Question

In: Nursing

Jasmine is a 65-year-old, non-smoker Hispanic female who is referred by her physician to see you...

Jasmine is a 65-year-old, non-smoker Hispanic female who is referred by her physician to see you for management of her Type 2 diabetes. She complains of increasing numbness in her feet and occasionally in her fingers, and frequent urination during the day and overnight. She was diagnosed with diabetes type 2 about 10 year ago and has been on metformin drug. However, she was not taking her medicine regularly as she thinks it wasn’t necessary. From interviewing her and reviewing her health record, you learn the following about her:

Education: Low education level (8th standard).

Occupation: Not employed outside the home, babysits infant grandchild on a daily basis

Household Members: Lives with her husband and with one of her four adult children.

Ethnic Background: Latin American, born in Mexico.

Religious Affiliation: Catholic

Language: Native Spanish, speaks English – has difficulty reading English

Patient History: Weighed more than 9 lb at birth.

Family history: Mother had type 2 diabetes

Medical History: Type 2 diabetes, hypertension, hyperlipidemia, hypothyroidism, episodic migraines

Physical exam shows the following:

Weight: 201 lbs.

Height: 5’2” inches,

Temp: 98.6 F

BP: 143/88 mm Hg

Heart rate; 80 bpm

Labs: A1C 9.8%; Total cholesterol 144 mg/dL, LDL 116 mg/dL, HDL 54 mg/dL; Triglycerides (TG) 545 mg/dL.

Recommended lab values

HbA1c

< 7.0%

BP

< 140/90 mmHg

LDL-C

< 100 mg/dL)

TG

< 150 mg/dL

HDL-C

> 40 mg/dL in men

> 50 mg/dL in women

Nutritional history

General: Good appetite, with wide consumption of foods and beverages. She plans and prepares meals for the household.

Performed a 24-hour diet recall.

Breakfast: coffee with milk and sugar (several spoons) + sweet bread 3 to 4 pieces

Lunch: chicken and vegetable soup, home-prepared fruit juice (1-2 x 16ounce glass) + soft drink

Dinner: Largest meal – chicken/beef, rice (2 cups) and beans (1½ - 2 cups), 1 corn tortillas (4-6), home-prepared fruit juice (1-2 x16 ounce glass) + soft drink

Afternoon snack: 1 can “natural” cola 1 3 to 4 sugar-free cookies

Evening snack: Cookies + soft drinks

Food allergies/intolerances/aversions: None

Question 1: Based on above case study, answer the following questions. (Total 9 marks)

A. Write three Nutrition diagnostic statements (PES) for Jasmine as instructed below:

One PES from intake domain

One PES from medical domain

One PES from behavioral and environmental

B. Write one Goal for each PES statement, based on signs and symptoms.

Expert Solution

Write three Nutrition diagnostic statements (PES) for Jasmine as instructed below:

One PES from intake domain

Imbalanced nutrition more than body requirement related to excessive intake and lack of physical exercise as evidenced by excessive body weight of 201 ibs.

Goal: Patient maintains a well balanced nutrition pattern as per bodys requirement as evidenced by achieving a healthy weight within the normal range.

One PES from medical domain

Ineffective therapeutic regimen management related to knowledge deficit of prescribed regimen as evidenced by verbalization of not taking the medications.

Goal: Patient describes, the understanding of importance of following the medication regimen as evidenced by follow the prescribed medications on time.

One PES from behavioral and environmental

Ineffective health maintenance related to impaired decision making as evidenced by failure to take actions necessary for reducing the associated risks.

Goal: Patient maintains an effective health management regimen by following helathy behaviours to improve health as evidenced by daily practising physical therapy, reducing the excess intake etc.

Nightingale answered 1 year ago

Chablis is a 14 year-old female who has been referred to you by her mother and...

Chablis is a 14 year-old female who has been referred to you by her mother and family physician. Chablis’ mom is concerned that she is not eating right and her doctor wants you to give Chablis some nutrition advice because she wants to be a vegetarian. Chablis has heard that red meat contains a lot of fat and she “does not want to get fat.” A physical test by her physician shows that Chablis is in the early stage of...

You are caring for a 59-year-old African American male who is a non-smoker and a non-drinker....

