Question

Nutrition

Case Study - Chronic Obstructive Pulmonary Disease Mrs. Hernandez is a 72-year-old, underweight, African-American patient with a history of hypertension, depression, and chronic obstructive pulmonary disease (COPD). She was recently seen by her primary health care provider for signs of illness: fever, loss of appetite, fatigue, chills, and dyspnea. She was diagnosed with bronchitis and started on a bronchodilator and corticosteroid nebulizer treatments as well as an oral antibiotic. However, she continued to feel ill without improvement, and became very confused with increased shortness of breath. She was taken to the hospital by ambulance and admitted with a diagnosis of pneumonia, and then started on 2 liters of oxygen via a nasal cannula and intravenous antibiotics. Mrs. Hernandez was placed on a regular diet. However, she ate sparingly and was not receiving the nutrients she needed. 4 points each, be specific and detailed 1. What are the main goals of medical nutrition therapy for patients wi s with COPD? 2. Consider her energy needs, how are her needs affected by her current condition/disease? 3. What factors interfere with food intake for patients with COPD? Consider her symptoms. 4. What dietary recommendations and interventions might help Mrs. Hernandez get the nutrients that she needs during her hospitalization? 5. Consider her fluid needs due to her COPD diagnosis, how would you recommend meeting her needs and why?

Answer 1

1.main goal is to relieved from loss of appetite and maintains adequate nutrition.

* high protein rich diet must be enhanced.

* high potassium rich diet such as coconut water, mushroom, peas

* should avoid fried food items, fried snacks, fried chicken

* add soft diet if dyspnea persist.

2.patient has complaints of loss of appetite, she feel fatigue

* avoid nutrition imbalance starts with hydration; iv fluids.

* avoid sodium rich food items to prevent hypertension.

* encourage oral fluid intake

* provide small & frequent feeds.that helps to prevent feeling of fullness and got nutrition in correct proportion.

3.* soft diet is recommended dyspnea persist and we are plan for non invasive ventilation if the client clinically bad: that time heavy meals affect the respiration and client feel discomfort.

* starts iv fluids to prevent dehydration.

* low sodium diet is recommended to prevent hypertension

* avoid hard food and food which produce gas.which can adversely affect respiratory pattern.

4.* provide iv fluidfluids to balance nutrition, avoid dehydration, maintains nutrition once patient took food orally

* fluid restriction is necessary the patient is symptomatic with dyspnea. OtherOther wise dyspnea worsen. Bt not allowed dry mouth, that can cause thick purulent secretion and discomfort to the patient.

* once patient took oral foods to ve give liquid diet.

* fever is due to pneumonia that can subside with antibiotics support. Bt fever can dehydrated the patient and also develop fatigue. For take better hyperthermia control & iv fluid therapy.