Question

Mrs. Burwell is a 61-year-old black female with type 2 diabetes, hypertension, and obesity. She lives with her husband of 35 years and maintains a moderate amount of activity. Because their children are grown, many meals are consumed at restaurants. In the past, she has been unsuccessful in maintaining any weight losses. Her family history for coronary heart disease is positive. Her height is 5’4” and her weight is 250 lbs. Her medications are Diabenase (an oral diabetes medication that helps to control blood sugar levels), Dyazide (a water pill used to treat fluid retention and hypertension), Avapro (an ARB [angiotensin II receptor blocker] used to treat high blood pressure), and Premarin (conjugated estrogens, a drug used to treat the symptoms of menopause). At her check-up, the lab tests reveal: Triglycerides: 400 mg/dl (normal = <150 mg/dl) HDL cholesterol: 37 mg/dl (normal = >60 mg/dl) Fasting blood glucose: 178 mg/dl (normal = 70 – 100 mg/dl) Hemoglobin A1C: 7.8% (normal = <5.7% Total cholesterol: 253 mg/dl (normal = <200 mg/dl) LDL cholesterol: 185 mg/dl (normal = <100 mg/dl) a. What are Mrs. Burwell’s risk factors for coronary heart disease? b. What type of diet would you recommend for Mrs. Burwell? What additional information needs to be obtained before teaching about a new eating plan? c. What suggestions for restaurant eating will help Mrs. Burwell adhere to her new eating plan?

Answer 1

a) What are Mrs. Burwell’s risk factors for coronary heart disease?

Answer-Mrs .Burwell risk factors for coronary heart disease includes ,

* Her Age (61) simply getting older increases risk of damaged and narrowed arteries.

* Family history,her familiy history for coronary heart disease is positive.

* High blood pressure,she has the history of hypertension and she is on Dyazide  (a water pill used to treat fluid retention and hypertension), Avapro (an ARB [angiotensin II receptor blocker] used to treat high blood pressure)

* High blood cholestrol levels, her lab results shows Triglycerides: 400 mg/dl (normal = <150 mg/dl), Total cholesterol: 253 mg/dl (normal = <200 mg/dl) LDL cholesterol: 185 mg/dl (normal = <100 mg/dl) .

* Diabetes,she has the history of type 2 diabetes and Her medications are Diabenase (an oral diabetes medication that helps to control blood sugar levels)Mrs.Burwell  lab values shows Fasting blood glucose: 178 mg/dl (normal = 70 – 100 mg/dl) Hemoglobin A1C: 7.8% (normal = <5.7% Total cholesterol: 253 mg/dl (normal = <200 mg/dl) LDL cholesterol: 185 mg/dl (normal = <100 mg/dl).

* Over weight and obesity,Mrs.Burwell height  is 5'4 and herweight is 250 Ibs and she has the habit for resturant eating.

b.) What type of diet would you recommend for Mrs. Burwell?

Answer-Diet plan for Mrs.Burwell includes ,guide her to a Heart -Healty CAD diet.

* Limit unhealthy fats and sodium

* Avoid surgary and processed foods

* Choose whole grains

* Choose low-fat protein sources,like skinless chiken and fish

*Eat wide variety of fresh fruits and vegetables like walnut,almond,salmon,tomato,edammae,spinach,broccoli.

* Choose skim or low-fat dairy products and instruct her to avoiding foods that raise LDL cholstrol- namely those are rich satured fat,such as red meat,coconut oil,butter,cheese,and whole and 2 percent milk.

c) What additional information needs to be obtained before teaching about a new eating plan?

Answer-The additionl information given to Mrs.Burwell regarding path to improve health and how does what she eat affect her heart.The foods she eat can affect her weight, hormones and the health of her organs ,including heart.Eating healthy diet can help to reduce the risk of heart disease .Explain to her the imprtance of exercise. Exercise helps her to reduce weight and its makes heart stronger.Exercise can also lower blood pressure.It reduces risk of heart disease and reduces levels of LDL(bad cholestrol).At the same time ,exercise can raise levels of HDL (good cholestrol).When combined with a healthy diet ,exercise can speed up weight loss.

c.) What suggestions for restaurant eating will help Mrs. Burwell adhere to her new eating plan?

Answer-When ordering main meal for her in resturant ,go for fresh fish or lean meat,and avoid anything fried or sauteed.Although sauteed stir-fry may be a healthy option for her at home, in a resturant you have no control over how much high-calorie oil is used. Health education given to Mrs.Burwell regaring habit of restaurant eating , Eating at resturant dosent have to sabotage a healthy ....and choose foods carefully to keep you on your plan.