Insert Draw Page Layout Formulas Data Review Times New Roman A A aste I UN General $ %" Conditional Format Cell Styles X Calibri 11 く Α Α ab Open recovered workbooks? Your recent changes were saved. Do you want to continue working where you left off? B C D G H I Patient interview in narrative format: Interview: B I U v V A▾ Qil B O Pe Analyze Data Create PDF and share link Yes L M N recovered workbooks? Your recent changes were saved. Do you want to continue workin Xfx Biochemical Data, Medical Tests and Procedures (BD): PT WAS FOUND SITTING IN A CHAIR NEXT TO HEMODIALYZER. PT STATED HER USUAL BODY WEIGHT IS AROUND 140-142# AFTER DIALYSIS. PT APPEARS TIRED AND REPORTED A FAIR APPETITE/EATING AROUND THREE-FOURTHS OF HER MEALS; PT LISTED SOME FOODS SHE TYPICALLY EATS AT HOME (HER HUSBAND HELPS PREPARES THEM); PT WAS SURPISED SHE SHOULD BE EATING MORE PROTEIN AS HER DOCTOR TOLD HER NOT TO IN THE PAST. PT ASKED QUESTIONS: HOW MUCH PROTEIN TO EAT, WHAT TYPES OF PROTEIN TO EAT, IF VEGETARIAN DINNERS ARE OKAY (BLACK BEANS AND RICE), HOW MUCH WATER TO DRINK, WHAT TYPES OF THINGS SHE CAN DRINK (LIKES DIET PEPSI), HOW TO AVOID BEING THIRSTY, DAIRY OPTIONS AND AMOUNTS, AND WHAT KINDS OF FOODS THAT COUNT AS FLUIDS. PT STATED SHE IS "GETTING TIRED"; PT AGREES TO DISCUSSING SODIUM, POTASSIUM, AND PHOSPHORUS TOMORROW (05/08/2020). A B FR C D E Biochemical Data, Medical Tests and Procedures (BD): Lab Test Result Units 10 mL/min/1.73m^ 2 7 10 F Times New Roman 10 Paste BIU V 田、 ♥ A A A 悲 General V $ % 9 ✓ Open recovered workbooks? Your recent changes were saved. Do you want to continue working where you left off? Normal Rangl T9 xvfx A B C D G 1 2 Medication E F H I JK L FH-3.1.1 Prescription medication use: Classification N P Q R S T U V W X Y Z AA AB Potential Drug Nutrient Interactions GLUCOTROL SULFONYLUREAS SUPPLEMENTING MAGNESIUM MAY ENHANCE EFFECTS, WHEN TAKEN WITH GINKGO MAY WORSEN GLUCOSE TOLERANCE, VITAMIN B2 MAY RAISE BLOOD SUGAR LEVELS POTASSIUM SPARING DIURETIC ALCOHOL MAY CAUSE LOWER BLOOD PRESSURE/AVOID SALT SUBSITUTES WHICH INCREASE POTASSIUM LVLS DYRENIUM CARDURA RENAGEL PHOSPHATE BINDER ALPHA-ADRENERGIC BLOCKER ALCOHOL MAY CAUSE LOWER BLOOD PRESSURE/DO NOT TAKE WITH GRAPEFRUIT LOW PHOSPH DIET, INTERFERENCE W/ANTACIDS 8 9 10 11 12 13 14 eatinine 2.5 mg/dL 15 16 17 18 19 20 21 22 23 24 25 ood Urea Nitrogen (BUN) 33 mg/dL bg A1C otassium hosphorus 9.2 % 5.5 mEq per L 5 mg per dL Assessment Biochemical Data Diet Hx Medications Pt Interview dy FEB LO 5 Paste Excel File Edit View Insert Format Tools Data Window Help AutoSave O Insert Draw Page Layout 100% Formulas Data Review View Renal and DM2 Complete Student Version FINAL(3) Acrobat Tell me Calibri 11 A General $1%9 898 Conditional Format Cell Formatting as Table Styles Sort & Find & Format Fiter Select Open recovered workbooks? Your recent changes were saved. Do you want to continue working where you left off? 1x ABCDEE Diet Ho G HIJKL M N ° P Q R ST U V W X Y Z AA AB AC AD PT REPORTS FAIR APPETITE BUT GETS TIRED WHILE ON DIALYSIS; PT IS EATING 70% OF TRAY.. OBTAINED TYPICAL DIET AT HOME: PT REPORTS NOT EATING MUCH PROTEIN "BECAUSE MY DOCTOR TOLD ME I SHOULDN'T A WHILE AGO, BECAUSE OF MY KIDNEYS", PT REPORTS LIKING PROTEIN SOURCES BUT HASN'T BEEN EATING MUCH THE LAST FEW MONTHS: EGG FOR BREAKFAST, AVOIDS FRIED FOODS AS HER HUSBAND HAS HIGH CHOLESTEROL, CHEESE, GREEK YOGURT, AND PEANUT BUTTER INSTEAD OF CHICKEN AND BEEF, VEGETARIAN DINNER ONCE A WEEK (BLACK BEANS AND RICE), DIET PEPSI (PT DRANK GINGER ALE BEFORE DIABETES DX), PT STOPPED DRINKING FRUIT JUICE BUT NOW DRINKS CYRSTAL LITE LEMONADE, MILK ONCE OR TWICE A WEEK WITH CEREAL, USED TO EAT A LOT OF SUGAR FREE CANDY BUT REDUCED TO A COUPLE AFTER CRAMPING AND DIARRHEA. esc Bochemical Data Diet Hr Medications To be completed by intern Launchpad " 