You are caring for a 59-year-old African American male who is a non-smoker and a non-drinker. The individual has a healthy weight for his height. On weekends, he coaches a youth baseball team in his community and enjoys eating hot dogs and nachos with the children after games. He has been monitoring his blood pressure at the community center and noted that the highest reading was 168/92 mm Hg. He is pleased with this number, as the results were "lower...

Jane is a 69-year-old black, married, retired female who lives with her husband. She was referred...

Jane is a 69-year-old black, married, retired female who lives with her husband. She was referred to you for individual counseling to work on severe anxiety and moderate depression. Jane's physical health has been declining after injuring her knee a year ago. Jane has been doing water aerobics weekly, and was working a part-time job and active in her prior to the onset of the medical problem. Jane underwent surgery to repair the injury, however, she still reports weakness and...

Case Scenario for CNS-Brain Cancer This is a case of a 45-year-old female, smoker, non-diabetic, non-hypertensive...

Case Scenario for CNS-Brain Cancer This is a case of a 45-year-old female, smoker, non-diabetic, non-hypertensive who was having on and off headache for 5 months prior to consult (April, 2015), this is associated with nausea and vomiting. The headache was becoming recurrent until August of 2015 she decided to consult her doctor. Aside from nausea and vomiting, symptoms include weakness of the left side of the body and numbness and tingling sensation. Apparently, complete neurological examination was done and...

Ms. Y. is a 31-year-old female who reported to her physician that she has recently lost...

Ms. Y. is a 31-year-old female who reported to her physician that she has recently lost weight, always seems tired, and has experienced night sweats. A few months ago she had noticed a small firm lump on her neck that was painless and not tender, so she ignored it. Closer physical examination revealed swelling of several lymph nodes in the neck and throat region. A blood test indicated a decreased lymphocyte count and a lymph node biopsy revealed the presence...

A middle aged female patient was referred to her primary physician for a lipid evaluation by...

A middle aged female patient was referred to her primary physician for a lipid evaluation by her dermatologist after she developed a papular rash over her trunk and arms. The rash consisted of multiple, red, raised lesions with yellow centers. She has no previous history of such a rash and no family history of lipid disorders or CHD. She is on a standard estrogen replacement therapy as she is postmenopausal, otherwise she is healthy. Lab work for her lipid evaluation...

I. Assessment: AB, 65-year-old African American female, who was admitted for generalized weakness and pain in her...

I. Assessment: AB, 65-year-old African American female, who was admitted for generalized weakness and pain in her right foot. Vital Signs: T - 38.6 oral; P- 110 apical; R- 22; BP- 165/75 LUE, manual, sitting; Sp02 – 96% on RA. AB is awake, alert, and orientated x4. AB appears to be uncomfortable. AB denies any numbness or tingling. Her skin is appropriate for ethnicity and is warm to the touch. She is tachycardiac, rate of 110 and regular. Pedal pulses are...

A 27-year old white female presented her self at her local physician on August 15. On...

A 27-year old white female presented her self at her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender abdomen and complained of headache, stiff neck and backache with diarrhea. The physician noted an irregular heartbeat. The patient complained of lack of ability to concentrate. The patient gave the following history: She is a graduate student in the wildlife program at the University in her town. She was in...

RB is a 35-year-old female who has recently married. She comes to see her primary provider...

RB is a 35-year-old female who has recently married. She comes to see her primary provider to discuss the possibility of becoming pregnant. RB would like to know how to tell when she would be most likely to conceive. Question: Describe what happens during the endometrial cycle. You will need to defend your answer using specific facts, data

Case Study: Mitral Stenosis Patient Profile L.S. is a 59-year-old female who goes to see her...

Case Study: Mitral Stenosis Patient Profile L.S. is a 59-year-old female who goes to see her primary care provider because of increasing fatigue and shortness of breath with activity. She has a history of hypertension, hypothyroidism, rheumatoid arthritis, and rheumatic fever as a child. She is taking the following medications: Triamterene/hydrochlorothiazide 37.5/25 mg PO daily Levothyroxine 150 mcg PO daily Methotrexate 15 mg PO every Sunday Subjective Data Does not exercise, but was always able to do daily activities such...