NHM 365 I

Module 1 Case Study Worksheet

Name: Vasundhara Dambal

Instructions:
1. Review the Module 1 Case Study Presentation [PPTX] linked in Blackboard in
Module 1.
2. Type your answers into this document and upload the completed assignment to
Blackboard. Reminder: This is an individual assignment and is not to be
completed as a group. Be sure to show your work for full credit.

Answer the following questions:

1. In addition to the information provided above, list 3 additional pieces of

information you would collect as part of your nutrition assessment. (3 pts)

 I would request for more detailed medical history, Description of physical

problems or chief complaints, anthropometric measurements.
 Any allergies intolerances, Alcohol drug use or any psychosocial factors
that may influence nutritional intake.
 Patients typical food pattern including specific food selection and
aversions.
 Any cultural or religious dietary practices.

2. Calculate DL’s BMI, and interpret according to the WHO categories.

Show your work, and report BMI to 1 decimal place. (2 pts)

175lbs/2.2 = 79.55 kg
BMI =weight in kg/m2 =79.55/(1.5748)2 =32.1
BMI (according to WHO categories) = Class 1 Obesity

3. Calculate DL’s %IBW using the Hamwi method, %UBW, and % wt change over
the past two years. Be sure to show your work. (3 pts)

Hamwi Formula =Women = 100 lb. for 5 ft + 5 lb. for every inch over 5 feet

100lb+5lbx2=110 lb = Ideal body weight

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% IBW = (ABW x IBW)/100 175lb/110lb = 1.59x100 = 159%

%IBW = 159%

%UBW = (ABW/UBW) x100= (175/155) x 100 = 112.9%

%wt. change =(UBW-ABW/UBW) x 100 = [( 175-155)/155] x100 = 12.9%

4. Calculate DL’s REE using the Mifflin St. Jeor Equation. Apply an Activity
Factor of 1.2 (sedentary) to approximate TEE. Subtract 500kcals per day for
recommended energy intake for weight loss goal. (Show your work. Remember,
these equations use weight in kg and height in cm). (2 pts)

Mifflin St. Jeor Equation:

REE for women: 10 x weight (kg) + 6.25 x height (cm) – 5 x Age – 161
REE = 10 x (175/2.2) + (6.25 x 62 x 2.54) – 5 x 44 – 161
REE = 1398.7
TEE = 1398.7 X 2 = 1678.4
Recommended daily energy intake for weight loss = 1178.4

5. Complete the chart below with the purpose of each medication for this pt: (3 pts)

Medication Condition this medication was prescribed to treat

omeprazole Gastrointestinal Reflux Disease

hydrochlorothiazide
Hypertension

simvastatin Hyperlipidemia
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NHM 365 I

glyburide
Diabetes

6. DL is also taking potassium chloride to prevent hypokalemia. Which of her

medications would most likely put her at risk for hypokalemia? (1 pt)
 Hydrochlorothiazide-This drug increases urinary excretion of potassium.

7. Identify any labs outside of normal range. (1 pt)

Glucose
HbA1C
Total Cholesterol
LDL-c
HDL-c
Total Triglycerides

8. Based on this nutrition assessment, write two PES statements for this patient. (3
pts)

 Obesity (NC-3.3.3) related to Physical inactivity (NB.2.1) as evidenced by

BMI and weight gain (NC-3.4).
 Excessive fat intake (NI-5.5.2) related to consumption of processed and
fast foods as evidenced by Hyperlipidemia and diet history.

9. For each PES statement, identify a goal for the patient. (2 pts)

 Increase physical activity. Follow recommended energy intake for weight

loss of 1lb per week until BMI of 24.9 is reached.
 Reduce the intake of fried and processed food to lower the cholesterol
levels.

10. For each goal, write an intervention plan to help her meet the goal. (3 pts)
Check yourself - Be sure each recommendation addresses the etiology (or at least
the s/s) of your PES statement.
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NHM 365 V

 Include 150 minutes of moderate intensity aerobic physical activity or at

least 75 minutes of vigorous intensity aerobic physical activity spread
throughout the week
 Incorporate home bought meals with minimum fat intake of 20% to 35%
from total calories

11. You schedule an outpatient follow-up visit for two weeks after discharge. What
will you assess during that follow-up visit to see if DL is progressing toward each
goal? (2 pts)

For my follow up visit I will monitor patients BMI and any changes noted from
the previous recorded weight. And for my second goal I will check for cholesterol
levels. The patient will be progressing toward each goal if there is any weight loss
and lower cholesterol levels measured on the day of the follow up visit.
Check yourself - Does your plan for monitoring relate back to s/s of PES
statement?

Sample documentation of a clinical case:

PES Statement Goal Intervention Monitoring/Evaluation

Improve caloric Monitor trays daily to
Inadequate Try oral supplements to
intake to stop determine if supplement is
energy intake determine patient
weight loss. being consumed.
related to preference and evaluate
Institute 3-day calorie counts.
dementia and acceptance. If patient
Weight gain of Weigh patient twice weekly.
poor appetite as enjoys supplement,
1-2 lbs/week
evidenced by diet provide Ensure Plus bid
until BMI of
history and with breakfast and
19.0 is reached.
recent dinner to provide an
unintentional additional 711 kcal/day.
weight loss