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Imagine that you are a clinical nutrition assistant working at a local hospital under the supervision
Overnight, a 74 year old male patient was admitted to the hospital and needs to be fully assessed
accordance with hospital/medical nutrition care laws). The hospital s initial nutritional
may be at nutrition risk, due to a high risk admitting diagnosis. The admitting physician
heart attack; however the full cardiac consult results are not yet showing in the computer.
moved here to the U.S. from a foreign country within the past year so that his daughter can help
health. The entire family speaks very little English. The patient s cultural background is
place much influence on Western style healthcare practices. The patient s expression of his
The nurse s notes reveal that the daughter does not know how much her father weighs, but
Your assignment from the supervising RD is to examine the patient s complete cultural,
that the next steps of the Nutrition Care Process can be instituted. Upon your initial investigation
mouth) and they are awaiting more lab results for various tests related to hydration, and kidney
work indicates that he suffered a Myocardial Infarction (MI). The MD notes confirm a heart
that the patient appears to be morbidly obese. His medications include: a blood pressure
lowering drug.
the next couple of hours. Record and describe this fictional patient s cultural
human expressions,
and any other unique characteristics about the patient s culture or background that may
any type of medical nutrition therapy, nutrition education, or dietary restrictions. (You may use
information created in
2. The patient and daughter are unaware of the patient s current height and weight. His
not have a built in weight scale. The patient is unable to stand up-right due to his medical
person s weight
that is covered in Chapter 7 of our textbook. (Refer to page 254 for general ideas and Tables 7.1,
3. Based on your knowledge of the patient s cultural background as well as your evaluation
current interactions with the patient and daughter, do you believe the patient will comply with the
MD suggesting a
strict very low calorie (1000-1200 calories), low fat, low cholesterol and low salt diet, due to the
heart attack/cardiac
4. Suggested change: How will you relay your assessment of the patient s readiness to
diet with the supervising Dietitian? How can you use your knowledge of the patient s cultural
background to instill
motivation and the desire to improve his health by eating a healthy diet? Do you think the patient
should be placed on