Nutrition Treatment Program

School of Applied Health Sciences and Wellness

Ohio University, Grover Center
S.R. October 6, 2016 4:30PM, Session #1

Assess Pt states sometimes skipping lunch if eating a larger breakfast

ment
Does not eat spinach, beans or strawberries due to hemicolectomy, also
states she tries to avoid red meat and calcium

Pt states she is not a picky eater

Due to busy schedule, pt states she often eats convenience foods and that
are quick and easy like pasta

Pt states that lack of time is her biggest restriction on cooking and

exercising

Pt states she finds herself frequently eating out and on-the-go due to time
restriction

Pt has tried weight loss programs for temporary success in the past and
enjoys group support

57 YO female

Ht: 52 ; Wt: 212.8 #

Waist: 48

BMI: 38.9

IBW: 110 lbs ; IBW%: 193.45%

TEE: 1,597.20 kcal/day

Family history: Diabetes, HTN, arthritis, osteoporosis, heart disease, thyroid

disorder, high cholesterol

Medical history: HTN, high cholesterol, thyroid disorder, arthritis, 2013

hemicolectomy, 2014 hysteroscopy, 2014 cataract surgery, kidney stones

Medications: fenofibrate, levothyroxine, pravastatin, metoprolol,

hydrothrozide, potassium citrate

Supplements: B12, D, nutravision

Diagno Food- and Nutrition-Related Knowledge Deficit (NB-1.1) related to lack of

sis prior nutrition-related education as evidenced by Pt stating concerns about

Form H Ohio University Nutrition Treatment Program 1

 previous attempts to learn information

Self-Monitoring Deficit (NB-1.4) related to a lack of focus and attention to

detail, difficulty with time management and/or organization as evidenced
pt stating she finds herself eating on the go frequently and tends to eat
convenience foods

Obesity (NC-3.3) related to physical inactivity as evidenced by a BMI of

38.9, 193.45% IBW, and waist circumference of 48 is more than normative
standard for age and sex

Interve Provide nutrition education related to nutrition relationship to hypertension

ntion (E-1.4) to ensure pt. understanding DASH diet and relation with
hypertension

Provide recommended modifications (E-1.4) and skill development (E-2.2)

about choosing healthy on-the-go food options

Monito Utilize self-monitoring (C-2.3) to target nutrient content of foods consumed

ring & to correspond with DASH diet

Evalua Utilize stress management (C-2.6) to help build skills to prepare quick and
tion healthful meals and give guidance on planning ahead

Student Nutrition Counselor Signature: Madilyn Sheerer

Form H Ohio University Nutrition Treatment Program 2