Question

Case Study #9 – Obesity and Eating Disorders

CC: “I hate being fat.” Client history: CC is a 43-year-old mother of three who has experienced gradual weight gain after the birth of each of her children. She is 5 ft 7 in tall, weighs 189 pounds, works full time, and does not engage in regular exercise. She is considered pre- diabetic and has prehypertension and appears eager to make lifestyle changes to improve her health and be a better nutritional role model for her children. She has successfully lost weight in the past through Weight Watchers but eventually got bored and regained all of the weight she lost. She does not want to count calories. She wants to know how many servings from each food group she should eat to lose weight and what the best foods from each group are. Her usual intake is as follows: no breakfast; snacks at a vending machine twice a day; fast food for lunch; and dinner with the family. Her dinner usually consists of about 6 oz of meat, potatoes, sometimes a vegetable, bread with butter, and dessert. CC admits to a weakness for “sweets.”

■ What is CC’s weight status based on her BMI?

■ What additional information about her eating behaviors would be helpful?

■ What MyPlate calorie level would you recommend for her?

■ What food groups does she need to consume more of? Less of? What would you tell her about the “best” foods from each group?

■ Create a nursing care plan complete with nursing diagnosis, client goal, interventions, and monitoring recommendations.

■ Devise a meal pattern with the calorie allowance you recommend; include three meals per day and two snacks. Prepare a sample menu.

■ What behavioral strategies would you recommend for her?

Answer 1

■ What is CC’s weight status based on her BMI?

5 ft 7 in tall, weighs 189 pounds

BMI: 29.6

25 to 30:

Overweight (29.6)

■ What additional information about her eating behaviors would be helpful?

Reduce interest towards sweets and take less sodium intake. Reduce usage of butter.

■ What MyPlate calorie level would you recommend for her?

• Fill half of your plate with vegetables like spinach, carrots and tomatoes.

• Protein a fifth of your plate, such as fish, lean pork or chicken.

• Fill the last quarter with whole-grain foods, such as brown rice or starchy vegetables, such as green peas.

• Contain small quantities of "healthy" fats, such as nuts or avocados.

• Add a fruit or dairy serving

■ What food groups does she need to consume more of? Less of? What would you tell her about the “best” foods from each group?

Let those healthy foods count on your calories. Select balanced carbs, foods rich in protein, fish and "strong" fats.

Hydrocarbons Stable

The sugars (simple carbohydrates) and starches (complex carbohydrates) break down through blood glucose throughout digestion. Focus on sound carbohydrates, like:

• Fruits

• Veggies

• Full grain

• Legumes, including beans and peas

Diets high in fibre

Dietary fiber includes all plant food parts which your body can not digest or absorb. Fiber regulates how the body digests and assists in regulating blood sugar. Foods which are high in fiber include:

• Veggies

• Outfits

• Muzzles

• Legumes, including beans and peas

• Full grain

Healthy-heartfish

· Eat heart-healthy fish twice a week or more. Fish like salmon , mackerel, tuna, and sardines are high in fatty omega-3 acids that can prevent heart disease.

· Evite fried seafood and high-mercury shrimp, such as king mackerel.

·

Fats 'Nice'

Aliments containing monounsaturated and polyunsaturated fats can help to lower the cholesterol levels. Includes:

• The Avocados

• Muzzles

• Canola, almond, and olive oil

Foods to avoid

· Through promoting the production of clogged and damaged arteries, diabetes raises the risk of heart failure and strokes. Foods that contain the following will work against your heart-healthy dietary target.

· Saturated lipids. Stop high-fat dairy foods and animal proteins including butter, beef, hot dogs, bacon and sausage. Ban coconut and oils from the palm kernel too.

· Cholesterol • Cholesterol. The sources of cholesterol include high-fat dairy products and high-fat animal proteins, yolks of eggs, liver and other organ meats. Obtain no more than 200 milligrams ( mg) a day of cholesterol.

· Soda. Look for under 2,300 mg of sodium a day. When you have high blood pressure, your doctor may recommend that you strive for even less.

■ Create a nursing care plan complete with nursing diagnosis, client goal, interventions, and monitoring recommendations.

Hypertension targets for nursing care include focusing on reducing or regulating blood pressure, adherence to the treatment regimen, dietary changes, and complication prevention.

1. Chance for decreased cardiac output

2. Intolerance of behaviors

3. Nutrition Imbalance: More than body needs

4.. Lack of Knowledge

Risk for unstable blood glucose

Risk for infection

■ Devise a meal pattern with the calorie allowance you recommend; include three meals per day and two snacks. Prepare a sample menu.

Breakfast: 2 Protein + 1 Fruit (+ vegetables if you wish) + 1 Starch / Grain

Snack: Snack of 1 protein

Lunch: 2 Protein + 2 Leafy Greens + 1 Starch / Grain + 1 Enhancer + 1 Fruit

Snack: 1 Protein Snack + 1 Vegetable or Fruit

Dinner: 2 Protein + 2 Starch / Grain + 2 Vegetables + Greens Leafy + 2 Enhancer Taste

1 Fruit Snack:

Totals of daily use: 6 protein, 3-4 meat, 5-6 vegetables

■ What behavioral strategies would you recommend for her?

· • This will earn no more than 1,500 milligrams of sodium a day as prehypertensive. This is less than a spoonful of teas.

· • "Visualize your plate as a clock" to get used to a healthy diet. Fill half your plate with fruits and vegetables. A fifth, like baked cod, beans or chicken, gets lean protein. The last fifth, like brown rice, contains grains, ideally whole.

· • Whole grains are rich in vitamins and minerals, plus fiber that keeps you full and helps keep blood sugar stable. Obtain three to five grain servings per day, and render at least half of those whole grain servings.

· • Saturated fats, such as chicken, butter and cheese skin-on, can make up less than 10% of your daily calories.

· • Evite trans fats — partially hydrogenated oils used in fried foods and baked goods. Then restrict saturated fats, found mainly in fatty cuttings of meat and whole-fat dairy products. "These unhealthy fats are both related to elevated cholesterol, leading to heart disease," says Armul.

· • “The best thing you can do to change your diet is be accountable,” Keep a food diary or smartphone app to track your eating habits, or regularly check in with a family member or friend.

• Bananas form a strong potassium supply. Those include cantaloupe, broccoli, rough carrots, lentils, onions, whole wheat bread, bran flakes, and nuts