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
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. s wife reports that she recently bought him a special multi-vitamin containing omega 3 fatty acids. It is designed to 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. – are the nutrition therapy goals for a patient with COPD receiving vent support? – 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? are specific diet plans, oral drink supplements, or vitamin/herbal therapies that may benefit Mr. C?
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