TOPIC : Management of Abruptio Placenta Purpose The purpose of
Nutritional Care Plan for a Patient with Type 2 Diabetes in adulthood This case study focuses on a 68-year-old Hispanic woman named Maria Hernandez, who is living with type 2 diabetes. Type 2 diabetes occurs when blood sugar levels rise due to issues with how the body uses or produces insulin. Nutrition Issues: Decreased appetite and poor nutrient intake due to factors like reduced sense of smell/taste, dental issues, and reduced gastric motility. Malnutrition, including protein-energy malnutrition and micronutrient deficiencies Dehydration Increased risk of chronic conditions like type 2 diabetes, hypertension, and cardiovascular disease Decreased absorption and utilization of certain nutrients (e.g., vitamin B12, calcium, vitamin D). ABCD Nutritional Assessment: Anthropometrics: Height: 162 cm (5’4″), Weight: 78 kg (172 lbs), BMI: 29.7 kg/m^2 (overweight), Waist circumference: 98 cm (38.6 inches) Biochemical: HbA1c: 8.2% (indicates poorly controlled diabetes), Fasting blood glucose: 158 mg/dL, Lipid profile: Total cholesterol 212 mg/dL, LDL 135 mg/dL, HDL 42 mg/dL, Triglycerides 175 mg/dL Clinical assement: Decreased visual acuity and hearing Edema in lower extremities Impaired mobility and balance Frequent urination and increased thirst Dietary Intake assement: Tends to skip meals, especially breakfast Limited intake of fruits, vegetables, and whole grains Consumes high-carbohydrate, high-fat foods like white bread, pasta, and fried snacks Drinks 2-3 cans of regular soda per day Takes a daily multivitamin supplement Medications: Metformin 500 mg twice daily for type 2 diabetes Lisinopril 10 mg once daily for hypertension Atorvastatin 20 mg once daily for hyperlipidemia Potential Herb/Nutrient/Drug Interactions: Metformin may decrease the absorption of vitamin B12 and folate Atorvastatin may decrease the absorption of CoQ10 Cultural and Socioeconomic Factors: Maria is a Hispanic woman living alone on a fixed income from social security and a small pension She lives in a low-income senior housing community and relies on public transportation She has limited access to affordable, nutrient-dense foods and struggles to prepare meals due to her physical limitations Nutritional Care Plan Goals: Improve glycemic control and reduce the risk of diabetes-related complications. Promote optimal nutritional status and healthy body weight. Enhance quality of life and independence through dietary and lifestyle modifications. Interventions/ Nutrition Counseling: Educate Maria on the importance of consuming a balanced, nutrient-dense diet for diabetes management and overall health. Provide guidance on appropriate portion sizes, meal planning, and food preparation techniques that accommodate her physical limitations. Recommend increasing the intake of fiber-rich foods, lean proteins, and healthy fats, while limiting added sugars and refined carbohydrates. Encourage the consumption of water and other non-caloric beverages to stay hydrated. Meal Assistance: Enroll Maria in a local meal delivery service or community-based meal program to ensure she has access to nutritious, balanced meals. Provide information on community resources, such as food pantries and meal preparation assistance, to support her nutritional needs. Supplement Recommendation: Recommend a vitamin B12 supplement to address the potential malabsorption caused by her metformin medication. Suggest a CoQ10 supplement to mitigate the potential side effects of her statin medication. Physical Activity Promotion: Collaborate with a physical therapist to develop a safe and feasible exercise plan that considers Maria’s mobility and balance issues. Encourage activities that improve her strength, flexibility, and cardiovascular health, such as chair-based exercises or low-impact activities. Psychosocial Support: Refer Maria to a social worker or community support group to address any social isolation, depression, or financial concerns that may impact her ability to access and consume a healthy diet. Provide education and resources to help Maria overcome any cultural barriers or misconceptions related to her dietary needs. Task 1: make a nutritional care plan for your client. This will include an evaluation of nutritional risk, a list of interventions, and a list of expected outcomes. List the goals of medical nutrition therapy for your patient and suggest an appropriate diet. Does your patient/client require a dietary modification of their regular diet? Are enteral feedings by tube necessary? If so, what formula will you use and why? Describe your recommended method of administration. Task 2: Describe your nutrition education teaching session with your patient and/or their family. What teaching methods will you use (explanation, discussion, demonstration, handouts, etc.)? make a detailing three specific points that you will need to teach your patient about his/her new diet. In addition, give at least one tip to avoid potential herb/nutrient/drug interactions.
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