Cardiovascular diseases (CVD) are health conditions that affect the heart, blood vessels, and blood circulation. Examples of CVD are atherosclerosis, coronary heart disease, heart failure, deep vein thrombosis, and peripheral arterial disease. The patient is at greater risk of developing CVD as a result to his genetic predisposition wherein his family has a history of CVD and for having a high intake of cholesterol at 815 mg. based on the 24-hour intake data.
The average allowance of cholesterol level is not more than 300 mg a day especially for patients with family of Cardiovascular Diseases (CVD). The patient is also at risk for CVD for being overweight as classified by the Body Mass Index (BMI). The dietary intake of the patient was based on the 24 hour intake called Meats, Eggs, Dairy, Frying Foods, In Baked Goods, Convenience foods, Table fats, Snacks (MEDFICTS) Dietary Assessment Questionnaire in which the patient. It is the most suitable tool to help identify high fat diets (cited in Taylor et al.
2003). I was able to validate my PES statement based on the MEDFICTS given that the patient recorded his consumption of meat and other components of MEDFICTS that further provided an explanation on how his cholesterol level was high. * An explanation of why you chose the nutrition diagnosis you selected. My nutrition diagnosis is shown as the PES statement as follows: Problem: Excessive cholesterol intake and excess total serum cholesterol levels Etiology: consumption of high cholesterol foods as evidenced by dietary items.
S/S: 10% weight loss in 90 days and lower in total serum cholesterol to 20 mg/dl The diagnosis that prevails among the rest of the PES statement is “excessive cholesterol intake and excess total serum cholesterol levels”. By introducing weight reduction and a low-fat, low cholesterol diet to the client, these lifestyle modifications will aid in lowering the patient’s high cholesterol level. The outcome of the lifestyle modifications is expected to result to a 10% weight loss in 90 days and lowered total serum cholesterol to 20 mg/dl. * The Nutrition Care Process
Nutrition Assessment After reviewing the 24-hour consumption form and the MEDFICTS questionnaire, we learn that the patient consumes fried, whole eggs, peanut butter, and average portion of meat. The patient regularly eats four or more servings of meat per week. Current weight of 230 lbs. is not within the recommended healthy weight range for the patient’s build and height. The biochemical and medical tests also found out that the total blood cholesterol level is beyond the recommended range at 260 mg/dl as compared to the ideal goal of 200 mg/dl.
Nutrition Diagnosis The patient has an excessive saturated fat intake related to regular consumption of fried whole eggs and higher than average meat portions as evidenced by an elevated cholesterol intake of 815 mg and total cholesterol level of 260 mg/dl. Risk factors, available guidelines, typical MNT used for the condition given, and describe the pathophysiology. The risk factors of cardiovascular diseases include the use of tobacco, hypertension, elevated blood lipid levels, family history of premature cardiovascular disease, and age. (cited in Smeltzer 2009).
The build up of cholesterol can gradually build up plaques along the inner walls of blood vessels. The narrowing of the arterial lumen, thrombus formation, and obstruction of blood flow to the vital organs, especially the heart, can result to cardiovascular diseases. The impediment to blood flow is more than often progressive in nature thus causing insufficient blood supply that deprives the muscle cells of oxygen required for their survival. In the patient’s case, a primary prevention or preventing the occurrence of CVD is needed to lessen his risk of developing cardiovascular disease given that his family has a history of CVD.
Four modifiable risk factors namely cholesterol abnormalities, cigarette smoking, hypertension, and diabetes mellitus as a major risk factor for coronary artery disease related to CVD (cited in Smeltzer 2009). The patient can modify his diet through a low fat, low cholesterol, high fiber diet to control the cholesterol abnormality. A regular, active lifestyle through regular exercise should be incorporated to the patient’s lifestyle to maintain, if not control, his blood pressure.
The patient should be given health teachings on how to differentiate the good fats, such as mono saturated fats and poly saturated fats, from bad fats, including saturated fats and trans fats, to help him identify which foods to avoid in his diet. It would have been helpful if the blood pressure of the client were also measured as well as his actual intake of meat products. His cholesterol level is higher than the normal level but his 24-hour intake showed healthy choices such as low-fat milk, lean meats among others.
The care plan will be evaluated for effectiveness by obtaining the total cholesterol level of the client, weight, and blood pressure after incorporating lifestyle modifications in his diet and level of physical activity. The patient should have a 200 mg/dl total cholesterol level, a blood pressure of more or less 120 mmHg, and a healthy weight within the range of 207 to 210 pounds. Additionally, the patient should be able to determine the different sources of fats in the diet without totally eliminating fats in the diet given its functions for nutrient absorption, nerve transmission, and cell membrane integrity maintenance, among others.
References Smeltzer, Suzanne. (2009). Brunner and Suddharth’s Textbook of Medical Surgical Nursing. New York: Lippincott & Wilkins. Taylor, A. , Wong, H. , Wish, K. , Carrow, J. Bell, D. , Bindeman, J. , Watkins, T. , Lehmann, T. , Bhattarai, S. , & Malley, P. (2003). Validation of the MEDFICTS dietary questionnaire: A clinical tool to assess adherence to American Heart Association dietary fat intake guidelines. Nutritional Journal 2: 4.