A – Pt referred to nutrition for dietary advice related to hypertension.

Pt possess desire to change diet

control hypertension and as an alternative to medicine. Current diet consists of homemade, fresh juices
consumed every 3 hours and one full meal per day, usually chicken, vegetable, and a starch. Half of a
meal is eaten around noon; the other half eaten when home from work. Pt doesn’t cook so meals are
usually from a restaurant. Pt discussed feeling hunger but lacking an appetite for healthy foods and
therefore turns to juice. Pt reports exercising 1-3 day a week for 45 min for the last 3 weeks (working up
to 1 hour of exercise).

Anthro: 41 y.o F, 157lbs, 27.88 BMI, BP: 136/84

Labs: low Hgb: 11.3 (11.7-15.5), low Hct: 34.6 (35-45)

Meds/Supplements: hydrochlorothiazide 12.5 mg, Calcium 500 + D 500 mg-10 mcg (400 unit)
tablet, Iron (ferrous sulfate) 325 mg (65 mg iron) tablet, folic acid 1 mg tablet

Diet: changed eating habits 3 weeks ago. Started with 2 days of only consuming juices. Currently
consuming fresh homemade juices 3-4x day, 1 meal split and eaten at 2 separate occasions during the
day: grilled chicken, veggies and a starch. Previously consumed all meals at restaurant. Breakfast: waffle
house, Lunch: Chick Fil A, Dinner: leftovers from lunch

D – Food and nutrition related knowledge deficit r/t harmful beliefs about nutrition related topics a.e.b.
using juice cleanse to manage hypertension by losing weight.

I – Provided pt with nutrition education on DASH diet and nutrient content of a juice diet. Pt set goals to
replace a juice for a snack consisting of a fruit/veg, increase meals from 1 to 2 meals a day.

M – Follow up with pt about goals/improvements in diet. Check weight.

E – Set new goals with pt, provide more education about DASH diet if needed.