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Nutrition Assessment unit 4 Assignment Kaplan University Dash Howard Professor Wondered August 26, 2013 During a nutritional assessment, the client’s height, weight, age, sex, and physical activity level are gathered and used in determining the body mass index (IBM) and daily caloric intake requirements of micro- and microinstructions. The following formula, from the Center for Disease Control and Prevention, was used to determine Josephine body mass index (IBM) using her current height and weight of 5′ 7″ and 17 pounds: height (inches) x [weight (pounds)2] x 703 (Healthy Weight, 2011).
During Josephine Initial session she mentions wanting to lose weight; however, when using the formula above, her IBM Is within normal range at 21. 4. Using the HAM formula for Ideal body weight (BIB) for women, 45. 5 keg + 2. 2 keg (per Inch greater than bib Josephine BID Is 110 lbs +1- 11 lbs; therefore, her weight Is wealth healthy range (HAM, 2013). Patient provided lab results can be a useful resource for evaluating the client’s current nutritional status. The lowered albumin can be an indication of several factors, including malnutrition, low iron intake, and reduced liver function Jaeger ; Headboard, 2001).
Albumin is a protein synthesized in the liver and helps maintain blood volume, and it acts as a carrier for substances, such as medications; therefore, it is important that Josephine slight lowered albumin not be overlooked or misdiagnosed. Josephine low iron can be an indicator off damaged liver because the liver stores iron; however, her diet recall showed insufficient Iron intake consuming less than half of the recommended intake for a 200 kcal dally Intake at more than 1800 kcal (Food Diary, 2013).
Vitamin 812 or folic is essential for healthy blood cells and the prevalence of Vitamin Blob 2 Is more common In the Hispanic culture than their non-Helpless, white counterparts according to the July 1, 2002 issue of The Journal of Nutrition: therefore, there should be an emphasis on consumption of fortified foods not typical in the Hispanic diet, such as cereals, and foods naturally high in folic acid, such as leafy greens, lean meats, poultry and fish (Swan, Bermuda, ; Tucker, 2002).
Addressing the dating disorder is first priority to improve Josephine nutritional status, and providing coping tools that include alternatives to her typical diet with substitutions that may not offend her mother or leave her feeling guilty. It will be important to monitor her lab results because these current results can be the beginning of liver and kidney failure, and kidney failure is high among the Hispanic culture, which Is usually a result of diabetes. Josephine Is not over-eating but she is not making the best choices, which Is associated to the fact that she Is often eating meals prepared y her traditional mother.
Her expected energy requirements are based on a physical activity level of 1. 25 and the ERE formula from the Institute of Medicine, and equate to 1850 Kcal per clay ( Ana Nutrition ) I nee TLS piece AT value for Josephine would be to reduce her carbohydrate and fat consumption by making substitutions, such as eating egg whites, one whole wheat tortillas, I-ounce of shredded cheese, salsa, and black bears with a glass of fat-free milk for breakfast; however, if she is lactose intolerant than a soy substitute would be recommended. Josephine can benefit from consuming low-fat dairy products, such as cottage cheese or yogurt.
For dinner Josephine had rice and tortillas for the second time in one day; therefore, I would recommend adding leafy green salad and oil dressing and avoid paring rice and tortillas, using a romaine leaf in place of a tortilla to make a wrap. Leafy green vegetables are a great source of B vitamins, iron, and calcium, and they make an easy addition to meals or for a snack without needing to be cooked. Many foods and beverages are available that have these essential nutrients added making t easier to meet dietary reference intake for vitamins and minerals, such as orange juice.
Many varieties of meal replacements and healthy-on-the-go snacks that can help Josephine avoid meal skipping and provide her with sustenance away from the temptations of her mother’s cooking. The following are three goals I would give Josephine: 1. Add a serving of fruit to two snacks or meals a day. Keeping apples, bananas, and grapes are quick take-a-long snack choices. Bananas and blueberries are a simple addition to cereals. 2. Consuming at least on serving of vegetables with inch and dinner leafy, green salad are an easy addition to a meal, and there is no loss in nutrients as with cooking.
Broccoli, spinach, asparagus, and lentils are other great choices of folic acid and iron. 3. Keep a food diary. It is important that Josephine consume enough calories, and this is an effective way for people to see what a serving contributes to their daily diet. This can assist in reducing home- cooked meal portions to maintain a healthy diet but understand the importance of portion control while not upsetting the mother by completely avoiding the traditionally prepared meals.
One whole grain tortilla, h cup of rice, and h cup of refried bears (substituting refried bears for black bears is a healthier choice to lower fat intake), fajita style meat and vegetables, and a side salad is an example of using portion control with what is being provided on a regular basis. Getting her mother involved will be a great asset to Josephine success and improvement of cooking methods and ingredients can increase Josephine motivation and dedication to her nutritional plan and more long-term goals. Bibliography Food and Nutrition Board. (2005). Dietary Reference Intakes.