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Just because she lives at Lenoir Manor, a continuing-care retirement facility, Laura, a petite (4 ft 8 in., 97 lb) widow of the local college dean, does not consider herself as old. She is 87. She has had no major nutritional or health problems and her appetite is good. She had been a good cook and entertained graciously, but in the residential care facility, meals are prepared for her. Because she has had slight fluid retention over the past year, she no longer adds salt to her meals. She tells Bridget Doyle, her nutritionist, that yes, occasionally she does not like her meals and misses cooking for herself. One Monday morning, Laura is found in bed with her left side paralyzed. The diagnosis is a right-sided stroke, resulting in three weeks of hospitalization. Back at the skilled-care wing of Lenoir, Laura needs a nasogastric tube for feeding. She is alert and knows people but is limited in speech. Overnight, Laura’s care has changed from an individual needing routine nutritional monitoring to someone with many interrelated problems: Inability to communicate her overall medical and nutritional concerns clearly Weight loss of 9 lb during the three-week hospital stay Intense dislike of the nasal tube, as demonstrated by repeated attempts to pull it out, leading to restraint of her hands Diagnosis The interdisciplinary care team wants to meet Laura’s needs in a dignified and respectful manner. How can the care team address both clinical and ethical concerns?

BuyFind

Nutrition Through the Life Cycle (...

6th Edition
Judith E. Brown
Publisher: Cengage Learning
ISBN: 9781305628007
BuyFind

Nutrition Through the Life Cycle (...

6th Edition
Judith E. Brown
Publisher: Cengage Learning
ISBN: 9781305628007

Solutions

Chapter
Section
Chapter 19, Problem 1.3CS
Textbook Problem

Just because she lives at Lenoir Manor, a continuing-care retirement facility, Laura, a petite (4 ft 8 in., 97 lb) widow of the local college dean, does not consider herself as old. She is 87. She has had no major nutritional or health problems and her appetite is good. She had been a good cook and entertained graciously, but in the residential care facility, meals are prepared for her. Because she has had slight fluid retention over the past year, she no longer adds salt to her meals. She tells Bridget Doyle, her nutritionist, that yes, occasionally she does not like her meals and misses cooking for herself.

One Monday morning, Laura is found in bed with her left side paralyzed. The diagnosis is a right-sided stroke, resulting in three weeks of hospitalization. Back at the skilled-care wing of Lenoir, Laura needs a nasogastric tube for feeding. She is alert and knows people but is limited in speech. Overnight, Laura’s care has changed from an individual needing routine nutritional monitoring to someone with many interrelated problems:

  • Inability to communicate her overall medical and nutritional concerns clearly
  • Weight loss of 9 lb during the three-week hospital stay
  • Intense dislike of the nasal tube, as demonstrated by repeated attempts to pull it out, leading to restraint of her hands

Diagnosis

The interdisciplinary care team wants to meet Laura’s needs in a dignified and respectful manner. How can the care team address both clinical and ethical concerns?

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