Case Study CVD on pt ZD 11-3-11

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Put that she ate fine before surgery Diet: regular Don't need to calculate the weight change Don't need to put the HDL, LDL because its an inpatient setting...too late had the surgery If you use adjusted weight don't go too low on calories 25-27 range Or use actual weight and go low in calories - 20-22 range Protein needs are high for wound healing, with actual weight use 1.2, if adjusted weigh use 1.4 Put Alb if there is a measure @ adm b/c we need to look if it was OK before the surgery If there is fluid issues do not estimate - "Fluids per MD" Intervention: Change diet from regular to 2 gm Na Recommend fluid restriction Nutrition Education Beneprotein BID (1 packet twice a day of protein) Need to address the problem. Three PES statements: 1. Increase protein needs RT wound healing AEB est intake is less than estimated requirement 2. Food and nutrition related knowledge deficit RT (related to) lack of education AEB diet history and cholesterol levels 3. Unintended weight gain related to recent surgery AEB edema and 11# weight change Goal: Meeting nutrient needs M/E: Intake (indicator) greater than 80% of meals and supplements (criteria) Extent of knowledge (indicator) pt verbalized understanding of diet (criteria) Case Study HW: type 1 diabetes - treated with insulin, blood glucose is spiking in the night, needs a bed time snack type 2 - CHO needs to be distributed evenly throughout day