The MAIN GOAL IS FOR THIS PATIENT

The MAIN GOAL IS FOR THIS PATIENT TO LOSE WEIGHT. How would a dietitian be able to help this patient based on this case study? Keep in mind this patient : really does not have a lot of nutrition issues as he is marked as “controlled”. however. He has knee pain. Why is this? What can we do if someone has joint or knee pain? What is the first thing we should look at CHIEF COMPLAINT? CASE: RIGHT KNEE PAIN, GERIATRIC MALE CASE 59 CHIEF COMPLAINT “Right knee pain.” HISTORY OF PRESENt ILLNess A 65-year-old man with a history of hypertension and dyslipidemia presents with right knee pain. This is his first visit to the clinic. The patient states the knee has been painful for 6 months and is exacerbated by prolonged standing and walking, pivoting, and going from sitting to standing. He also complains of start-up pain and pain at night. The patient denies any knee snapping but does complain of an occasional audible grinding sensation in the right knee. The patient has tried massage therapy and ibuprofen with little to no benefit. He rates his pain is 10 of 10 today and 7 of 10 on most days. The patient complains of occasional popping and locking of the knee but no giving-away symptoms. The patient is community ambulatory but uses a three-prong cane due to his pain. REVIEW OF SYSTEMs The patient’s ROS is negative for fever, chills, vomiting, diarrhea, constipation, SOB, and chest pain. He denies any altered sensation or weakness of both extremities, any temperature changes to the feet, any recent illnesses or hospitalizations, and any radicular pain or paresthesia. RElEVANT HISTOrY The patient has a history of controlled hypertension and dyslipidemia. He uses CBD oil, drinks occasionally, and does not smoke. His family history is noncontributory. ALLErGIEs • No known drug allergies. No known food allergies. MedIcaTIons Lisinopril 40 mg 1 tablet PO QD Lovastatin 20 mg 1 tablet PO QD Ibuprofen 200 mg PRN for pain PHYSICAL EXAMINATION Vitals: T 6.5°C (97.7°F), P 64, R 20, BP 134/88, WT 142 kg (313 Ibs), HT 177.8 cm (70 in.), BMI 45. General: Morbidly obese male in no apparent distress. Musculoskeletal: Right knee range of motion is expressed in degrees; range of motion, actual/ normal-extension: 0/0; flexion: 130/130. Mild effusion. No skin lesions or abrasions. While standing, the patient has excessive varus alignment, which is not present on the contralateral leg. There is no patellofemoral crepitus or patellar instability. The patella tracks well clinically. There is no tenderness around the patellofemoral joint. Patellofemoral compression test is negative. The Q-angle is normal. There is no tenderness in the medial parapatellar region or painful medial patellar cord. The patient has no instability to varus/valgus test in full extension. SCIENCE HEALTH SCIENCE NURSING NUR 6512

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