The Problem Background Story: Margaret was taken to her doctor because of her breathing problem when sleeping. Her doctor diagnosed her with sleep apnea related to her weight and referred to the registered dietitian for nutrition counselling. Personal Information: Name: Hufalar, Margaret G. Gender: Female Height: 5’4" Weight: 175 lbs Doctor’s Diagnosis: Obstructive sleep apnea (OSA) secondary to obesity and physical inactivity Nutrition: General: Very good appetite with consumption of a wide variety of foods. Margaret’s physical activity level is generally low. She discontinued physical activities for five years now. She likes playing video games and reading. Sample of 24-hour meal recall: Breakfast: 4 servings of pancakes (4 inches across, 1/4 inch thick), 8 oz whole milk, 4 oz apple juice Lunch: 2 burrito and cheese sandwiches (2 slices of white bread, 1 oz. mozzarella, 1 tbsp mayonnaise each) 1-oz pkg potato chips, 8 oz whole milk After school snack: Peanut butter and jelly sandwich (2 slices white bread with 2 tbsp crunchy peanut butter and 2 tbsp fruit jelly), 12 oz wholemilk Dinner: Skinless lean chicken (10 oz.), 1 c mashed potatoes, 1 c blanched okra, 16 oz lemonade Snack: 3 c microwave popcorn, 12 oz Coca-Cola Vitamin intake: Multivitamins (plus zinc) daily Laboratory Results: Chemistry Reference Range Physical Assessment Results Sodium (mmol/L) 136-145 142 Potassium (mmol/L) 3.5-5.5 4.3 Chloride (mmol/L) 95-105 101 Creatinine (mg/dL) 0.6-1.2 0.6 Glucose (mg/dL) 70-110 122 ↑ Bilirubin total (mg/dL) ≤1.5 0.1 Protein, total (g/dL) 6-8 6.2 ALT (U/L) 4-36 5 AST (U/L) 0-35 6 Cholesterol (mg/dL) <170 180 ↑ HDL-C (mg/dL) >55 F, >45 M 34 ↓ LDL (mg/dL) <110 125 ↑ LDL/HDL ratio <3.22 F; <3.55 M 3.68 ↑ Triglycerides (mg/dL) ≤150 114 3. Evaluate the patient's results. If no intervention is applied, explain how the patient’s result may post biochemical and metabolic changes in the body? What are the possible risks if patient’s case if not managed?
- The Problem
Background Story: Margaret was taken to her doctor because of her breathing problem when sleeping. Her doctor diagnosed her with sleep apnea related to her weight and referred to the registered dietitian for nutrition counselling.
Personal Information:
Name: Hufalar, Margaret G.
Gender: Female
Height: 5’4"
Weight: 175 lbs
Doctor’s Diagnosis: Obstructive sleep apnea (OSA) secondary to obesity and physical inactivity
Nutrition:
General: Very good appetite with consumption of a wide variety of foods. Margaret’s physical activity level is generally low. She discontinued physical activities for five years now. She likes playing video games and reading.
Sample of 24-hour meal recall:
Breakfast: 4 servings of pancakes (4 inches across, 1/4 inch thick), 8 oz whole milk, 4 oz apple juice
Lunch: 2 burrito and cheese sandwiches (2 slices of white bread, 1 oz. mozzarella, 1 tbsp mayonnaise each) 1-oz pkg potato chips, 8 oz whole milk
After school snack: Peanut butter and jelly sandwich (2 slices white bread with 2 tbsp crunchy peanut butter and 2 tbsp fruit jelly), 12 oz wholemilk
Dinner: Skinless lean chicken (10 oz.), 1 c mashed potatoes, 1 c blanched okra, 16 oz lemonade
Snack: 3 c microwave popcorn, 12 oz Coca-Cola
Vitamin intake: Multivitamins (plus zinc) daily
- Laboratory Results:
|
Chemistry |
Reference Range |
Physical Assessment Results |
|
Sodium (mmol/L) |
136-145 |
142 |
|
Potassium (mmol/L) |
3.5-5.5 |
4.3 |
|
Chloride (mmol/L) |
95-105 |
101 |
|
Creatinine (mg/dL) |
0.6-1.2 |
0.6 |
|
Glucose (mg/dL) |
70-110 |
122 ↑ |
|
Bilirubin total (mg/dL) |
≤1.5 |
0.1 |
|
Protein, total (g/dL) |
6-8 |
6.2 |
|
ALT (U/L) |
4-36 |
5 |
|
AST (U/L) |
0-35 |
6 |
|
Cholesterol (mg/dL) |
<170 |
180 ↑ |
|
HDL-C (mg/dL) |
>55 F, >45 M |
34 ↓ |
|
LDL (mg/dL) |
<110 |
125 ↑ |
|
LDL/HDL ratio |
<3.22 F; <3.55 M |
3.68 ↑ |
|
Triglycerides (mg/dL) |
≤150 |
114 |
3. Evaluate the patient's results. If no intervention is applied, explain how the patient’s result may post biochemical and
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