Question

C.M. is an 89-year-old female who presents with her daughter to the provider’s office. The daughter is concerned because her mother has not been eating well.

Subjective Data

PMH: HTN, Hypothyroid
24-hour diet recall reveals approximately 1,100-calorie intake
Lives alone, daughter nearby
Does not drive
Daughter shops
Patient cooks light meals

Objective Data

Vital signs: T 37 P 72 R 12 BP 104/64
Weight: 105 lb
Weight last visit, 3 months ago: 115 lb
HT: 5 feet, 1 inch
Medications: Metoprolol 12.5 mg per day, Synthroid 0.75 mg per day
Oral mucosa dry, gums bleeding, dentures loose
Poor skin turgor

Questions

Develop a problems list. Differentiate from the objective and subjective data.

What two (2) nursing diagnoses can be derived from the problems list?

What should be included in the plan of care?

Calculate the patient’s body mass index.

How many calories a day does this patient need to maintain her current weight? Explain your answer.

Discuss three (3) laboratory studies that would help determine the patient’s nutritional status. Explain your answer.

Answer 1

1.Develop a problems list. Differentiate from the objective and subjective data.

The problem list including the subjective data and objective data it is seen that patient is having hypothyroidism with hypotension , so less blood pressure is low and dry oral mucose and poor appetite and poor skin texture etc these are the signs of the hypothyrodism.

2.What two (2) nursing diagnoses can be derived from the problems list?

Nursing diagnosis for the problems enlisted are :-

1.Imbalanced nutrition less than body requirement related to less metabolic rate

2.Impaired body temperature related to metabolic alteration

3.Ineffecti coping related to irritability , emotional instability

4. Low self esteem related to changes in appearance and weight gain.

5. Deficient knowledge regarding the relationship between the treatment regimen and control of disease process.

3.What should be included in the plan of care?

Plan of care includes:-

1.Teache the patient about the importance of drug Compliance.

2.Teachi the patient how to adjust to changing body temperature.

3. Providing emotional support and reliving anxiety

4. Providing information regarding the near by day care to avail for some help when she is alone in the house

5.Teaching the patient about the diet to be taken like less sodium diet ,less oily food intake etc .

4.Calculate the patient’s body mass index.

BMI is body mass index , its formula is :-

= Weight in kg / height in meter square

= Weight of the patient is 105lbs

1lbs =0.454kg

= 105×0.454kg = 47.6kg

Height of the patient is 5feet 1inch

= 1.549m

BMI = 47.6kg / 1.549m× 1.549m

= 19.9 kg / meter square

5)How many calories a day does this patient need to maintain her current weight? Explain your answer.

1,600 calories a day to maintain weight,

89 year old female with active disease condition of Hypertension and Hypothyroidism seems to have a sedentary life style which requires approximately 1600 calorie intake,but her calorie intake is less by approximately by 500 calorie. So this has to be taken in consideration for her healthy lifestyle.

Therefore a dietary requirement plan has to be planned and implemented to get better outcomes

6)Discuss three (3) laboratory studies that would help determine the patient’s nutritional status. Explain your answer.

Laboratory examines to determine the patients nutritional status is serum proteins like albumin, prealbumin, transferrin and retinol binding protein to ,measure malnutrition, c reactive protein, total lymphocyte count and serum total cholesterol etc.