Case study Annie Questions and Answers

Case study Annie Questions and Answers medical history -80 years old -Female -hypertension -diabetes -complications of cardiac heart disease and neuropathy -diabetic retinopathy (legally blind) -are you taking any medications? -do you have any injuries? -do you exercise at all? psychosocial history -widowed -lives alone -relationship with daughter -do you eat alone? -who do you see and interact with frequently? anthropometric assessment -5 ft 5 inches -170 lbs -pulse: 82 -BP 150/90 -BMI 28.3 (overweight) -7.6% weight loss in last 5 months -how do you think you lost this weight? biochemical what is your? -cholesterol -LDL -HDL -glucose level -eyesight dietary assessment -receives meals on wheels -not compliant with diet, but takes insulin -why aren't you compliant with your diet? -what does your meals on wheels consist of? -what foods does your daughter buy for you? -do you eat any snacks throughout the day? -what is your normal day's intake? -how do you normally cook your food? -do you add additional sodium, oil, or fat? -do any cultural, religious, or ethnic considerations influence your eating habit? -do you use any vitamins, minerals, or nutritional supplements? if so, how much, which ones, and why are they taken? -do you use alcohol, tobacco, or caffeine? -how is your appetite? -how much water do you drink daily? diagnosis -imbalanced nutrition -overweight with hypertension -noncompliance as evidence by failure to adhere to diabetic diet planning the client will: -attain a healthy weight -consume, on average, a varied, balanced and healthy diet that meets the recommended nutrients for a client her age trying to return to a healthy weight according to MyPlate -implement low cholesterol, low sodium changes to her intake, without compromising nutritional or caloric adequacy -inform Meals on Wheels to only provide her with meals specific to these guidelines -inform her daughter to buy groceries that abide these guidelines -exercise more often -keep blood glucose levels as normal as possible -decrease blood pressure -lose 5 pounds in 2 months nursing interventions (nutrition therapy) -encourage a varied, balanced, and healthy diet that meets the recommended number of calories for a client her age trying to return to healthy weight according to MyPlate nursing interventions (client teaching) instruct the client on: -the importance of nutrition in maintaining health and quality of life -a balanced diet on major food groups -sodium intake recommendations varies on individual basis and client's health -importance of meeting new nutritional requirements and sustaining from high fat and sodium based on MyPlate recommendations -eating plan essentials -skipping a food group may increase risk of nutritional deficiencies -drink adequate fluid amounts -eating high fiber foods -physical activity goals that may help improve appetite and intake evaluation -monitor weight and BP -provide periodic feedback and reinforcement on food intake and questions about diet -report any additional pain/problems that arise