Meals on Wheels Case Study

1. CASE STUDY:
USING THE NUTRITION CARE PROCESS TO PROVIDE SAFE, EFFECTIVE, HIGH
QUALITY NUTRITION CARE
KAYLEIGH KAISER

2. STEP 1: NUTRITION ASSESSMENT
CH Clinical Hx
Age: 84 Male Dx: Rheumatoid Arthritis, Glaucoma, Gout, Cholesterol, Open Wound Gout,
Hypertension, Mobility Issues
AD Anthropometric data/measurements
6’2” /188 cm 142 lbs./65 kg IBW: 190 lbs./86 kg 75%
weight goal
UBW: 158 lbs 11% weight decrease in 3 months (wt. stated at admin. date)
NPF Nutrition Focused Physical Findings
Very thin/Fat Wasting

3. LIST OF MEDICATIONS
Celecoxib: NSAID, Should be monitored closely in patients with hypertension
Nifedipine ER: Calcium Channel Blocker-Used to treat hypertension, Interacts with grapefruit products
Latanoprost: Reduces pressure in the eye
Hydo-APAP: Narcotic pain reliever, food interaction with grapefruit
Timolol Maleate: Beta-blocker used for hypertension,

4. 24 HOUR DIETARY RECALL
Breakfast: MOWI breakfast
Lunch: MOWI lunch
Dinner: Chicken and Cauliflower/Snap Peas with 8 oz of milk or OJ
Snacks/Supplements: Cookies occasionally, Bananas, apples
Fluid Intake reported by client: 88 oz/2600 ml

5. STEP 1: NUTRITION ASSESSMENT CONTINUED
FH Food/ Nutrition related Hx
Intake: ≈2,000 kcal (330g carbs; 88g protein;34g fat) Goal: 2150-2600 kcal (Mifflin)
Est. Fiber: 26 g Goal: 28 g
Est Fluid Intake: 88 oz /2600 ml
Diet Order: Regular Meal w/ Org. Juice
Receives 4 Lunch Meals & 2 Breakfast Meals per week
Environment: Dirty/Cluttered
PA: formerly used rollator to walk outside, sever joint disfigurement and slow-healing foot wound
Attitude: seemed cheery despite extremely large, swollen or disfigured joints on hands

6. STEP 2: NUTRITION DIAGNOSIS
Involuntary Weight
Loss
Lack of, or limited access to food and/or
food supplements or other means of
nutrition and increased nutrient needs due
to wound healing
Self reporting of a significant weight decrease of 11% within 3
months, and a BMI of 18.23 (slightly underweight)
Related to:
As evidenced
by:

7. STEP 3: NUTRITION INTERVENTION
NE Nutrition Education
Foods to Avoid for Gout Relief- Sweetbreads, Liver, high-fructose corn syrup, large amounts of alcohol
NC Nutrition Counseling
Eat 3 meals + 2-3 nutrient dense snacks, supplemental drinks

8. FOLLOW-UP
 Diet
 Supplements
 Weight
 Activity
 Gout