80 " 888 FA Made with Basecamp atv MacBook Air 200 44 Di 8 " @ # 4 % & 2 3 4 5 6 7 8 9 Q W E R T Y 9 710 1 0 - 0 P B CDEFGHIJ K LM N CP Q NMSU Dietetic Internship MRS. SARA BELLUM R STU VWXY Z AA AACAL AE Please read the dinical patient record, all the sections, and complete the purple lavender sections throughout the dinical record. A-Assessment 5/06/2020 Reason for Nutrition Assessment: 62 YOF REFERRED TO RDN IN ACES DIALYSIS CLINIC FOR CONSISTENT CARBOHYDRATE/RENAL DIET EDUCATION Client History (CH): note which diagnosis is the primary or admitting diagnosis Patient chief nutrition complaint: PT IS TIRED (PT IS ON HEMODIALYSIS) Age: 62 CH-2.1.1 CH-1.1.1 CH-1.1.3 Sex FEMALE CH-1.1.4 Race: CAUCASIAN CH-1.1.6 Language: ENGLISH Patient/Client/Family Medical/Health History: CH-2.1.1 CH-2.1.3 Social History: CH-3.1.2 CH-3.1.4 CH-3.1.5 Patient chief nutrition complaint: PT IS TIRED (PT IS ON HEMODIALYSIS) Endocrine/metabolism: DM2 DIAGNOSED 5 YEARS AGO Living/housing situation (specify): UVES WITH HUSBAND Social and medical support (specify): HUSBAND DOES THE COOKING WHEN PT IS TOO TIRED TO COOK Geographic location of home (specify): LAS CRUCES Anthropometric Measurements (AD): AD-1.1.1.7 Stated Height: 160 CM (5'3") AD-1.1.2.16 Postdialysis weight: 64.4 KG (142#) AD-1.1.5.1 BMI: 25.2, OVERWEIGHT Nutrition Focused Physical Findings (PD): PD-1.1.5 PD-1.1.9.2 Vital signs: Digestive system: PT WITH FAIR APPETITE Anuria: PT REPORTS PRODUCING URINE "MAYBE TWO OR THREE TIMES A DAY" PD-1.1.21.5 PD-1.1.21.6 PD-1.1.21.7 Pulse rate: 85 BPM Respiratory Rate: 13 BREATHS PER MINUTE Temperature: 37 CELSIUS Food/Nutrition Related History (FH): FH-1.2.1.1 FH-1.2.2.1 FH-1.2.2.2 FH-1.2.2.3 FH-2.1.1.2 Oral fluid estimated intake in 24 hours: 900-1100 ML FLUID/DAY Estimated amount of food: 70% OF TRAY Types of food/meals: PRE-SELECT MENU Meal/snack pattern: 3-5 MEALS PER DAY AT HOME Modified diet order: CONSISTENT CARB/RENAL DIET Renal and DM2 Case Study Patient Data Anthropometrics Height: 5'3" Mrs. Sara Bellum DOB: 03/28/1958 Diet Labs Meds Intake Consistent GFR: 10 ml/min Weight: 142 lbs Carbohydrate/Renal diet BUN: 33 mg/dL Creatine: 2.5 mg/dL Glucotrol Dyrenium Cardura 70% of tray 900-1100 mL/day Renagel Referral Steps Referred to RDN in ACES dialysis clinic Case Study Brief You conducted a nutritional Case Study Flow Knock on door and ask permission to enter room Greet patient by name Introduce yourself assessment on this patient a couple Identify patient by two patient of days ago and agreed on a discussion about a dialysis and diabetes diet. Now, provide an in- depth protein and fluid education to the patient. You will need to know: Protein sources Amount to eat daily Protein and other foods high in phosphorus (I.e. cheese, legumes) Cooking method of protein sources Urine produced daily Dividing fluids throughout the day Types of fluid Acceptable fluids (l.e. ginger ale) Fluids to avoid (l.e. dark colas) Food considered fluid (l.e. jello) Tips to reduce thirst identifiers State purpose of visit Give patient protein and fluid education Mention further education at next dialysis session Give the patient a renal diabetic dietic booklet Give the patient an idea of what to expect next session Ask if the patient has any questions Thank the patient Note You must motion a knock on the virtual door I.e. Mrs. Bellum Full name and DOB will be used for virtual reality case studies The RD will provide this for this case study These can be done in any order Sodium, potassium, and phosphorus Blood sugars, carbohydrates, sample meals

Nutrition Intervention (education, like your talking to the pt)  Nutrition monitoring and evaluation  Need to know: Fluid needs  Feeding frequnecy  Foods that thicken stools  Foods that thicken stools  Foods that cause discomfort  vitamin type needed