Medical Nutrition Therapy 1

Practice 3
Myocardial Infarction

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Case Questions:

I. Understanding the Disease and Pathophysiology

1. Mr. Klosterman had a myocardial infarction. Explain what happened to his heart.

2. What risk factors indicated in his medical record can be addressed through nutrition

II. Understanding the Nutrition Therapy

3. Are there any current recommendations for nutritional intake during a hospitalization
following a myocardial infarction?

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 III.Nutrition Assessment

A. Organize the assessment data in the table below

Food/ Nutrition Anthropometric Biochemical Data, Nutrition Client History

Related Measurements Medical Tests, and -Focused
History Procedures Physical
Findings

B. Evaluation of Weight/Body Composition

4. What is the healthy weight range for an individual of Mr. Klosterman’s height?

C. Calculation of Nutrient Requirements

5. This patient is a Lutheran minister. He does get some exercise daily. He walks his dog
outside for about 15 minutes at a leisurely pace.
a. Calculate his energy need.

b. How many grams of protein should he have daily?

D. Intake Domain

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6. From the information gathered within the intake domain, list possible nutrition
problems using the diagnostic term.

D. Clinical Domain

7. Examine the chemistry results for Mr. Klosterman. Which labs are consistent with the
MI diagnosis? Explain.

8. What is abnormal about his lipid profile? Indicate the abnormal levels.

9. Mr. Klosterman was prescribed the following medications on discharge. What are the
food–medication interactions for this list of medications?

Medication Possible Food–Nutrient Interactions

Lopressor 50 mg daily
Lisinopril 10 mg daily
Nitro-Bid 9.0 mg twice
daily
NTG 0.4 mg sl prn chest
pain
ASA 81 mg daily

10. From the information gathered within the clinical domain, list possible nutrition
problems using the diagnostic term.

E. Behavioral–Environmental Domain

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11. What issues might you consider to support the success of his lifestyle change?

12. From the information gathered within the behavioral–environmental domain, list
possible nutrition problems using the diagnostic term.

IV. Nutrition Diagnosis

13. Select two nutrition problems and complete the PES statement for each.

V. Nutrition Intervention

14. For each of the PES statements that you have written, establish an ideal goal (based on
the signs and symptoms) and an appropriate intervention (based on the etiology).

15. Mr. Klosterman and his wife ask about supplements. “My roommate here in the
hospital told me I should be taking vitamin E and—I think it was folate along with
omega-3 fatty acid supplements.” What does the research say about vitamin E, folate,
and omega-3 fatty acid supplementation for this patient?

16. Based on exchande list, design one day menu for Mr. Klosterman. What type of diet is
best described for him?

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VI. Nutrition Monitoring and Evaluation

17. What would you want to assess in 3 to 4 weeks when he and his wife return for
additional counseling?