Nutrition Assessment for E.N.
E.N. is a sixty-year-old male with a height of 6’0″ and a weight of 221 pounds, resulting in a calculated BMI of 30.0, which indicates obesity. During the 24-hour Diet Recall, E.N. consumed 2543 calories and 1227 mL of fluids. His food intake consisted of 4 servings of proteins, including 7 ounces of chicken breast and two extra-large eggs. He also had three servings of fats, three servings of vegetables, two servings of fruits, four servings of grains, and three servings of dairy.
E.N. reports struggling with weight loss and maintaining normal blood pressure. A few weeks ago, his blood pressure reading at the doctor’s office was 141/92, indicating elevated blood pressure. Additionally, E.N. experienced osteoarthritis due to years of physically demanding work and underwent a suitable hip replacement in 2014. Currently, he is facing challenges with his left hip. E.N.’s primary nutritional goal is to incorporate more fruits, vegetables, and whole grains into his diet to aid in weight loss and reduce his blood pressure.
NR 228 Nutrition Assessment for E.N.
Diet Analysis
The recommended diet for older adults typically includes around 2000 calories, 2 cups of fruit, 2 1⁄2 cups of vegetables, 6 ounces of grains, 5 1⁄2 ounces of protein, 3 cups of dairy, and six teaspoons of fats (Henry et al., 2016). However, for E.N., a more tailored recommendation based on his age, height, and weight would be to consume approximately 2200 calories, 2 cups of fruit, 3 cups of vegetables, 7 ounces of grains, 6 ounces of protein, and 3 cups of dairy, according to MyPlate (2018).
Regarding E.N.’s current intake, he consumed the recommended amount of fruit and dairy. He slightly exceeded the recommended amount for fat intake by drinking an extra tablespoon and slightly more protein, around 1 to 1 1⁄2 ounces more than recommended. However, E.N. fell short in his consumption of vegetables, consuming only 1 1⁄2 cups instead of the recommended 2 1⁄2 cups, and grains, drinking only 3.6 ounces instead of the recommended 7 ounces.
Regarding fluid intake, there are varying recommendations for older adults. Henry et al. (2016) suggest consuming eight 8-ounce glasses of water, while Hodgkinson, Evans, and Wood (2003) recommend a daily intake of more than 1600 mL. Although E.N. consumed 1227 mL of fluids, he also obtained some water from the watermelon and broccoli he finished, which helped him meet a portion of the recommended intake.
E.N.’s Goals for Weight Loss and Reducing Hypertension
To address E.N.’s goals of weight loss and reducing hypertension, the main areas for improvement would be increasing his consumption of fruits, grains, and vegetables. In this case, I would recommend the DASH diet, as it can help E.N. decrease his sodium and fat intake, promote weight loss, and ultimately lower his blood pressure.
NR 228 Nutrition Assessment for E.N.
Education
According to the DASH diet, the client’s diet is recommended to primarily consist of vegetables, fruits, whole grains, low-fat or fat-free dairy products, poultry, beans, nuts, and vegetable oils (“DASH Eating Plan,” n.d.). To reduce sodium intake, the current recommendation is to consume no more than 2300 mg of sodium per day (Grodner et al., 2016). It is advised to replace high-sodium foods with low-sodium or sodium-free spices. I emphasized to the client the importance of checking food labels for sodium and fat content, as certain foods may contain hidden sodium.
To achieve a healthy weight, Grodner, Escott-Stump, and Dorner (2016) recommend consuming low-fat, high-fiber snacks when feeling hungry. Regular exercise is also recommended to improve stamina, strength, and overall well-being (Grodner et al., 2016). Henry et al. (2016) suggest that all adults should engage in moderate or vigorous exercise for at least 30 minutes daily, 3-7 days per week.
Clients must choose activities that elevate heart rate and incorporate weight-bearing exercises to prevent osteoporosis in both men and women. Considering E.N.’s challenges, I advised him to start brisk walking for around ten minutes daily and gradually increase the duration as he becomes more physically capable.
NR 228 Nutrition Assessment for E.N.
Due to physical, economic, and mental restrictions, older adults often experience nutrient deficiencies, such as B12, folic acid, and calcium (Henry et al., 2016). E.N. faces physical challenges due to osteoarthritis in his hands and hips, limiting his ability to cook and exercise as desired. He mentioned that his daughter occasionally prepares fresh meals for dinner, which significantly helps him. However, he mainly prepares his meals, including sandwiches with butter or honey wheat bread and eggs.
I encouraged him to diversify his food choices by purchasing various fruits and vegetables and suggested replacing honey wheat bread with whole grain bread to enhance nutrient intake. I also informed him that he could consider supplements, such as Vitamin D and B12, to address any potential nutrient deficiencies.
I explained that as we age, our ability to produce sufficient intrinsic factors, which aid in B12 absorption, decreases, making B12 supplementation necessary (Groder et al., 2016). When he inquired about the need for vitamin D supplements despite consuming milk, I clarified that similar to B12, our ability to synthesize Vitamin D declines with age, hence the recommendation for supplementation. I informed him that the recommended Vitamin D intake is ten mcg per day for individuals aged 51 to 70 years (Grodner et al., 2016).
NR 228 Nutrition Assessment for E.N.
Conclusion
E.N. responded positively to the recommendations, and we worked together to compile a list of foods he enjoyed, which would assist him in making healthier choices during grocery shopping. During our discussion, we delved into the specifics of the DASH diet, and E.N. mentioned various spices he could use as alternatives to salt. He expressed his intention to start paying closer attention to food labels. We also established an exercise routine whereby he committed to walking his two dogs every evening. E.N. displayed genuine interest and determination to improve his health, which is encouraging.
References
DASH Eating Plan. (n.d.). Retrieved from
https://www.nhlbi.nih.gov/health-topics/dash-eating-plan
Grodner, M., Escott-Stump, S., & Dorner, S. (2016). Nutritional foundations and clinical
Applications: A nursing approach (6th ed.). St. Louis, MO: Elsevier.
Henry, N. J., McMichael, M., Johnson, J., DiStasi, A., Holman, H. C., Hertel, R. A., . . . Lemon,
- (2016). Nutrition for Nursing: Review module (6th ed.). Leawood, KS: Assessment
Technologies Institute.
Hodgkinson, B., Evans, D., & Wood, J. (2003). Maintaining oral hydration in older adults: A
Systematic review. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/12801253
MyPlate Plan. (2018). Retrieved from
