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Referred for: CVD diet consult

Food and Nutrition Related History: Pt, reports avoiding corn and seeds due to diverticulitis Pt. does not follow a diet at home and reports not believing she needs to be on a cardiac diet Pt. reports eating scrambled eggs, dry toast, and decaf tea for breakfast

Anthropometric Measu rements

Age:55

| Gender:F

I Ht:5'
l7s2.4cm
BUN

Wt: 2021b
91.5 Creat
Na+
K+

BMI: 39 (obese class ll)

Biomedical Data, Medical Tests & Procedures Labs/Date I Albumin I Glucose HbAIC
Reviewed

Heb

Hct

MCV

Other

Medical Diagnosis/PMH/Relevant Conditions: Hx of HT Pertinent Medications:

Reviewed Skin

status: X lntact n

Pressure Ulcer/Non-healing wound; Comments

Estimated Nutritional Needs Based on Comoarative Standards: Calories: MSJ ABW 1.3 stress factor Protein: .9 e/kcal/day L,800-2,000 kca l/day 80-859 protein/day (-500kcal/day to promote weight loss) Current Diet Order: Heart Healthy DASH diet 1.59 sodium/day >l%kcal from saturated fat
Feeding Ability

Fluid: 25mL/kcal 2-2.5L/day

Oral Problems

nta ke

X n tr

lndependent Limited Assistance Extensive/Total Assistance

tr tr ! X

Chewing Problem Swallowing Problem

Mouth Pain
None of the Above

tr tr

Good (>75%l Fair (approx. 50%)

Poor (<50%)

a Minimal - k25%)
S (Signs & Symptoms):BMl 39 and denies need to follow diet recommendations

n
P

No Nutritional Diaenosis at this

:

time

Proceed

to Nutrition Diasnosis Below

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(problem): Obese (class ll) NC-3.44 related to:

(Etiology): limited adherence to nutritionrelated recommendations as evidenced by:

E

Recommended Nutrition Prescription: 1300-1500 kcal/day 80-859 protein/day 1.59 sodium/day >7% kcal from saturated fat/day

2-2.51fluid/dav Food or Nutrient Delivery:

Meals and snacks

Nutrition education:
lmportance of cardiac/DASH diet and weight loss for pt. Coordination of Care (refer to):

Nutrition Counsellng: None at this time

Goal(s): Pt. to accept of the need to follow recommended diet and
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to lose weight
Criteria: Pt. report acceptance ofthe need to follow a cardiac diet and

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to lose weleht

ndicators:

Monitor intake and weieht

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