Question

When you talk to Stella about her food intake at home, she indicates that her appetite is poor. “Sometimes I feel bloated; I fill up so quickly – after a few bites of food.” “Food doesn’t taste good anymore.” She tells you that her highest adult weight was 145-150 lbs (about 5 years ago). She complains that her dentures are fitting very loosely. She consumes coffee, juice, and dry cereal with a small amount of milk in the morning and one other larger meal during the day, usually at lunch – which consists of meat, vegetables, rice, potatoes, or pasta. She admits that she eats only small amounts. At night she often has a bowl of soup. She drinks Pepsi throughout the day (usually three 12 oz cans).

Her Lab results concludes:

Ht: 5’3”; Wt: 119 lbs

Physical Exam

Vital signs: Temperature 98.8°F, blood pressure (BP): 130/88, respiratory rate (RR): 22

Extremities: 1 + bilateral pitting edema

Chest/lungs: Decreased breath sounds; prolonged expiration with wheezing; using accessory muscles at rest

Sodium: 136 mEq/L; Potassium: 3.7 mEq/L; pH: 7.29; PaCO₂: 50.9 mmHg; PaO₂: 77.7 mmHg; O₂Sat: 92%; HCO₃: 29.6 mEq/L

1)Identify and write at least two (2) PES statements indicating Problem, Etiology, and Sign/Symptoms for the nutritional issues identified. Be sure to write in proper PES statement format

Answer 1

PES statement based on the above scenario:

P: Biting difficulty related to loosening of teeth

E: Decreased appetite secondary to respiratory distress as evidenced by decreased breath sounds, prolonged expiration with wheezing

S: Consuming less than 50% of estimated energy needs for prolonged duration and unintentional weight loss since 5 years