This case study discusses a 52-year-old former tricycle driver diagnosed with multi-drug resistant tuberculosis (MDR-TB) and gout. Prior to admission, the patient experienced fever, severe cough, night sweats, and difficulty breathing. The patient's BMI was normal but he needed to gain weight. The plan was to lower his uric acid levels through diet and exercise to reduce gout risk, gain weight, and follow directly observed therapy to eliminate MDR-TB. The intervention included nutrition counseling, follow up appointments, and lifestyle changes. Evaluation involved reassessing the patient's status and monitoring compliance.

1. A Case study on

2. Definition
Prevalence
The subject
Subjective
Objective
Assessment
Plan
Intervention
Evaluation
Multi-drug-resistant
TB
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4. Definition
• Multi-drug-resistant tuberculosis
(MDR-TB), resistant to:
- Isoniazid (INH)
- Rifampicin (RMP)
• Mycobacterium tuberculosis
• spread from person to person as
readily as drug-sensitive TB

5. Prevalence
MORTALITY: TEN LEADING CAUSES
PHILIPPINES, 2009
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Diseases of the Heart
Diseases of Vascular System
Malignant Neoplasms
Pneumonia
Accidents
Tuberculosis, all forms
Chronic lower respiratory diseases
Diabetes Mellitus
Nephritis, nephritic syndrome and nephrosis
Certain conditions originating in the perinatal period

6. Prevalence

7. The Subject
Name:
Age:
Occupation:
Height:
Weight:
DBW:
BMI:
TER:
Ramon Jovero
52 years old
former tricycle driver
5’1”
48 kg
52.7 kg
20
1920 kcal
Interpretation:
BMI is considered normal, but needs to gain
4.7 kg to achieve his DBW.

8. Subjective
• Underlying disease:
• Secondary condition:
• Civil Status:
MDR-TB
Gout disease
Married but is separated
• Chief complaints:
Prior to admission, the patient experiences
fever, severe cough, night sweats and
difficulty in breathing. He also experiences
to be easily felt being tired even if he’s not
doing his usual work and physical activities.

9. Objective

10. Objective

11. Objective
Nutrient Adequacy
Actual Nutrient Intake/Recommended
Nutrient Intake *100
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CHON
Energy
CHO
Fats
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=
175 % (excessive)
86 % (inadequate)
80 % (inadequate)
36 % (inadequate)

12. Assessment
• Pt’s BMI is considered normal but
needed to gain 4.7 kg to achieve his
DBW.
• Prior to admission, to pt. showed
evidences featuring s&s of his
underlying and secondary medical
condition.
• The pt’s attitude towards food intake
shows a lack nor excess acquisition of
nutrients which made him susceptible
in acquiring other complications.

13. Plan
Short term goals:
• To lower uric acid level, to reduce patient’s
susceptibility to Gout’s disease.
• To gain 4.7 kg weight to meet his desirable
body weight.
• To introduce aerobic exercises (walking,
jogging, biking,) lasting 20 to 30 minutes, at
least three to four times a week as
applicable on patient’s condition.
• DOT (directly observed therapy)

14. Plan
Long term goals:
• Proper education and awareness.
• To encourage the patient follow the
prescribed diet for lowering of uric
acid level until the normal value will
be achieve.
• To encourage the patient follow the
prescribed medication to eliminate
MDR-TB.

15. Intervention
• Nutrition counseling to the patient and
his family, allowing them to learn and be
independent in applying and maintaining
the nutritional guidelines given to their
affected family member/s.
• Making of follow up schedules to check
the patient’s compliance to the
prescribed diet and medications.

16. Intervention
• Facilitation of normal weight
maintenance
by
encouraging
structured programs that emphasize
therapeutic
lifestyle
changes
including nutrition
and physical
education, management of fat and
calorie intake, appropriate physical
activities and regular checkups.

17. Evaluation
• Reassessment on patient’s nutritional
status.
• Checking food intake/dietary history
through his food records/diary to
confirm if the recommended diet for
the patient was been prepared and
implemented by the patient and his
family.
• Monitor patient’s physical activities
on weekly basis.