-aware of his conditions and how to treat them through his medication and his lifestyle. He was very open to the proposed changes such as increase in exercise and limiting of his current food choices to expanding his choices to more healthy alternatives. He has stated he will attempt to make these changes in order to achieve a healthier future.
References
WebMD medicines
ATI
Healthy people heart disease n stroke
Healthy people nutrition and weight