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PES Assignment notes, Lab Reports of Dietetics

Problem, etiology, and symptoms notes.

Typology: Lab Reports

2021/2022

Uploaded on 09/12/2023

nayle-aranda
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FDNT 441: MNT 1 Name: Nayle Aranda
Assignment #6 /5 points
PES ASSIGNMENT
Please show all of your work.
1. 75-year-old woman admitted with Altered Mental Status/ UTI, PMH of Dementia
UBW per hospital records 150 lbs (past 2 admissions in last 3 months)
Actual body wt upon current admission: 135 lbs. Height: 5’ 6’’ PO intake < 50% meals x 3
days. Reports poor appetite at home “for months”
Write a PES statement for this patient. (2 pts)
Inadequate energy intake related to decreased appetite as evidenced by PO intake <50%
meals x 3 days. (NI.1.4)
Category Excellent
(2)
Acceptable
(1)
Needs Improvement
(0)
Score
/2
Nutrition
Diagnosis
Identify the priority
nutrition-related
problem(s). Writes the
PES statement utilizing the
nutrition care process
(NCP) language.
Identify an acceptable
nutritional problem.
Writes the PES statement
utilizing the nutrition care
process language with one
minor error.
Identify a nutritional
problem that is not
applicable to the patient
case. Writes the PES
statement utilizing the
nutrition care process
language with more than
one error or one major
error.
2. 58-year-old male 5’9” 184 lbs with history of type 2 diabetes. Complains of a decreased
appetite due to bloating and discomfort after eating for the last 5 months. He reports his
normal weight 5 months ago was 192 lbs.
Identify a Nutrition Diagnosis/Problem (P only) for this patient. (1 pt)
Inadequate oral food/beverage (NI.2.1)
3. Gary is a 47 year old black male. He is admitted with SOB and chest pain. He is a manager at
an automobile garage. He enjoys his job, but it is very stressful due to high task demand and
little time to fulfill the demand. He says he has also been worried and anxious recently due to
lack of staffing and changes in the economy increasing gas prices, and as such the number of
people who are buying cars. He is married with 2 children, one in high school and the other
in middle school. His wife works as a cashier in a food store and sometimes has to work
evenings. This increases Gary’s stress since he doesn’t know how to cook and the children
complain when he has tried. He often will buy ready-prepared foods or grab take out on the
way home. He has a history of HTN but has not been checking his BP as he should. He had a
routine physical recently and his BP was 175/100. His medication includes Capoten 50 mg
BID, Lasix 30 mg QOD. He has been on hypertensive medication for five years, with the
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FDNT 441: MNT 1 Name: Nayle Aranda Assignment #6 /5 points

PES ASSIGNMENT

Please show all of your work.

1. 75-year-old woman admitted with Altered Mental Status/ UTI, PMH of Dementia UBW per hospital records 150 lbs (past 2 admissions in last 3 months) Actual body wt upon current admission: 135 lbs. Height: 5’ 6’’ PO intake < 50% meals x 3 days. Reports poor appetite at home “for months” Write a PES statement for this patient. (2 pts) Inadequate energy intake related to decreased appetite as evidenced by PO intake <50% meals x 3 days. (NI.1.4) Category Excellent (2) Acceptable (1) Needs Improvement (0) Score / Nutrition Diagnosis Identify the priority nutrition-related problem(s). Writes the PES statement utilizing the nutrition care process (NCP) language. Identify an acceptable nutritional problem. Writes the PES statement utilizing the nutrition care process language with one minor error. Identify a nutritional problem that is not applicable to the patient case. Writes the PES statement utilizing the nutrition care process language with more than one error or one major error. 2. 58-year-old male 5’9” 184 lbs with history of type 2 diabetes. Complains of a decreased appetite due to bloating and discomfort after eating for the last 5 months. He reports his normal weight 5 months ago was 192 lbs. Identify a Nutrition Diagnosis/Problem (P only) for this patient. (1 pt) Inadequate oral food/beverage (NI.2.1) 3. Gary is a 47 year old black male. He is admitted with SOB and chest pain. He is a manager at an automobile garage. He enjoys his job, but it is very stressful due to high task demand and little time to fulfill the demand. He says he has also been worried and anxious recently due to lack of staffing and changes in the economy increasing gas prices, and as such the number of people who are buying cars. He is married with 2 children, one in high school and the other in middle school. His wife works as a cashier in a food store and sometimes has to work evenings. This increases Gary’s stress since he doesn’t know how to cook and the children complain when he has tried. He often will buy ready-prepared foods or grab take out on the way home. He has a history of HTN but has not been checking his BP as he should. He had a routine physical recently and his BP was 175/100. His medication includes Capoten 50 mg BID, Lasix 30 mg QOD. He has been on hypertensive medication for five years, with the

FDNT 441: MNT 1 Name: Nayle Aranda Assignment #6 /5 points dosages increasing slightly each year. Gary admits that he is not compliant with taking his medication because he usually feels fine and believes that he is too young to have high BP. His father died of a stroke and he has an uncle on his father’s side with renal failure secondary to untreated HTN. Gary is 5’10” and 222 lbs. He is moderately active. He has always been on the heavier side, but has noted a 20 lb weight gain in the past 2 years. The doctor has ordered an 2 g Na diet and RD consult for an assessment and education. Mr. G’s Diet Recall: Breakfast: 2 cups of coffee, Sausage gravy over biscuits Lunch: Sandwich with bologna, cheese, mustard and mayo, an apple, orange juice Dinner: Fried chicken, Potato wedges with sour cream, Green beans Snack: Salted peanuts, pretzels, and M&M’s Labs: Glucose = 80 mg/dl Cholesterol= 204 LDL= 160 HDL = 45 TG= 200 Write a PES Statement for this patient. (2 pts) Category Excellent (2) Acceptable (1) Needs Improvement (0) Score / Nutrition Diagnosis Identify the priority nutrition-related problem(s). Writes the PES statement utilizing the nutrition care process (NCP) language. Identify an acceptable nutritional problem. Writes the PES statement utilizing the nutrition care process language with one minor error. Identify a nutritional problem that is not applicable to the patient case. Writes the PES statement utilizing the nutrition care process language with more than one error or one major error. Excessive fat intake related to unrestricted diet order as evidenced by cholesterol, LDL, and triglycerides, and HDL reduced such as 204mg/dl, 160mg/dl, 200mg/dl, and 45mg/dl respectively. (NI.51.2)