PRINCESS LEVIE CENIZA BSN 2A

GARY: FENDING FOR HIMSELF

Gary, a 7-year-old Caucasian boy, was discovered searching a garbage can by a police
officer. The officer noticed that Gary was dirty, unkempt, and thin. His skin was pale.
Gary was taken to the police station, where he was turned over to social services.
Gary told social services that his mother had been sick and was taken to the hospital;
he had not seen her for many months. He did not know what hospital she was in,
and he had been alone all this time. He told the social worker that he had run out of
food immediately after she left; he had been able to survive by searching behind
restaurants and in garbage bins. Social services brought Gary to the local hospital,
and upon examination, it was found that Gary had a distended abdomen,
serosanguinous sores on his body, and swollen and painful lower limbs. Gary limped
and found walking very tiring.

ASSESSMENT

1. Identify three distinguishing signs of malnutrition.

- distended abdomen
- serosanguinous sores on his body
- swollen and painful lower limbs

2. What would you introduce first into Gary’s diet?

- I will introduce first the simple changes of his meals, snacks, and drink that may
help him adjust with choosing nutrient dense food and drinks that can improve his
calorie intake without having to make portion size much bigger.

3. How frequently would you offer nutrition and how large a portion?

- it should be a eat a little and often, 3 small meals a day with 2-3 snacks in between
meals.

4. What other signs of malnutrition would you expect to find?

- the other sings of malnutrition should be tiredness or low energy, poor growth and
increased risk of infection in the children.
DIAGNOSIS

5. Write a nursing diagnosis for Gary.

- imbalanced nutrition related to insufficient dietary intake as evidenced by

distended abdomen.

PLAN/GOAL

6. What two changes can you predict will occur with the introduction of a good,
nutritionally sound diet?

- with the introduction of a good, nutritionally sound diet Gary will improve his
health, will have more energy and can lower the risk of health problems.

7. Whom can you refer to for assistance?

- I can refer for assistance is the dietitian, because they are expert in identifying and
treating disease- related malnutrition and in conducting medical nutrition therapy.

IMPLEMENTATION

8. Name at least three methods that could be employed to improve Gary’s nutrition.

- first, should be to figure out how many calories that he needed for optimal health.
Second, he should eat nutrient dense foods. Third, chooses nourishing drinks such as
milky drinks or high sugar drink.

9. Could a food diary be helpful?

- the food diary is helpful, because it helps you understand your eating habits and
helps you identify the foods that are good or no good in what you eat.

10. Would a home visit be beneficial for Gary and a caregiver?

- a home visit is very beneficial for Gary and the caregiver so that they will be
notified if the diet is still working and also to make sure that Gary is recovering his
health for good.

EVALUATION/OUTCOME CRITERIA
11. What could the doctor measure at the next appointment to see if the plan is
working?

- the doctor will measure the optimum health of the patient if the plan is working.

12. What observations could the caregiver offer about the success of the plan?

- the caregiver can observe the eating habit and the likes and dislikes of food from
Gary so that they can improve the diet for Gary.

13. What could be an important piece of information from Gary?

- the important information that they could get from Gary is on how he could cope
up or the information and decisions that they make to help him recover from
malnutrition is working and how to improve it for their research in the future
through observing their patient.

THINKING FURTHER

14. How could the Internet be of benefit to the caregiver?

- the caregiver benefited in the internet through searching online on what else could
he/she do to make sure that the patient he/she has can have the optimum health
needed.

15. Who would also benefit from this information?

- the other who will also benefit to the information in the internet is the patient
himself, because he would know how to gather some advice or information that can
maintain his health throughout the process and he can be independent in the future.