Case Study, Chapter 13, Assessing Nutritional Status

A 24-year-old female client who has been on a diet for 6 months visits the health care

facility with complaints of tiredness and fatigue. She works as a law clerk for a judge in

the municipal courthouse of her town. She tells the nurse she spends 10 to 12 hours a day

at work and has noticed that she can barely get up in the morning. The client has dark

circles under her eyes, pale skin, and thinning, dry hair. The nurse asks her what she

usually eats for meals. The client states that she does not eat breakfast; for lunch, she eats

a lettuce sandwich, and, for dinner, she eats a piece of chicken. When asked about fluid

intake, she said that she doesn’t like to drink water, not even the vitamin waters that are

very popular now. Most of the time, she drinks diet soda but she doesn’t drink a lot. She

likes orange juice, but it has too many calories so she doesn’t drink it often.

VS: BP 110/70, Pulse 62 and thready, Temp. 97.6°F (36.4°C)

(Learning Objectives: 3, 6 )

Questions:

a. What client response should the nurse expect when the amount of calories and
fluid intake are not sufficient for the client’s basal metabolic rate?

b. After completing the interview and physical exam, what further data must
the nurse obtain to determine if the client is undernourished or malnourished?