16 Jan Nutrition Care Plan for COPD Unit outcomes

Order Instructions

Review the following case study details for a patient with COPD and respiratory failure:

 

Mr. C is a 72-year-old male who was admitted to the hospital complaining of shortness of breath. Mr. C has a complicated medical history that includes: COPD, HTN, depression, obesity, and sleep apnea. Mr. C has smoked since the time he was a teenager. He is a retired auto-mechanic and is married to his wife, Mrs. C. Mr. C is 5’10″ and 240 pounds. He has been instructed to follow a heart healthy diet and to lose weight, but his wife reports that he is non-compliant with any dietary therapy. He is currently taking a diuretic, a blood pressure medication, and an antidepressant, and he uses an inhaler when SOB (shortness of breath). The patient uses a breathing mask at night due to his sleep apnea history. His wife reports that she recently bought him a special multi-vitamin containing omega 3 fatty acids. It is designed to help older men’s hearts and other medical issues.

 

Upon admission to the hospital, Mr. C’s respiratory status declines, and the ER physician decides to intubate the patient in order to deliver proper oxygenation. The MD also starts the patient on IV fluids consisting of NS (normal saline) for hydration. While on ventilator support, the patient is sedated and is unable to talk or consume an oral diet. The medical chart notes from the pulmonologist reveal that there are no immediate plans to extubate the patient (wean from the ventilator). Currently, the laboratory lab values of the patient are all within normal limits (WNL). However, upon admission and before vent support was initiated, his labs were abnormal. Some affected lab values were: CO2, BUN/Cr, pH, and Na. The patient has had an NPO (nothing by mouth) diet order status for 4 days and has only received IV fluids for intake. The nursing notes reveal that he has normal urine output and bowel sounds are present and normal.

 

As a nutrition professional working at this hospital, you are to start the nutrition care process on this patient. Your hospital has a protocol to see all patients that have NPO diet orders and/or are on the ventilator for more than 4 days. You have NOT received a doctor’s consult for a tube feeding (enteral) order; however, it is imperative that this patient is assessed and appropriate nutrition recommendations are made.

 

For this Assignment, you will write a descriptive essay concerning COPD. The essay will include a detailed definition and explanation of COPD. The patient’s personalized ADIM/E chart note (nutrition care plan) should include an appropriate nutrition intervention based on the patient’s current nutritional problem (nutrition diagnosis). You MAY use the ADIM/E Chart Note TEMPLATE located in Course Resources.

 

This descriptive essay should include the following:

 

Describe COPD, its risk factors, and its common treatments.

Explain Mr. C’s current status. Describe why he was intubated and how vent support can impact a patient.

What are the nutrition therapy goals for a patient with COPD receiving vent support?

What are your specific nutrition therapy recommendations for Mr. C while he is on ventilator support? Include estimated calorie and protein requirements and the method(s) for how he should receive these nutrients (enteral, parenteral, or oral diet/supplements). You do not need to include details of specific brands, amounts/serving sizes and/or infusion rates.

When the condition of the patient improves and he is taken off the vent, what are your recommendations for nutrition therapy for Mr. C upon discharge from the hospital? What are specific diet plans, oral drink supplements, or vitamin/herbal therapies that may benefit Mr. C? Appendix: Write a Nutrition Care Plan/Chart note on this COPD patient, addressing the current clinical situation of the patient. Write this note as though you were the nutrition professional caring for this patient in a hospital setting. See the Nutrition Diagnostic Terminology PDF file in Course Resources along with Box 10-2, Table 10-3 and Table 10-4 for examples of nutrition diagnostic (PES) statements. You may utilize/edit the TEMPLATE for the ADIM/E Chart note TEMPLATE available in Course Resources for this section of the assignment. Then, attach your chart note with assignment essay into the dropbox.

Requirements:

 

Your descriptive essay should be written in paragraph format, including an introduction, body, and conclusion. Refer to the structure provided below. The viewpoint and purpose of this essay should be clearly established and sustained.

Your writing should be well ordered, logical and unified, as well as original and insightful. Your work should display superior content, organization, style, and mechanics.

 

Your writing should:

 

Follow the conventions of Standard American English (correct grammar, punctuation, etc.).

Include a title page and reference page.

Follow APA style format and citations guidelines, including Times New Roman 12-point font and double spacing. The minimum page requirement is 2 pages not including the title page, reference page, and appendix.

Include at least 4 references. References may include your textbook, other textbooks, and scholarly websites and journal articles. Use APA style for all citations, including course materials.

For additional support, utilize the GEL 1.02 Universal Writing Rubric and the Writing Center resources available in the Academic Success Center: Writing Center.

Please organize your essay in the following paragraph format. Please see the Academic Success Center: Writing Center for more information regarding essay and paragraph format.

 

Section 1: Introductory paragraph(s) (include your response to question 1)

 

Section 2: Body paragraph(s) (incorporate your response to question 2)

 

Section 3: Body paragraph(s) (incorporate your response to question 3)

 

Section 4: Body paragraph(s) (incorporate your response to question 4)

 

Section 5: Concluding paragraph(s) (incorporate your response to question 5)

 

Section 6: Appendix: ADIM/E/Chart note. Utilize/edit the TEMPLATE for the ADIM/E Chart note TEMPLATE available in Course Resources for this section of the assignment See the Nutrition Diagnostic Terminology PDF file in Course Resources along with Box 10-2, Table 10-3 and Table 10-4 for examples of nutrition diagnostic (PES) statements.

 

below is the template

 

Appendix/Part 6 UNIT 9 Assignment- ADIME Chart Note TEMPLATE

Nutrition Care Process

[TEMPLATE Directions ****Please fill in the blanks . DELETE all italicized text inside brackets & this highlighted text. Place in Dropbox with U9 Assignment essay portion. FYI: Dx= diagnosis, Hx= History]

• A –Assessment Pt is a 72 y/o male Medical dx: COPD Admitting Dx:___ _ ___

Wt: _ lbs. ( ___ kg) Ht.:__ft__inches (___meters) BMI:____ (_______) [BMI= wt category/normal/overwt/obese?]

Labs: [lab values relevant to nutrition status]

Clinical Info: [include nutritionally significant past & current medical dx/hx. EX: significant medications, clinical changes that may impact his nutrition status & intake. Ex: any changes in chewing/ swallowing? OK to LIST & abbreviate]

Diet: __________________________ [include any current or recent diet orders, any past dietary intake patterns or diet compliance history. Include Est’d calorie and protein needs…. consider his current MEDICAL status and treatments]

• D – Nutrition Diagnosis Statement [PES: Problem-Etiology-Signs/symptoms]

[< — Choose ONE nutrition diagnosis PHRASE/problem + dx CODE # that is the patient’s MAIN NUTRITION problem to address right NOW. Use one phrase from the Nutrition Diagnostic Terminology PDF located in Course Resources- there are MULTIPLE correct answers within the list of nutrition dx phrases]

related to ______ [ < –the main causes aka etiology of the problem]

as evidenced by ___________ _. [<– signs, symptoms or proof of the problem]

I- Intervention: Recommend ___________ __to meet the patient’s est’d nutritional needs. [Choose one SOURCE/route of nutrition while IN the hospital for SHORT term: specific oral diet & supplements, enteral feeding/tube feeding, or a TPN-total parenteral nutrition/IV nutrition…consider patient’s medical status when choosing 1 of the 3 options]

• M/E- Monitoring/Evaluation: will be monitored in ___ day/s. [EX: the patient’s weight, I/Os< intake/ output>, any labs, & STATUS of the nutrition recs OR nutritional intake amount/ GI tolerance will be monitored within x time frame]