Anne Morell is a seventy-four year old female with a past medical history of hyperlidemia, hypertension, osteoarthritis, osteoporosis, diabetes mellitus type 2, renal insufficiency, Charcot foot, and osteomosteomyeltits. Anne has a history of osteosarcoma treated in 1996 with surgery, chemotherapy and radiation. Anne also has a history of breast cancer, diagnosis in 2003 treated with radiation therapy. Anne past surgical history includes tonsillectomy in 1962, removal if osteosarcoma of left thigh in 1996 and lumpectomy of left breast in 2003. On assessment, Anne’s reported height is 5’1” and weighs one hundred ninety one pounds. Based on Anne’s BMI, Anne is obese. Anne reports difficulty to adhere to a low carbohydrate diet and previous unsuccessful attempts at weight loss due to impaired physical mobility. A Mini Nutritional Assessment (MNA) was completed on Anne. The MNA is a tool used to provide a rapid assessment of elderly patients’ nutritional status. The MNA is made up of simple measurements and a few brief questions that can be completed by the patient in no more than ten minutes. The nutritional status of a patient is evaluated using a two-step process to accurately determine a patient’s nutritional status (McGee …show more content…
Anne is a seventy-four year old female with multiple comorbidities. The patient I interviewed is a sixty five year old male with a past medical history of hypothyroidism and no other reported medical conditions. Additionally, Anne requires assistance with completing her activities of daily living such as shopping, transportation and managing her finances. Also she rarely leaves her home, and is inactive due to chronic pain. The patient I interviewed is able to care for himself independently and is rather active. The patient I interviewed continues to work outside his home and routinely
The case of Anne Gunter fits the modern stereotype of witchcraft accusations and the trials that resulted from them; a young girl falsely claims that an older woman or women are causing her harm using supernatural abilities they have gained through nefarious means, sending the community into an uproar. Hysteria runs rampant through the community and the poor women are harshly punished – the formulaic story plays out similarly throughout popular media, must notably in Arthur Millers’ ‘The Crucible’. Yet in the case of young Anne Gunter from North Moreton, there is a deviation from the “standard plot” of a witchcraft trial – the women are acquitted and Miss Gunter’s subterfuge is revealed. The fact that the allegations are not only proven to be false, but a confession of such is given by Anne Gunter allows the focus to shift from the actual Gunter case to what factors played into why people were accused of witchcraft. What we can infer from the Gunter case is that people in England were accused of witchcraft because of three major things: lack of power, prestige, and plenty within society.
Cynthia is a 65 year old African American female diagnosed with type 2 diabetes mellitus, diabetic peripheral neuropathy, hypertension, kidney disease, hyperlipidemia and hypothyroidism.
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning urination, and decreased urine output for three days. Upon admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings.
In the United States, nutrition screening is a part of inpatient admission. The Joint Commission requires a nutritional screening to be completed within 24 hours of inpatient admission (Treas & Willkinson, 2014). Proper nutrition is important for staying healthy and is particularly vital for the elderly. For the purpose of this week discussion this learner will concentrate on explaining the health status of a 81 year old patient who presented at the primary care for a routine visit. We observed the patient height is around 72 inches and weight is 135 ponds. We will calculate the patient Body mass index (BMI) and interpret the result. In addition two specific assessments will be perform and included the rationale for each one.
The registered dietitian completes an assessment within 72 hours of admission and initiates appropriate intervention and goals based ion signs/symptoms of altered nutritional status to achieve desired outcomes. The RD interviews patients to obtain diet history, oral intake, food allergies, cultural/religious preference and other pertinent information needed.
Explanation: Answer A is incorrect as patient does not have a problem with eating excessive amount of food in a short period of time then induced vomiting, and her BMI is < 18. Answer B is correct as patient meets the DSM criteria for
MUST is a five-step screening tool designed for healthcare professionals to identify adult patients who at risk of, or are malnourished. It includes guidelines on how to develop an effective treatment plan. The Malnutrition Advisory Group (MAG) in 2000 adapted and extended their community screening tool to include care homes and hospitals, in response to national concerns. (Department of Health, 2001). In 2003 MUST was designed by MAG and the British Association for Parenteral and Enteral Nutrition (BAPEN). It was piloted across many care settings, to target patients who may be at risk of malnutrition.
As dental professionals it is our job to provide nutritional counseling to increase the patient’s awareness to make better choices in regards to nutrition. After
Ultimately, these physiological changes result in different nutritional needs for the elderly. The Food and Nutrition Board of the National Academy of Sciences issues the Recommended Daily Allowances for healthy people over the age of 51. However, these RDAs are limited in that they have been derived from studies of younger, healthy populations and do not account ...
The information is somewhat dated, but additional studies are currently being conducted and more recent studies show slightly different variables. This article would be very useful to dieticians, nutritionists, and therapists in nursing rehabilitation.
The three dietary assessment methods, 24-hour recall, three-day food diary, and NHANES food frequency questionnaire, share
Two dietary assessment methods that are commonly used to determine an individual’s dietary intake include “food record” and “24-hour recall.” The food record method involves the individual tracking and recording the type and amount of food he or she consumes throughout the day. The 24-hour recall method involves the individual recalling a day’s worth of food he or she has consumed and is dependent on the individual’s memory. According to the National Cancer Institute “A key feature of the 24HR is that, when appropriate, the respondent is asked for more detailed information than first reported. For example, a respondent reporting chicken for dinner or a sandwich for lunch would be asked about the preparation method and type of bread. This open-ended
There is a body of literature on physical status and nutrition intake in the elderly that has looked at functional status as a predictor of nutrition intake, and conversely, nutrition intake as a predictor of functional status (An, et al, 2015; Evans et al, 2010; Brewer et al, 2010; Ribeiro, et al., 2016; Shikany et al, 2013; Ziliak, Gundersen, & Haist, 2008). For example, adequate nutrient intake can reduce the effects of functional limitations in the elderly, and conversely, undernutrition can increase risks of physical, mental, and social impairment (Kleinpell et al, 2008; Sharkey et al, 2003). Moreover, as the number of functional limitations increases the risks of poor nutritional intake increase among the elderly (Bartali et al, 2003).
There are several methods to assess nutritional status, including dietary, laboratory, and anthropometric and clinical methods. These methods are useful to identify each stage in the development of a nutritional deficiency state. Anthropometry is the “single most universally applicable, inexpensive, and non-invasive method available to assess the size, proportions, and composition of the human body” . Anthropometric measurements are able to detect chronic imbalance of protein and energy, such as malnutrition, but are unable to pinpoint a specific nutritional deficiency. These measurements would need to be assessed appropriately according to factors such as age, sex and degree of nutrition. Furthermore, measurements are easily, quickly and reliably performed using portable equipment, with results often expressed as an index (Gibson, 2005).
Nutritional assessment mainly depends on nutrients, foods and eating habits. It also depends on body composition which reflects calorie and protein needs. Nutritional statues calculates morbidity, mortality, length of stay etc of the respondents. Baseline body composition and biochemical indicators determine if nutrition support is effective includes height, weight, unintentional weight loss and change in appetite and serum albumin loss. Data used to determine respondent’s nutritional risk and the need for a detailed assessment. Nutrition care plan developed to reflect calorie, protein and other nutrient needs from the information collected, implement plan, monitoring and revise as needed (Wrieden, et.al,