Question

subject- nutrition

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 with COPD? 2. Consider her energy needs, how are her needs Cons 3. What factors interfere with food intake for patients with COPD? Consider sympt 4. What dietary recommendations and interventions might help Mrs. Hernandez get the nutrients that she needs during her hospitalization? Consider her fluid needs due to her COPD diagnosis, how would you recommend meeting her needs and why?

Answer 1

Goals of medical nutrition therapy in copd patient

1. To provide nutrition that will maintain adequate respiratory muscle function, mass and force which will further improve overall performance of patient.
2. to maintain adequate lean body mass and adipose tissue
3. to correct the water imbalance in copd patient.
4. To prevent further weight loss

Changes in her energy needs due to copd

• her energy expenditure will be increased because of increased work of breathing
• there will be increased carbon dioxide accumulation so energy needs will be kept at or lower than estimated requirements
• 5-10% increase in resting energy expenditure

factors affecting her decreased food intake in copd

• Anorexia
• Morning headache due to hypercapnia in copd
• fatigue
• Difficult chewing and swallowing because of dyspnea

dietary recommendations and interventions

• High fat and low carbs diet to reduce hypercapnia
• protein rich food like eggs, meat, pulses etc to be included
• Complex carbs like peas, oats, barley, beAns to be included
• Fresh fruits and vegies to provide vitamind and minerals to be included
• Potassium rich foods like avocados, bananas,tomatoes, green leafy vegies etc to be included in diet to improve lung function
• Healthy fats like coconut oil, olive oil, cheese and fatty fish will be opted in diet
• Foods that result in flatulance to be avoided like beans, coffee, tea, cauliflower etc

Fluid needs in patient

1. Patient has water imbalance in copd so she should take around 6-8 ounce of non caffeinated beverages as it will liquify mucus and it will be easier to cough out
2. she will be advised to limit or avoid caffeinated drink as it leads to frequent urination.