Bma Reflection

11. The fact that a patient has experienced recent weight loss, fatigue, and loss of appetite would be included in which part of the review of systems (ROS)?

After consultation with the client, a healthy diet will be the focus. The client is not overweight, exercises adequately and consistently, and is generally in very good health. The client reports eating ‘junk food’, not eating breakfast, and not getting the recommended daily servings of each food group as endorsed by the United States Department of Agriculture (USDA).

His target for calories is 3,185 per day and he reached 1808 calories which was identified as under. According to the attached analysis, he consumed 122g of protein, 206 g of carbohydrates and 40 grams for fat which were all recognized as ok according to the analysis. For fruits and vegetables his status was considered under for both. For fruits the recommended amount was 2 ½ cups and he only consumed 2 cups and for vegetables the recommended amount was 4 cups and he only consumed 2 ½ cups. His fiber intake for that day was 18 g and the recommended amount was 38 g which was not adequate enough based on the recommendation.

Patient Y is a fifty nine year old widow, with a BMI of 29.0kg/m2 (severely overweight). Patient is currently unemployed and lives alone after the passing of her husband in 2008. Patient states that there is a strong family history of heart disease and confirms this by explaining that her father had died at the age of fifty after suffering from chronic heart failure for several years. Patient states that she drinks up to 24 units of alcohol a week and has prevalent past history of smoking.

Total fat was 63.9 grams compared the 125.43 grams of total fat recommended. Also, my saturated fat was 18.16 grams when listed at 40.32 grams of recommended intake. Not too sure on fats, except from the fact that the key is to replace bad fats (saturated and trans) with good fats (poly and monouns) in our diet. Knowing which fats will raise my LDL cholesterol and which ones will not is the first step to lowering my family’s history of heart disease.

Lisa is 5’4’’ tall and weighs 140 pounds. She has not been hospitalized recently and she does not have any chronic medical conditions. She explains that she does not have any health conditions that keep her from participating in activities that she does enjoy. She explains that she does not practice preventative health measures. Lisa does not have a regular physician. Lisa rated her health as a 7.2 because she believes she eats healthy. However, she is concerned because she has not been to the doctor since her twins were born eight years ago. Lisa’s health history is “excellent” because she has not had any issues since the last time she went to the doctor which was eight years ago. She states that she does not get sick easily. She explains that medical bills are very expensive and she does not believe it is necessarily important. Lisa explains that

Its great to be back again for the fourth (and last) of the TMAs of this module.

The offender returns to clinic today for a number of issues. 1. Diabetes mellitus type 2: This has been well controlled on oral metformin and the patient reports that she has no concerns in this regard. Last hemoglobin A1c was 5.9 about a month ago and all other labs within normal limits except for a quite high LDL at 171. She has not been on cholesterol-lowering therapy in the past. In addition, her TSH was very slightly elevated at 4.740 which can be considered the upper limit of normal. She has not noticed any significant constipation, excessive fatigue, or cold intolerance but she has had continued trouble with weight gain and thinks she may benefit from some low-dose thyroid replacement. 2. Chronic low back pain: At

Over the past week or so I have learned more about the Boys and Girls Club of American in the Austin area and I felt the need to share with my families whom have school age children in their home. I am finding that most BGCA only accept children 6 years of age or older; however, there is an Austin BGCA that accepts children 5 years of age.

R was initially diagnosed with Type two diabetes. Her doctor prescribed medication for Type two diabetic patients and provided pain pills to relieve her knee pain. The doctor recommended she improve her diet. She saw a diet program from TV (she didn’t provide a name) that was said to help individuals reverse Type two diabetes. The diet was quite restrictive, limiting intake to eggs, meat, fish, and vegetables. Fruit was heavily prohibited early in the trial. Only after two weeks can you relax the restriction and open up to more food options. Her one-month duration didn’t improve her problems – her condition continued to worsen, so she immediately halted the diet program in fear that the program further exacerbated her health

I have gathered a great deal of experience in analyzing nutritionally relevant data to assess the nutritional status of the patient, and determining health status goals and monitoring its progress. I have also developed an understanding of the importance of sympathetic, clear, and effective communication with the patients. Likewise, I enjoyed the opportunity to work in Diet Center, which allowed me to have one to one contact with the patient and gain more knowledge about new techniques in weight

TSH was 0.9, cholesterol was 256 and triglycerides at 280. Blood glucose was 262 on admission. Alkaline phosphatase 170. White cell count was 11,100, and his hemoglobin 12.2. Urinalysis was negative. EKG showed normal sinus rhythm.

An important deficit is that most of the patient’s meals come from a food truck at work or from fast food restaurants. He reports eating no fruits or vegetables. His diet is high in salt, carbohydrates and fat. Moreover, he does not exercise. These lifestyle factors put him at risk for obesity, hypertension and cardiovascular disease (Hardy & Gray,

This case study looks at initiation of treatment and choices therein. OTHER PERTINENT INFORMATION: Temperature - 98.6 degrees Fahrenheit Weight - 80 kg

Scientists have been able to estimate the amount of nutrients that the body requires. However, the amount of any particular nutrient varies from person to person, depending on your “age, sex, general health status, physical activity level, and use of medications and drugs” (Schiff 2013). It is also important to remember that consuming the required amount of nutrients that meets your dietary guidelines does not mean you will achieve an optimal nutritional status either. There are various references to determine one’s adequate calorie intake and the nutrients that one should be consuming, including looking at DRI’s(Dietary Reference Intakes) that nutritional excerpts have used to