ADIME WORKSHEET

Student Name: Andrea Grove

Food & Nutrition
History summarize
key findings here
from the Client
assessment form and
diet records

Anthropometrics:
Height/Weight/BMI
Height: 61
Weight: 185 lbs

Biochemical/Tests/Procedur
es-You may write N/A if you
do not have any lab work
to review.
N/A

The patient has a

normal diet and tends
to eat on the run
because he is busy in
school. He eats out a
few times a week and
does not incorporate
many fruits and
BMI: 24.4
vegetables into his diet.
He has knowledge of
healthy food options,
drinks a lot of water
daily, and will
occasionally have
alcoholic drinks on
weekends. Food is
readily available to him
because he is financially
stable and has
transportation to the
grocery store. His
physical activity is low
besides occasionally
going for a run. He is
prescribed Concerta,
which can suppress his
appetite.
Nutrition Focused
Physical Findings.physical appearance,
bowel movement
habits, menstrual cycle

Client Socioeconomic
History-summarize
history here including
family history

The patients physical

The patient is a college

student and has a part

Comparative StandardsCalculate this clients

actual nutrition needs-use
appropriate formula for
your client

appearance is healthy
and he appears his
stated age and well
nourished. No evidence
of muscle or fat
wasting. Appetite is
normal except for when
he takes his medication
that he feels can
suppress his appetite.
His bowel movements
are regular.

time job. His parents

financially support him. He
has a family history of
cancer and high blood
pressure. He has increased
stress and has had a
greater than ten pound
weight change.

Actual
Food Diary
Harris Benedict
9/18/15
Kcal= 2510 kcal/day
1641kcal/day
Pro ~67 g/day
67g
Fluid ~70 oz/day
~128 oz
Carb ~383-452 g/day
195g
Lipid ~59-104 g/day
54g
Fiber ~38 g/day
28g

Nutrition Assessment:
The patient would like to lose weight due to unintentional weight gain
because of quitting basketball, an unchanged diet, and having a busy
schedule. He eats out a few times per week because of convenience,
which can lead to excessive energy intake. He is 61 and 185 pounds
with a BMI in the normal range of 24.4. He appears healthy and well
nourished but takes Concerta, which he feels can suppress his
appetite. His parents financially support him. He has a family history of
high blood pressure and cancer. The patient has increased stress and
has had a greater than ten pound weight change in the past year. The
patients calculated energy needs are 2,510 kcal/day when using the
Harris Benedict equation but his food diary states that he consumed
1,641 kcal/day, which implies that he did not track everything and left
out some food items because of his unintentional weight gain.
Nutrition Diagnosis

Friday

Nutritional Problem (use standardized nomenclature):

NC-3.4 Unintentional weight gain
Related to (etiology):
Related to limited physical activity (NB-2.1) after quitting basketball and an
unchanged dietary intake
As evidenced by (signs & symptoms):
As evidenced by a greater than ten pound weight gain in the past year.

Nutrition Intervention and Treatment (What do you plan to have your patient do?
Be specific here):
Modification of diet to help with weight loss
Discussed eating out frequency which contributes to unintentional weight gain
because of excessive energy intake (NI-1.5)
Discussed the low consumption of fruits and vegetables in diet
Set a goal to increase food intake (FH-1.2.2.1) of fruits and vegetables by one
serving of each per day or one serving of each every other day
Will increase intake goal up to recommended amounts as he becomes
successful with current goal
Provided basic education (E-1) by giving an educational document on food
group serving sizes for him to reference
Physical activity
Patient would like to get back into shape
Plan to discuss at future visits in more detail
Will help with weight loss and to decrease his increased stress
Patient wants to incorporate running more into his daily schedule
Monitor/Evaluate (how do you plan to monitor or evaluate
whether they did what they committed to do?)
Will do goal setting (C-2.2) for my patient and then will be sure to
review them at each session
Will monitor by having him keep a food diary in between sessions
so we can be sure that he is getting these foods into his diet and
increasing his nutrient needs (NI-5.1) for the fruits and
vegetables

 Can be in contact with him throughout the week to remind him of

his goals
Client would like to increase his physical activity and we will
monitor this at future sessions when we set more specific goals
Monitor weight loss by evaluating his weight (S-1.1.4) over a
period of time
Monitor the behavior change

Evaluate food intake (FH-1.2.2.1) for fruits and vegetables