Assignment Case Study 7 - Nutrition and Metabolic Stress done PDF

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Understanding case studies concerning Nutrition and Metabolic Stress done...

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Case Study 7 Nutrition and Metabolic Stress Total Points: 25 (As you complete this case study, you will find it helpful to refer to Chapter 11 on Nutrition Assessment and Patient Care.) Kristin, age 19, is a member of her college’s cheerleading team and was involved in a serious motor vehicle accident (MVA) when the team was returning for a game. She was admitted to the hospital through the emergency department suffering from multiple fractures and contusions. Kristin is 5 feet 5 inches tall and weighed 120 pounds prior to the accident. Because she is young, looked healthy and somewhat muscular from being a cheerleader, the physician did not order a consult from the registered dietitian to evaluate Kristin’s nutritional status. After 2 weeks in the intensive care unit, Kristin developed pneumonia. The nurse learned that Kristin had been using a commercial weight loss product and was consuming approximately 1000 kcal/day for the 3 months prior to the accident in an attempt to “make weight” so that she could remain on the cheerleading team. Her weight after 2 weeks in the intensive care unit is 115. 1. (5 points) Calculate Kristin’s pre-accident BMI (Body Mass Index). Use her admission weight of 120 pounds. BMI = weight (lbs) divided by height(inches) divided by height (inches) multiplied by 703. 20.7 Was she underweight, normal weight, overweight or obese prior to the accident (see page 235 for BMI classifications)? She would be classified as normal weight Go to page 234 and calculate Kristin’s per cent weight change since her admission to the hospital. Based on the per cent weight change, classify her weight change status using Table 11-1 on page 234. 2. (4 points) Estimate Kristin’s daily calorie needs prior to her accident using Table 9 -1 page 163 of your textbook. Use: Age: 19, Weight 120# (54.5 kg) and an Active Activity Level. She needs 2400 calories. Based on this calculation, was Kristin consuming adequate calories prior to her accident? She was not consuming enough calories.

3. (4 points) How would a very low calorie diet, like Kristin’s, affect nutritional status? (See Immune System and Inflammation, pages 347 - 348). A very low calorie can affect Kirstin’s nutritional status because a compromised nutritional status makes it difficult for the body to mount both a stress response and an immune response when confronted with a metabolic stressor like a virus. 4. (4 points) Describe the variety of stresses that Kristin experienced. (Per the Case Study, what things in her life caused stress?) The thing in her life that caused stress was trying to loss weight so she was able to be part of the cheerleading squad. One more thing that caused stress was the motor vehicle accident that caused her to have fractures and contusion. Lastily, she is in college so she has other stresses like homework assignment and balance cheerleading and school work. 5. (4 points) Why did pneumonia develop? (See The Stress Response, pages 348 – 352). The pneumonia developed because of malnutrition. Kirstin was not eating enough food so her mucous, gastrointestinal tract, skin, T lympochytes, macrophages and granulocytes and antibodies were compromised. The mucosa gastrointestinal tract was affecting when she was not eating enough because it decreased antibody secretion, and increased risk of bacterial spread outside the gastrointestinal tract. Next, the skin is going to take time to heal. Third, the T-lymphocytes depressed the T-cell distribution. Macrophage and granulocytes result of malnutrition is that it takes longer time for phagocytosis to kill time and lymphocyte activation. Also, the effect of malnutrition on the antibodies reduced antibody response. Since Kirstin was not getting enough nutrients her immune system got compromised. 6. (4 points) Could the pneumonia have been prevented? What steps could have been taken post hospital admission to prevent the pneumonia? The pneumonia could have been prevented. I would make sure that Kirstin is getting enough vitamins and minerals because the body needs this under stress....