Sage nC lorm SLudenL name: klmberly Scannevln

Case: PyperLenslon ln a Mlddle-Aged Man

aLlenL: !ohn uoe 8eferred for: AsslsLance ln lowerlng blood pressure Lhrough Mn1 (wlLhouL meds).
!"#$%#%&! ())*))+*!#
,--. /0. !123424-0 $56/25. 7482-39: Cooks aL home ofLen, savory dlshes wlLh excess salL. Lxerclses 2-3 days a week, for 20 mlnuLes. uleL recall
lnslnuaLes a hlgh faL and hlgh sodlum dleL, low on flber wlLh no frulL and llmlLed vegeLables.
(02;3-<-=5234> +5/8135=5028
Age: 60 years old Cender: Male PL: 3'9" WL: 234 lbs.
WL Px: none glven - sLable
8Ml: 34.8
8Ml ClasslflcaLlon: Cbese
?4-=5.4>/6 @/2/A +5.4>/6 #5828 B C3->5.1358
Labs/uaLe Albumln Clucose 8un CreaLlnlne na+ k+ 1oLal
CholesLerol
LuL
CholesLerol
PuL
CholesLerol
1rlglycerldes
11/18 4.2 g/dL 110
mg/dL
21 mg/dL 1.2 mg/dL 136 mLq/L 4.6
mLq/L
238 mg/dL
(Plgh)
174 mg/dL
(Plgh)
37 mg/dL
(Low)
133 mg/dL
+5.4>/6 @4/D0-848E$565F/02 G-0.424-08: revlously dlagnosed wlLh hlgh blood pressure and currenLly hlgh blood pressure: 143/92. 1oLal and LuL
cholesLerol levels are hlgh. PuL cholesLerol ls low, per labs.
C53240502 +5.4>/24-08E)1<<65=5028E753H8: PydrochloroLhlazlde.
)I40 82/218: x lnLacL ! ressure ulcer/non-heallng wound, CommenLs:

C/24502EG64502E,/=469 +5.4>/6E75/62;EG(+ 7482-39: revlously dlagnosed wlLh hlgh blood pressure. Leg and feeL paln, llmlLs physlcal acLlvlLy.
*824=/25. !123424-0/6 !55.8 ?/85. -0 G-=</3/24F5 )2/0./3.8:
Calorles - uslng Mlfflln -SL. !eor: 2360 calorles roLeln - 0.8 g/kg (uslng 106.4 kg) = 83 grams
Level suggesLed: 62.3-83 grams
lluld: 30 mL/kg (uslng 106.4 kg) = 3200 mL
CurrenL uleL Crder

none currenLly, buL l would
suggesL a Cardlac/uASP uleL
leedlng AblllLy
x lndependenL
! LlmlLed AsslsLance
! LxLenslve/1oLal AsslsLance

Cral roblems
! Chewlng roblem
! Swallowlng roblem
! MouLh aln
x none of Lhe Above
lnLake
x Cood (> 73)
! lalr (approx. 30)
! oor (<30)
! Mlnlmal - (<23)
! no nuLrlLlonal ulagnosls aL Lhls Llme x roceed Lo nuLrlLlon ulagnosls 8elow
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(problem) undeslrable food cholces n8-1.7
(10779) relaLed Lo:

L (LLlology) Lack of prlor exposure Lo accuraLe
nuLrlLlon-relaLed lnformaLlon as evldenced by:
S (Slgns & SympLoms)
-Plgh 1oLal CholesLerol 238 mg/dL
-Plgh LuL CholesLerol 174 mg/dL
-Plgh 8lood ressure 143/92 mm Pg
-Self-8eporLed lood 8ecall wlLh hlgh faL/hlgh
sodlum lLems
-8Ml of 34.8 (Cbese)
(problem) Lxcesslve mlneral lnLake - Sodlum
(7) nl-3.10.2 (10736) relaLed Lo:

L (LLlology) Lack of knowledge abouL
managemenL of dlagnosed dlsease sLaLe
requlrlng mlneral resLrlcLlon (hyperLenslon and
sodlum) as evldenced by:
S (Slgns & SympLoms)
-Plgh 8lood ressure: 143/92 mm Pg
-lood 8ecall wlLh hlgh sodlum food lLems
%!#*$K*!#%&!
8ecommended nuLrlLlon rescrlpLlon: Cardlac uleL lmplemenLaLlon: lollow Lhe uASP dleL, lncrease exerclse lncremenLally, and nuLrlLlon educaLlon
regardlng Lhe uASP dleL and lowerlng sodlum and faL ln Lhe dleL.
lood or nuLrlenL uellvery: Change Lhe composlLlon of meals and
snacks. lrulLs, vegeLables, whole gralns and low-faL dalry should be
lncreased, faL and sodlum should be reduced greaLly.
nuLrlLlon educaLlon: uASP dleL educaLlon, llsL of low-faL, low-sodlum
food cholces and reclpes as he en[oys cooklng.

nuLrlLlon Counsellng: 8ecommended wlLh dleLlLlan Lo offer healLhy
food cholces and seL goals for sodlum and faL reducLlon. rogress
should be Lracked regardlng decreased sodlum and faL, and aLLempL Lo
lncrease exerclse bouLs.
CoordlnaLlon of Care (refer Lo): n/A
Coal(s): 8educe CholesLerol levels Lo < 100 mg/dL, reduce blood pressure Lo 120/80 mm/Pg, reduce 8Ml from obese sLaLus (decrease calorlc lnLake
by 300 calorles per day) Lo overwelghL sLaLus.
+&!%#&$%!J B *K(L"(#%&!
lndlcaLors:
8Ml - Cbese (34.8 - reduce)
1oLal CholesLerol Level - 238 mg/dL (reduce)
CrlLerla: use 8eference SLandards:
8Ml - 8eference SLandards: 18.3-24.9 normal WelghL
1oLal CholesLerol Levels: < 200 mg/dL
LuL CholesLerol Level - 174 mg/dL (reduce)
8lood ressure - 143/92 (reduce)
lood 8ecords (check compllance)
hyslcal AcLlvlLy 8ecords (lncrease)


LuL CholesLerol Levels: < 100 mg/dL wlLh preexlsLlng hearL dlsease or
dlabeLes, < 130 mg/dL wlLh hearL dlsease rlsk facLors
8lood ressure: 120/80 mm Pg
lood 8ecords - uASP dleL sLandards
hyslcal AcLlvlLy 8ecords: aLLempL Lo walk for a half hour mosL days of Lhe
week.